A new outbreak of Covid cases in Nepal recalled that the pandemic is not over yet, and on the need to wear a mask, avoid crowds and get vaccinated.
Hospitals have not reported an increase in admissions and no deaths from Covid have been reported since March. But highly transmissible new substrains such as BA.4 and BA.5 have also been detected in Nepal, as elsewhere in the world.
“For the most part, people who have been fully vaccinated are unlikely to get very sick from the new strains, there has been no real increase in hospitalizations,” confirms Sher Bahadur Pun, virologist at the Teku Hospital in Kathmandu.
The fact that the new substrains are all Omicron variants means that unlike the Deadly Delta variant, they mainly infect the upper respiratory tract and not the lungs. Delta was responsible for millions of deaths in India in 2021 and killed at least 8,000 people in Nepal as hospitals ran out of oxygen and vaccines were delayed.
But with 82% of the eligible population now fully vaccinated, Nepalis are now better protected against serious diseases. But the virus is still mutating and scientists are engaged in a game of cat and mouse to stay ahead of new strains.
“Covid-19 has turned out to be even trickier than we thought. It is clearly still widespread and can be life-threatening,” warns Buddha Basnyat, a physician at the Patan Academy of Health Sciences. “This is not the end of the Covid story.”
This does not mean that the current push is a new wave. Although each new Omicron sub-line is more contagious, it is also gentler. This is good news, but asymptomatic infected people are also spreading the virus more widely.
While active cases are on the rise in Nepal, hospitalizations are not, and those infected could put the elderly and those with comorbidities at risk at home or at work.
Studies abroad have shown that up to half of people infected with the new substrains are asymptomatic. As people travel more this summer and lose their masks, the BA.5 and other variants are infect and re-infect even those who are vaccinated.
“We must continue to vaccinate and do a booster, especially those who have not even received their first vaccine. This may also be the time to start thinking about a fourth dose for vulnerable populations,” says Buddha Basnyat.
Because “immune evasion” puts even more people who have had Covid-19 at risk of reinfection, scientists are trying to improve the vaccine effectiveness as they try to track the mutations of the coronavirus.
“Eventually, Covid-19 will be like the seasonal flu, and maybe we will have vaccines for different strains,” says Sher Bahadur Pun of Teku.
BA.4 and BA.5 were first observed in South Africa and are currently the dominant strains in Nepal. This is surprising as it was the BA.2.75 that swept through India last month, and the surge is now peaking there. Whatever happens in India arrives in Nepal with a delay of two weeks, say the experts, and predict that the same scenario could play out here with the current surge.
“New strains and mutations are nothing out of the ordinary, but we need to keep masking and vaccinating. As for the new surge, it is peaking right now and it will have subsided by the end of July,” predicts Sameer Dixit of the Center for Molecular Dynamics.
The Center is leading the sequencing of the Covid-19 gene in Nepal, and it has worked with the Nepal Health Research Council, Birat Nepal Medical Trust, Liverpool School of Tropical Medicine and Oxford to study 1,800 Covid-19 samples collected from across Nepal. over the past year. . The results will be published soon and could reinforce the importance of genetic sequencing in Nepal so that scientists can predict the behavior of the next variant.
Nepal is also part of the largest Covid-19 recovery study, currently underway in the UK, which has led to important findings including the use of certain steroids in the treatment of coronavirus disease.
But the fact that the new strains are milder doesn’t overlook the inherent correlation between health and economy. Even the best health care systems can collapse, as seen in Sri Lanka. In addition, we now have record inflation caused by the Russian invasion of Ukraine, which made health care even more unaffordable for most Nepalese.
“Nepal, with its limited resources and the indifference of the government, must be even better prepared for a health crisis, which often spells disaster for those who cannot afford treatment”, warns the epidemiologist Lhamo Yangchen Sherpa.
She adds, “The new push may seem light, but it’s always better to be over-prepared than under-prepared.”