COVID-19 UPDATE IN NEPAL

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  .The global COVID-19 coronavirus pandemic was confirmed to possess spread to Nepal when its first and only case was confirmed on 24 January 2020. The patient only presented mild symptoms and had been discharged every week earlier with instructions to self-quarantine reception . As of 16 March, Nepal has tested 477 people , all of whom have tested negative.

  
  
  
  The government has taken various precautions to stop the spread of disease. It evacuated 175 individuals, mostly students, from Hubei, in February, and quarantined them in Bhaktapur. All of them tested negative and were sent home. Sukraraj Tropical and communicable disease Hospital in Teku, Kathmandu, commonly mentioned as Teku Hospital, is that the primary hospital for the treatment of the disease, handling all suspected cases. Nepal has established health-desks at the international airport also as on border checkpoints with India. Nepal has poor health-care and a severe lack of medical infrastructure, manpower and equipment, and is therefore considered poorly prepared to handle an outsized scale outbreak of the disease.
  
  Nepal cancelled its international promotional activities associated with Visit Nepal Year 2020 and therefore the Nepalese economy is predicted to be severely impacted by the pandemic due its effects on tourism, manufacturing, construction and trade.
  
  
  
                                                                     Contents
  
  1 Background
  1.1 COVID-19 Pandemic
  1.2 Nepal
  2 Timeline
  2.1 January
  2.2 February
  2.3 March
  3 Nepalis in foreign countries
  4 Impact
  4.1 Essential drugs
  5 References

  
  

  
  

  
  

  
  Background
  
  
  COVID-19 Pandemic
  
  The ongoing pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak was first identified in Wuhan, Hubei, China, in December 2019 and recognised as an epidemic by the planet Health Organization (WHO) on 11 March 2020, because the first known pandemic which will be controlled. As of 16 March, over 173,000 cases of COVID-19 are reported in additional than 150 countries and territories, with major outbreaks in China , Europe, Iran and South Korea , among others. quite 6,600 people have died from the disease and over 77,000 have recovered.
  
  
  The virus primarily spreads between people during a way almost like influenza, via respiratory droplets from coughing or sneezing. The time between exposure and symptom onset is usually five days, but may range from two to 14 days. Symptoms are most frequently fever, dry cough and shortness of breath. Complications may include pneumonia and acute respiratory distress syndrome. there's no vaccine or specific antiviral treatment, but research is ongoing. Efforts are aimed toward managing symptoms and supportive therapy. Recommended preventive measures include handwashing, covering the mouth when coughing, maintaining distance from people (particularly those that are unwell), and monitoring and self-isolation for fourteen days for people that suspect they're infected.
  
  Nepal
  
  China is one among two countries bordering Nepal; Nepal shares a 1,414 kilometres (879 mi) border with China's autonomous region of Tibet, within the Himalayas.[10] China is Nepal's second-largest trading partner. Nepal lies in South Asia, one among the smallest amount developed and therefore the most densely populated world regions, which performs poorly in education also as health care and sanitation metrics, and is therefore considered one among the very best risk areas for the pandemic, and also one among the smallest amount prepared.
  
  According to The Kathmandu Post, hospitals in Nepal have few ICU beds (just three in Teku Hospital) which are nearly always occupied, with people in critical condition usually having to attend for the beds to become empty. It reported doctors as saying that it might be next to impossible to admit new patients to ICU as soon as they have them. Teku Hospital, the sole one designated for handling communicable disease , had built an isolation ward during the avian influenza outbreak a decade ago, but had never brought it into use, because it didn't have experts to guage or maintain the specified standards.
  
  As news of a replacement communicable disease in China broke, concerns were raised in Nepal over the high potential risk, the necessity to implement preventative measures and a severe lack of necessary medical equipment and infrastructure; consistent with Baburam Marasini, former director of Epidemiology and Disease Control Division, Nepal doesn't have any double cab ambulances to move highly infectious patients safely, isolation wards in hospitals, or biosafety level-3 or better laboratories needed to check for highly communicable disease .
  
