Abstract
COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, >69% of the patients were male and patients ≥54 years accounted for 67.9% (n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy campaign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.
Highlights
Specialty section: This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health
The South Asian Association of Regional Cooperation (SAARC), a regional inter-government consortium of eight South Asian countries, which includes Nepal, India, Bangladesh, Pakistan, Maldives, Bhutan, Sri Lanka, and Afghanistan, comprises over 21% of the global population and is vulnerable to COVID due to multiple factors including poor health literacy, poor housing and living conditions, fragile health systems coupled with inadequately trained frontline health workers, poor quality of health care coupled with the poor diagnostic capacity of laboratory facilities and population of poor and migrant individuals [5, 6]
Effective systems to trace the contacts of those people who have come into contact with carriers of COVID-19 is essential to stop the rapid spread of the disease [29]
Summary
In the earliest weeks of the COVID-19 pandemic, the health surveillance desk at Tribhuvan International Airport—the only international airport in the country—was initially authorized to screen all incoming passengers from affected regions around the globe [26]. Of the home minister, formed a patient receiving team to transport the suspected patients to hospitals designated to receive COVID patients [27]. RT-PCR tests were performed for quarantined individuals who displayed suspected COVID symptoms. Uninterrupted treatment services were prioritized by setting up twenty-five-bed hospitals. The government of Nepal has set up 36 COVID dedicated hospitals categorized into three levels: 16 Level 1 hospitals responsible for treating mild cases, 16 Level 2 hospitals for treating moderate cases, and four Level 3 to provide advance and specialized care for severe cases [28]. The government ensured uninterrupted treatment services to non-COVID patients with life-and-limb-threatening conditions or injuries such as abscesses, acute pain, heart failure, acute exacerbation of COPDs, haemodialysis and ketoacidosis, among others [28]. The ground crossing points of entry at the NepalIndia border and the Nepal-China border were tightened in March 2020
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