Off the Record 004: The jab

Issue 004 • 30 April 2021

Apr 30, 2021

It’s April 30, 2021, and you’re reading Off the Record, the weekly newsletter from The Record. We are an independent, ad-free, digital news publication out of Kathmandu, Nepal.

I’m Pranaya Rana, editor of The Record, and in this newsletter, we’ll stop, take a deep breath, and dive deep into one singular issue that defined the past week.

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Good morning, good afternoon, and good evening from locked-down Kathmandu.

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Parts of Nepal, including all three districts of the Kathmandu Valley, are currently under lockdown after an exponential rise in the number of daily Covid-19 cases. The Valley alone has a lion’s share of national cases, with over 2,000 daily cases every day for three out of the past four days. After last year’s botched nationwide lockdown, the federal government has this time around ceded authority to the districts to enforce restrictions. So it was the three Chief District Officers of Kathmandu, Lalitpur, and Bhaktapur that decided to enforce a 15-day lockdown in the Valley starting Thursday, April 29, restricting all public movement and closing down all businesses. Haunting images from last year’s lockdown continue to linger and there is hope that this one will not be as devastating on the poor and marginalized.

But we are just a day into the lockdown and much remains to be seen. Thousands have already left the Valley to go back to their home districts while others are staying put and waiting out the lockdown, hoping it will not be extended beyond the two weeks. That, however, is unlikely, as public health experts believe that the coronavirus has already spread far and wide into the community for the lockdown to halt its spread effectively. Nepal’s reproduction rate of the virus (R0 factor) was 2.08 as of April 26, compared to 1.39 in India. This means that every infected person in Nepal is spreading the virus to at least two other people.

Doctors say that it is unlikely that numbers will decrease significantly over the coming two weeks for the lockdown to be lifted, but it could buy the country some time to prepare for the health care crisis that seems inevitable. Already, hospitals in urban centers like the Valley, Pokhara, and Nepalgunj have filled up with Covid-19 patients and ICU beds are getting more scarce. Supporting the health care system will require a significant mobilization of the state’s resources, especially at the federal level. Doctors are advising that the authorities commandeer banquet halls, school gymnasia, and sports stadia and turn them into makeshift field hospitals.

Everyone, from doctors to journalists to everyday citizens, seems to be calling for more concerted action from the authorities but little appears to be forthcoming. There appears to be a divide between the Health Ministry, led by Minister Hridayesh Tripathi, and the rest of Prime Minister KP Sharma Oli’s Cabinet. When the Health Ministry’s projections showed that daily cases could climb to around 11,000, Tripathi, in an interview with Nepali Times, says he was ridiculed and dismissed, even as Oli and his coterie continued political rallies with thousands in attendance.

The coming weeks are going to be critical in how hard the second wave of the pandemic is going to hit Nepal, and if Nepal will be able to weather the blow. Stay tuned to The Record over the coming days as we attempt to parse just how this second lockdown is going to affect Nepalis and if it will dampen the Covid-19 wave.

For now, a deep dive into an equally pressing matter — vaccinations.

The deep dive: The jab

Nepal rolled out its vaccination drive on January 27, months ahead of most countries around the world. Armed with a million doses of the Covishield vaccine — developed by Oxford University and AstraZeneca, produced by the Serum Institute of India, and donated by the Government of India — Nepal began with vaccinating its frontline health workers, a welcome move.

But then, the Nepal government, inexplicably, began to provide vaccines to bankers, development workers, diplomats, and journalists, before the elderly had even had a chance to get the vaccine. The media, which is quick to harangue the rich and powerful over such ethical infractions, quietly vaccinated its workers, including accountants, IT personnel, desk and copy editors, even friends and family of mediahouse owners. The UN had publicly assured that its employees would not be receiving the vaccine ahead of more at-risk groups, but privately contradicted its own promise. The Record was the only media outlet that reported on journalists, UN officials, and diplomats jumping the vaccine queue.

This lack of accountability from journalists is perhaps to be expected. After all, many were just happy to be protected and if the government had prioritized them upon the lobby of some very powerful media owners, so be it. They weren’t going to look a gift horse in the mouth, as the cliche goes. And of course, ethics and morals are only for politicians; everyone else gets a free pass. And who is to report on the UN when for many journalists, a job at the UN is their end goal.

Perhaps I’m being a little bitter here, so let’s move on.

The elderly eventually received the first dose of the vaccine, over a month later, in the first week of March. The authorities justified the delay by saying that they did not have enough vaccines left over from India’s 1 million dose donation to cover the entire elderly population. It was only when the first shipment of Nepal’s 2 million vaccine order that it had placed with the Serum Institute of India arrived that it began to vaccinate the elderly. Nepal paid $4 per dose for the 2 million vaccines, but the remaining 1 million doses have yet to arrive as India has placed a moratorium on vaccine exports in light of its own crisis.

Right about this time, on March 7, Nepal also received 348,000 doses of the AstraZeneca vaccine through COVAX, the global vaccine alliance. These doses too were employed for the elderly.