  
  
  Timeline
  
  
  January
  
  A 31-year-old student of Wuhan University who had returned home on 5 January, was admitted with mild symptoms on 13 January and discharged on 17 January with instructions to self-quarantine reception after preliminary tests showed he might not be infected. Although Nepal had the laboratories and therefore the skilled manpower to check for the disease, Nepal didn't have the reagents required. The reagents cost around Rs 17,000 per test and wish to be bought in bulk, sufficient for about 200 tests. As there have been no other suspected cases needing testing, the officials decided to send the samples to Hong Kong rather than buying the reagents. The samples were sent to Hong Kong on 21 January. On 24 January, the Health ministry confirmed that the test had come positive. The ministry said the patient was under surveillance, those that came into close contact with him were being investigated, and health information on all passengers coming back from China was being sought. However, The Kathmandu Post quoted officials at the Epidemiology and Disease Control Disease as saying that nobody knew of the patient's activity since he was discharged which they were trying to find him. Later, they said that that they had only spoken to the patient on phone; he had reported being in healthiness and wasn't asked to return certain check-up or monitoring. The patient was confirmed completely treated when RT-PCR throat swabs returned negative for COVID-19 in followup assessments of 29 and 31 January. None of the people known to possess are available contact with the patient showed any symptoms after three weeks of the patient's return to Nepal, and it had been therefore presumed that he had not transmitted the disease to anyone else in Nepal.
  
  On 17 January, urged by the WHO, Nepal began screening passengers arriving in Tribhuvan International Airport from China, Thailand and Japan, the three countries with multiple confirmed cases. Eight persons manned the health desk. The airport didn't have infrared thermal scanners and was therefore using thermal scanners as preparations were being made to put in the infrared ones. The passengers who showed fever were being asked to stay in touch and get in touch with the hospitals if they showed additional symptoms.
  
  On 23 January, Dr. Bashudev Pandey, director of Teku Hospital, was quoted as saying that the hospital was on high alert, while three other hospitals — Nepal Police Hospital, Patan Hospital and Tribhuvan University Teaching Hospital — would also treat the disease. Six beds in Teku Hospital had been allocated for isolation of suspected patients.
  
  On 25 January, each day after the primary case was confirmed, the Health Ministry informed that two other suspected patients were in isolation at Teku Hospital. The hospital discharged them within the morning of 27 January without expecting test results albeit the results were due later that very same day, raising concerns over its handling of the crisis. The tests which confirmed a negative result for both patients were conducted at the biosafety level-2 labs of the National Public Health Laboratory, the primary such tests to be performed in Nepal. Reagents sufficient for 100 tests were borrowed from the Centre for Molecular Dynamics and test kits were provided by the planet Health Organisation. a lady was in isolation awaiting test results as of 27 January.
  
  On 28 January, Nepal closed down the Rasuwagadhi border with China, bringing Nepal-China trade to an entire halt. Bordering districts of India were reported to be in high alert, and medical personnel had been deployed to varied entry points along the Indo-Nepal border
  
  
  February
  
  
  By the primary week of February, Nepal reported a shortage of face masks, as people hurried to shop for them following reports of the primary confirmed case.
  
  
  The Epidemiology and Disease Control Division had devised its own treatment protocol supported the one developed by UN Health Agency and had directed all private hospitals to strictly follow the rules in handling any suspected new cases.
  
  On 4 February, the Minister for Health informed that three hospitals had been made capable of testing for the virus, and 43 beds had been made available for patients of the possible outbreak. He also informed that health desks had been setup in Pokhara, Chitwan and Bhairahawa. On 5 February, Nepal donated 100,000 protective masks to China as a gesture of friendship.
  
  As of 13 February, Nepal had conducted tests on 19 suspected patients. A Saudi national who only spoke Arabic and seemed to object to being kept within the hospital, fled from isolation, and will not be located. The health ministry said it might start using police to protect suspected patients at the hospital.
  
  On 14 February, the govt was reported to possess devised contingency plans to tackle the virus. Under Plan A, the govt was preparing to evacuate Nepali citizens stranded in Hubei and keep them in isolation in Bhaktapur. Plan B included educating the people and distributing protective kits. the small print of Plan C which might be implemented just in case the disease actually spread and began killing people weren't shared.
  
  Nepal evacuated 175 Nepalis, mostly students, who had been stranded in Hubei, on 16 February 2020, and placed them during a 14-day quarantine at Kharipati in Bhaktapur. Six other Nepalis were prevented from leaving by the Chinese government, while four of the applicants who had requested rescue later changed their minds. On 20 February, the Health Ministry reported that each one of the scholars had tested negative.
  
