COVID-19

COV I D- 19 - N EPA L
By A u t h o r N a m e

Nepal:
Nepal is a landlocked country with
China in the northern side and India
in the east, west and south. Nepal
shares a 1,414 kilometers (879 mi)
border with China's autonomous
region of Tibet, in the Himalayas.
China is Nepal's second-largest
trading partner. Nepal has an 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.
Overview
Coronavirus disease (COVID-19) is an infectious disease caused by a
newly discovered coronavirus. Most people infected with the COVID-19
virus will experience mild to moderate respiratory illness and recover
without requiring special treatment. Older people, and those with
underlying medical problems like cardiovascular disease, diabetes,
chronic respiratory disease, and cancer are more likely to develop serious
illness. The best way to prevent and slow dow n transmission is be well
informed about the COVID-19 virus, the disease it causes and how it
spreads. Protect yourself and others from infection by washing your hands
or using an alcohol based rub frequently and not touching your face.The
COVID-19 virus spreads primarily through droplets of saliva or discharge
from the nose w hen an infected person coughs or sneezes, so it ?s
important that you also practice respiratory etiquette (for example, by
coughing into a flexed elbow ). At this time, there are no specific vaccines
or treatments for COVID-19. However, there are many ongoing clinical trials
evaluating potential treatments. W HO will continue to provide updated
information as soon as clinical findings become available.
02 | TDO NEPAL

According to The Kat hm andu Post , hospitals in Nepal have few
ICU beds ( just three in Teku Hospital) w hich are 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 disease.
But No Need To Panic; We are here To fight
against COVID-19
For Fight COVID-19; The private sector is seen to be increasingly contributing in the
COVID-19 fund established by the government. As per the Office of the Prime Minister and
Councils of Ministers (OPMCM), Rs 150 million has been contributed in the fund from the
private sector
And We are here to answer all your question and
queries regarding CORONA Virus Disease -19.
Click here: NEPALFIGHTSCORONA
TDO NEPAL | 03

What is
COVID-19?
Helpline Det ails:
Communication Resources :-Dial
1115 to receive more information
on COVID-19, including information
on testing and medical services.
The hotline, by the Ministry of
Health and Population, is available
from 6AM - 10PM. Or dial
9851255838, 9851255837, or
9851255834. These three numbers
are available from 8AM - 8PM. Or
send WHO a WhatsApp text. Text
?hi? to +41 79 8931892.
Coronaviruses are a large
family of viruses that are
common in many different
species of animals, including
camels, cattle, cats, and bats.
On 12th March 20 20 , W HO
has declared a pandemic,
outbreak of respiratory
disease caused by novel
(new ) corona virus, the virus
is called ?SARS-CoV-2? and
the disease it causes has
been named ?coronavirus
disease 20 19? (abbreviated
?COVID-19?). In the past,
other types of coronaviruses
have caused illness such as 1.
SARS-associated coronavirus
(SARS-CoV), first detected in
Asia in February 20 0 3. Since
20 0 4, there have not been
any know n cases of SARS
reported anyw here in the
world. 2. Middle East
Respiratory Syndrome
Coronavirus (MERS-CoV),
first reported in Jordan in
April 20 12 and later detected
in Saudi Arabia in September
20 12. The largest know n
outbreak of MERS outside the
Arabian Peninsula occurred in
the Republic of Korea in 20 15.
All cases have been linked
through travel to, or
residence in, countries in and
near the Arabian Peninsula.
COVID-19 epicentre was in
Wuhan, Hubei Province,
China. The first case was
detected on 31st December
20 19.
W hat is the difference
between SARS and COVID
19?
Severe Acute Respiratory
Syndrome (SARS) and
COVID-19 are diseases
caused by viruses
belonging to a large family
of coronaviruses. The
viruses are related to each
other genetically, but the
diseases they cause are
quite different.
W hat is the difference
between MERS and COVID
19?
Middle East Respiratory
Syndrome (MERS) and
COVID-19 are diseases
caused by viruses
belonging to a large family
of coronaviruses. The
viruses are related to each
other genetically, but the
diseases they cause are
quite different.
04 | TDO NEPAL

