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Volume 3, Issue 4 (2024)
GMJM 2024, 3(4): 117-119 |
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Received: 2024/04/2 | Accepted: 2024/10/28 | Published: 2024/12/4
Received: 2024/04/2 | Accepted: 2024/10/28 | Published: 2024/12/4
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Chalise H. Fears of COVID-19 Catastrophe Increases Death Rate. GMJM 2024; 3 (4) :117-119
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H.N. Chalise *
Department of Public Health, Novel College, Pokhara University, Sinamangal, Kathmandu, Nepal
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The coronavirus disease 2019 (COVID-19), which is widely accepted as having first identified and spread from Wuhan, China, was declared a pandemic by WHO on 11th March 2020 [1]. The COVID-19 pandemic (CP) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 10th November 2020, there have been more than 50 million confirmed cases of CP, with 1.27 million deaths and more than 36 million recovered [2]. The latest data shows that CP has affected both developed and developing countries [3, 4]. CP started in Nepal about 3 months later than in China. This indicates that nature tried to protect Nepal, giving adequate time to learn about the pandemic and prepare to face it.
Nepal is one of the world’s poorest and most populous regions. The first case in Nepal was confirmed on 23 January 2020 when a 31-year-old student, who had returned to Kathmandu from Wuhan on 9 January, tested positive for the disease 9 [1, 5]. It was also the first recorded case of COVID-19 in South Asia [3, 4]. Nepal's first case of local transmission was confirmed on 4 April in Kailali District. The first death occurred on 14 May [6]. A country-wide lockdown occurred on 24 March 2020 and ended on 21 July 2020 [5, 6]. As of 9 November 2020, the Ministry of Health and Population (MoHP) has confirmed a total of 197,024 cases, 159,724 recoveries, and 1,126 deaths in the country [6].
Most confirmed cases were initially imported from other countries in Nepal [1, 5, 6]. Nepal was braced for a "major outbreak" after some thousands of migrants returning from India tested positive for COVID-19. Most CP cases in Nepal initially involved either Indian nationals or Nepali workers who had recently returned from India due to the open and porous borders between India and Nepal [1, 5]. At first, major outbreaks were seen in the eastern area (Udayapur district), western area (Banke district), and central area (Birgunj) of Nepal, which were directly linked to people coming from India. However, since the beginning of September 2020, Kathmandu (Capital) has been considered the epicenter of CP, and nearly half of all COVID-19 cases have been reported from Kathmandu alone. Further, Nepal now ranks in the 34th country with 200 thousand reported COVID-19 cases [2].
However, the CP death rates are unequal across age groups. Since the CP death rate increases sharply with age, the larger the older population, the greater the challenges for communities and societies. Early data from Nepal shows people most affected by CP were people of the young age group, both in terms of infection and death [7]. However, the latest data shows that people of higher age groups are more vulnerable to CP, like many other countries. Many studies show older adults are more likely than younger people to have pre-existing conditions such as cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer. It makes older people more vulnerable to CP.
Figure 1 and Figure 2 show the daily and cumulative CP death chart of Nepal.
Figure 1. Daily new deaths from COVID-19 in Nepal
Figure 2. Total deaths from COVID-19 in Nepal
Nepal reported its first COVID-19 death on May 16 [8]. At the end of August, the number of deaths stood at 228, which went up to 498 at the end of September and 937 at the end of October [6]. In September and October, deaths doubled, and with winter setting in, fatalities may skyrocket. But if the data of the Nepal Army, which has been managing the bodies of the people infected with CP for their last rites, is anything to go by, the number of CP deaths has been quite higher than the government reported [9].
Among the total CP cases in Nepal, nearly 50% are from the Capital Kathmandu. Similarly, more than 50% of active cases of CP (total 36174 as of 9 November 2020) are also from Kathmandu. Among 1126 deaths, nearly 40% were from Kathmandu [6]. So, people living in Kathmandu Valley are more vulnerable to CP these days.
CP has created so many mental and psychological health issues [8, 10]. The recent tremendous increase in CP cases, along with daily more than 20 deaths, has also increased the fear among Nepalese. One study found the long prevalence of this pandemic has created different types of psychological disorders and chaos among Nepalese people [11].
