The current trend is similar to October 2020 at the peak of the first wave, when there were over 5,000 daily new cases and 30 deaths. The decline in second wave infections and fatalities have now stalled, and the case positivity rate has increased to 25%.
“After two months of lockdown, restrictions were suddenly lifted even though we were still reporting 2,000 cases. Everything is up and running and it is business as usual, crowding and no distancing,” says virologist Sher Bahadur Pun at Kathmandu’s Teku Hospital.
He adds: “Now we have vaccination centres which risk being virus hotspots. People who have not been infected, and those not vaccinated yet are at greater risk.”
The behaviour of the virus in Nepal has generally followed India’s pandemic trajectory after two weeks. After peaking at over 400,000 daily cases back in May, India has seen a decline in daily cases and fatalities. However, after registering less than 30,000 confirmed cases on 27 July, India registered 43,654 fresh cases the day after.
With only 7% of its 1.3 billion people fully vaccinated, recovery from the second wave has tapered off in India, with states like Kerala are seeing a new surge.
A recent survey showed that India’s seroprevalence rate is about 70% — the proportion of the population infected in the recent past who carry antibodies. The rate is highest in the bordering states of Bihar (75%) and Uttar Pradesh (71%).
The antibodies provide some immunity against the coronavirus, which is why Kerala is seeing a spike because the seroprevalence rate there is India’s lowest, at 44%.
A seroprevalence survey is currently being carried out in Nepal, and experts predict that antibody rates will be similar to India, at least in the Tarai. However, they caution that this may not mean Nepal is protected by herd immunity.
Nepal is administering more than 55,000 doses of Covid vaccines a day, but the government’s assurance that more vaccines are on the way may have sent the wrong message to people.
“People who are vaccinated are being careless, they have stopped wearing masks and distancing themselves. I know of at least 10 acquaintances who with their families were fully vaccinated, but are now in quarantine,” says epidemiologist Lhamu Yangchen Sherpa. “Jabs protect us from hospitalisation, but we could still get infected and continue the chain of infection.”
But despite projections of a new surge in late August, public health experts both in India and Nepal are cautiously optimistic that it will not be as deadly as the second wave unless a new variant of concern emerges before a large portion of the population is vaccinated.
So far, 1.5 million Nepalis, which is 5.1% of the total population, have been fully vaccinated with either AstraZeneca Covishield, Chinese VeroCell or the single-shot J&J vaccine. Over 2.3 million have been partially inoculated.
But vaccine doses have been distributed unequally across the country with about half of it concentrated in Bagmati Province. More than 14% of people in Bagmati are fully inoculated compared to only 2.5% in Province 2, 2.8% in Far West, and 3% in Karnali. (See map)