Covid is becoming endemic from pandemic, doctors say

 

  Nepal: Ten out of 11 swab samples on which whole-genome sequencing was carried out at the Kathmandu University have been found infected with BA.2 sub lineage of the SARS-CoV-2.

The remaining one was found infected with BA.1 and it belonged to a person who had recently returned from the United Arab Emirates. The results of the study were unveiled on Tuesday.

Officials from the National Public Health Laboratory said that almost all cases of coronavirus, spreading throughout the country, are caused by BA.2 sub lineage, which is dubbed as Omicron’s close cousin and a “stealth subvariant”.

Experts say BA.2 does not have the same missing target gene and some early reports indicate that the subvariant may be even more infectious than BA.1, which itself is super contagious.

And what is concerning is that a person infected with Omicron BA.1, had entered Nepal even before the World Health Organisation designated it as “a variant of concern.”

And authorities were only focussing on S-gene dropout to identify Omicron.

And when whole genome sequencing was carried out last month on the swab samples of infected persons whose S-gene targets were found positive, BA.2 sub variants were found in 88 percent of the swab samples.

“We are carrying out whole-gene sequencing on a regular basis and almost all cases are found infected with BA.2,” Dr Runa Jha, director at the National Public Health Laboratory, told the Post.

Public health experts say that mutations in the virus variant are not uncommon and should not be taken as otherwise, but what is concerning is the authorities concerned have stopped taking preventive measures—active surveillance, sufficient testing, contact tracing, isolation of the infected, quarantine, monitoring health condition of the infected people, and enforcing public health measures strictly among other things.

“I don’t see any point in telling what should be done and what not, as authorities concerned have given up all measures necessary to contain the spread of infection,” Dr Sarad Onta, a public health expert told the Post. “We had asked the authorities concerned to manage the border points properly, increase testing of the people entering the country, place them in quarantine for a certain number of days and increase active surveillance, but I don’t think that those things are being implemented.”

Of the 74,653 Covid-infected people throughout the country, 73,178 are in home isolation. The remaining others whose health conditions are serious, have been admitted to hospitals. The responsible agencies are indifferent to the health conditions of the infected people and their movements.

The Ministry of Health and Population has been counting the infected people on the basis of reports sent by various laboratories. But many infected have not undergone testing despite having symptoms and some perform antigen tests at home, so the government is unaware about their disease status.

What is interesting is that the Health Ministry every day unveils data on Covid-recovered people by assuming that people normally recover after ten days of infection.

“We actually do not know about the condition of the infected people once they get discharged from hospitals,” an official at the Epidemiology and Disease Control Division said, asking not to be named, as he is not authorised to speak to the media. “Some of the people we discharged could have died or landed in other hospitals.”

Doctors say not doing anything to prevent the spread of infections and inability to do anything are two different things.

“Time has come to contemplate what we did to prevent the spread of infections and what should have been done,” Dr Sher Bahadur Pun, the chief of Clinical Research Unit at the Sukraraj Tropical and Infectious Disease Hospital, said. “This is not the first and not the last wave as more variants will emerge in the coming days, and they could be more contagious and deadlier.”

Covid is shifting from pandemic to endemic in many countries including in Nepal, as infections have continued for the last two years and there is no sign of the virus spread stopping.

Experts say the authorities can do only two things—get back to the basics meaning, making active surveillance systems effective and ramping up vaccination.

“Like with the influenza virus, regular active surveillance is needed to monitor the coronavirus variants,” said Dr Shrawan Kumar Mishra, chief of Provincial Public Health Laboratory of Madhes Province. “Surveillance of the virus is necessary both for containing the spread and also for upgrading the vaccine.”

On Tuesday, 5,583 people tested positive—3,657 in 10,776 polymerase chain reaction tests and 1,926 in 6,898 antigen tests–in Nepal. In the last 24 hours nine people died of the coronavirus.

Doctors say the infection numbers being reported by the government are just the tip of the iceberg as most of the infected people are not undergoing testing.

“Case investigation, testing, contact tracing, isolation, quarantining, and enforcement of public health measures are the basic things to be done to stem the spread,” Dr Dr Rajiv Shrestha, head of genomic sequencing at Dhulikhel Hospital, told the Post. “Without doing these, it is not possible to contain the virus.”

Arjun Poudel