The psychological issues due to the pandemic in Nepal may hit in several ways due to considerably low socio-economic status and fragile health care system.
The country was in full lockdown for more than four months. Further, the Nepal government's controversial statement about the free test and treatment of CP-suspected patients, not to visit the hospital unless someone is quite serious, and handling the dead body has also created some dilemma and fear in Nepalese people. Further, the situation that most of the hospital beds in Kathmandu are fully occupied with CP patients, and it is not easy to get beds for general people has also created lots of fear and stress among Nepalese people. Some people are already stressed as they face the problem of hand-to-mouth communication.
Therefore, the government's major challenges are early diagnosis, management of confirmed cases, contact tracing, and implementing some public health measures to reduce the infection's transmissibility.
Despite the limited resources, the Nepal government is trying its best to cope with CP. As the health care system of Nepal is fragile and lacks the necessary infrastructure to cope with an increasing number of CP, the country is not ready for a full epidemic. Nepal still needs to strengthen the health care system country-wide to control the present and future epidemics.
Nepal should also focus on mass counseling to get rid of the psychological fear of CP and other issues resulting from it.
Nepal is one of the world’s poorest and most populous regions. The first case in Nepal was confirmed on 23 January 2020 when a 31-year-old student, who had returned to Kathmandu from Wuhan on 9 January, tested positive for the disease 9 [1, 5]. It was also the first recorded case of COVID-19 in South Asia [3, 4]. Nepal's first case of local transmission was confirmed on 4 April in Kailali District. The first death occurred on 14 May [6]. A country-wide lockdown occurred on 24 March 2020 and ended on 21 July 2020 [5, 6]. As of 9 November 2020, the Ministry of Health and Population (MoHP) has confirmed a total of 197,024 cases, 159,724 recoveries, and 1,126 deaths in the country [6].
Most confirmed cases were initially imported from other countries in Nepal [1, 5, 6]. Nepal was braced for a "major outbreak" after some thousands of migrants returning from India tested positive for COVID-19. Most CP cases in Nepal initially involved either Indian nationals or Nepali workers who had recently returned from India due to the open and porous borders between India and Nepal [1, 5]. At first, major outbreaks were seen in the eastern area (Udayapur district), western area (Banke district), and central area (Birgunj) of Nepal, which were directly linked to people coming from India. However, since the beginning of September 2020, Kathmandu (Capital) has been considered the epicenter of CP, and nearly half of all COVID-19 cases have been reported from Kathmandu alone. Further, Nepal now ranks in the 34th country with 200 thousand reported COVID-19 cases [2].
However, the CP death rates are unequal across age groups. Since the CP death rate increases sharply with age, the larger the older population, the greater the challenges for communities and societies. Early data from Nepal shows people most affected by CP were people of the young age group, both in terms of infection and death [7]. However, the latest data shows that people of higher age groups are more vulnerable to CP, like many other countries. Many studies show older adults are more likely than younger people to have pre-existing conditions such as cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer. It makes older people more vulnerable to CP.
Figure 1 and Figure 2 show the daily and cumulative CP death chart of Nepal.
Figure 1. Daily new deaths from COVID-19 in Nepal
Figure 2. Total deaths from COVID-19 in Nepal
Nepal reported its first COVID-19 death on May 16 [8]. At the end of August, the number of deaths stood at 228, which went up to 498 at the end of September and 937 at the end of October [6]. In September and October, deaths doubled, and with winter setting in, fatalities may skyrocket. But if the data of the Nepal Army, which has been managing the bodies of the people infected with CP for their last rites, is anything to go by, the number of CP deaths has been quite higher than the government reported [9].
Among the total CP cases in Nepal, nearly 50% are from the Capital Kathmandu. Similarly, more than 50% of active cases of CP (total 36174 as of 9 November 2020) are also from Kathmandu. Among 1126 deaths, nearly 40% were from Kathmandu [6]. So, people living in Kathmandu Valley are more vulnerable to CP these days.
