Understanding COVID-19 Situation in Nepal and Implications for SARS-CoV-2 Transmission and Management

Abstract

Background: The pandemic of Coronavirus Disease 2019 (COVID-19), one of the most infectious diseases in the modern history, is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and has had a profound health and economic toll, globally. This paper identifies the overall health status associated with COVID-19 pandemic in all 7 provinces of Nepal, a developing country in South Asia, analyzing data from January 2020 to February 2022. It focuses on the SARS-CoV-2 prevalence, transmission through wastewater and other routes, diagnostics, treatment options, and alternative medicines, thereby offering key perspectives for its management. Materials and Methods: Studies regarding coronavirus spanning the 2017 to 2022 period were searched on the web, Nepalese database, and Web of Science. Refined criteria included SARS-CoV-2 in wastewater of Nepal or worldwide. Demographic data (sex, age-group, and geographic location) were also obtained from websites and relevant reports of the Ministry of Health and Population (MOHP) of Nepal, ranging from January 2020 to February 2022. Moreover, trends concerning lockdown, business, and border activities in Nepal between February 2020 and October 2020 were evaluated. The viral dissemination pathways, diagnosis, and available treatment options, including the Ayurvedic medicine, were also examined. Results: Aerosols generated during the hospital, industrial, recreational, and household activities were found to contribute to the propagation of SARS-CoV-2 into environmental wastewater, thereby putting the surrounding communities at risk of infection. When lockdown ended and businesses opened in October 2020, the number of active cases of COVID-19 increased exponentially. Bagmati Province had the highest number of cases (53.84%), while the remaining 6 provinces tallied 46.16%. Kathmandu district had the highest number of COVID-19 cases (138, 319 cases), while Manang district had the smallest number of infections (81 cases). The male population was found to be predominantly infected (58.7%). The most affected age groups were the 31 to 40 years old males (25.92%) and the 21 to 30 years old females (26.85%). Conclusion: The pandemic impacted the public health and economic growth in our study duration. SARS-CoV-2 was prevalent in the wastewater of Nepal. The Terai districts and the megacities were mostly affected by SARS-CoV-2 infections. Working-age groups and males were identified as the highest risk groups. More investigations on the therapeutic and alternative cures are recommended. These findings may guide the researchers and professionals with handling the COVID-19 challenges in developing countries such as Nepal and better prepare for future pandemics.

SARS-CoV-2 Burden in Wastewater and its Elimination Using Disinfection

“…Public health and economic progress were impacted by the pandemic. 5 Since the discovery of the epidemiological surveillance of pathogens in wastewater systems in the 19th century, it has made a substantial contribution to the surveillance of highly transmissible infectious illnesses. 41 In theory, a sewage system stores the biological waste that it carries from the human population.…”

“…During the low- and middle-risk COVID-19 periods, the SARS-CoV-2 RNA has been found in groundwater, surface water, wastewater, sludge, and other hospital-related water systems. 5 , 57 However, there is no suitable standard procedure for RNA detection in wastewater. The method employed to determine the virus concentration is not very effective at recovering these viruses.…”

“…4 It was shown that aerosols produced during hospital, industrial, recreational, and domestic activities assisted SARS-CoV-2 spread into environmental effluent, placing the nearby communities at risk for infection. 5 Household sewage, industrial sewage, and other pollutants are contaminating water supplies. Organic materials, bacteria, ammonia, pesticides, and many other toxins are present in contaminated water.…”

“… 4 It was shown that aerosols produced during hospital, industrial, recreational, and domestic activities assisted SARS-CoV-2 spread into environmental effluent, placing the nearby communities at risk for infection. 5 …”

Clinical Features and Management of Patients Admitted for Emergency Surgery at Tertiary Care Hospital during COVID-19 Pandemic

“…The most common symptoms were fever, fatigue, dry cough, shortness of breath, loss of smell and/or taste, loss of appetite and myalgia. Less common symptoms were diarrhea, abdominal pain, sputum production, rhinitis, sore throat and headache (Dawadi, Syangtan, & et.al., 2022).…”