Covid cases rise again, new virus variant suspected

 Nepal: The ongoing rise in Covid cases is a clear sign that a new virus variant is penetrating the communities, infectious disease experts in Nepal said on Tuesday.

                                       photo: google image

They warned that the country could witness a big rise in new cases in the coming days since no measures have been taken to prevent the infection’s spread.

“The actual number of positive cases could be several times more in communities than the numbers unveiled by the health authorities, as all infected people are not testing themselves,” said Dr Rajiv Shrestha, an infectious disease expert at the Dhulikhel Hospital. “And, the rise might have been caused by a new virus variant. Authorities should resume active case finding, which was stopped months ago.”

Nepal on Tuesday recorded 24 new Covid cases. On Monday, the figure was 69—twenty five in 488 polymerase chain reaction tests and 44 in 778 antigen tests. The test positivity rate is more than five percent.

The Ministry of Health and Population, however, said that the 69 cases represent a cumulative figure of the past four days. But on Sunday too, 16 people had tested positive and the ministry claimed that it was the cumulative figure of the cases that had yet to be documented over the past five days.

Officials say that the majority of the people testing positive for coronavirus, of late, are those who returned home from India. Lately, India has been reporting a sharp rise in coronavirus cases. The country on Tuesday recorded four deaths and 1,573 fresh coronavirus infections, according to media reports.

Several states and territories of India, including Delhi, Maharashtra, Gujarat, Tamil Nadu, Uttar Pradesh, Bihar, West Bengal, Uttarakhand and Telangana saw a surge in new cases. Uttar Pradesh, Bihar, West Bengal and Uttarakhand are states bordering Nepal.

Experts say the rise in new cases of coronavirus in Nepal comes as no surprise after the rise in new cases in India and given the uninterrupted cross-border movement. Thousands of people from both countries enter each other’s territories every day on top of the large number of those who use unregulated points along the porous borders to cross over to the other side.

Health Ministry officials said that they have already alerted the agencies concerned about the risks, asking them to step up surveillance. The problem, however, is that almost all polymerase chain reaction (PCR) laboratories set up in the districts have been shut for months. The contract period of lab technicians expired months ago, which means the laboratories do not have the human resources required to run those facilities or carry out testing on swab samples of suspected cases.

Moreover, most districts in the Tarai region bordering India do not have health desks.

“The time has come to start active case finding and for that, we need to start community testing,” said Dr Janak Koirala, an infectious disease expert. “Along with this, we should also ramp up booster vaccination drives. Vaccine doses should be secured for all eligible populations and the public health measures need to be strictly enforced.”

Doctors say that even if the new virus variant does not severely impact the young population, the elderly and those with weak immunity are at a high risk. The rise in infections also increases the severity and hospitalisation rate, the doctors added.

Scientists in India say that a new sub-variant of Covid, XBB.1.16, is responsible for the recent surge in cases. They, however, say people in India have developed a hybrid immunity due to vaccination and natural infection, so the current Covid variant will not lead to hospitalisations and severity. The Indian government has advised people to wear face masks, avoid crowds and complete their vaccination doses if they haven't already done so.

Officials at the National Public Health Laboratory, which conducts whole-genome sequencing to identify virus variants on a regular basis, said that no new virus variant has been detected in Nepal so far.

“We have already brought swab samples of infected persons from Sudurpaschim Province and have asked them to be sent to the provincial health laboratories,” said Dr Runa Jha. “We will bring those swab samples to Kathmandu and carry out whole-genome sequencing to identify the virus variant.”

Whole-genome sequencing is a comprehensive method of analysing the entire DNA sequence of an organism’s genes. Researchers believe that whole-genome sequencing of coronavirus could help track the properties of the virus and the infection’s severity. As many as 12,020 Covid-related deaths have been reported in Nepal so far, according to an official count.

India covid cases

With gradual increase being reported in new Covid cases in India, the Central government on Saturday requested all states and union territories to follow operational guidelines for integrated surveillance of respiratory pathogens.

According to media reports, fresh daily cases crossed 600 in India for the first time on Wednesday in 117 days.

Several states of India, including Delhi, Maharashtra, Gujarat, Tamil Nadu and Telangana recorded a surge in new cases.

Infectious disease experts as well as virologists in Nepal said that there is no need to be worried about reports of a new Covid surge in India, as last year’s surge there did not spread to Nepal. They said that authorities concerned, however, should closely monitor the infection rate in India and remain vigilant, if the new surge is caused by a new variant or sub-variant of the virus.

“We don’t know what variant is causing the new surge in India,” said Dr Prabhat Adhikari, an infectious disease expert. “We don’t need to be worried, if the virus variant causing a surge in India is the one already circulating in our country. If the virus variant is a new one, then it is a cause of concern for us.”

Some experts in Nepal said that the rise in new cases in India is a matter of concern since there is an uninterrupted cross-border movement every day. Thousands of people from both countries enter each other's territories every day. Also a large number of people choose unregulated porous borders to enter the other side.

Nepal had witnessed the second and third wave of Covid pandemic after the virus wreaked havoc in India. More than 8,000 people died of infection during the second wave of the pandemic triggered by the Delta variant, in Nepal, in 2021. Hundreds of thousands of people were infected during the third wave of pandemic caused by the Omicron variant.

“It has already been a year that many people were administered with booster shots,” said Dr Sher Bahadur Pun, a virologist, who is also the chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “Health authorities should try their best to administer second booster doses at the earliest.”

Life has returned to normal in Nepal and most people seem shunning even the basic Covid safety measures such as wearing face masks, maintaining social distance and washing hands.

Doctors say even if authorities concerned cannot enforce public health safety measures strictly, they should continue the awareness drive about the risks and the importance of vaccines.

Meanwhile, health authorities in Kathmandu Valley are preparing to launch a campaign to administer second booster shots of Covid vaccine in the third week of March.

The move by health offices of all three districts—Kathmandu, Lalitpur and Bhaktapur—comes amid reports of a poor uptake of the second booster shots by members of priority groups.

The Ministry of Health and Population had started administering second booster shots some two weeks ago, after COVAX, a UN-backed international vaccine-sharing scheme, delivered 1.5 million doses of the Pfizer-BioNTech bivalent Covid vaccine to Nepal.

Health workers, pregnant women, those having compromised immunity, people suffering from chronic diseases and those above 55 years of age have been designated as priority groups for the inoculation of the bivalent Covid-19 vaccine, in the first phase.

The second booster shots are being administered from district hospitals throughout the country. In Kathmandu, vaccine doses are being administered from the hospitals of the Nepal Army, the Armed Police Force, Bir Hospital, Tribhuvan University Teaching Hospital, Sukraraj Tropical and Infectious Disease Hospital and Civil Service Hospital. The jabs are also being administered from the central office of the Nepal Red Cross Society.

Doctors say booster shots are needed to give people an added level of protection against Covid. Several studies, including the one carried out in Nepal, show that the immunity levels achieved from vaccination or natural infection wane after six months of the vaccination or natural infection.

So far, Nepal has used Covid vaccines developed by the University of Oxford and the pharmaceutical giant AstraZeneca, manufactured in various countries of Europe, India and Japan, the Chinese Vero Cell, and the US-made Janssen, Moderna, and Pfizer-BioNTech.

As many as 12,020 Covid-related deaths have been reported in Nepal, according to an official count.