Nepal had been battling the coronavirus effectively with a March 24 lockdown, which helped keep confirmed cases below 1,000 until May 29, according to World Health Organization situation reports. Since then, cases have surged to just under 17,000, with 144 cases reported since yesterday.
However, even as the landlocked, mountainous nation of about 29 million people deals with an uptick over the past two months, fatalities have stayed far below baseline figures globally, with 38 deaths, with no new deaths reported by the Nepali government. One of the speculative reasons for Nepal’s low death rate is that confirmed cases have been in young individuals, who have better outcomes, in general, than older populations. Increases have been attributed in local media to Nepalis who returned home, while carrying the virus, after working abroad.
As of yesterday, Nepal has conducted over 289,000 tests total (less than 1% of total population) and has 23,470 people currently in quarantine, according to the Nepali government. By comparison, the U.S. has conducted 41.8 million tests, according to Oxford University’s Our World in Data, representing over 12% of the population. Testing in Nepal has been hampered by a lack of both reliable antibody test kits and PCR testing capacity.
The WHO has classified Nepal as being a country with “clusters of cases” which is a status level below “community transmission” but more critical than their “sporadic cases” and “no cases” classifications. It currently stands as having the fourth-highest case total in the WHO’s Southeast Asia region, behind India, Bangladesh, and Indonesia.
In response to Nepal’s rapidly increasing number of cases since late May, Direct Relief has been responding to help support the nation’s healthcare system with critical medications and supplies, including via ICU Kits, which contain medications most in-demand while treating Covid-19 patients, as identified by Direct Relief’s pharmacy team.
In part due to existing relationships forged during the 2015 earthquake response, Direct Relief was able to respond to requests by preparing 27 ICU kits in support of all 18 government appointed Covid-19 treatment and testing centers. Of those kits, 15 are designated for the Ministry of Health and Population, five are for Patan Hospital, and five are for Kathmandu Model Hospital. Two ICU kits arrived at Dhulikhel Hospital on June 22. The teaching hospital also received a $50,000 Emergency Covid-19 grant to increase its ICU capacity. The remaining kits are scheduled to leave at the end of this month, pending international flights resuming into Kathmandu.
“The geography of Nepal causes inherent challenges in healthcare delivery and, as they are reliant on imports for essential commodities, this lockdown is causing severe shortages in the country,” said Dan Hovey, who oversees emergency response for Nepal at Direct Relief. “We saw a similar situation after the 2015 earthquake. Due to Nepal’s reliance on Indian production, whenever the India-Nepal border closes, the medical supply chain in Nepal becomes severely constricted resulting in nationwide shortages.”
Dhulikhel Hospital, a government-designated Covid-19 testing and treatment center which is affiliated with Kathmandu University, also received 20 oxygen concentrators, one ventilator, and assorted personal protection equipment. The hospital has a catchment area that includes more than 2 million people, including its satellite locations.
Direct Relief also distributed 13 additional oxygen concentrators, for a total of 33, and ventilators to all of the 17 public Covid-19 treatment facilities in Nepal.
Since 2010, Direct Relief has worked closely with the Nepali government and local hospitals to provide medicines, supplies, and infrastructure. Overall, this totals $67.7 million in medical aid, resulting in more than 18 million doses of medicine to 40 healthcare providers.