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|2020 coronavirus pandemic in Nepal|
Map of the outbreak in Nepal (as of 29 March)
Confirmed cases reported
|First outbreak||Wuhan, Hubei, China|
|Index case||Kathmandu District|
|Arrival date||5 January 2020|
(2 months and 3 days)
|Kathmandu, Kailali, Baglung|
|Health Emergency Operation Centre (HEOC)|
The global COVID-19 coronavirus pandemic was confirmed to have spread to Nepal when its first case was confirmed in Kathmandu on 24 January 2020. The patient only showed mild symptoms and had been discharged a week earlier with instructions to self-quarantine at home; he was subsequently confirmed to have completely recovered. Between January and March, Nepal took steps to prevent a widespread outbreak of the disease, while preparing for it by procuring essential supplies, equipment and medicine, upgrading health infrastructure, training medical personnel, and spreading public awareness. The second case was confirmed on 23 March 2020. As of 29 March 2020[update], three additional cases have been confirmed, including one each in Kailali and Baglung districts. All five confirmed cases have been in people who had recently returned from abroad. The four patients under treatment are reported to be in "normal" condition. A country-wide lockdown came into effect on 24 March, and is scheduled to end on 8 April.
Nepal established health-desks at the international airport as well as on border checkpoints with India, starting in mid-January. Land borders with India as well as China were later completely sealed off, and all international flights suspended. All academic examinations were cancelled, and schools and colleges were closed. Quarantine centres and temporary hospitals are being setup across the country. Laboratory facilities are being upgraded and expanded. Hospitals have been setting up ICU units and isolation beds. The SAARC countries have pledged to cooperate in controlling the disease in the region. India, the United States and Germany have increased their support to Nepali health sector.
Nepal cancelled its international promotional activities related to Visit Nepal Year 2020. Its economy is expected to be severely affected by the pandemic due its impact on foreign employment, tourism, manufacturing, construction and trade.
The ongoing pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak was first identified in Wuhan, Hubei, China, in December 2019 and recognised as a pandemic by the World Health Organization (WHO) on 11 March 2020. As of 29 March 2020[update], more than 708,000 cases of COVID-19 have been reported in over 190 countries and territories, resulting in approximately 33,500 deaths. More than 150,000 people have since recovered.
The virus primarily spreads between people in a way similar to influenza, via respiratory droplets from coughing or sneezing. The time between exposure and symptom onset is typically five days, but may range from two to fourteen days. Symptoms are most often fever, dry cough, and shortness of breath. Complications may include pneumonia and acute respiratory distress syndrome. There is no vaccine or specific antiviral treatment, but research is ongoing. Efforts are aimed at managing symptoms and supportive therapy. Recommended preventive measures include handwashing, covering the mouth when coughing, maintaining distance from other people (particularly those who are unwell), and monitoring and self-isolation for fourteen days for people who suspect they are infected.
Nepal is a landlocked country with China in the northern side and India in the east, west and south. Nepal shares a 1,414 kilometres (879 mi) border with China's autonomous region of Tibet, in the Himalayas. China is Nepal's second-largest trading partner. Nepal has an 1,800-km open border with India in the east, west and south. Nepal lies in South Asia, one of the least developed and most densely populated world regions, that performs poorly in education as well as health care and sanitation metrics, and is therefore considered one of the highest risk areas for the pandemic, and also one of the least prepared.
According to The Kathmandu Post, before the pandemic, hospitals in Nepal had few ICU beds (just three in Teku Hospital) which were almost always occupied, with people in critical condition usually having to wait for the beds to become empty. It reported doctors as saying that it would be next to impossible to admit new patients to ICU as soon as they need them. Teku Hospital, the only one designated for handling infectious disease, had built an isolation ward during the avian influenza outbreak a decade ago, but had never brought it into use, as it did not have experts to evaluate or maintain the required standards.
As news of a new infectious disease in China broke, concerns were raised in Nepal over the high potential risk, the need to implement preventive measures and a severe lack of necessary medical equipment and infrastructure. According to Baburam Marasini, former director of Epidemiology and Disease Control Division, Nepal does not have any double cab ambulances to transport highly infectious patients safely, isolation wards in hospitals, or biosafety level-3 or better laboratories needed to test for highly infectious diseases.
