The following excerpt from The Britain Nepal Society gives insight into the current Coronavirus situation in Nepal:

Latest COVID-19 Situation Report from Nepal & Recent Press Highlights, Nov-Jan, 2022

• The Ministry of Health and Population in late November had sent some 750 samples for gene sequencing to the UK to find out whether the new omicron variant of the coronavirus had entered Nepal.
• Less than a month after India started getting affected by the suspected omicron strain of COVID-19, the variant is currently spreading like wildfire in neighbouring Nepal.
• The COVID-19 spread in India also resulted in mass return of migrant workers across the porous border to Nepal, and a lack of effective border testing and quarantine procedures have also greatly contributed towards the spread of COVID-19 in Nepal.
• Nepal is currently reporting a daily rise of approximately 10,000+ new COVID-19 infections, highest figures since onset of pandemic in March 2020. The majority of this is concentrated in the capital Kathmandu. It is also worth noting the current local trend shows that a lot of symptomatic people are not testing themselves and therefore, the real figure for positive cases would be much higher.
• 14 districts have over 500 active COVID-19 cases as of January and WHO Nepal has reported that COVID-19 infection is being seen massively amongst children. The risk of infection is more in children below the age of 12, ineligible for the vaccine.
• Latest COVID-19 infection rate is reported to be higher than 50%, the highest average infection rates the country has recorded till now and five times higher in comparison to earlier waves. Health Ministry projects COVID-19 infection will peak on the last week of January with highest number of infections being recorded between 22-29 January.
• Superspreader political events and mass gatherings from November through to December 2021 increased risk of further transmission which have contributed to the exponential rise in recent COVID-19 cases.
• With the surge in cases, the Ministry of Health and Population (MoHP) of the Government of Nepal has come up with a COVID-19 Health Sector Rapid Action

1. Plan (November – February 2021), and different federal ministries, provincial governments and local governments are working together to ensure that response plans are in place to mitigate the impacts of the latest spike in COVID-19 cases.

• Although there was a good mix of both Delta and Omicron variants in December 2021, the latest gene sequencing report from the Ministry of Health and Population indicated that 88% of the recent cases as of January 2022 is Omicron.
• However, while case numbers have risen exponentially, hospitalisations are not reported to have increased at the same rate, and are definitely lower than that during the first two Delta waves, thanks to a good vaccination coverage. According to MoH Dr Manisha Rawal, the number of critically ill COVID-19 patients admitted in hospitals is four times less currently, in comparison to the second wave. WHO reported that over 90% of COVID-19-infected are in home isolation. Having said that, the Omicron variant remains a great concern for the unvaccinated.
• Whilst the first and second waves of COVID-19 Delta variant resulted in shortage of hospital ICU beds and oxygen supplies, Omicron so far is causing a significant shortage of health workers who are continuing to get infected across Nepal’s hospitals, and especially so in Kathmandu:
• There is acute and chronic shortage in medical staff across Nepal due to the rapid spread of Omicron, which has prompted the Ministry of Health and Population to consider shortening the isolation period for doctors, nurses and paramedics to five days in a similar fashion to rules in the USA and India.
• With more and more healthcare personnel testing positive for COVID-19, health system coming under tremendous pressure, public health experts say human resources is proving to be the major problem in the third wave; Operation Theatre of Koshi Hospital in Biratnagar has been shut down after 76 staff members of the hospital tested positive; Sudurpashchim hospitals are feeling pressure of both seasonal flu and COVID-19 patients as mercury drops; Bagmati Provincial government to deploy 300 nurses for the treatment and care of COVID-19 patients. Even major health facilities such as Teaching Hospital (TUTH), BIR Hospital and Sukraraj Tropical and Infectious Disease Hospitals in Kathmandu are finding it increasingly challenging to cope with medics getting infected. At the latter, there are so many health workers infected by COVID-19 that they have had to postpone the vaccination drive by a week due to short staffing.
• At the district level, human resource capacity to operate ventilators and provide ICU case management is a critical challenge and of the utmost importance to address in order to effectively respond to severe COIVD19 cases across the country.
• Given Nepal’s largely unprepared and limited healthcare infrastructure which works on a shift basis, medical staff having to isolate even just a few days is seriously disrupting medical care in Kathmandu and especially in rural areas where hospitals and doctors were always few and far between.
• Cost of PCR Test has been reduced to Rs 800 for asymptomatic people, where as those showing symptoms can get the test done for free in government centres. Private

2. testing facilities have also reduced costs per test to Rs 1500 from an earlier charge of Rs 2000.

