Sunday, May 17, 2020

Should Nepalese be worried about the coronavirus?

The outbreak of the 2019 novel coronavirus in China, also known as the Wuhan Coronavirus, has now affected 17 countries.
There are approximately 6,000 cases in China with the majority being diagnosed. Total casualties have crossed 130, most of them in Wuhan, in Hubei Province. Nepal has recorded its first confirmed case: a student studying in China who went to Nepal when diagnosed. Coronavirus family viruses have historically caused respiratory infections in human populations worldwide.




The most recent outbreaks include acute acute respiratory syndrome (SARS) in 2002 and Middle Eastern respiratory syndrome (MERS) in 2012.
Both have affected thousands of people and in some cases can be fatal. SARS killed 10% of infected people, while MERS was fatal in 37% of the infected population. The current death rate due to Wuhan coronavirus is 2.2%. If we reverse this number, 98 percent of people infected with this virus will not die. Given the low mortality rate compared to previous coronavirus outbreaks, why is there so much concern about this outbreak?
The first reason is that the Wuhan Coronavirus is a ‘novel’.
The term is used to refer to a new species in viral epidemiology that has never been found in the population. Therefore, scientists do not know enough about the symptoms of the virus and provide public health indications about treatment.
Second, unlike SARS and MERS, the incubation period of the virus is up to 14 days, and asymptomatic individuals can spread the disease to others.
Infected individuals who show development may also continue to spread the virus. The R0 (n r naught ') value of this virus is estimated to be 3, which means that the infected person transmits on average three more people. It is believed to have a high infectivity number, but it is still lower than SARS or MERS. Chinese authorities have taken tough steps in Wuhan to stop the spread of the virus. However, this may not be enough as most infected people may be out of the city until they take action. Wuhan's population is 10 million, and many begin this week's Chinese New Year. According to experts at Imperial College in London, the number of infected populations is less than about 100,000. Therefore, we can expect more cases around the world as infected people spread and transmit the disease.



However, the question has arisen once again about how many people have been infected so far.
The virus may be spreading, but not the cause of many deaths?
Nepal has a common outbreak of respiratory diseases such as seasonal influenza, 'avian influenza' and 'swine flu'. Nepali media often report cases of ‘unknown viral disease’. The Nepalese government set up screening centers for coronaviruses at airports and border posts before the first infected person was diagnosed in Tibet. The National Public Health Laboratory is working with private hospitals and laboratories and technical assistance from the World Health Organization (WHO) to make timely and accurate diagnosis of Wuhan coronaviruses. These cases are referred to the Sukhraj Tropical Infectious Diseases Hospital and are monitored by the Department of Epidemiology and Disease Control in the country.
The Ministry of Health and Population has ordered all private hospitals in the country to be on standby if ventilator-supported ICUs are needed. The state mechanism seems to have learned from the vulnerabilities previously seen during the SARS and H1N1 (swine flu) outbreaks. However, the exact clinical diagnosis of the disease is a challenge, as people who are infected with non-symptomatic phosphoses are more likely to be infected with other viruses, such screening is the only way to identify the maximum number of cases entering the country and prevent the population from getting infected.



There have been no cases of coronavirus infection since January 25 in Nepal.
The first case has only been reported to date. The global media reporting of the outbreak is more focused on malignancy than recovery, and the WHO fails to note that the Wuhan coronavirus outbreak with its expertise and access to data has not yet declared a public health emergency. The experience of making a 'premature and hasty' decision to end the 2009 influenza A (or H1N1) - or swine flu - is still a pandemic, at which point the
WHO decided to take a close look at the situation. 
WHO is focusing on China as a priority over the action, while observing the rest of the world. This does not mean that we can be complacent, because the risk of mutation in the more severe form of the virus is real. However, this also does not help to be afraid. We need to look at the numbers, listen to the experts in this field and move on accordingly. After the end of the week, several high-level coordination committees, led by Deputy Prime Minister and Defense Minister Ishwar Pokharel, made several important decisions aimed at limiting the spread of
Travelers from more than 50 countries in Nepal, Europe, Britain, the Gulf and West Asia have been banned; Nationwide secondary education exams are postponed; Asked to close all gyms, health clubs, movie theaters, and dance bars; And all meetings of more than 25 people are banned.
Civil Aviation Minister Yogesh Bhattarai told the Post on Wednesday, "These strong measures have been taken based on the global impact of the coronavirus, the fear it has created and While these measures are welcomed, many public health officials fear they may not be enough and the public is not sure that the government is doing enough. Sundar Mani Dixit's video has criticized the government's response that the government is not conducting enough tests as the test kit is not viral. Despite a conspiracy theorist signaling for Dikshit, especially the claim that the test kits are being saved for 'VIPs', the video is taken aback by Nepal's lack of confidence in the dense urban development, poor security measures and health infrastructure. As of March 20, only 546 Nepalis were tested for Kovid-19, excluding adverse cases in January, according to the Ministry of Health and Population.



Current screening procedures include assessing whether patients have a fever with severe respiratory symptoms or have a surgical condition; And then they are assessing whether Kovid-19 may be in the 14 days they are performing, or in the affected country.
Fever is being tested for those who arrive in Nepal, and when they show no symptoms, they are asked to self-confine. If there is fever, they are left alone and sent to a designated hospital. But the airport has suffered long-term institutional and infrastructure failures. On March 9, the Diplomat reported that 13 health workers at the Tribhuvan airport were inadequate to check passengers coming from China, South Korea, Hong Kong, Thailand, Malaysia, Japan. Some travelers skip the screening process due to the limited number of health workers," one passenger told the publication.
On March 18, The Himalayan Times reported that incoming travelers were not being properly investigated and many were not being asked to remain in self-restraint. Nepal's hospitals and laboratories are also pre-equipped, first to screen potential patients, then to isolate them, and then to provide adequate care. Nepal Public Health Laboratory officials told the Post that they had only 1,000 test kits.
As of March 20, more than half of them were used and it is unclear whether they received the 5,000 kits they sought from the WHO.
On March 19, the Medical Council of Nepal urged all hospitals, private and public, to set up more than 100 beds with special fever clinics, and urged everyone to conserve resources for the outbreak, with health workers postponing elective surgery to ensure safety. Decrease. Unnecessary congestion in hospitals and treatment centers.
Kathmandu is one of the most densely populated cities in the region and the spread of it will increase health care facilities quickly. The Covid-19 mortality rate is not very high - revised from the initial estimate of 3.4 percent to less than 1 percent - but when coronavirus patients come to hospitals, those who need immediate medical care do not need care. .


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