As of 29 March 2020, Nepal has confirmed five cases of COVID-19 disease, all of them in persons who had recently returned from abroad. The first case was confirmed on 24 January in a 32-year-old man who had recently returned from China. The patient had shown mild symptoms, and was completely cured by the end of January. The second case was confirmed on 23 March in a 19-year-old woman who had recently returned from France via Qatar. She is being treated in Teku hospital, Kathmandu. Her family has been put in quarantine at home. The third case was confirmed on 25 March, in a person who had recently returned from the United Arab Emirates. The fourth case, the first outside Kathmandu, was confirmed on 27 March, in a 34-year-old man who had recently returned from the Middle East. He is being treated in Seti Provincial Hospital in Dhangadhi. The fifth case was confirmed in Baglung on 28 March, in a 19-year-old woman who had returned from Belgium via Qatar. She had shared a flight from Doha to Kathmandu with the patient who was confirmed on 23 March. All four patients undergoing treatment are reported to be in "normal" condition.
Sukraraj Tropical and Infectious Disease Hospital is the designated primary hospital for the treatment of COVID-19. A temporary hospital, named Bharatpur Corona Special Hospital, has been established in Chitwan District. Nepal Public Health Laboratory in Kathmandu was the only laboratory capable of testing for the disease as of 15 March 2020[update]; it was capable of conducting 500 tests a week and had a stock of 1,000 viral transport media (VTM) kits for transporting samples to be tested. It had conducted a total of 917 tests as of 29 March 2020[update].[a]
|United Arab Emirates||2||0|
A Nepali student who had recently reached Tasmania via Singapore tested positive for COVID-19 on 8 March. On 9 March, the UAE's Health Ministry confirmed that two Nepalis in the country had tested positive for the virus. On 16 March, it was reported that seventy four Nepali migrant workers were put into 14-day quarantine in Faro City, Portugal, after one of them tested positive. Later, it was reported that only three of the quarantined were Nepalis. Three Nepalis tested positive in Bahrain, two of them on 21 March and one on 22 March; three more were put into 14-day quarantine.
A 66-year-old former British Gurkha soldier of Nepali origin died from COVID-19 in the United Kingdom on 17 March. A 50-year-old man of Nepali origin died of the disease in the United States on 24 March.
A 31-year-old student of Wuhan University who had returned home on 5 January, was admitted with mild symptoms on 13 January and discharged on 17 January with instructions to self-quarantine at home after preliminary tests showed he may not be infected. Although Nepal had the laboratories and the skilled manpower to test for the disease, Nepal did not have the reagents required. The reagents cost around Rs 17,000 per test and need to be bought in bulk, sufficient for about 200 tests. As there were no other suspected cases needing testing, the officials decided to send the samples to Hong Kong instead of buying the reagents. The samples were sent to Hong Kong on 21 January. On 24 January, the Health ministry confirmed that the test had come back positive. The ministry said the patient was under surveillance, those who came into close contact with him were being investigated, and health information on all passengers returning from China was being sought. However, The Kathmandu Post quoted officials at the Epidemiology and Disease Control Division as saying that no one knew of the patient's activity since he was discharged and that they were looking for him. Later, they said that they had only spoken to the patient on phone; he had reported being in good health and was not asked to come in for check-up or monitoring. The patient was confirmed completely treated when RT-PCR throat swabs returned negative for COVID-19 in followup assessments of 29 and 31 January. None of the people known to have come in contact with the patient showed any symptoms after three weeks of the patient's return to Nepal, and it was therefore presumed that he had not transmitted the disease to anyone else in Nepal.
On 17 January, urged by the WHO, Nepal began screening passengers arriving in Tribhuvan International Airport from China, Thailand and Japan, the three countries with multiple confirmed cases. Eight persons manned the health desk. The airport did not have infrared scanners and was therefore using thermal scanners as preparations were being made to install the infrared ones. The passengers who showed fever were being asked to remain in contact and contact the hospitals if they showed additional symptoms.
