BackgroundThe coronavirus disease 2019 (COVID-19) pandemic strained the already weak health system of Nepal, especially during the surge of the delta variant. A telephonic consultation service was rapidly established to provide free consultations to assist those in home isolation due to severe acute respiratory syndrome coronavirus 2 infection. In this study, we describe the process of establishing the hotline and share preliminary findings. During the peak of the delta wave in Nepal, the hotline was started by a local nonprofit organization. MethodologyWe established the hotline with help of a private telecommunication company. The hotline was advertised on social media, radio, and newspapers. Healthcare workers were recruited and trained and the service was provided for free. Patient data were recorded and de-identified for analysis, monitoring, and evaluation. ResultsThe majority of the callers were from Kathmandu valley, which includes three districts, Kathmandu, Lalitpur, and Bhaktapur. Overall, 44% of the callers inquired about the clinical manifestations of COVID-19. On average, there were 75 calls each day between May 2021 and February 2022. The average call duration was three minutes and 42 seconds. Trained healthcare workers answered the calls for 15.5 hours a day. ConclusionsOur work established the feasibility of a rapid hotline service in response to the pandemic causing high strain on the health system. Lessons learned from this experience can be useful for future disasters in Nepal and other places with similar health system strains.

There are estimated over 8 million Nepali migrants spread across various countries around the globe. Though the majority of them enjoy good health in general, a large proportion of them suffer from non-communicable diseases, mental health issues and communicable diseases. Telemedicine services, which are organized by Non-Resident Nepali Association (NRNA), have been proven to be effective in addressing some of the medical needs of the migrant Nepali workers. The purpose of this study is to assess the use of tele-health services among Nepali migrant population and examine the limitations. During the pandemic period from March 2020 through August 2021, Nepali in different countries utilized telehealth services. Mental health issues, chronic diseases, skin diseases were the most common ailments people sought telehealth services for. Digital gap, lack of cross-border regulations and unwillingness to utilize telemedicine were the challenges the service faced in the optimal use of such services. Training and education, use of easy Apps and subsidies from the government would help in the long-term use and sustainability of telehealth services amongst the Nepali migrants.