"People with fever, cough or
difficulty breathing should call
their doctor and seek medical
attention."
The COVID-19 virus affects
different people in different
ways. COVID-19 is a
respiratory disease and most
infected people will develop
mild to moderate symptoms
and recover without requiring
special treatment. People
w ho have underlying medical
conditions and those over 60
years old have a higher risk of
developing severe disease
and death.
Common symptoms include:
- fever
- tiredness
- dry cough.
Other symptoms include:
- shortness of breath
- aches and pains
- sore throat
- and very few people
- will report diarrhoea,
nausea or a runny nose.
People with mild symptoms
w ho are otherwise healthy
should self-isolate and contact
their medical provider or a
COVID-19 information line for
advice on testing and referral.
HOW LONG DOES IT TAKE FOR
SYMPTOMS TO APPEAR?
Symptoms of COVID-19
may appear 2-14 days after
exposure. However in some
cases, such as younger
people, symptom
appearance may be as
delayed as 27-28 days.
CAN SYMPTOMS OF COVID-19
PRESENT EVEN AFTER 14 DAYS?
Commonly, the symptoms
of COVID-19 may appear 2-14
days after exposure. However
in some cases symptom
appearance may be as
delayed as 27-28 days.
W HO IS AT HIGHER RISK OF
SEVERE ILLNESS WITH
COVID-19?
These include elderly,
individuals with weak immune
system (underlying chronic
health conditions such as
Diabetes, hypertension, Heart
ailments, lung ailments,
cancer).
Symptoms Checker
Symptoms
TDO NEPAL | 05

Spread
HOW COVID-19 SPREADS?
Person-to-person spread: The
virus is thought to spread
mainly from person-to-person
contact. Between people w ho
are in close contact with one
another (within about 6 feet).
Through respiratory droplets
produced w hen an infected
person coughs or sneezes.
These droplets can land in the
mouths or noses of people w ho
are nearby or possibly be
inhaled into the lungs. - Spread
from contact with
contaminated surfaces or
objects: It may be possible that
a person can get COVID-19 by
touching a surface or object
that has the virus on it and
then touching their ow n mouth,
nose, or possibly their eyes,
but this is not thought to be the
main way the virus spreads.
W HY DOES THE CORONA
VIRUS SPREAD RELATIVELY
EASILY BETW EEN PEOPLE?
The virus is thought to
spread mainly from
person-to-person contact.
W hen an infected person
coughs or sneezes, they release
virus containing droplets of
saliva or mucus. These droplets
fall on people in the vicinity and
can be either directly inhaled
especially between people w ho
are in close contact with one
another within 1 meter (3 feet).
These droplets are heavy and
they fall quickly to the
surface/ground below. If you
touch a surface with the virus
on it and then touch your
mouth, nose or eyes, you may
get sick.
CAN SOMEONE SPREAD THE
VIRUS WITHOUT BEING SICK?
People are thought to be
most contagious w hen they
are most symptomatic (the
sickest). Some spread might
be possible before people
show symptoms, but this is
not thought to be the main
way the virus spreads.
W HAT IS CLOSE CONTACT?
Close contact is defined as?
a) being within approximately
6 feet (2 meters) of a
COVID-19 case for a
prolonged period of
time; -OR- b) close
contact can occur w hile
caring for, living with,
visiting, or sharing a
health care waiting area
or room with a COVID-19
case -OR- c) having
direct contact with
infectious secretions of a
COVID-19 case (e.g.,
being coughed on,
handshake, hugging).
Touched body fluids of
infected individual
(respiratory tract
secretions, blood, vomit
us, saliva, urine, faeces).
If such contact occurs
w hile not wearing
recommended personal
protective equipment
(PPE) e.g., gow ns, gloves,
NIOSH-certified
disposable N95
respirator, eye
protection.
More Q & A on Spread....
06 | TDO NEPAL