On 23 January, Dr. Bashudev Pandey, director of Teku Hospital, was quoted as saying that the hospital was on high alert, while three other hospitals – Nepal Police Hospital, Patan Hospital and Tribhuvan University Teaching Hospital – would also treat the disease. Six beds in Teku Hospital had been allocated for isolation of suspected patients.
On 25 January, a day after the first case was confirmed, the Health Ministry informed that two other suspected patients were in isolation at Teku Hospital. The hospital discharged them in the morning of 27 January without waiting for test results even though the results were due later that same day, raising concerns over its handling of the crisis. The tests which confirmed a negative result for both patients were conducted at the bio-safety level-2 labs of the National Public Health Laboratory, the first such tests to be performed in Nepal. Reagents sufficient for 100 tests were borrowed from the Centre for Molecular Dynamics and test kits were provided by the World Health Organisation. A woman was in isolation awaiting test results as of 27 January.
On 28 January, Nepal closed down the Rasuwagadhi border with China, bringing Nepal-China trade to a complete halt. Bordering districts of India were reported to be in high alert, and medical personnel had been deployed to various entry points along the Indo-Nepal border.
By the first week of February, Nepal reported a shortage of face masks, as people hurried to buy them following reports of the first confirmed case. Districts bordering India began setting up health desks at border crossings. The Epidemiology and Disease Control Division reported that it had devised its own treatment protocol based on the one developed by UN Health Agency and directed all private hospitals to strictly follow the guidelines in handling any suspected new cases. By 1 February, Teku Hospital had handled five suspected cases all of whom tested negative. On 4 February, the Minister for Health informed that three hospitals had been made capable of testing for the virus, and 43 beds had been made available for patients of the possible outbreak. He also informed that health desks had been setup in Pokhara, Chitwan and Bhairahawa. On 5 February, Nepal donated 100,000 protective masks to China as a gesture of friendship.
A village in Sindhupalchok District reported hundreds of cases with fever, cough and difficulty breathing, starting on 10 February. On 12 February, the district ruled out the possibility that it could be COVID-19 based on travel history of people in the village. Laboratory testing later confirmed that the outbreak was influenza but not COVID-19.
As of 13 February, Nepal had conducted tests on 19 suspected patients. A Saudi Arabian national who only spoke Arabic and appeared to object to being kept in the hospital, fled from isolation, and could not be located. The health ministry said it would start using police to guard suspected patients at the hospital.
On 14 February, the government was reported to have devised contingency plans to tackle the virus. Under Plan A, the government was preparing to evacuate Nepali citizens stranded in Hubei and keep them in isolation in Bhaktapur. Plan B included educating the people and distributing protective kits. The details of Plan C which would be implemented in case the disease actually spread and started killing people were not shared.
Nepal evacuated 175, mostly students, who had been stranded across Hubei, on 16 February 2020, using a Nepal Airlines chartered aeroplane and placed them in a 14-day quarantine at Kharipati in Bhaktapur. Six other Nepalis were prevented from leaving by the Chinese government, while four of the applicants who had requested rescue later changed their minds. Although 180 Nepalis had applied for immediate evacuation from China by 2 February; the effort took almost two weeks, as the government struggled to meet WHO's evacuation standards, and find a suitable venue for quarantine. The government was criticised for its slow response; a Public interest litigation was filed at the Supreme Court demanding immediate action, while the locals around the designated quarantine site in Bhaktapur protested the government's decision which the viewed as endangering to the local community. On 19 February, the Health Ministry reported that all of the evacuees had tested negative.
On 18 February, the Chinese Embassy in Nepal criticised The Kathmandu Post for republishing a Korea Herald piece critical of China's handling of the pandemic, accusing editor-in-chief Anup Kaphle of anti-China bias. In response, 17 editors from Nepalese mainstream press released a joint statement expressing concern about the singling out of the editor, and reminding the Chinese Embassy of diplomatic norms and constitutionally guaranteed freedom of the Press in Nepal; The Kathmandu Post published an editorial criticising the Embassy's actions. The Chinese embassy's actions were seen as uncharacteristic and surprising as China is known for non-interference in Nepal's internal matters.
