Mapping out COVID-19 Cases in Nepal

Case #1, January 24, 2020, Recovered on February 7.
The first case of COVID-19 was reported in January 24, 2020 in a male of 32 years age. It was in a Nepali PhD student who came from Wuhan China. His blood samples were taken to Singapore for Polymerage (PCR) test, and he was confirmed positive. he was admitted to Shukra Raj Tropical Hospital on ... and Discharged on...The patient had shown mild symptoms, and was completely cured by the end of January.

A 31-year-old student of Wuhan University who had returned home on 5 January,^[49] was admitted with mild symptoms on 13 January and discharged on 17 January with instructions to self-quarantine at home after preliminary tests showed he may not be infected.^[50] Although Nepal had the laboratories and the skilled manpower to test for the disease, Nepal did not have the reagents required. The reagents cost around Rs 17,000 per test and need to be bought in bulk, sufficient for about 200 tests. As there were no other suspected cases needing testing, the officials decided to send the samples to Hong Kong instead of buying the reagents.^[51] The samples were sent to Hong Kong on 21 January.^[52] On 24 January, the Health ministry confirmed that the test had come back positive. The ministry said the patient was under surveillance, those who came into close contact with him were being investigated, and health information on all passengers returning from China was being sought.^[53] However, The Kathmandu Post quoted officials at the Epidemiology and Disease Control Division as saying that no one knew of the patient's activity since he was discharged and that they were looking for him.^[54] Later, they said that they had only spoken to the patient on phone; he had reported being in good health and was not asked to come in for check-up or monitoring.^[55] The patient was confirmed completely treated when RT-PCR throat swabs returned negative for COVID-19 in followup assessments of 29 and 31 January.^[36]^[56] None of the people known to have come in contact with the patient showed any symptoms after three weeks of the patient's return to Nepal, and it was therefore presumed that he had not transmitted the disease to anyone else in Nepal.^[34

In January, 2020, the outbreak of the 2019 novel coronavirus (2019-nCoV) in China spread progressively to other countries, 1, 2 with WHO declaring it a Public Health Emergency of International Concern.
3 Among the affected countries beyond China (where 12 307 cases and 259 deaths were reported as of Feb 1, 2020) are others in Asia, including Nepal. 4

On Jan 13, 2020, a 32-year-old man, a Nepalese student at Wuhan University of Technology, Wuhan, China, with no history of comorbidities, returned to Nepal. He presented at the outpatient department of Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, with a cough. He had become ill on Jan 3, 6 days before he flew to Nepal. He indicated no exposure to the so-called wet market in Wuhan. Throat swabs obtained from the patient tested positive for 2019-nCoV on real-time RT-PCR assays at the WHO laboratory in Hong Kong. On admission to hospital in Kathmandu, his temperature was 37·2°C (99°F), with throat congestion, but with no other relevant signs or symptoms. He was isolated and treated with broad-spectrum antibiotics and supportive therapies. After 6 h, he complained of mild breathing difficulty and had decreased oxygen saturation (SpO2 87% on room air). Chest radiographs obtained on admission showed an infiltrate in the upper lobe of the left lung (figure). On Jan 14, his temperature rose to 38·9°C (102°F) and the next day he had breathing difficulties while in the supine position, with crepitations in the right lower lung field. His fever was no longer present on Jan 16, and his clinical condition improved. He was discharged the next day and instructed to self-quarantine at home. Laboratory tests showed no abnormalities. Real-time RT-PCR assays for influenza A and B viruses, and NS1 antigen rapid tests for dengue viruses, scrub typhus, and Brucella spp were negative. Follow-up assessments on Jan 29 and Jan 31 gave an RT-PCR negative throat swab for 2019-nCoV. Informed consent was obtained from the patient to be included in this Correspondence.

Compared with other recently reported cases, which included rapid worsening and even progression to death,
1, 2, 5, 6 our patient had only mild disease and survived and recovered after 13 days.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30067-0/fulltext

https://economictimes.indiatimes.com/news/international/world-news/nepal-confirms-first-case-of-deadly-coronavirus/articleshow/73590302.cms

KATHMANDU: Nepal on Friday confirmed the first case of deadly coronavirus in the country identifying the infected person as a Nepali student who recently returned from the Chinese city of Wuhan, local media reports said.

The 31-year-old man, who is doing his PhD in Wuhan, had returned from the Chinese city on January 5. He had visited a hospital complaining of respiratory problems and was admitted on January 13, the Kathmandu Post reported.

He was given medication and once his ..

The travel restrictions were not imposed and Nepal's TIA allowed the travelers, both Nepalis and international, check out un-checking. Corona is highly contagious disease. It spreads from the nasal and oral droplets of an infected person to the one who is in close contact of less than 3 meter.

Case #2, March 23, 2020
The second case of COVID-19 was a student of 19 years old female, confirmed on 23 March, who had returned from France's Paris via Quatar. Prashidhi Shrestha of Kathmandu Municipality, Ward..., who is a student in Paris and had come back home after the corona became pandemic in France and else where. She was admitted to Teku hospital and was discharged on ... after ... days stay in the hospital. Her family was also put in quarantine at home.

https://thehimalayantimes.com/kathmandu/one-more-case-of-coronavirus-confirmed-in-nepal/

Case #3, March 25, 2020
The third case was confirmed on 25 March, 2020. It was on a man who was working in UAE and returned to his home district Dhading on ... The patient was staying in a hotel in Kathmandu. He was admitted to Shukra Raj Tropical disease Hospital on ... and got discharged on ...after ... days of stay in the hospital.

