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On Tuesday, Nepal recorded 1,069 new infections, taking the national tally of Covid cases to 40,529. Kathmandu Valley recorded 481 new cases, the highest in a single day so far. Of them, 393 cases were in Kathmandu District, 58 in Lalitpur, and 30 in Bhaktapur, according to the Ministry of Health and Population (MoHP).

Kathmandu Valley was the country’s least affected area until the government lifted the lockdown on July 21. Currently, the Valley alone accounts for 45 percent of the nation’s new Covid cases. In response, the local authorities on August 17 imposed prohibitory orders for the Valley’s districts. However, they have seen no decline in new Covid case numbers. 

There are many indicators proving that the Valley is now at the community-level infection stage, said Public Health Specialist Dr Suresh Tiwari. For instance, the number of infected women has seen an almost fivefold increase. Last month, the infection rate for women used to hover around the 5 percent mark, but it has reached 23 percent this month. Similarly, the infection rate for the elderly has increased from 1 percent to 5 percent now. 

Experts say other parts of the country too are seeing community-level spread of the virus. On August 26, for example, it was reported that Nepal’s first death of a health worker (a 35-year-old health assistant in Manara Shiswa Municipality-4 of Mahottari District) had occurred on Monday.

“Initially, the corona cases were detected among people coming into the country,” said Dr Tiwari during a virtual MoHP press briefing. “Now, almost 96 percent of new cases in Kathmandu District are being detected among its locals. We’re seeing this not just in Kathmandu. It’s true for all of Nepal’s districts that have above 500 cases.”

The districts with more than 500 cases are Morang, Sunsari, Dhanusha, Parsa, Bara, Mahottari, Rautahat, Sarlahi, Kathmandu, Lalitpur, Chitwan, and Rupandehi. 

According to Dr Tiwari, the death rate has also started spiking among the elderly demographic. On Tuesday alone, five of the 11 Covid death cases reported were above 60 years old; one of them was 80. 

Further, there has been a rise in the number of positive cases per total tests conducted. Positive cases used to hover around 6 percent per tests conducted per day, but this has increased to around 9 percent now. 

The latest daily figures show that over the last 24-hour period, Nepal conducted 12,088 tests. Among them 1,069 tested positive, a positivity rate of 8.8 percent. The total positivity ratio for the day before was 8 percent (899 positive cases out of 11,129 tests), while two days ago, the ratio was 9.6 percent (1,221 positive cases out of 12,717 tests)

And 12 districts have turned into hotspots in the past month. These districts account for 73 percent of the country’s total Covid cases. Dr Tiwari argued that containment measures should be focused on these districts. “Since there is no medicine to kill the virus, the public can play an important role in containing the disease, in addition to the government measures,” he said. “The best medicine is using a mask, and society’s role is crucial in fighting the virus.”

Given the country’s dismal health system, shortage of health workers, and lack of drug availability, lockdowns are advisable in districts where the infection numbers have crossed the 200 mark. That said, the districts with the least or even no cases should still follow the mandated health protocols when opening up. 

Protocols such as lockdowns and curfews are imposed to slow the spread of the virus. They temporarily help  slow down virus transmission. But according to Public Health Specialist Dr Rabindra Pandey, lockdowns are also clamped to allow the government to make other preparations–which the government should have started doing long ago. This is the time for conducting tests, arranging for hospital beds, oxygen plants, and ventilators, and setting up isolation centres.

Dr Pandey said that there is no point in merely worrying that many places in Nepal have reached the community-level stage of virus spread, as the virus has now spread at the psych-social level among the public. People are, for instance, suffering from depression brought on by the pandemic’s impacts. 

“The virus has shattered our social fabric, among other impacts. People don’t welcome even health workers in neighbourhoods and villages,” he said.