  On 18 February, the Chinese Embassy in Nepal criticised The Kathmandu Post for republishing a Korea Herald piece critical of China's handling of the pandemic, accusing editor-in-chief Anup Kaphle of anti-China bias. In response, 17 editors from Nepalese mainstream press released a joint statement expressing concern about the singling out of the editor, and reminding the Chinese Embassy of diplomatic norms and constitutional guaranteed freedom of the press in Nepal; The Kathmandu Post published an article criticising the Embassy's actions. The Chinese embassy's actions were seen as uncharacteristic and surprising given China is understood for non-interference in Nepal's internal matters.
  
  March
  
  On 1 March, Nepal suspended visa-on-arrival service for nationals of 5 countries which were badly suffering from COVID-19: China, South Korea, Japan,Italy and Iran.
  
  
  On 10 March, 71 Chinese workers employed within the construction of Pokhara Airport who had returned from China after undergoing a 14-day quarantine were again put into quarantine by the Nepalese side for an additional 14 days. They were being closely monitored and everybody was reported to be in normal health. Previously, 36 Chinese workers working for the project had also skilled an identical quarantine upon return to figure .
  
  On 12 March, Nepal government decided to suspend on-arrival tourist visa for all countries with an exception to diplomatic and official visas. just in case of emergency, the foreign nationals are to use for visa with a submission of health certificate indicating no infection of the novel Coronavirus. This suspension is to last from 14 March till 30 April. the govt has also restricted visit and from India via land routes and canceled all spring hiking expeditions including Everest until 30 April from 14 March. The Province No. 1 government unveiled plans for 2 quarantine sites within the province, including one on a Koshi River island. It also assured plans were underway to supply additional equipment to health personnel, to line up health desks on border-crossings with India, to stay ambulances in standby and to take care of isolation wards in three major hospitals — BP Koirala Memorial Hospital in Dharan, Koshi Hospital in Biratnagar and Mechi Hospital in Jhapa.

  
  

  
  

  On 14 March, BP Koirala Institute of Health sciences in Dharan reported that a suspected patient had refused to stay in hospital and returned home. He had promised to return the subsequent day for testing. an equivalent day, Bihar transport department suspended Patna-Nepal bus services with immediate effect, to be enforced until 31 March, in an attempt to contain the virus, after many cases emerged throughout India. India declared a suspension of all passenger movement through Indo-Nepal border, except a couple of designated checkposts with intesified health inspections, effective from 15 March.
  
  Nepalis in foreign countries
  
  
  A Nepali student who had recently reached Tasmania via Singapore tested positive for COVID-19 on 8 March. On 9 March, the UAE's Health Ministry confirmed that two Nepalis within the country had tested positive for the virus.

  
  
  Impact
  
  
  Image result for image of corona virus dignosis
  
  
  
  
  Nepal had declared 2020 because the Visit Nepal Year and aimed to usher in two million foreign tourists, almost double the figure from previous year. because the pandemic spread and Nepal had to suspend aviation to and from China, the most important source of international tourists arriving by air, Nepal suspended its promotional campaigns.
  
  
  Nepal's economy is predicted to be negatively impacted by the pandemic. The tourism sector has been reported to be suffering thanks to the absence of Chinese tourists, also because the various travel restrictions imposed on travel globally. Manufacturing sector is experiencing a shortage of raw materials, most of which wont to come from China. things is exacerbated by spread of the pandemic to the Middle-east which is that the main source of remittance which makes up quite half Nepal's GDP. The wholesale and retail sector has also been impacted thanks to fall of imports from China. the development sector which imports most of its building materials from China has bogged down . because the Chinese contractors and workers who went home for the Chinese New Year couldn't return, the general public construction projects have also been affected.
  
  
  The temporary blanket ban on animal markets imposed by China as a response to the pandemic is predicted to curb wildlife poaching and trafficking through Nepal, because the Chinese traditional medicine which uses various body parts of endangered animals as its ingredients has been the most important challenge to wildlife conservation within the region.
  
  The annual Holi celebrations, which fell on 9 and 10 March in 2020 saw decreased activities, low business and cancellation of organised celebrations.
  
  
  
  Essential drugs
  
  
  Nepal's pharmaceutical industry has been impacted thanks to lack of raw materials as variety of essential ingredients were previously imported from Hubei. Nepal faced the prospect of a possible shortage of essential medicines when India imposed restrictions on export of 26 sorts of raw materials including of essential medicine citing disruption within the supply chain from Hubei; however India later agreed to relax restrictions just in case of Nepal, and asked the Nepalese government to provide an inventory of names and quantities of essential medicines that it needed to supply to Nepal.
  
  
  
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                                        Stay home if possible and lookout of yourself😊
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