Namrata Sharma

As the Omicron variant of the COVID-19 virus has become a household phenomenon in Nepal and globally, a new term “endemic” is being talked about. The Centres for Disease Control and Prevention (CDC) of the USA, defines endemic as “the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.” In simpler terms, it means “a point at which the infection is no longer unpredictably disruptive,” according to Stuart Ray, a professor of medicine in the division of infectious diseases at Johns Hopkins. In an article of The Washington Post, CDC director Rochelle P. Walensky is quoted saying that it is likely that COVID-19 become endemic in USA and elsewhere with the spread of Omicron.

There are many diseases that are endemic, like the influenza. It causes minor challenges year after year that can be handled. The assumption is that that could very well be what happens with COVID-19. Apart from influenza, another example of an endemic is malaria in Africa and dengue in the tropical places. In Greek, the word ‘endemos’ means ‘in population’. It is important to note that endemic virus is seen by experts as no less bad than the pandemic virus. Data shows that malaria still kills almost half a million people all over the word every year.

Periodic vaccination
“The current wave of Omicron variant of C-19 is likely to affect majority of world population but not likely to lead to the severe form which means deaths will be less. If COVID-19 vaccination coverage reaches 70-80 per cent of total population and public measures are followed strictly by the public, this variant could lead to the endemic status needing periodic vaccination with less damage to human life and pressure to health system,” said Dr Nastu Sharma, a clinical tropical medicine specialist. Dr Sharma is currently supporting Nepal government in Neglected Tropical Diseases and COVID-19 cases management, and counselling COVID-19 patients who are in home isolation.

The government has taken measures of reducing traffic by implementing alternate days for odd and even vehicles, but the streets of the valley is thronged with traffic and people are trying to get on with their daily lives. More than the signs of the endemic, which many Nepali citizens are not aware of, they now have an urge to move on with life and do their daily chores to sustain their livelihoods and existence.

A primary school teacher shared with me that the children who started their school and early education virtually had become very excited once the school opened. In fact, a few children who were very inactive during virtual classes started opening up with the teachers once the physical lessons commenced. However, now that the classes were once more virtual, the teachers felt that it may have a negative impact on the growth of the tiny minds, who actually had difficulties in understanding why they had to be cooped in all the time.

What should be done now? “A good infection control policy and protocols that everyone should follow is to take personal precautions like wearing masks at all times, avoid crowding, and keep sanitizing,” says Dr Rakshya Pandey, a senior consultant pulmonologist, at HAMS hospital. She adds that it is important to vaccinate all staff, test early and isolate. There is also a need to make testing easily available at low cost, says Dr Pandey. In hospitals and healthcare places. It is important to separate COVID and non-COVID patients as far as possible. Limiting visitors and prioritising clinical cases is important she stressed. Hospitals also needed to delay non urgent surgeries or procedures.

Although Nepal government has made free PCR tests in some government hospitals, majority of the people need to pay between Rs 1500-3000 per test. They are thus avoiding these testing as it actually dents a hole in their pockets. Due to the marriage months in Nepal, data has it that during winter months many children are born. Dr Nastu Sharma says that during winter it is very important to take special precaution in saving children and mothers. In remote places, women and children huddle around fires to save themselves from the cold, but while doing so they can be subjected to unprecedented health hazards of both long term and short term.
 
Safety measures
Dr Tumla Shah Lacole, a gynaecologist and founder of the Sukhi Pariwar hospital at Kalimati, says that it is very important to give special attention to women who have given birth to children and also the new-borns, especially as it is very cold now. She advises all, especially new mothers and their family members to “wear mask even at home, keep social distancing, hand washing, and avoid going to the crowds, and eat healthy food, and rest to keep new mothers and new born safe and sound. It is very important to keep good ventilation in all rooms. Closed rooms are not good for viral infection. She continued that in Nepal people close doors and windows to save from cold, but that practice needs to be changed. Rooms should be well ventilated and kept warm while doing so.

Therefore, even as the term ‘endemic’ for the ongoing pandemic is being talked about, for the population in Nepal, it is important to carry on with the precautions of masking, keeping social distances and taking the vaccines that Nepal government is providing. However, it may also be necessary for Nepal government to start offering free PCR tests in all hospitals so people do not shy away from testing.

(Namrata Sharma is a journalist and women rights advocate. namrata1964@yahoo.com Twitter handle: NamrataSharmaP)