Starting March 24, 2020, The Nepali government imposed a nationwide lockdown amidst the rising number of cases in the country. Millions of people were barred from leaving their homes with restrictions on trips to stores other than pharmacies, and transportation halted with the exception of essential goods. Such extreme measures were unprecedented but considered necessary to “flatten the curve” with countries all over the world going into lockdown. The Hubei Province in China, including Wuhan, the city of 11 million people where the outbreak began, is a lockdown success story. The province went into a lockdown on January 23. According to China’s National Health Commission, cases began to decline and by 19 March and no new infections had been detected. However, the WHO has said that “Lockdown alone won’t be enough, how many more is decided on the basis of decision we make and action we take”. As cases continue to peak despite strict prohibitory measures, Nepal is also facing other major hurdles in its fight against Covid-19.
Countries have achieved a great deal of success in curbing the spread of the virus by enforcing a lockdown. However, they have also used the time to ramp up their testing and contact tracing efforts that are key in slowing the spread and not overwhelming the health system until a vaccine is found. However, lockdown appears to have failed as a strategy in Nepal. Although Nepal is not a rich country like the US, with a ventilator bank or an established epidemic response office, this is precisely why a lockdown seemed ideal, to buy the government time to ramp up efforts in areas they were lacking. Nonetheless, even after over 4 months of a blanket lockdown, cases have continued to rise at alarming rates, leaving people wondering if the hardships endured during this period were worthwhile.
Experts have long maintained that a lockdown cannot beat the virus on its own. Healthcare workers in Nepal have said that along with the hardships of a weak health system, Nepal is faced with other hurdles. For instance, due to the low testing capacity, the spread of the virus has not slowed down and has reached the community level in various places, when early tests and detection are the keys to successful stemming of the spread. If testing efforts are not ramped up, infections will go untested and number of cases will continue to multiply. Furthermore, the stigma associated to Covid-19 has made contact tracing difficult. According to health workers, cases of self-misidentification and purposely ignoring phone calls from health officers so that individuals can keep their medical condition hidden are common. Due to the stigma attached to the virus, the infected fear being alienated from the society if identified. Similarly, while in other countries, health care workers are applauded as heroes, in Nepal they are facing social stigmatization. As the virus has continued to spread, the stigma surrounding the virus has also been spreading. The government should tackle the issue through efforts to generate public awareness and dissemination of accurate information about the virus.
Infections among healthcare workers that have been working on the frontline due of the lack of better protection has become another obstacle for Nepal. The country has been observing an alarming rise in infection rate among health workers and those in over 150 health facilities have tested positive for the virus. According to the Ministry of Health and Population, while over 800 health workers across the country have tested positive, one health worker has died because of the virus. Health workers in hospitals private, state-run, and community, have complained that they are forced to reuse disposable masks due to the shortage of masks in hospitals. They have also complained about having to reuse other protective gear and equipment. “The World Health Organization has said that health workers are at risk on two fronts; shortage of personal protective equipment and the chance of being infected in hospitals”. Nepal’s health system is already overwhelmed and under capacitated, if the infection among health workers is not controlled, we may face a shortage of health workers to treat patients.
The lack of strategic planning has led to more severe consequences of the pandemic. Over 500 people have lost their lives and at the current rate, Nepal is likely to overtake China, with its roughly 85,000 cases against a population of 1.4 billion, in about a week. As the government has failed to make progress in containing the spread, yet another lockdown seems imminent. However, if issues such as ramping up contact tracing efforts, protection of healthcare workers, and generating public awareness about Covid-19 to tackle stigmatization, are not addressed, they can become major obstacles in Nepal’s fight against Covid-19.