The COVID-19 pandemic is having far reaching impacts, well beyond the health sector, with the most severe impacts experienced among vulnerable and marginalized communities who are typically hardest affected by humanitarian crises, including natural disasters. While the numbers of cases in Nepal were relatively few until August, they increased sharply until the end of October, reaching over 5,000 new cases per day. In November daily new case figures subsided somewhat but remain at up to 2,000 per day. While initially border areas were most affected, in recent months the majority of cases have been identified in the Kathmandu Valley. As of 10 January 2021, the total COVID-19 caseload in Nepal is 264,780, with over 1,900 deaths. The Government of Nepal is leading the response to the outbreak in Nepal but, as in many countries, capacities are stretched, and international solidarity is required.
With the surge in cases, the Ministry of Health and Population (MoHP) of the Government of Nepal has come up with a COVID-19 Health Sector Rapid Action Plan (November – February 2021), and different federal ministries, provincial governments and local governments are working together to ensure that response plans are in place to mitigate the impacts of the latest spike in COVID-19 cases. Governmentled clusters are operational at federal and provincial levels, and international partners in-country are working closely with government counterparts to provide support where required. While the health system is being strengthened to respond to the public health emergency, and given that the impacts of COVID-19 extend beyond the health sector, the clusters are working to address humanitarian needs, mitigate the impact on broader service delivery and ensure service continuity in key sectors, such as protection, psychosocial, education and the provision of water, sanitation and food assistance where needed.
At the current stage of the COVID-19 outbreak, the health system faces several critical challenges. The proportion of asymptomatic cases is falling, while symptomatic cases are increasing due to both increases in transmission, as well as a change in testing policy. This has led to an increased caseload for hospitals, requiring not only additional bed capacity, but also greater oxygen availability, monitoring of oxygen perfusion, additional ICU capacity and ventilators for monitoring and treatment of severe cases. At the district level, human resource capacity to operate ventilators and provide ICU case management is a critical challenge and of the utmost importance to address in order to effectively respond to severe COIVD19 cases across the country.
The revised CPRP is a plan prepared by the Humanitarian Country Team and the clusters working in collaboration with, and support to, the Government of Nepal. Given the continuous multi-dimensional impact of COVID-19, the revised CPRP still includes a significant health component, but also highlights needs related to coordination planning and monitoring, protection, risk communication and community engagement, food security, water, sanitation and hygiene (WASH), nutrition, education, shelter/CCCM, early recovery, and logistics. The Humanitarian Country Team will continue to work with government at federal, provincial and local levels.