Rudra Dahal

Nepal which is just entering in crisis mode of COVID-19 now; there are 5 deaths from COVID -19 pandemic, and confirmed cases are 1042 as of today. In a global scenario, there are 5 million 593 thousand 631 confirmed cases and 353 thousand and 334 deaths in 216 countries. In Southeast Asia, there are 227 thousand 611 confirmed cases of COVID -19, and deaths are 6 thousand 630. Nepal got a long time to learn a lesson from around the World to manage this pandemic, and now it is a real-time to fight against this devastation.

Although, Nepal has a big challenge to curb the spread of this pandemic considering overall public health situations and its geopolitical condition. It lacks both human resources and material resources for aggressive testing to combat this pandemic. It is hard to get assistance from the international community because most of the countries are impacted by this pandemic and needing more effort to manage their own home country. However, it is receiving some international help from the neighbour country – China and other countries as well as local help from soft-hearted Nepalese people to fight this enemy. There is an extreme need to maximize the testing capacities for vulnerable areas. Testing facilities are located mainly in Kathmandu and other major cities only. Nepal’s government is trying to do its best to combat this situation. This needs cooperation from the public as they are the key to minimize this menace. In this time community transmission is rapidly increasing every day which is a danger sign for Nepali people. The following strategies may help to decrease this pandemic situation and the existing healthcare system could manage the situation.

1. Continuation of lockdown: Lockdown is the only effective measure to control the mass spread of the novel corona virus. This virus transmits through person to person contacts, so, strict lockdown is mandatory to manage the situation. We can learn from China, Italy, Spain who used strict lockdown measures, and they were able to control the spread of this pandemic. Nepalese people need to be more sensitive to safeguard themselves and their community by staying at home, maintaining social distance, and following public health measures.
2. Travel ban: Nepal is experiencing caravans of inner migration as many people were returning their village feeling safe there when cases were found in Kathmandu and other major cities. Now, there are COVID-19 cases in different districts and people started to return back to Kathmandu, which is very dangerous because Kathmandu is a crowded city and there are high chances of community spread of infection to a large number of populations. Due to this reason, it is ideal to keep people in their own place until the situation comes under control. It can be done through internal travel banning from local government.
3. 3. Increase testing capacity: It is necessary to increase the number of aggressive testing capacity in vulnerable areas and groups. For example, geriatric homes, disability care and rehabilitation facilities, jail, army and police barracks, slum, and marginalized residential areas. Priority should be given to seniors, low immune persons and people who have underlying chronic health conditions – they are the most vulnerable population. Mass testing in a broad population can save time and provides more extensive measures such as social distancing, isolation, quarantine and promptness contact tracing and finally accelerates the containment of the outbreak, but it needs more resources which may not fit in the context of Nepal. So, pool testing could be the right fit for our case as it is the sample testing system which saves resources and provides faster results which allows prompt action in the community.
4. Isolation: It is mandatory to isolate suspected and confirmed cases to control the spread of the virus. This battle could not win by the single army; it needs cooperation and coordination between stakeholders and solidarity where all individuals have an equal responsibility to save them, their loved one, their community and the entire world. In addition to, during self isolation people should maintain their good hand hygiene, social distancing (2 meters apart), minimizing to use public transportation, wearing a mask, and avoiding crowds are advantageous.
5. Increase hospital capacity: In this time all the private hospitals and private healthcare service providers should focus on the management of this crisis. So, government and local authorities can coordinate with the private sector and arrange necessary beds and life support systems at hand to manage this pandemic such as ICU beds, ventilators, isolation/barrier care unit etc. This provides the extra infrastructure to handle the situation if needed.
6. Border seal: Located between two big countries China and India, (China in the North and India in the East, West and South) has an open border. It is highly susceptible to incidents from its immediate neighbours (5) due to sharing an open border that allows the free flow of people and goods from both neighbours. In this situation, there should strictly ban to crossing border from both sides by sealing the border.
7. Availability of PPE: As the COVID-19 pandemic is accelerating, the healthcare system in Nepal is overwhelmed. Preventing the spread of this virus to and from healthcare professionals and patients relies on the availability and proper use of PPE-gloves, face masks, respirators, goggles, face shields and gowns. It is mandatory to use PPE for all front-line workers and health professionals. Authorities should be aware to make an efficient supply of these items.
8. Health information sharing: It is the right of people to get the necessary information about COVID-19. So, it is beneficial to establish COVID -19 information center and disseminate all related information through different public medias 24/7 that informed the general population to know the exact situation and their responsibilities to overcome this crisis. This prevents people becoming more panic as different medias are providing several statistics among people, so reliable resources of information saves people becoming overwhelmed.
9. Encouragement to COVID -19 fighters:  It is necessary to encourage front line workers who are directly involved managing this crisis 24/7, especially health professionals, front line workers. They are the true army of this battle. We can provide emotional support, provide quiet space for rest and meditation, take care of their necessities, share information among the team, and most importantly provide safer and positive workplace culture.

To conclude, there is a huge challenge for Nepal to safeguard the Nepalese population from COVID-19. Open border, limited health resources, scarcity of international assistance are some of the challenges in front of the Nepalese healthcare system. Now, situation is more dangerous than speculated by Nepalese people. So, with integrated cooperation and solidarity, Nepal will be able to combat this risk.