By the end of February, the health desk at Tribhuvan International Airport was screening passengers from China, South Korea, Thailand, Singapore, Malaysia, Japan and Saudi Arabia, but did not have sufficient manpower and equipment to screen all new arrivals. A total of six infrared scanners had been setup; the only thermal scanner had yet to be repaired, but plans were underway to purchase three more. Passengers were not being asked to fill locator forms that would make it possible to track them down later. It was also reported that the government was seeking help from the UN having failed to procure masks and protective gear due to global shortages. On 29 February, the government formed a high level committee to prevent and control the spread of COVID-19 under the leadership of Deputy Prime Minister Ishwor Pokhrel. The government also decided to suspend promotional activities for Visit Nepal 2020. Nepal suspended labour migration to South Korea. India started screening passengers from Nepal and making masks compulsory for all visiting Nepalis. It was also screening Nepalis travelling into India by land, at various checkpoints at the border.
1 March: Nepal announced suspension of visa-on-arrival service for nationals of five countries badly affected by COVID-19 – China, South Korea, Japan,Italy and Iran – to be enforced from 7 to 30 March.[b] It also urged the general public to avoid large gatherings. The passengers and crew involved in the evacuation of Nepalis from Hubei were released from quarantine after all tests again came back negative following a two-week quarantine.
2 March: The Supreme Court issued an interim order to suspend flights to and from countries affected by the disease, in response to a public interest litigation. The government issued a travel advisory against non-essential travel to countries hardest hit by the disease, including China, Iran, South Korea, Japan and Italy. The visitors coming from or via these countries would be required to submit a health certificate. Health checkpoints were to be established at all major entry points from India and third country citizens would be allowed to cross from select border check-points only. The Sagarmatha Sambad programme scheduled for April was also postponed.
4–5 March: Due to a severe shortage of face-masks and protective gear as well as increase in price following a ban on export in China and India, some hospitals were reported to be sewing plain clothes masks as a precaution. A shortage of hand sanitisers was also reported. Everest Premier League, the domestic T20 cricket tournament was postponed indefinitely.
8 March: Qatar imposed a temporary ban on arrivals from Nepal and other countries, affecting almost 40,000 labour migrants with valid work permits who were yet to leave. Nepal Airlines and Himalaya Airlines suspended their flights to Doha indefinitely following the ban.
9 March: The government expanded the suspension of visa-on-arrival service to include three additional countries — France, Germany and Spain.
10 March: Seventy one Chinese workers employed in the construction of Pokhara Airport who had returned from China after undergoing a 14-day quarantine were put into quarantine for another 14 days. They were being closely monitored and everyone was reported to be in normal health. Previously, 36 Chinese workers working for the project had also gone through a similar quarantine upon return to work.
12–15 March: Nepal decided to suspend on-arrival tourist visa for all countries, with an exception to diplomatic and official visas, to last from 14 March till 30 April. The government closed land border entry points for third country nationals, and cancelled all mountain climbing expeditions including on Mount Everest, to be enforced from 14 March to 30 April. It also declared two-week mandatory self- and home-quarantines for everyone visiting Nepal. Labour permits for all countries were suspended indefinitely, including to workers who were only back home on holiday. The government also suspended issuance of no objection letters to students going for abroad study until 30 April. The Province No. 1 government unveiled plans for two quarantine sites in the province, including one on a Koshi River island. It also assured plans were underway to provide additional equipment to health personnel, to set up health desks on border-crossings with India, to keep ambulances in standby and to maintain isolation wards in three major hospitals – BP Koirala Institute Of Health Science in Dharan, Koshi Hospital in Biratnagar and Mechi Hospital in Jhapa. BP Koirala Institute of Health sciences in Dharan reported that a suspected patient had refused to remain in hospital and returned home. He had promised to return the following day for testing. The same day, Bihar transport department suspended Patna-Nepal bus services with immediate effect, to be enforced until 31 March, in an effort to contain the virus, after many cases emerged throughout India. India declared a suspension of all passenger movement through Indo-Nepal border, except a few designated checkpoints – Banbasa, Raxaul, Ranigunj and Sunauli – with intensified health inspections, effective from 15 March. The land-border checkpoints with China began releasing imported goods following quarantine procedures as cases in China began to drop. Indian Prime Minister Narendra Modi proposed starting the COVID-19 Emergency Fund for the SAARC region; he also said India could share a Disease Surveillance Software with SAARC partners, and hinted at the possibility of conducting coordinated research on controlling epidemic diseases in the SAARC region.
