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The Kathmandu Valley recorded a total of 377 new Covid cases on Thursday, the highest in a single day. Of this, Kathmandu district alone recorded 270 new cases, 59 more than the combined number of Covid cases in Province 2’s eight districts which are the most affected districts in the country.

On Wednesday, the valley had recorded its highest daily numbers, with 301 new cases, of which 230 were in Kathmandu district. The sudden spike in the number of cases in the valley is an indication that Kathmandu is becoming a hotbed of coronavirus, according to public health experts.

“Kathmandu is becoming a hotbed of coronavirus, but the government is still in denial. It still hasn’t accepted the fact that the virus has spread at the community level, which is a worrying scenario for us all,” said epidemiologist Dr Lhamo Sherpa.

Apart from frontliners, doctors who haven’t had any contact with Covid patients are also testing positive in the capital. A dozen medical doctors have so far tested positive in Kathmandu. Across the nation, 454 health workers have been infected, including 142 medical doctors and 94 nurses.

“We don’t feel safe. This is not even the peak. We can expect an even higher number of cases in the days to come,” a government hospital doctor who did not wish to be identified told The Record. “If we can’t convince private hospitals to take in Covid patients, we must expect a rise in deaths too.”

According to the Ministry of Health and Population (MoHP), the total number of Covid-19 cases in the valley has reached 4,397. Given the lack of contact tracing as well as proper quarantine and isolation facilities in the capital, the virus could explode in the days to come.

The ratio of tests to positive results gives another indication that cases will continue to rise in the near future. On Thursday, the government conducted 12,629 reverse transcription polymerase chain reaction (RT-PCR) tests and found that 1,111 had shown positive results. This amounts to almost nine percent of the total tests. Prior to this, the average positive results in recent days have been around seven percent of total tests. 

Ever since the four month long lockdown was lifted on July 22, Covid cases have been rising constantly. Parsa district in Province 2 imposed another lockdown a week after the first lockdown was lifted. Many districts followed suit. District authorities in the valley decided to impose a prohibitory order on August 18, less than a month after the first set of restrictions were eased. But by then, Kathmandu had already seen a huge influx of people from outside the valley.

Even with the wealthiest and well-resourced metropolitan cities, the Kathmandu Valley has no quarantine or isolation centres. A week has passed since the prohibitory order was imposed, but authorities have not done anything to set up new facilities. The sole focus of the government has been on testing, which is not enough to contain the spread of the virus.

The mayor of Lalitpur Metropolitan, Chiri Babu Maharjan, said that not much has been achieved so far. Lalitpur has identified three isolation centres, including the ANFA building in Satdobato, the Nepal Youth Foundation premises in Sunakothi, and Jyapu Society’s Elderly Home in Bagdol.

“The problem is becoming more serious. I just received a message saying that 15 people from Patan have tested positive for coronavirus,” said Maharjan. “If you go through the number of cases, it’s really scary.”

As Covid cases have continued to spike in the densely populated cities of Nepal, Dr Jos Vandelaer, the World Health Organization’s representative for Nepal, held a meeting with Prime Minister KP Sharma Oli to discuss the strategies for tackling the crisis. According to sources, the government was advised during the meeting to increase the number of isolation beds and stay prepared to face a worsening situation in the days to come.

Given the infectious nature of Covid-19, one infected person can infect several other people by the time the swab is collected and the results are confirmed. On August 23, the government announced that it would start tracing the people that Covid patients had come in contact with. The MoHP instructed District Public Health Offices to initiate the intervention. However, contact tracing has not been implemented in an effective manner, although some districts reported that they have set up a team — each comprising a district health officer, nurse, and lab technician — to trace contacts. Kathmandu, in particular, has not been able to initiate this process in the last one week.

With Thursday’s cases, the country’s total tally has reached 35,520, while an additional eight deaths have taken the death toll to 183. The current Covid death rate in the country is at 0.52 percent.

According to the MoHP, there are 9,488 people in quarantine, 9,063 in institutional isolation, and 6,210 in home isolation.