• The booster dose for frontliners only began on January 16th, and the rapid rise in cases have resulted in poorly organised vaccination drives, requiring medical workers to queue up for hours and also return on another day depending on the daily vaccine stock levels of the centre. According to the Ministry of Health and Population, the booster dose will also be provided to all senior citizens aged above 60 years as well as those who have completed six months of the full dose vaccine from January 28th onwards.
• Despite having around 13 million vaccine doses in stock (as of the first week of January 2022), authorities failed to boost the overall vaccine drive, despite relatively low levels of general COVID-19 vaccination hesitancy in Nepal.
• The vaccination drive against COVID-19 has been affected due to a lack of syringes required to administer the vaccine in Nepal. The government has ample stock of the vaccine which have been delivered across Nepal, but there is a critical shortage of around syringes to administer them.
• Students are being given the vaccine against COVID-19 in their respective schools. The schools are closed for winter vacation amidst the third wave of COVID-19 pandemic till 29 January, and the children aged 12 to 17 of this age group are being administered the vaccine during the vacation.
• As of December 2021, Nepal has received over 31 million doses of Covid-19 vaccines from various sources.
• As of December 2021, 58.4% of the population above 18 years have been administered at least one dose of COVID-19 vaccine and 47% have been fully vaccinated (United Nations Nepal).
• Lab tests have shown that the AstraZeneca and VeroCell vaccines most used in Nepal may not be so effective against Omicron, and only m-RNA vaccines like Pfizer and Moderna may be effective as boosters to stop infections. However, researchers have said all vaccines, including AstraZeneca and the Chinese jabs, significantly protect against serious illness. Infectious diseases specialist at HAMS hospital in Kathmandu Anup Subedi stated that mRNA vaccines are indeed more effective against the new variant but all the shots significantly reduce severity and mortality and therefore, the priority should be to vaccinate as many people as soon as possible and to boost the immune-compromised and frontliners.
• Secretary of the Ministry of Health and Population, Dr Roshan Pokharel, has acknowledged that there is no record of 2 - 2.5 million doses of COVID-19 vaccines and there have been speculations that these vaccines may have been sold to corporate houses. There are also videos in the social media showing vaccine vials being sold in the black market.

3 Amid the record surges in COVID-19 cases across the country a meeting on 20th January of the chief district officers of the Valley’s three districts has decided to re- introduce odd-even number plate rule for vehicles starting 23rd January. Public health experts have swiftly criticised the decision as impractical, saying fewer public vehicles will cause more crowding in such vehicles and contribute to the spread of infections.
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Great news - villagers have now received their second doses of the vaccine to protect them from the Coronavirus.

ITV's report into the current nightmare situation in Nepal as the Indian variant of Covid-19 spikes out of control..
​https://www.itv.com/.../covid-19-threatening-to-overwhelm...

Article from The Kathmandu Post
Post Report
Published at : May 12, 2021
Updated at : May 12, 2021 23:21
KathmanduNepal government's poor communication system has left many Nepalis confused about its vaccination campaign, the status of the country’s stock of the doses and its plan—if it is planning—to procure more jabs against Covid-19. Back in January, Nepal became one of the first countries to launch its vaccination drive against the virus, even as some western countries were struggling. The country was seeing a dramatic decline in the number of new cases. The KP Sharma Oli government acted triumphant, as if it had already won the fight against the pandemic. Complacency, coupled with negligence, missteps and poor governance, then led to a sharp rise in the cases. The country has been overwhelmed by the pandemic. Nepal’s health system is buckling under pressure. Hospitals are turning away patients because they lack beds and oxygen. Nepal’s plan to procure millions of doses of vaccines is currently in a state of limbo.

edit.