Case#4, March 27, 2020
The fourth case, the first outside Bagmati Province, was confirmed on 27 March, in a 34-year-old man who had recently returned from the Middle East. He was treated in Seti Provincial Hospital in Dhangadhi

Case #5, March 28, 2020
The fifth case was confirmed in Baglung on 28 March, in a 19-year-old female who had returned from Belgium via Qatar. She had shared a flight from Doha to Kathmandu with the patient who was confirmed on 23 March, the 19 years old female from Kathmandu. She was admitted to Dhaulagiri Hospital on .... and discharged on ... after ... days.

Case #6, April 2, 2020
The sixth case was confirmed on 2 April in a woman from Baglung. She traveled on AR-652 flight from Doha to Kathmandu. She was admitted to Dhaulagiri Hospital in Baglung on ... and discharged on ... after ... days.

Case #7, 8 and 9, April 4, 2020

Three new cases were confirmed on 4 April, two of them were men who had recently returned from India and one was a 34-year woman, a relative of one of the previously confirmed patient (Case #4). She was also the first instance of local transmission within Nepal.
Three new positive cases were confirmed in the far-western region of Nepal. Among the three are a 21-year-old male of Kailali who had returned from Mumbai in India, 41-year-old male of Kanchanpur who had returned from Uttarakhand in India, and a 34-year-old female from Kailali who is known be a relative of one of the earlier infected persons.^[161] This is the first local transmission in Nepal.^[162]

Case #10, 11 and 12, April 11, 2020

On 11 April, three more cases were confirmed, in Indian nationals who had been stranded in Birgunj of Parsa District.

According to the ministry, throat and nasal swabs from 21 men residing in a mosque at Chhapkaiya in Birgunj Metropolitan City Ward No. 2 were tested for the coronavirus at the laboratory of the Vector Borne Disease Research and Training Center in Hetauda on Friday.

“Three of them aged 37, 44 and 55 were taken to an isolation ward of the Narayani Hospital after they were suspected to have contracted the virus,” the ministry said in a statement.

After the samples tested positive for Covid-19, they were dispatched to the National Public Health Laboratory in Kathmandu for confirmation.

“The laboratory on Saturday evening confirmed Covid-19 in all three samples,” said Dr Bikash Devkota, spokesperson for the Health Ministry, at a regular press briefing on Sunday. “All three have been sent to the isolation facility set up at the Narayani Provincial Hospital in Birgunj.

Devkota said that the health condition of all three patients is normal and that contact tracing of all who came in close contact with them has begun.

https://kathmandupost.com/national/2020/04/12/three-indian-nationals-in-birgunj-test-positive-for-covid-19

Case#13 and 14, April 13, 2020

On 13 April, a 65-year-old woman from Kailali and a 19-year-old man from Rautahat tested positive.

The Ministry of Health and Population (MoHP) has confirmed detection of two new positive cases for the COVID-19. With this, total number of COVID-19 cases in Nepal has reached 14.

According to Dr. Devkota, a 65-year old lady of Lamkichuha Municipality, Kailali and a 19-year old male of Rautahat had tested positive for the virus.

The 65-year old woman used to sell tea at Birgunj border. After she got stranded in Birgunj due to the lockdown, she, along with 16 others was sent to Kailali by the help of local administration on March 30.

They were kept in quarantine at Lamki Multi-purpose Campus, Kailali.

As the virus was not detected in Rapid Diagnostic Test (RDT), she was sent back to her home, after completion of quarantine period.

But as she tested positive for the virus through PCR method, preparations are going on to quarantine 16 others again, who were quarantined with the patient on March 30.

https://risingnepaldaily.com/main-news/mohp-confirms-2-more-covid-19-cases-number-reaches-14

Case# 15, 16, April 14, 2020

On 14 April, two new cases were confirmed in a family from Kathmandu which had returned from the United Kingdom four weeks prior.

https://myrepublica.nagariknetwork.com/news/92625/

KATHMANDU, April 14: Two of three members of the same family residing in the Sun City Apartment in Kathmandu have tested positive for COVID-19 at Teku based National Public Health Laboratory on Tuesday, according to Health and Population Ministry.

On its Facebook update this afternoon, the ministry said that a 58-year-old male and 81-year-old female have tested positive for this deadly virus during the polymerase chain reaction (PCR) test.

However, another patient has tested negative in the first PCR test.

Earlier, they tested positive for the virus through rapid diagnostic test (RDT) on Monday. After the test results came positive, the ministry took the family members to the Patan Hospital. Currently, they have been receiving treatment at the isolation ward of the hospital.

It has been learnt that the family had returned to Kathmandu from the United Kingdom 28 days ago. According to a high-level government official, they [UK returnees] were tested as per the decision of the government to test all the individuals arriving in Nepal after mid-March.

Case# 17 - 30, April 17, 2020

On 17 April, 14 new cases were confirmed, 12 of them, Indian nationals from Delhi, quarantined in Udaypur, and two, Nepalis from Chitwan who had recently returned from abroad, taking the total number of cases to 30.

Recovered case #2: On 18 April, a second complete recovery was confirmed in Kathmandu, bringing the total number of active cases to 28.

May 6: 17 cases in Nepalgunj

May 7: 2 cases males in Kapilbastu (16 and 22 years)

As the number of cases started increasing, it became inevitable to build a COVID-19 tracking dashboard for Nepal. I worked on acquiring ESRI software support. Then the platform was ready on April 5, 2020.

Ministry of Health and Population started giving briefings on the number of tests and resulting positive or negative cases every day to the media and people of Nepal through TV and Facebook live.

The data collected from online news portals and news on TV and radio was compiled during day time and verified with the Government's data provided during the media briefing.

The dashboard has now information profiling the nature of spread of COVID-19 in Nepal. These are the components of the dashboard:

A. Maps