In July, as the government eased the first lockdown, people streamed across the border from India into Nepal, spreading the coronavirus infection along cities in the Tarai.
The districts from Jhapa to Parsa became hotspots. Hospitals ran out of ICU beds and ventilators, municipalities had no test kits left, and there were horror stories of patients dying while going from one hospital to another that refused admission.
But it did not take too long for asymptomatic carriers to bring the virus into Kathmandu Valley, where population density and high mobility made the capital an ideal breeding ground for SARS-CoV-2.
With 16 additional deaths on Monday and two on Tuesday, total Covid-19 fatality in Nepal has now reached 429. Kathmandu Valley alone accounts for over one-fourth of all deaths in Nepal from the virus. On Monday, Kathmandu, Lalitpur and Bhaktapur districts recorded 647 new cases (about half the nationwide total of 1,356).
The tables are now turned. Even as the Tarai has the virus largely under control, the majority of the 223 patients in ICU and 37 on ventilator support nationwide are in Kathmandu Valley. The country’s only infectious diseases hospital in Teku, despite adding isolation wards, ventilators and ICU beds, has run out of space for Covid-19 patients.
“Even with the increased capacity, we cannot admit all the patients,” hospital director Sagar Rajbhandari told Nepali Times.
Three months after the government announced it would build a 300-bed hospital just for coronavirus patients, there has been no action. It has not followed the advice of its own public health experts to expand testing and tracing.
In fact, the Nepal government seems to have admitted defeat. Its unspoken strategy now is now letting the virus take its course, warning citizens to adopt their own precautions and learn to live with the disease until a vaccine is available.
This explains why even as the number of new cases and fatalities in Kathmandu Valley break its own record every day, the lockdown is being further eased with public transport, flights, shops and restaurants allowed to open.
Adding to this is the utter lack of coordination between locally elected municipality officials and the District Administration Offices which issue new and contradictory guidelines every day, and blame each other for the situation getting worse.
Locally elected representatives should have been allowed to handle the outbreak like in the Tarai, with the central government only ensuring that they have adequate resources, equipment and medical personnel.
“Kathmandu’s response to the pandemic shows that the central government doesn’t trust local units who are close to the people and can respond fastest to their needs,” says Chandra Kishore, a Tarai-based journalist in Birganj. “The focus should be on empowering local governments and health posts to contain the spread of the virus.”