After several months of relatively low daily cases in Nepal, COVID-19 cases began to rapidly spike in mid-April, increasing consistently from 152 on 1 April to over 8,000 per day since 5 May. Despite its relatively small population of 29.5 million, Nepal currently finds itself among the countries with the highest daily number of cases in absolute terms. Over 45% of COVID-19 RT-PCR tests are coming back positive. At its current trajectory Nepal is well on track to meet or exceed the worst-case scenario case figure of 300,000 cases over a fourth month period, laid out in the COVID-19 Preparedness and Response Plan (CPRP).
Hospitals in Kathmandu and other cities are already at capacity and turning away patients due to a shortage of beds. Critical gaps in supplies, including oxygen, are reported across the country. In rural health facilities human resource capacity to operate ventilators and provide ICU case management is an acute challenge and of the utmost importance to address in order to effectively respond to severe COIVD-19 cases across the country.
In an attempt to curb the spread of the virus prohibitory orders, and localized lockdown measures, have been imposed in all districts. Twenty-two points of entry along the India-Nepal border have been closed and all domestic and international flights have been suspended, with the exception of two weekly flights from the Indian capital of New Delhi. Thirteen points of entry remain open; however, the 1,200 kilometre land border with India is easy to cross informally, which is reported to be increasing. Even at operating points of entry, there is currently insufficient capacity to conduct consistent health screening at points of entry, systematic contract tracing or case investigation and limited adherence to public health and safety measures.
Critical shortages in vaccines, oxygen, testing supplies, skilled human resources and critical care medicines and supplies have been identified as immediate life-saving needs. The humanitarian community is working in support of the Government’s efforts to respond to these key needs, as well as prevent and mitigate adverse health impacts.
The renewed lockdown measures will have the greatest impact the most vulnerable, who are facing existing struggles to recover after the dramatic economic and development setbacks they faced as a result of extended lockdowns in 2020. Certain groups continue to face marginalization and discriminatory practices, heightening their need for targeted support. Vulnerable groups, including women, children, youth, persons with disabilities, those with compounded care burdens, socially excluded groups, indigenous peoples, refugees, displaced persons and migrants, have limited or no coping strategies to manage the shocks they have endured since March. There are concerns that the most vulnerable are increasingly being forced to adopt negative coping strategies in response to new risks and economic challenges, which often compound existing vulnerabilities.