To prevent infection and to slow transmission of COVID-19, do
the following:
- Wash your hands regularly with soap and water, or clean them
with alcohol-based hand rub.
- Maintain at least 1 metre distance between you and people
coughing or sneezing.
- Avoid touching your face.
- Cover your mouth and nose w hen coughing or sneezing.
- Stay home if you feel unwell.
- Refrain from smoking and other activities that weaken the
lungs.
- Practice physical distancing by avoiding unnecessary travel and
staying away from large groups of people.
Prevention &
Howto protect
yourself and Others
Take steps to protect yourself
Clean your hands often
- Wash your hands often with soap and water for at least 20 seconds especially after you have
been in a public place, or after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use a hand sanitizer that contains at least 60 %
alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact
- Avoid close contact with people w ho are sick
- Put distance between yourself and other people if COVID-19 is spreading in your community. This
is especially important for people w ho are at higher risk of getting very sick.
Take steps to protect others
Stay home if you?re sick
- Stay home if you are sick, except to get medical care. Learn w hat to do if you are sick.
Cover coughs and sneezes
- Cover your mouth and nose with a tissue w hen you cough or sneeze or use the inside of your
elbow.
- Throw used tissues in the trash.
- Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are
not readily available, clean your hands with a hand sanitizer that contains at least 60 % alcohol.
Wear a facemask if you are sick
If you are sick: You should wear a facemask w hen you are around other people (e.g., sharing a room or
vehicle) and before you enter a healthcare provider ?s office. If you are not able to wear a facemask (for
example, because it causes trouble breathing), then you should do your best to cover your coughs and
sneezes, and people w ho are caring for you should wear a facemask if they enter your room. Learn w hat
to do if you are sick.
If you are NOT sick: You do not need to wear a facemask unless you are caring for someone w ho is sick
(and they are not able to wear a facemask). Facemasks may be in short supply and they should be
saved for caregivers.
TDO NEPAL | 07

Avoid travel if you have a fever and cough.
Stay
healthy
while
traveling
If you have a fever, cough and difficulty
breathing seek medical care early and
share previous travel history with your
health care provider.
W hen coughing and sneezing
cover mouth and nose with flexed
elbow or tissue - throw tissue
away immediately and wash
hands.
If you choose to wear a face mask,
be sure to cover mouth and nose -
avoid touching mask once it's on
Immediately discard single-use
mask after each use and wash
hands after removing masks
Avoid close contact with people suffering
from a fever and cough
Frequently clean hands by using
alcohol-based hand rub or soap and water
Avoid touching eyes, nose or mouth
If you become sick w hile traveling, inform crew and seek medical care early
If you seek medical attention, share travel history with your health care provider
Test Center w here you may get tested for COVID-19
Sukraraa j Tropical And
Infectious Disease Hospital
Sunday - Friday (8 AM - 3 PM)
0 1-4253395
Patan Hospital
Sunday - Saturday (24 hours)
0 1-5522295
National Public Health
Laboratory
Kathmandu
Mahanagarpalika,Kathmandu
0 14240 217
08 | TDO NEPAL

Timeline
February
By 1 February, Teku Hospital had
handled five suspected cases all of
w hom tested negative. By the end of
February, the health desk at Tribhuvan
International Airport was screening
passengers from China, South Korea,
Thailand, Singapore, Malaysia, J apan
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 dow n 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 20 20 . 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.
Misinformation
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.
J anuary
A 31-year-old student of Wuhan University w ho had returned home on 5
J anuary, was admitted with mild symptoms on 13 J anuary and discharged on 17
J anuary 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 17,0 0 0 per test and need to be bought in
bulk, sufficient for about 20 0 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 J anuary. On
24 J anuary, the Health ministry confirmed that the test had come back positive.
The ministry said the patient was under surveillance, those w ho came into close
contact with him were being investigated, and health information on all
passengers returning from China was being sought. On 25 J anuary, 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 J anuary 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 w hich 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
10 0 tests were borrowed from the Centre for Molecular Dynamics and test kits
were provided by the World Health Organization. A woman was in isolation
awaiting test results as of 27 J anuary.
On 28 J anuary, Nepal closed dow n 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.
March
1 March: Nepal announced suspension of visa-on-arrival service for nationals
of five countries badly affected by COVID-19 ? China, South Korea, J apan,Italy
and Iran ? to be enforced from 7 to 30 March.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.
23 March: COVID-19 was confirmed in a 19-year-old woman w ho 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-dow n effective from 2 pm.
Arghakhanchi District also declared an indefinite lock-dow n.
24 March: The country-wide lockdow n 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.
27 March: Fourth case nationally, the first outside Kathmandu, was confirmed.
It involved a 34-year-old man w ho 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 w ho 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 w ho 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.
TDO NEPAL | 09

Protecting Nepal?s elderly from COVID-19
Shelters for senior citizens
and orphans that survived
the earthquake five years
ago now have to deal with
a bigger upheaval
:- Nepal Times
TDONEPAL
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