17 March: A meeting of the high-level coordination committee for prevention and control of COVID-19 decided to add 115 ICU and 1,000 isolation beds in the Kathmandu Valley. It also instructed the provincial governments to setup a total of 120 ICU beds.
18–19 March: The government declared suspension of all classes and postponement of all academic examinations including the Secondary Education Examination until 12 April, the end of the Month of Chaitra, the last month of Nepali calendar year when all schools hold the final examinations. Tribhuvan University and the Public Service Commission also postponed all their examinations. The government banned all passengers, including Nepalis, from EU and the UK, West Asia and the Middle East as well as Malaysia, South Korea and Japan, effective from 20 March until 15 April. It also decided to shut down all cinema halls, gymnasiums,museums and cultural centres, and ban gathering of more than 25 people in any public spaces including at places of worship. Nepal began to see a significant influx of people from India to Nepal as India saw increase in new cases throughout the country. A noticeable outflux of people from the Kathmandu Valley was reported. The House of Representatives meeting was postponed until 26 March. The Province No. 1 government established quarantine centres throughout the province with a total capacity of 440 beds.
20 March: The National Assembly was suspended indefinitely. The Health Ministry instructed public employees to report on weekends as well, and not leave the Kathmandu Valley. All weekly newspapers published from the Kathmandu Valley ceased their print editions. The US government pledged $1.8 million to Nepal. Prime Minister Oli addressed the nation for the first time since the start of the pandemic and announced a list of preventative measures. All international flights would be stopped from 22 March to 31 March and vehicular movement on long routes would be closed from 23 March. All government services and private offices except those providing essential services would be closed until 3 April. A notice from Nepal Tourism Board announced the suspension of issuance of trekking permits for tourists. The outflux of people from the Kathmandu Valley intensified; almost 300,000 people had left in the preceding three days. The Health Ministry decided to halt non-urgent health check-ups and surgeries until 12 April in hospitals in the Kathmandu Valley with 50 or more beds. A full bench meeting of the Supreme Court presided over by the Chief Justice decided to halt all non-urgent proceedings in courts across the country until 4 April. Nepal government pledged Rs 100 Million to the SAARC COVID-19 Emergency Fund.
21 March: Kathmandu city launched a central help desk and a toll-free 24-hour hotline. Germany pledged an additional one million Euros to its existing health programmes in Nepal to help combat the disease. Around sixty passengers from COVID-19 affected countries that landed on Tribhuvan Interantional Airport were sent to quarantine at Kharipati, Bhaktapur; they had not presented any symptoms. It was reported that Gandaki Province had set up 111 isolation beds. The Metropolitan Traffic Police Division suspended breathalyser tests as well as educational classes for drivers found breaking traffic rules. It also deployed 200 of its personnel to display placards with awareness messages about the disease by the roadside. Nepal Police established coronavirus response units in all its stations and decided not to make arrests for minor offences. The Health Ministry informed that private hospitals with more than 100 beds would not be allowed to refer patients to other hospitals; they were required to treat suspected patients, wait for test results and provide free treatment if the disease were confirmed.
22 March: Nepal decided to close its land border with India and China for a week effective from 23 March. The government also declared a Rs 500 million fund with contributions of a month's salary from government ministers. It also increased the allowances for health workers working at the front desks of hospitals by 50–100%. Kanchanpur and Banke Districts declared lockdowns.
23 March: COVID-19 was confirmed in a 19-year-old woman who had returned from France on 17 March via Qatar, the first case in two months, second overall. She was admitted into isolation at Teku Hospital. Her family is said to be in quarantine at home. The Office of the attorney General was reported to have asked the Police to release people held for minor crimes under bail or parole to reduce crowding. The Minister of Health declared that all patients of COVID-19 would be rescued as necessary and provided free treatment. Kailali District was reported to have declared an indefinite lock-down effective from 2 pm. Arghakhanchi District also declared an indefinite lock-down.
24 March: The country-wide lockdown came into effect.
25 March: The third case in Kathmandu was confirmed. The patient had recently returned from the United Arab Emirates and was staying in a hotel in Kathmandu. They are being treated in Teku Hospital.
