Dr Pratima Sharma
Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. It was initially reported to the WHO on December 31, 2019. On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency. On March 11, 2020, the WHO declared COVID-19 a global pandemic.
First case of COVID-19 was seen in Nepal on 23rd Jan 2020, almost after a month of the disease incidence in China. At that time this disease was not declared a pandemic, but its cases were spreading slowly over Europe and North America. This first case landed Nepal from China. The case was mild symptomatic and was discharged within 2 weeks after full recovery. The second case was seen a month after the first case and then the frequency of positive cases rose over the period. However, the scenario for other countries was getting chaotic with dramatic increase in COVID-19 counts as well as deaths.
Nepal is a landlocked country which shares its southern border with India and China at the north, Nepal was declared was one of the vulnerable countries for corona epidemic by WHO considering the poor health system of the country and fairly relaxed border with both neighbouring countries. After announcement of COVID -19 as pandemic, Nepal was locked down after few days. Cases were expected to rise, and people were horrified after seeing the situation of developed countries like Italy, US and Spain.
Fortunately, the condition in Nepal is not as dire as expected even after 3-4 weeks of lockdown. Till date there are 31 cases, each with mild symptoms. The cases are scattered in Western and Central region mostly and some in Eastern region as well. The greatest achievement so far has been the zero death with no ICU admission till date. Cases are recovering and none of the patients have shown severe symptoms.Even the members of family with positive cases are tested negative without self isolation. It is very strange to find this picture, amidst the skyrocketing count of cases and death in our neighbouring country India despite open border.
Many studies and researches are being conducted globally to find the proper treatment and vaccine against this malady. One of the pulmonologists in Germany recently suggested that there are two primary phenotypes of this virus: Type L and Type H which requires different respiratory treatment. Likewise, another group of doctors in New York identified three main variants of this virus and named them A, B and C. A and C are found in significant proportion in Europe and America whereas Type B in East Asia. In addition, different symptoms and complications of COVID-19 are adding up everyday. It has not spared any system of the human body. Medical science is facing the immense challenge and no standard treatment protocol has been proposed yet.
Why the symptoms, severity and transmission of SARS-CoV-2 is showing different pattern in Nepal? Is it the mutation of the virus to less contagious and less severe form or is it the herd immunity of Nepalese or the geography of Nepal? No one is really concerned about it and noneof the research has been conducted to study the variation. Amidst this, Nepalese have their own believe. Some think Nepal has always been protected by the presence of holy shrine of Lord Pashupatinath while others believe that their lifestyle, polluted environment around them along with contaminated food and water had made them immune to this virus. However, the developing countries in South Asia having similar living condition to that of Nepal like Pakistan and Bangladesh haven’t shown the similar pattern.
The reason behind this distinctform of the perilous virus might not be imperative at this stage asmany developed countries are struggling to save the lives of their people. What if this study helps the scientiststo learn more about this virus and develop the precious vaccine? I am not sure whether this is the perfect time to divert the researcher’s eyes towards this unusual pattern. However, being a medical doctor from Nepal, I feel the answer to theperplex case of COVID-19 could be foundin the land of Himalayas.