Nepal was the first country in the South Asia to clamp a stay-at-home order on 24 March, after only the second confirmed case. It was a bold move, sacrificing the economy to save lives.
That proactive decision to enforce a nationwide lockdown bought us time to prepare for possible outbreaks, and to prevent a peak. It worked well, and the government deserves credit for daring to take the step. Nepal has a relatively low number of confirmed cases, and no reported deaths so far.
However, public health experts interviewed for this editorial tell us there is no way of knowing what the real extent of infection is. They are certain that COVID-19 has killed people in Nepal, but they may have died at home because of stigma if they went to hospital, or they succumbed to co-morbidities like tuberculosis or pre-existing pneumonia.
The detection of clusters of 16 new cases in Nepalganj and 17 people in one family in Parsa this week brought the total number of cases to 99. It will rise for the simple reason that there is not enough testing being done. The new cases only came about because of contact tracing a cohort at risk.
As has been said, the lockdown was a balance between saving lives and saving livelihoods. But now after 6 weeks, it is a balance between saving lives, and saving lives. Whose lives are we going to save? We have to protect the general population from the coronavirus as well as save it from poverty, hunger and disease.
Nepal prepares for economic fallout of pandemic, Kaustubh Dhital
Joblessness, indebtedness and bankruptcies are already costing lives with a spike in suicides. There have been measles outbreaks because vaccination campaigns had to be postponed, dialysis patients have died because of lack of treatment, and patients with chronic diseases have run out of life-saving medicines. More people are dying of causes other than the coronavirus.
In a best-case scenario, the lockdown period should have been used for a massive campaign for testing. But in Nepal and other developing countries we do not live in an ideal world. In fact, even industrialised countries face a severe shortage of test kits.
But despite limited testing, we have more or less nailed down the places with high risk. These are districts on the Indian border, where despite the lockdown there has been movement of people. There are probably infections among the many thousands of migrant workers who have dispersed across the mountains of western Nepal.
The India connection in Nepal’s COVID-19 status, Nepali Times
But large parts of Nepal have not reported any new cases in the last six weeks despite testing. Most of those who tested PCR positive have relatively mild symptoms. Hospital records across the country show no discernible spike in deaths from influenza-like causes.
On Wednesday, the government extended the lockdown by 11 days till 18 May. But experts continue to urge for a carefully calibrated sectoral and geographical easing of the rules. Where and by how much will depend on the data available, and we should err on the side of caution.
India has extended its lockdown till 18 May, but has divided the country into red, amber and green districts. In the absence of widespread testing, for Nepal to have similar designation would be arbitrary. But the government task force could look at partially lifting the shutdown for agriculture, industry and the supply chain to ensure food production and spur economic activity.
Continuing the lockdown for the sake of lockdown with no solution lessens its impact on the people and the economy and could send us from the frying pan into the fire.
Unlocking the economy post-lockdown, Sanjib Subba
Even as the Ministry of Health and Population in Kathmandu was briefing the media on Monday about the new coronavirus cases in Nepalganj via Facebook live, two children had died of measles in Dhading. Throughout this crisis, the number of children felled by preventable infections has not gone down – in fact there is evidence it may be increasing.
Over 30,000 kidney patients in Nepal are at risk because the COVID-19 lockdown is preventing them from travelling to hospitals for regular dialysis. Some have died as a result. Other patients suffering from chronic diseases are not getting vital medicines. Ironically, a nationwide quarantine aimed at controlling one disease is causing deaths from other.
The best possible solution going ahead, experts say, is to continue COVID-19 testing, identifying hotspots and isolating them, designating low, medium and high-risk areas, gradually lifting restrictions while taking precautions, and being on the lookout for flareups so they can be immediately contained.
Since testing everyone is impossible, and continuing with a complete clampdown would be much more damaging, the next best option is a partially lifting the restrictions.
Nepal’s economy, already weak, takes direct hit, Sanghamitra Subba
Pandemic is a chance to rethink development, Ivan G Somlai