26 March: Rescue of tourists stranded throughout Nepal was initiated. By 28 March, hundreds of tourists had been rescued and brought to Kathmandu; many were being repatriated via chartered flights.
27 March: Fourth case nationally, the first outside Kathmandu, was confirmed. It involved a 34-year-old man who had recently returned from the United Arab Emirates. He is being treated at Seti Provincial Hospital in Dhangadhi.
28 March: A 19-year-old woman who had recently travelled to Kathmandu from Belgium via Doha tested positive, bringing the total to five in the country. She had shared a flight from Doha with the patient who was confirmed on 23 March. She had since travelled to her home in Baglung; she was admitted for treatment at Dhaulagiri Zonal Hospital after the test came back positive.
29 March: The government decided to extend the suspension of international flights to until 15 April. The country-wide lockdown was extended to until 8 April.
The tourism sector has been reported to be suffering due to the absence of Chinese tourists, as well as the various travel restrictions imposed on travel globally. Manufacturing sector is experiencing a shortage of raw materials, most of which used to come from China. The situation is exacerbated by spread of the pandemic to the Middle-east which is the main source of remittance that makes up more than half of Nepal's GDP. Remittances were expected to sharply drop after Nepal suspended issuance of workers permit to Nepalis for all countries. The wholesale and retail sector has also been affected due to fall of imports from China. The construction sector which imports most of its building materials from China has slowed down. As the Chinese contractors and workers who went home for the Chinese new year could not return, the public construction projects have also been affected. The domestic airlines were reported to be struggling for survival as ticket prices dropped to half or a third of normal following a sharp decline in demand. Number of international flights to and from Nepal had decreased by more than 50% by 13 March. Nepal's import-dependent economy is also vulnerable to depreciation of Indian currency to which its currency is permanently pegged, as Indian economy suffers the impact of the pandemic. 20,000 tour, trek and mountaineering guides lost their livelihood when mountaineering was suspended.
Nepal had declared 2020 as the Visit Nepal Year and aimed to bring in two million foreign tourists, almost double the figure from previous year. As the pandemic spread and Nepal had to suspend air travel to and from China, the biggest source of international tourists arriving by air, Nepal suspended its promotional campaigns.
The temporary blanket ban on animal markets imposed by China as a response to the pandemic is expected to curb wildlife poaching and trafficking through Nepal, as the Chinese traditional medicine which uses various body parts of endangered animals as its ingredients has been the biggest challenge to wildlife conservation in the region.
The department of Commerce, Supplies and Consumer Protection conducted raids on 161 firms and fined 57 of them, a total of around four million Rupees in the month of Falgun (February–March). It inspected multiple pharmacies and surgical shops in Kathmandu on 5 March and fined a total of Rs 430,000 for hiking prices and other offences. On 10 March, four pharmacies were fined a total of Rs 800,000 after they were caught charging 1000% of normal price for surgical masks. Some groceries and LPG stores were also inspected. One million units of face masks were confiscated from a warehouse in Kathmandu and the owner arrested on 18 March, bringing the total of masks confiscated in the week past to 2.3 million. Around 50,000 units of hand-sanitisers were also confiscated from the black market. Around two dozen black marketeers had been arrested. As the outflux of people from Kathmandu intensified, 23 transport entrepreneurs and workers were arrested on 20 March for overcharging the passengers.
Nepal's pharmaceutical industry has been impacted due to lack of raw materials as a number of essential ingredients were previously imported from Hubei. Nepal faced the prospect of a potential shortage of essential medicines when India imposed restrictions on export of 26 types of raw materials including of essential medicine citing disruption in the supply chain from Hubei; however India later agreed to relax restrictions in case of Nepal, and asked the Nepalese government to provide a list of names and quantities of essential medicines that it needed to supply to Nepal.
On 21 March a 20-year-old man was arrested on charges of spreading misinformation online through an unregistered fake news website and causing public fear, after audio tapes alleging cover-up of COVID-19 cases were found circulating online. The same day, Nepal Army dispelled rumours circulating in social media that claimed Army helicopters were being used to spray disinfectants over settlements at midnight.