CP has created so many mental and psychological health issues [8, 10]. The recent tremendous increase in CP cases, along with daily more than 20 deaths, has also increased the fear among Nepalese. One study found the long prevalence of this pandemic has created different types of psychological disorders and chaos among Nepalese people [11].
The psychological issues due to the pandemic in Nepal may hit in several ways due to considerably low socio-economic status and fragile health care system.
The country was in full lockdown for more than four months. Further, the Nepal government's controversial statement about the free test and treatment of CP-suspected patients, not to visit the hospital unless someone is quite serious, and handling the dead body has also created some dilemma and fear in Nepalese people. Further, the situation that most of the hospital beds in Kathmandu are fully occupied with CP patients, and it is not easy to get beds for general people has also created lots of fear and stress among Nepalese people. Some people are already stressed as they face the problem of hand-to-mouth communication.
Therefore, the government's major challenges are early diagnosis, management of confirmed cases, contact tracing, and implementing some public health measures to reduce the infection's transmissibility.
Despite the limited resources, the Nepal government is trying its best to cope with CP. As the health care system of Nepal is fragile and lacks the necessary infrastructure to cope with an increasing number of CP, the country is not ready for a full epidemic. Nepal still needs to strengthen the health care system country-wide to control the present and future epidemics.
Nepal should also focus on mass counseling to get rid of the psychological fear of CP and other issues resulting from it.
References
1. Chalise HN. COVID-19 situation and challenges for Nepal. Asia Pacific J Public Health. 2020;32(5):281-2. [Link] [DOI:10.1177/1010539520932709]
2. Worldometer. COVID-19 coronavirus pandemic [Internet]. New York: Worldometer. 2020 [cited 2021, January 22]. Available from: https://www.worldometers.info/coronavirus/? [Link]
3. Chalise HN. South Asia is more vulnerable to COVID-19 pandemic. Arch Psychiatr Ment Health. 2020;4:46-7. [Link] [DOI:10.29328/journal.apmh.1001018]
4. Chalise HN, Pathak KP. Situation of COVID-19 Pandemic in South Asia. J Health Allied Sci. 2020;10(2):11-4. [Link] [DOI:10.37107/jhas.184]
5. Chalise HN. COVID-19 situation in Nepal. Arch PsychiatrMent Health. 2020;4: 33-4. [Link] [DOI:10.29328/journal.apmh.1001015]
6. Novel coronavirus (COVID-19) media briefing. Ministry of Health and Population (Nepal) [Internet]. Kathmandu: Nepal. 2020 [cited 2021, March 16]. Available from: https://covid19.mohp.gov.np/ [Link]
7. Chalise HN, Rosenberg E. COVID-19 and Immunity in the Elderly. J Geriatric Med. 2020;1(3):9-12. [Link] [DOI:10.30564/jgm.v1i3.2049]
8. Chalise HN, Dhungana HN. Fears of COVID-19 catastrophe as Nepal reports death from new Coronavirus. J Phys Med Rehabil Disabil. 2020;6:47. [Link] [DOI:10.24966/PMRD-8670/100047]
9. Kathmandu Post. Nepal's Covid-19 death toll crosses 1,000 mark [Internet]. Kathmandu: Nepal. 2020 [Cited 2020 November 10]. Available from: https://kathmandupost.com/health/2020/11/04/nepal-s-covid-19-death-toll-crosses-1-000-mark [Link]
10. Xiang YT. Timely mental health care for the 2019 novel Coronavirus outbreak is urgently needed. Lancet.2020;7(3):228-9. [Link] [DOI:10.1016/S2215-0366(20)30046-8]
11. The Himalayan Times. Psychosocial problems due to COVID-19 and coping mechanisms [Internet]. 2020. Kathmandu: Nepal [cited 2020, September 5]. Available from: https://thehimalayantimes.com/opinion/psychosocial-problems-due-to-covid-19-and-coping-mechanisms/?fbclid=IwAR1mUISw-SaNGgfZpdbjaNcJ1TRzu-EhYgI9Wg5X9UexEwtsoxwyP-6LnsQ [Link]