The problem is further exacerbated by unmanaged home isolation, and quarantine cases. According to the Ministry of Health, 10,741 people across seven provinces are self-isolating at home, often without much resources or knowledge on how to manage their condition.
Ideally, asymptomatic or mildly symptomatic people self-isolating at homes should have a separate room and a bathroom. Patients should confine themselves in their rooms, wash their own utensils, wear masks while going to the toilet and sanitise it after use and wipe touch points with disinfectant.
Individuals need to keep track of their temperature and symptoms, measure oxygen saturation level if possible, take paracetamol for body ache and fever and make sure to eat nutritious food. One must be aware of danger signs: oxygen level below 93, chest pain, difficulty in breathing and blue tint to lips and limbs.
But most families who have members in home isolation do not have this information, or live in such crowded quarters that it is impossible to fulfil all precautions. Conflicting directives from the government haven’t helped.
At one point, overwhelmed with the surge of Covid-19 cases in Kathmandu, the Ministry of Health spokesperson Jageswar Gautam advised people live on television to go to hospital only if they feel faint. By then it is too late because it means the patient’s oxygen saturation is already dangerously low.
The government has left the people to their own devices, and ignored expert advice on increasing the number of beds in wards with basic oxygen supply instead of spending money on ICUs and ventilators.
“When I tested positive for coronavirus and had slight difficulty breathing, I called a government health expert for advice, and he himself dissuaded me from going to a public hospital,” says Rajendra Dahal, Editor of the magazine Shiskyak. “This is why the death rate is going up, while the positive totals are going down. People are at home, and their oxygen levels are falling, and they have no idea. The main point is that the people have lost their trust in the government health system.”
The chief consultant at the Infectious Diseases Hospital in Teku Anup Bastola agrees that the risk has been heightened because health experts are unaware about the actual condition of people isolating at homes. “Nepalis have a tendency to not visit hospitals until it’s too late. We have found that this is even more true for coronavirus,” he says.
With much of the 2020 overshadowed by the pandemic and its impact on all the sectors, young people wanting to get back to their lives are now ignoring the signs and symptoms, preferring not to voluntarily test in case they might have to isolate for two weeks.
Even according to government figures, the number of people testing positive in Kathmandu Valley is not going down. With the marriage season, and people intermingling indoor in banquet halls, the surge is not expected to subside. At Pashupati Aryaghat, there are five times more cremations happening compared to the same period last year, according to reports. It is not clear how many of these extra deaths are due to Covid-19.
The movement of the younger people has had a direct impact on the elderly, as they take home the virus and make parents and grandparents seriously sick. People in their sixties and above now make up over 60% of Covid-19 fatalities in Nepal.
Even without the added risk of coronavirus, senior citizens are prone to pneumonia and other chronic respiratory illness in winter. Public health experts advise being alert in regards to their condition even before they complain of symptoms and keeping communication channels open.
Says Sher Bahadur Pun: “These are extraordinary times and we need to take extraordinary measures to protect the more vulnerable among us. Until we get a vaccine, we must realise our responsibility in containing the virus and not become a medium for more deaths.”