The COVID-19 crisis, which has been declared a pandemic by the World Health Organization (WHO), has infected more than 1.3 million people and killed around 75,000 while over 250,000 people have recovered.
Nepal has reported nine cases, with one cured and eight positive at the time of writing this. There has been no officially reported death from COVID-19 in Nepal until now. While this is not a very bad news at the moment there are certainly things to worry about. There is also concern about under-diagnosis which may have resulted in lower number of cases.
This article will focus on the overall efforts being made and additional measures that would help to deal with the crisis.
Overall security and safety of health workers and frontline workers:
The government should focus on boosting the morale of health workers. Adequate personal protective equipment (PPE) and encouraging words from leaders, mainly the prime minister or his deputy, and health minister are important. Guidelines regarding PPE is developed by the WHO and also approved by Ministry of Health and Population (MOHP). PPE is needed for following reasons:
- to motivate health workers, ambulance drivers and security persons or people working on the front line.
- to reduce number of infections as we need to protect the health workers from getting infected in the first place. They will also be carriers if not provided adequate PPEs.
- to protect health workers on the frontline who are waging the battle against COVID-19, whom we cannot afford to lose.
- to protect other security persons from getting infected.
Besides, government should provide quarantine facilities for the health workers and take care of their safety and security.
Civic engagement:
The government has imposed lockdown and asked people to stay home unless for urgent reasons or emergency services. The people are helping the enforcement by staying home as much as possible. The government has also asked for donations for relief funds. It should seek to mobilize civil society to deal with current crisis.
Garner the support from I/NGOs:
It is imperative for the government to engage NGOs and INGOS and seek their support and mobilize possible resources, including available expertise and human resources. The government should tap on their resources and connections by mobilizing them.
Involvement of private medical colleges and hospitals:
The government should provide PPEs to the private medical colleges and big private hospitals and engage them to deal with this crisis. The medical colleges have large infrastructure and equipment as well as a large number of trained human resources, health workers, specialists, etc. We will need their full support to deal with this crisis.
Raising awareness:
We need to adopt and put all preventive measures in place and take precautions, but not panic. We don't want to see more people with mental health problems related to COVID-19. Besides, the social media and anti-virus campaign should focus on stigma and discrimination issues beyond hand washing, social distancing and so on. We should not let anyone be stigmatized, harassed or discriminated because of the COVID-19 infection.
The government need to take extra measures beside those already been taken:
Coordination among different levels of government
There needs to be a clear coordination at all three levels of government and allocation of roles and responsibilities. There is a need for better management of quarantine centers along with the basic services as envisioned in the guidelines by Ministry of Health and Population. There is a clear need of security forces to provide security at those centers.
Lockdown and overall government response:
The government has extended the nationwide lockdown until the next week. In the meantime, lockdown is no panacea in itself. This is where we expect further work from the government in for preparations to prevent, contain and mitigate the impact of COVID-19 We need to implement/adopt it as per our local context and culture. Farmers should continue with agriculture.
Testing Increase:
The most important thing is testing which the WHO has marked as the best strategy to contain this pandemic. It is where we are lacking the most. So far only over 1,400 tests have been done. The government has brought test kits and some PCR machines and is increasing sites where the test can be done which will certainly help increase the number of tests in the coming days. Sample collection and delivery up to the center should be done properly.
Contact tracing:
Another is contact tracing and testing people coming from abroad and putting them in either home quarantine or in quarantine facilities which are arranged by the government. The collection of data is very essential. Mobile teams of health workers, female community health volunteers (FCHVs) and security persons need to be mobilized for contact tracing, sample collection and enforcing quarantine as necessary. While this is already being done it needs to be stepped up.
Relief package and financial stimulus plan:
The people are not only cooperating with the government but are also paying the prices. The businesses are closed and the people are forced to stay home and so on. The relief package brought by the government seems too little too late and there is no stimulus plan for the business sector and migrant workers who returned from abroad but whose contribution in the form of remittance is the backbone of our national economy.
Logistics supply:
The emergency purchase and provision of adequate ventilators, ICU set ups, and emergency medicines and other equipment supplies should be ensured. There are chances for shortage of oxygen supply as well. Hence, procuring as many oxygen concentrators as possible could be helpful. The various organizations should coordinate with the MOHP to identify the needs and help procure necessary equipment and supplies.
Migrant workers returning from India:
There have been news reports that people have been forced to stay on river banks for days and nights because they cannot enter Nepal because the borders are closed. The Nepalis who have reached the border points should be let in and immediately put in mandatory quarantine for 14 days.
Nepali diaspora/ Nepalis living abroad:
The government should further use embassies and missions abroad to take stock of the Nepalis living abroad. The migrant workers and students abroad who are worst hit by this crisis need to feel that government is coordinating with various governments regarding their safety, security and treatment.
PM Relief Fund:
The government has appealed for donations in PM relief fund. Many companies and corporate houses and business organizations have contributed. There is also a policy that requires medium and large scale enterprises to spend one percent of their net profit on corporate social responsibility. However, the money is spent by the corporates themselves and meaningful works are not done most of the times. The money needs to be channelized and spent in the government identified priority areas or go to the PM relief fund directly.
(Dr. Koirala is involved in infectious diseases and public health works. He can be reached at koiralasushil@hotmail.com)
Disclaimer: These are personal opinions and the views expressed don't reflect or represent the organization he works for.
