As the number of COVID-19 cases and fatalities in Nepal continue to rise at an alarming rate, it has become apparent that its testing is more than a matter of individuals safeguarding their own health and that of their families. It has become an important tool in limiting the disease’s spread. Therefore, the Health Ministry enforcing a Cabinet decision to roll back on free COVID-19 testing and treatment of patients (except for the poor, single women, disabled, senior citizens above 70 years, frontline health workers, security personnel and cleaning staffers) on October 17 courted controversy. Following the announcement, state-run laboratories stopped free tests and health workers assigned to carry out contact tracing stopped collecting nasal and throat swabs for polymerase chain reaction tests. The decision to halt free test, trace, and treatment came amidst spiking number of infections in the country and was heavily criticized by experts as irresponsible and unacceptable.
The government’s decision to not bear the cost of COVID-19 tests and treatment also affected health workers tasked with contact tracing. According to them, following the announcement, infected individuals responded in anger and even refused to cooperate when rung up and inquired about their health status. Experts have long stressed that contact tracing and testing are essential components of the toolbox for containing a disease outbreak. This is especially true for a disease such as COVID-19, which can be spread by people who have no symptoms. Furthermore, since the efficacy of contact tracing relies on information provided by infected individuals, without their cooperation, it is rendered ineffective.
Having to pay for tests and treatments out of their own pockets can be a real financial barrier for many people and can also become the reason they decide against being tested. Public health experts expressed that this will not only discourage individuals from seeking tests and treatment, leading to reduced testing but will also ultimately result in further spread of the virus. The government’s decision in this context appears counterproductive, risking making the pandemic even more difficult to control.
The Health Ministry reversed its decision to discontinue free tests and treatment two weeks later and announced that it will begin running free tests based on contact tracing. However, public health experts argue that if the continued spike in cases and fatalities are any indication, the damage has been done and the COVID-19 situation in the country has already aggravated. To make matters worse, the unavailability of beds in hospitals even for serious cases has not only put immense pressure on a health system that is already buckling under the pressure of a pandemic but has also compelled infected individuals to isolate at home without the guarantee of access to treatment should they require it. Experts argue that the current chaos and confusion is a result of ignoring international guidelines issued by the WHO and other experts, overlooking scientific evidence, and the overall poor handling of the COVID-19 crisis since it first started unravelling in the country.
The development of a vaccine for COVID-19 has constantly been in the news but it is yet to take any shape. Therefore, it is imperative that until a vaccine is successfully formulated, international guidelines to mitigate and control the infection such as contact tracing, testing, and treatment be made a continued priority. The World Health Organization’s director general recently said that when leaders act quickly and deliberately, the spread can be curbed. However, political division at the national level and blatant disrespect for science and health professionals has created confusion while cases and deaths have mounted. Acknowledging that the COVID-19 crisis in Nepal is growing, testing should not be treated as a scarce resource and the government should further strengthen the efforts to contain the virus instead of backpedalling on the few measures that would help mitigate its spread.