Part of the report from Peter Beaumont of 'The Guardian' published on 6th May '21:Nepal facing ‘human catastrophe’ similar to India’s amid Covid surgeCountry appeals for international help, with vaccines in short supply and a reported 47% positivity rate
"Nepal is struggling to contain an explosion in Covid-19 cases, as fears grow that the situation in the Himalayan country may be as bad, if not worse, than in neighbouring India, with which it shares a long and porous border.
Following warnings by health officials earlier this week that the country was on the brink of losing control of its outbreak, Nepal has appealed for urgent international help.
As the country reported its highest daily number of new infections – 9,070 – the prime minister, KP Sharma Oli, who has been criticised for his handling of the crisis, asked the army to help manage emergency facilities to take pressure off the health system.

With vaccines running short and hospitals overwhelmed, serious outbreaks have hit both the capital, Kathmandu, and the south-west and west of the country. The national positivity rate – the percentage of tests that come back positive – is being reported at a staggering 47%. Rates are even higher in some locations.
Earlier this week Oli appealed to the international community for vaccines as officials warned that those who had already received a first dose of the AstraZeneca jab were in urgent need of second shots.
The government’s haphazard vaccination campaign, with people queuing for hours in the capital, has been blamed for spreading the disease.
Amid new lockdowns and the cancellation of most international flights, travellers told of checkpoints in Kathmandu en route to the airport.

One of the worst-hit areas outside Kathmandu has been the city of Nepalgunj in the Banke district, close to the border with the Indian state of Uttar Pradesh, which experienced a sudden influx of thousands of returning Nepali migrant workers from India ahead of the closure of the border between the two countries.
“We need to act now and we need to act fast to have any hope of containing this human catastrophe,” said Alexander Matheou, the Asia Pacific director for the Federation of Red Cross and Red Crescent Societies.
Netra Prasad Timsina, the chair of the Nepal Red Cross, said: “What is happening in India right now is a horrifying preview of Nepal’s future if we cannot contain this latest Covid surge that is claiming more lives by the minute.”

Last year The Nestling Trust High Hopes Team reached the virtual height of Everest by climbing up local hills - this year we aim to walk or cycle the distance between Tower Bridge in London to the Swayambhunath Stupa in Kathmandu. We hope to raise funds to provide medical care at this time of desperate need for families living in areas of Nepal where no medical facility exists. ​

Nepal sharing a border with India has seen a huge surge in Covid-19 cases reported in the Kathmandu Valley. The Nepal Government has announced prohibitory measures to restrict movement across the country from Thursday, in a bid to curb the rampant spread of the virus. However, it has been reported in the Kathmandu Post and Himalayan Times that today crowds are fleeing from the capital, back to their villages. The increasing risk of widespread infection is grave, and especially so in remote villages without even basic healthcare.
The Nestling Trust has established 5 Health Clinics in the remote villages of the Dolakha region thanks to the donations from our generous supporters - please help us to do more at this time of crisis. 

(Photo curtesy of United Nations)

Nepal has received a delivery of COVID-19 vaccine under COVAX facility. It is an international initiative coordinated by the World Health Organisation and partners.

The following article was published in the Himalayan Times on March 07, 2021.
'Nepal is getting a total of 13,000,000 doses of AstraZeneca/ Oxford vaccine produced by the Serum Institute of India under the COVAX facility. From among the total doses of the vaccine the country is getting 348,000 doses of vaccine tomorrow. "We will receive the first batch of the vaccine under the COVAX facility tomorrow," said Minister of Health and Population Hridayesh Tripathi at an interaction in the capital today.
 The vaccine received under the facility will be administered to people above 55 years of age. The government is launching its vaccination campaign in the community level from tomorrow by vaccinating people above the age of 65 years. After 10 days those aged between 55 and 64 will get the vaccine.
The government has aimed to inoculate 72 per cent of the total population in the vaccination campaign.
The country had launched its COVID-19 vaccination drive from January 27 and has vaccinated 429,705 persons with the first dose of the vaccine, which is 1.4 per cent of the total population.'


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The Children’s Home Horticultural Project
‘Grow our own’ nutritious food, self-sufficiency, and sustainability
 
In a year when we have been unable to hold our normal fundraising events this 'Match Funded' Big Give Christmas Campaign  provides a great opportunity.
 
Please help us reach our £10,000 target
One donation Twice the Impact! 
 
