Kathmandu: I have just completed two weeks of home isolation after testing positive for Covid-19. I have seen why Nepal is failing to contain the Covid-19.
I did not have to suffer the horrors many of my friends and relatives did. Last year this time, the story of Covid-19 was a story of horror—the intense pain, fever, headache, loss of appetite, breathing difficulty, and even death. I felt all of these symptoms but it never felt like I would die of Covid, perhaps because I was doubly vaccinated or I don’t know.
I did not have to go through what many of the Covid patients had to. In that sense, I was lucky but my wife was not. She must have caught it from me though I completely isolated myself from the rest of the family the moment I received the test report. She felt debilitating pain, nausea, dizziness, weakness, terrible cough and headaches.
Both of us feel very weak but we both are recovering, without having to go to the hospital. We wish we would never have to go to the hospital.
Those two weeks of isolation was also the time for me to reflect and realize where the state’s response on Covid has gone awry.
I cannot say where I got it from. I wore masks (two), washed hands frequently and every time I was out I conducted myself most cautiously assuming that every single person I met could be a Covid infected person. But I traveled in public transport, this is where I may have got the virus from.
I began to have Covid suspicion after I lost sense of smell and taste. Even the most pungent smells like that of garlic and Sancho balm smelt nothing to me. Everything I ate tasted extremely bland.
Then I went to Sukraraj Tropical and Infectious Disease Hospital in Teku. I paid, gave the swab and later that evening they sent the report on my mobile phone. I was a Covid patient.
Most people sneeze and cough, live with fever but they do not go for the test unless they reach the critical stage. Here is where the big problem lies.
Two days later, they called me from the Public Health Division, Teku. “How are you feeling?” A lady on the other end asked. “Do you have any complications? Fever? Shortness of breath? Any issue?”
I received some five calls in 10 days. “How many children do you have? Are they all fine? How is your wife? If you experience any difficulty, call at 1115. We will help you out.” They were extremely concerned about my health and the health of my family.
That Nepal’s public health system has failed in Covid response felt like an unfair allegation to me.
But there were other people I knew in my neighborhood and the neighborhood of my relatives and friends, who had all the symptoms of Covid but who never went for a test. People are sneezing, coughing, walking out with red watery eyes, worried, but they are not going for the test.
In my neighborhood, one of the indications of prevalence of Covid-19 has been the heavy demand for khasi ko khutto (goat leg) in meat shops. If you want one, you need to order two days earlier, says the meat seller. “Everybody has Covid here, so they want to have haddiko soup.”
Most people sneeze and cough, live with fever but they do not go for the test unless they reach the critical stage. Here is where the big problem lies.
Getting oneself tested has obvious benefits. If you test positive, you will at least keep away from others, you would walk out by following all the safety protocols if you had to, you would keep yourselves away from the crowds—every Covid patient once worries s/he might die—and this keeps you from being reckless, which helps prevent the transmission.
But in Nepal testing is not easy, it is expensive, unaffordable even for the middle class families with modest income, in this time of the pandemic when income has fallen low for almost everybody.
First, not all hospitals around you will test you. You have to go to the designated labs and hospitals, the great majority of them private.
Testing cost is high. There is a way to get the free test from government hospitals but for that you have to secure a letter of recommendation from your ward office—which is not hassle-free. If you go to Teku or other government hospitals it is Rs 1,000. Go to private labs and hospitals, it is flat Rs 2,000, even more in some places.
Now suppose you are a family of five. One of you has tested positive and you want to know if others have contracted the disease. Go for the test at the nearest hospital (which is often the private one), it will drain Rs 10,000 from your family budget just to know whether you have Covid or not. Trust me, 10,000 is a lot of money in these times of pandemic. It can feed a family for a month.
One of the main shortcomings identified by public health experts in Nepal’s Covid response has been that Nepal is not testing enough. That’s true. Initially, there was a stigma attached with being a Covid patient. That stigma has now gone. People want to be tested. The cost and availability and access to testing facilities is the issue.
This is the area where the government has failed to address. The government’s response has been to lock the country, shut the businesses, and let the people live with the disease.
If we lowered the cost of the test to Rs 500 or even to Rs 200, for example, many would go for it. If Nepal provided PCR test machines to at least every public health facility, many would go for the test and that would help to prevent the transmission.
We are not testing enough, therefore we do not know exactly how many of us are living with the disease. We could be walking amid or living with people who have had Covid but who never went for the test and who thus transmitted the disease to others, who passed it to others and others.
At the face of the third wave, our failure in conducting enough testing might make the situation much worse.
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