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Next door to hard-hit India, coronavirus cases surge in Nepal

Relatives of a covid-19 victim mourn at a crematorium in Kathmandu, Nepal, on Thursday. (Narendra Shrestha/EPA-EFE/Shutterstock)

NEW DELHI — Just one month ago, after dropping steadily since a spike in the fall, the rate of coronavirus infections across Nepal plateaued at around 100 cases per day. Many hoped the worst was behind them.

But with vaccine programs languishing and thousands of workers returning from neighboring, hard-hit India, cases shot up to more than 2,000 a day in late April. By last week, that figure had soared to more than 8,000.

The surge has rapidly overwhelmed hospitals and depleted medical supplies in the Himalayan country of 30 million. Online covid-19 support groups, flooded with posts as people seek information, advice and solace, have become medical and emotional lifelines for a frightened, isolated population that has few other places to turn.

“We have not been able to admit even the critical patients,” Anup Subedee, director of the Hospital for Advanced Medicine and Surgery in Nepal’s capital, Kathmandu, said in a telephone interview Wednesday. He said the staff could do little more than prescribe steroids and painkillers.

Last week, health officials said 20,000 oxygen cylinders had been ordered from abroad, but many private hospitals announced that because of the lack of oxygen, they could not admit any more patients.

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The government of Prime Minister K.P. Sharma Oli warned this week that new infections could continue to rise while the country's medical system is collapsing under the strain. Writing in the Guardian on Monday, Oli described the pandemic as an "overwhelming burden" and appealed for international help.

The Health Ministry spokesman in Nepal, Samir Kumar Adhikari, echoed Oli’s alarm Thursday, saying that the situation is “currently out of control” and that hospitals face a “deepening crisis” that is likely to get worse in the coming weeks.

In Washington on Wednesday, several members of Congress expressed alarm about the situation and an official with the U.S. Agency for International Development said Nepal is now a “priority” for coronavirus-related aid, although there was no public indication of how soon it would materialize.

The government has imposed a nationwide shutdown, banned all international flights and declared a strict size limit on public gatherings. But the shutdown came after thousands of migrant workers returned from India, which has the highest levels of coronavirus infection and death in the world.

The flurry of measures did little to strengthen public confidence in the government, which has been roiled by partisan rivalries and accused of being caught off-guard by the new surge. On Monday, Oli lost a parliamentary vote of confidence and is now serving in a caretaker role while several parties joust for power.

The total number of deaths has remained low, at about 4,200. Since the pandemic began, more than 422,000 Nepalis have been infected and about 316,000 have recovered. But with hospitals running out of oxygen, supplies, medicine and beds, officials said the death rate could also rise.

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Subedee, the hospital director, said unless the government begins setting up oxygen production plants soon, health facilities will be merely “trying to wipe the floor as water runs down from the tap. This situation is going to get worse in coming weeks.”

One night this week, the emergency room at Bir Hospital in the capital was crammed with people anxiously waiting for treatment. Every bed was occupied, and overflow patients and visitors crowded together on the floor, ready to grab any vacant bed.

The hospital had announced it could not provide oxygen, and a few visitors hauled in cylinders from outside. Others clung to cellphones, hoping to locate an oxygen source. One man frantically tried to find a lab that would give his ailing father an emergency coronavirus test. An elderly man hunched on the floor in pain for many minutes until a guard brought him a wheelchair.

Nanu Bhattarai, 54, a teacher in the capital, said her father had tested positive and was suffering from a fever, weakness and breathing difficulties but had been turned away from several hospitals in the past week. “We found a bed at one, but there was no oxygen,” she said.

The country’s vaccination rate is also very low; only about 7.2 percent of the populace has received one shot. The government is urgently seeking international vaccine donations, but it may be too far behind in the prevention process to make much difference in the near future.

Many in Nepal claim that the government let down its guard after the first wave of coronavirus subsided. During the lull, people began attending mass religious events and weddings. Some officials traveled to India for a large Hindu festival, held in stages between January and April, that was later identified as a spreader of the virus.

In his appeal for help this week, Oli’s tone was grave. He said his government was doing its best to “save people from this lethal enemy” and was in dire need of vaccine, oxygen and equipment. But before the crisis erupted, he was quoted as saying people could resist the virus by gargling with guava leaves. His government was also criticized for allowing high mountain treks to continue, preserving an iconic national attraction at the risk of spreading the virus further.

Experts said the situation is especially acute in rural areas bordering India, where health facilities are limited and vaccination rates are extremely low. A network of humanitarian groups is providing some emergency assistance, but Kanchan Jha, the director of one group, called the conditions “heartbreaking.”

“There are a lot of unreported cases in border towns, and the hospitals can’t handle the heavy influx of patients,” he said in a phone interview. “Rich people in the capital can evacuate if needed, but here poor people have nowhere to go. Infected families are stuck in home isolation.”

Suswopna Rimal, 31, created a covid-19 support group on Facebook after she and her husband recovered from mild cases last year. She found there was still much social stigma about discussing the disease and wanted to give people a place to express their concerns.

“We survived the first wave, but we felt a void. There was fake information on social media, and it created fear,” she said from Kathmandu. “People needed advice, but there was a lot they couldn’t discuss. I wanted them to have scientific information and feel comfortable.”

Today, the site has 2.8 million members and is filled with queries, suggestions, condolence posts with tearful emoji and videos from doctors explaining how to improve breathing or avoid suspicious cures. It offers lists of oxygen providers, coronavirus test labs and ambulance services. Among the upcoming topics — why to say no to big summer weddings this season.

Ankit Adhikari in Kathmandu contributed to this report.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will probably challenge a key line of treatment for people with compromised immune systems — the drugs known as monoclonal antibodies.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people.

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