The project will improve the sustainability of our Children’s home in Sarangkot by providing organic fresh fruit and vegetables for the Home and local villagers, as well as generating an income to offset other expenditure such as clothes, education etc. Land at the home is exposed to adverse weather and as a consequence crops in the garden often fail. Water supplies are scarce and unreliable. Fruit and vegetables have to be bought at considerable cost and at some distance.
 
The project involves building protected ‘pit greenhouses’ which will provide fresh produce for the home and local villagers but also training opportunities and work for those who have lost their jobs as a consequence of the pandemic.

Proposed site for the 3 Pit Greenhouses - below the playground area of the Children's Home.

Children's Home livestock would provide organic fertiliser!

Bijendra Aryal, Nestling Trust director in Nepal has been to visit Bikram Bhadel, a pharmacist whose workplace is opposite the Tribhuvan University Teaching Hospital in Kathmandu. The visit was the result of the Nestling Trust seeing the following article:
(https://apnews.com/c1cd52ef723a5435aef7dd339a99af23?fbclid=IwAR0Gxd19tIvWBVWXC1aq6qQT7EfSJmWToDNIy52bVDjzewfB6dTb9E_Ii28)
The following was reported:
 KATHMANDU, Nepal (AP) — From his pharmacy outside Tribhuvan University Teaching Hospital, Bikram Bhadel saw what happened when coronavirus lockdowns closed the facility’s cafeteria and nearby cafes.
“Every day I watched the patients, their families, doctors and other health workers struggling to get a good meal,” Bhadel said. “They were already having a tough time and the food situation was making it worse. This is where I decided that I need to step in and help out.”
He took 1 million rupees ($8,333) out of his family’s savings. And with the help of his friend Indra Kumar Newar -- a taxi driver who had no work in recent months due to the lockdowns -- he rented a vacant restaurant across the street from the hospital, bought groceries and hired a few helpers.
Now, at one of Nepal’s largest hospitals, more than 200 COVID-19 patients, doctors, nurses and workers get hot, tasty and nutritious food three times a day.
“I have heard there is no medicine for the COVID-19 patients and the only thing to do is to take care of them and give them health food to help recover and regain their immunity. This is what we are trying to do to help,” Bhadel said.
The meals are vegetarian, prepared after consulting with nutritionists. They offer a combination of rice, lentil, beans, vegetables, fruit and salad for brunch and dinner, and snacks in afternoon.
They begin their day early in the morning. preparing hundreds of meals. Food is packed in disposable packets and carried by Bhadel and Newar to the hospital reception area, where the staff eagerly awaits.
“The doctors and health workers have been working risking their own lives and away from their families. It was time to do something for them when they need them,” Newar said.
Staffers work and stay at the hospital for a week on duty and then another week in quarantine before they are allowed to return home for a week off work. While they are at the hospital, their only access to hot meals has been what the team delivers.
Nepal -- which has 49,219 confirmed cases of the coronavirus and 312 deaths -- first imposed a lockdown in March, which lasted for four months. A second lockdown was set last month in nearly half the country when the numbers kept rising.
Bhadel and Newar estimate they spend about 50,000 rupees ($416) a day for groceries. They have hired 11 cooks and helpers, all of them paid minimum wage and are regularly tested for the virus.
Families, friends and neighbours have donated food, money and supplies. Bhadel and Newar have paid the rent for three months.
“We are hopeful the situation will get better in three months,” Bhadel said, “but if that does not happen, we will continue our work.”

KATHMANDU:  The Health Ministry has reported 1,325 new cases of coronavirus infection in the last 24 hours taking the national tally to 64,122.

Today’s reported infections in the Kathmandu valley is 59.05 per cent of the country’s total cases.
11 more Covid-19 fatalities were recorded on Saturday bringing the total nationwide death toll to 427. Despite the escalating figures the government released the lockdown in Nepal on Thursday. Thousands have already lost jobs and livelihoods due to the lockdown which has been in place since March.
It has been reported in the Himalayan Times that 400 Nepalese people per day are risking the high prevalence of Coronavirus in India (cases now estimated as 90,000), and are returning in order to find jobs.

The Himalayan times reported today that the total number of people infected with coronavirus has increased to 50,465. 1246 new infections were reported in the last 24 hours.
The death toll now stands at 317.
The lockdown is beginning to be eased albeit with restrictions.

