Fighting the pandemic requires coordination

Fighting the pandemic requires coordination, yet it is lacking at all levels.

fighting coordination

The Covid-19 Crisis Management Centre wants the Health Ministry to devise a strategy to stop the virus from spreading. The Ministry claims that its recommendations are not being implemented, and that the Centre is to blame.

Senior officials from the Ministry of Health and Population were assigned to all seven provinces last month to assess the handling of the Covid-19 pandemic’s first and second waves.

According to multiple ministry officials the Post spoke with, the litany of complaints from health workers and people’s representatives in local governments was similar: insufficient financial resources, not enough antigen test kits, lack of viral transport medium needed for polymerase chain reaction tests, and non-payment of promised allowances to health workers.



“Like at the center, we noticed a lack of cooperation as organizations under provincial and local governments did not take the pandemic’s hazards seriously enough,” a Health Ministry official stationed in one of the provinces told the Post, requesting anonymity.

“I am not authorized to speak to the media, but we discovered that we could have controlled the epidemic significantly better than what happened if all agencies involved had taken responsibility for their actions.”

Even after 18 months, as the official pointed out, there appears to be no central coordination in the fight against the pandemic.

The Covid-19 Crisis Management Centre, established under the Covid-19 Crisis Management Ordinance of May 20, is in charge of taking the required steps to stop the epidemic from spreading and formulating the policies needed to do so. However, it blames the Health Ministry for failing to come up with action measures.

“We have had several rounds of meetings with officials from the Health Ministry and other ministries, but the Health Ministry officials have not presented any plan for better and effective pandemic management,” said Nurhari Khatiwada, a spokesperson for the Covid-19 Crisis Management Centre, to the Post.

“We’ve been attempting to persuade them to improve coordination and cooperation.”

Despite the fact that the Covid-19 epidemic is a public health issue, the Centre is led by a retired Nepal Army lieutenant general. It includes officials from the ministries of the interior, trade, and health, as well as security agencies.

The Health Ministry, on the other hand, points to the Covid-19 Crisis Management Centre, which it claims should be coordinating and issuing orders.

“The CCMC was established to coordinate among all the agencies concerned, and it is responsible for taking the necessary actions [to contain the pandemic] and delivering orders to the authorities concerned,” Dr. Samir Kumar Adhikari, the Health Ministry’s joint spokesman, told the Post.

According to Khatiwada, the Centre has met with representatives from a number of other ministries.

The current Covid-19 Crisis Management Centre is distinct from the previous one in that it is solely responsible for reacting to the pandemic.

The Covid-19 Crisis Management Centre was established on March 29 of last year, with the then-deputy prime minister as its director. Several ministers were present, but the Centre had nothing to show for its attempts to halt the pandemic’s spread.

When the country was attacked by the second wave of the epidemic in April of this year, the administration of KP Sharma Oli issued the Covid-19 Crisis Management Ordinance. Balanada Sharma, who served as the coordinator of the Army Integration Special Committee throughout the peace process, was named the Centre’s new director.

However, it appears to be overly reliant on the Ministry of Health.

“The CEO has been attempting to get officials from the Ministry of Health to cooperate and coordinate,” Khatiwada stated. “Without the support of all agencies involved, this pandemic will not be vanquished, and the Health Ministry’s responsibility in confining the pandemic is critical.”

According to experts, this pandemic is no less than a war, and the battle cannot be won without improved coordination and cooperation among all state institutions and the general public.

Dr. Biraj Karmacharya, an epidemiologist at Dhulikhel Hospital, told the Post, “We are still battling to overcome the pandemic, therefore coordination is still vital.”

The Ministry of Health claims that its directions and recommendations are ignored.

“For example, testing should be increased, and we have sent hundreds of thousands of antigen testing kits to local governments to do so, but tests are not being conducted in adequate numbers,” said Adhikari, the Health Ministry’s joint spokesperson. “Public transit and gatherings should be restricted and supervised, and crowding should be prohibited,” says the author, “but nothing has been done.”

Local governments, on the other hand, claim that they are simply granted tasks without any inquiry from provincial or federal government entities.

“Neither the federal government nor the provincial government agencies contact us to inquire about our difficulties or pandemic preparations,” said Uddhav Prasad Kharel, mayor of Kathmandu’s Budhanilkantha Municipality. “We tried to do everything we could with the resources we had, including maintaining isolation centers.”

With the rapid spread of the Delta variety of SARS-CoV-2, which is more transmissible than other strains, producing a surge in new cases in recent days, public health experts say better preparations are needed to minimize the loss.

There has, however, been very little planning.

Even the construction of holding centers at Nepal-India border crossings, which began before the second wave of the pandemic, has not been completed. The Ministry of Health is completely unaware of the situation.

“As of now, we are unaware of the completion and handover of the holding centers,” Adhikari said. “Before the start of the second wave, the Nepal Army was charged with establishing one 1,000-bed holding center in each of the seven provinces, as well as one in Kathmandu.”

According to Santosh Ballav Poudyal, a spokeswoman for the Nepal Army, they would take some time to complete because the national defense force has already signed a contract to put up six detention centers.

“The Nepal Army has already inked a contract for the establishment of six detention centers. We plan to finish their construction in two months and expect to have them ready before the third wave reaches the country,” Poudyal told the Post. “Work has not begun in two locations due to land acquisition issues.”

According to the Health Ministry, there were 31,298 active cases across the country on Sunday. 1,981 persons tested positive in polymerase chain reaction tests in the last 24 hours. The optimism rating has remained high—it was 24% on Sunday.

Experts argue that, in addition to restoring quarantine and isolation centers, testing should be increased, and contact tracing and isolation of sick people should be made more effective.

Despite the fact that the phrase has been repeated for the past 18 months, neither testing nor contact tracing has improved.

According to Dr. Baburam Marasini, former Director of the Epidemiology and Disease Control Division, “the only approach to restrict the transmission of any virus, including the Delta variety, is to increase testing, isolate patients, and make contact tracing effective.”

“I am baffled by the government’s policy. Why have all of these efforts been abandoned, without which the epidemic would not be brought under control?”

One of the responsibilities given to Health Ministry officials when they were dispatched to the provinces last month was to gather input from provincial and local government agencies in order to begin planning for a possible third wave.

But, according to specialists, the writing is on the wall in terms of bringing the pandemic under control–testing, contact tracing, increasing vaccination, and establishing infrastructures, among other things.

“These are essential things,” said Karmacharya, who is also the chairman of Dhulikhel Hospital’s Department of Community Programme.

According to Marasini, a former government official, creating many bodies that simply issue instructions is unhelpful since it undermines coordination and cooperation.

“Instead of building agencies that carry out directions, authorities continue to expand agencies that merely provide orders,” Marasini added.

“Things might have been different if the government had expanded health personnel, including doctors, and hired volunteers for contact tracing and lab technicians for testing.”

Source – The Kathmandu Post

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