Dr Anup Subedee: Too early to predict next covid wave

Covid-19 cases are surging in different states of India. The country’s positivity rate, which indicates the spread of the disease, has gone up to three percent from 0.5 percent—within a week. As Nepal shares a 1,850km-long open border with India, there is a risk of a coronavirus resurgence here as well. With local-level elections knocking on the door, political campaigns and rallies could also fuel the spread. Pratik Ghimire of ApEx talked to Dr Anup Subedee, infectious disease consultant at Medharma CliniX. 

Can we predict the next covid wave in Nepal based on what is happening in India?

Cases in India directly impact Nepal, as we saw in the previous waves. But till this point, the new covid cases in India are yet to be thoroughly examined. So it is difficult to predict what will happen. Indian officials claim no new variant has been detected, but I doubt there has been enough research.  

Is the next wave the most likely scenario in Nepal?

If the new cases in India are of the current Omicron (BA.2) variant, there is a low probability of an outbreak, as two waves of a single variant are rare. An increase in new cases is not a new thing, as the covid trend suggests a rise in such cases every few months. This is both predicted and expected. 

Yet, every six months, we have seen a new variant too. If that happens, it could result in the next wave. But again, it is too early to predict because we have little information as of now. 

Could upcoming elections help with the spread of coronavirus? 

Hard to say. But mass demonstrations and political campaigns that took place in Kathmandu during the Delta variant surge had played a key role in previous outbreaks. So elections this time could also have an impact, as there will be more than usual mobility of people. Nepalis working in India will come home to vote. This could lead to the virus reaching various corners of the country. Everything depends on which variant it is—the old one or the new. 

Right now, we don’t have many cases, so there is nothing to panic about. But that also suggests we might not have conducted enough tests. Further, the Health Ministry doesn’t have real data. It is important to fill these gaps because we can’t prepare and fight effectively without real data. 

What do you suggest?

The holding centers and quarantines should be in working condition. We rushed to set up the infrastructure only after the pandemic hit the country. By that time, it was too late. So preparation is important. 

To some extent, our incompetence has also invited trouble. The vaccine campaign looks dormant at the moment. Many people don’t know the current vaccine situation in Nepal. There are eligible people who are yet to get the jabs. Some have refused to take them, but the government should convince them. Also, the vulnerable groups have not gotten their booster doses. Many have not even taken the second dose. 

Again, we have no proper data to track things down. For the current variant, the vaccines that are being given to Nepalis are fine, but there could be better options. The authorities should focus on importing more effective vaccines. 

How long do we need to keep taking booster doses?

Booster doses should be routinely administered unless a vaccine that provides lifelong immunity is invented. We should also import the most effective vaccines like Viral Vector (AstraZeneca) and RNA (Moderna, Pfizer). Novavax is also effective.