The Health Ministry on Wednesday reported 1120 new cases of coronavirus infection from across the country. Nepal’s Covid-19 tally now stands at 41,649 with 251 deaths. Lockdown has now been extended until at least 9th September '20, causing extreme hardship for families who now have no work. Schools remain closed and children from the poorer backgrounds are unable to access distance online learning.

Those known to have Coronavirus has now reached 29,645 with numbers escalating daily especially in the Kathmandu valley. This has led the government to announce a week long prohibitory order enforced in Kathmandu valley effective from Wednesday 19th August at midnight.
The Himalayan Times reports that the prohibitory order has been issued to 'discourage unwarranted movement of people in order to control the increasing spread of coronavirus infection in Kathmandu, Lalitpur and Bhaktapur....'

 I am Dr. Arun Upreti.
​ I am currently working as a Staff Physician in Charikot Hospital from Nyaya Health Nepal. Previously I worked as a medical officer for Government of Nepal in the same institute for 2 years. Charikot Hospital is operated in by Nepal Government in Partnership with Nyaya Health Nepal. Charikot Hospital is the largest health care provider in the district and provides health care services to over 50,000 annually. 

COVID has been a unique challenge for Nepalese health care system. The rural health care system which is run mostly by paramedics, nurses and fresh MBBS graduates is particularly vulnerable due to lack of adequately trained human resource, unavailability of COVID tests, under funded quarantine and isolation centers.

Nepal government’s policies and guidelines are not replicated at the local level. I have now been working here for 2 months during the COVID pandemic - the only protection that I use is a N95 mask and gloves. The fever clinic is almost non functional. We feared working like that initially but now it has become a norm. There is a little difference between us practicing medicine pre and post COVID.

Other public health measures like point of entry testing, community screening, contact tracing and surveillance do not meet the standards recommended in national protocols. Most teams are formed with inadequately trained staffs without proper IT and communication facilities.

However there has been vast community engagement, thanks largely to the lockdowns which has completely changed the lives of everyone. Agencies and health care workers across all level are engaged in health education about COVID. Use of masks and hand washing has been prompted at all levels through available health facilities and FCHVs.

While lockdowns have been important in curbing the spread of COVID, it has brought several impediments to health seeking behaviour of people. Due to unavailability of transportation facilities the number of patients in our OPDs has halved. The obstetric cases have been on the rise probably due to lack of services in other centers and people not having access to higher centers. As many complicated obstetric cases cannot go to higher centers in Kathmandu, our CS rate has also been on the rise. We have also seen too many cases of ruptured appendix, strangulated hernia all probably due to lack of elective procedures.

Mental health is an aspect that has been overlooked. We have seen a significant rise in suicides in the district. We have been performing autopsies almost everyday, and the average autopsies for suicides has almost doubled in the last few months.

The elderly and single women have also been significantly affected by the lockdowns. Many of them cannot get the health care they need. We had one elderly women who presented to our center with fractured femur, which needed operative management. None of her family members were willing to take her to higher center for treatment. We get similar stories almost everyday. Some day its a fracture needing operative management, other days it COPD requiring ICU admissions. Most have given up on treatment for the elderly because of lack of transport and risk of COVID infection.

I strongly believe these are the areas that needs significant work and should be important part of the COVID response. I believe we need community based programs that are related to mental health. Also assistance to elderly, single women and pregnant mothers especially for transportation would be particularly helpful in the lockdown. 

​The Nestling Trust is running a campaign to Hike the Height of Everest (Virtually) The Team High Hopes has members in the Wiltshire and New Zealand. It is a huge effort with the aim of saving lives in the vulnerable communities of Nepal.
​Coronavirus is escalating in Nepal. It is reported that at least 83,020 Nepali migrant workers have returned from India alone, with at least 400 still entering Nepal daily. India is fourth in the table of the worst Coronavirus hit countries with figures still soaring. Thousands more are returning from the Gulf countries and China.
Nepal's frail health system is struggling with inadequate testing and with thousands heading for the remotes villages, the situation is of huge concern. The Nestling Trust with SITARA their partner NGO, has already provided vital medical equipment, PPE, disinfectant and soap for the Health Posts it has established, but much more is needed to support their work, to quarantine those newly arriving and to ensure needy families have food and soap at this time of crisis.