Covid-19 experiences and activities in Nepal

Abstract

With a population of nearly two million people, Kathmandu is the largest city and capital of Nepal, located in Kathmandu District with ten municipalities and one metropolitan city.1 The first COVID-19 case was reported on January 23, 2020, in Kathmandu, Nepal, from a student returning from Hubei China.2 The second case appeared two months later, on March 17, 2020, in a person returning to Nepal from France. The first community transmission was detected on April 4, 2020. From the month of May 2020, new case identification has been greatly increased due to the increased capacity of testing as well as community transmission in parallel. As the news of China’s declaration of COVID-19 as a pandemic spread across the world, it became obvious that the threat of the virus transmission in Nepal would increase because of the shared northern border of Nepal with China. The only international airport in Nepal is in Kathmandu, and the district is densely populated with much movement of people inside and outside the country. Thus, Kathmandu was highly vulnerable to the virus transmission. As a result, the Government of Nepal as well as the Health Office Kathmandu began actively working for the prevention and management of this threat. The first step was to assign a Public Health Nurse Officer as the focal person for COVID-19 management. I was that person and was chosen because I was a trained EpiNurse (epidemiology nurse) with skills in disaster management. I was also appointed as an executive member of the District COVID-19 Crisis Management Committee (DCCMC) of Kathmandu district, which had become active in the prevention and control of COVID-19. A Rapid Response Team (RRT) was formulated at the district and municipal levels, after which various programs of disease prevention, control, and management were conducted. Initially these included carrying out awareness programs for department chiefs of all the municipalities of the Kathmandu district, local level health workers, female community health volunteers, and mothers’ groups. Similarly, we mobilized school health nurses to conduct awareness programs for students, teachers, and parents to prevent, control and manage COVID-19 using banners, pamphlets, posters, social and mass media. We also listed different resources: the number of hospital beds including Intensive Care Units (ICU) and ventilators, numbers of available ambulance services, available human resources, suggestions for quarantine and isolation centers, and possible high-risk areas. Similarly, the Health Office Kathmandu coordinated with all the stakeholders such as municipalities, hospitals, and external developmental partners to plan for the possible spread of the virus. After detection of the first case in Kathmandu, the government and Health Office Kathmandu started to work immediately. The Health Office helped to established health desks at national and international entry and exit points for screening of suspected COVID-19 cases and collection of samples for polymerase chain reaction (PCR) testing (Fig. 1). All suspected and confirmed cases were quarantined and isolated. Nurses were key health workers here. We helped in establishment of centraland municipal-level quarantine and isolation centers. One of