Then, in late March, Nepal received a donation of 800,000 doses of China’s Verocell vaccine, developed by Sinopharm, which it began to dole out to the public. This particular inoculation drive has been an unmitigated disaster. First, the authorities said that they were only providing the Verocell vaccine to a selected few, primarily students going to China for higher studies. Then, without adequate or even clear notice, the vaccine began to be provided to anyone above 18 and below 60 years of age in the Kathmandu Valley. There was no press release from the Health Ministry outlining when and where to get the vaccine, let alone who was eligible. As India began to fall into chaos, Nepalis made a mad-dash for the vaccine. Inoculation centers were overwhelmed with hundreds of people lining up for the vaccine, leading to mass crowding and creating infection hotspots. Neither the hospital authorities nor governments showed any interest in managing the vaccination drive.

The authorities simultaneously announced that those who had received the first dose of the Covishield vaccine in the first phase would now be receiving the second dose, leading to even more confusion as Valley residents struggled to figure out which hospital was vaccinating what group of people.

I was at two hospitals for the Verocell vaccine — Alka Hospital in Ekantakuna and the Nepal Police Hospital in Pani Pokhari. At both hospitals, serpentine queues packed with people stretched hundreds of meters. Social distancing was nigh impossible as we waited in line for hours. The only saving grace here was the fact that everyone was wearing a mask. I finally managed to get the first dose of the vaccine at around 3.30 pm, after arriving at 9 am in the morning.

Nepalis awaiting the vaccine outside of the Kathmandu Valley have been abandoned by the wayside. Although frontline and health care workers and the elderly received vaccines across the country, the Verocell vaccine has only been deployed in the Kathmandu Valley, citing transportation and storage concerns. This alone speaks to the continuing primacy of Kathmandu in Nepal’s socio-political geography.

Now, with a lockdown in the Valley, all vaccination campaigns have been suspended. Frontline and health workers, bankers, journalists, aid workers, diplomats, and bureaucrats are currently the only ones who are fully vaccinated. Everyone else — those with comorbidities and the elderly, both groups most at risk — have not received their second dose and there is no telling when.

So far, at least 2,091,511 vaccine doses have been administered, according to the Ministry of Health and Population. This is just about 7 percent of the population, but the numbers don’t delineate how many are fully vaccinated and how many have only received the first dose. If Nepal is to achieve herd immunity, it will need to vaccinate at least 20 million of its 29 million population. There is no telling when this will happen, if ever.

To date, Nepal has received:

1 million Covishield vaccines from India as a gift
1 million Covishield vaccines from India (out of 2 million total) as a purchase
380,000 AstraZeneca vaccines through COVAX
800,000 Verocell vaccines from China as a gift

This adds up to a total of 3,180,000 vaccines that Nepal has received. If Nepal has administered 2,091,511 vaccines so far, around 1,088,489 doses should be remaining. This number is not enough to provide second doses to the 1.3 million elderly people who have received the first dose, and the federal government will have to arrange more doses of Covishield, as that is what the elderly have received and it is not recommended to mix-and-match vaccines.

The federal government is reportedly in talks with Russia to procure 8 million doses of the Sputnik V vaccine, according to the Kathmandu Post. Sputnik V was the most recent vaccine to receive emergency authorization from Nepal’s Department of Drug Administration, after India’s Covishield and Covaxin and China’s Verocell. But there are concerns about the efficacy of the Sputnik V vaccine, with Brazil most recently rejecting the vaccine due to concerns over its “safety, quality and effectiveness”. There are reports that the vaccine contains a replicating version of the adenovirus that is used as a vector in the vaccine. Adenovirus vectors in vaccines must be engineered so that they cannot replicate inside human cells. Slovak regulators have also expressed concern that the Sputnik V vaccine they received was not the same vaccine tested in peer reviews to be over 91 percent effective. None of these concerns have been addressed by Nepal’s Health Ministry or the Department of Drug Administration. The media too has failed to interrogate administration officials over these concerns.

As of now, it is unlikely that Nepal will be able to vaccinate a majority of its population any time soon. This failure is not just the fault of Nepal’s leadership. Vaccines are in short supply across the world, with a handful of wealthy nations hoarding vaccines beyond their capacity. Under international pressure, the Joe Biden administration in the United States has said that it will make 60 million vaccines available internationally. Nepal is said to be in talks with American ambassador Randy Berry and British Ambassador Nicola Pollitt to source more vaccines but nothing substantial has developed of late.

There is no real end to this long and distressing saga. The second wave of the coronavirus shows that Covid-19 is not going away anytime soon, and the only real protection is herd immunity. Even vaccines aren’t 100 percent effective, although they are believed to reduce harsh symptoms even if infected. As Nepal scrambles to contain the spread of the coronavirus while also attempting to procure vaccines, it appears that there is a difficult time ahead of us.

Ambulance sirens ring out every few minutes. There are already numerous calls on social media for ICU beds and plasma. Nepal is on the cusp of what India is going through, and most of us are waiting with bated breath for the calamity that is to come.

For more, read:

The Record team on how to deal with mild Covid-19 symptoms at home and avoid burdening hospitals

Aishwarya Baidar on preserving your mental health during the lockdown

Happenings this week:

Saturday - Nepal handily defeated The Netherlands by 142 runs in the finals of the Tri-Nation Twenty20 International Series. The three nations competing included Malaysia.

Sunday - The executive editor and general manager of Ujyaalo Network were arrested by the Kathmandu Metropolitan Police for publishing a fake document that was purported to be an agreement between Prime Minister KP Sharma Oli and Samant Goel, chief of the Indian external intelligence agency RAW. The journalists had taken down the article once the document was proved to be fake and had apologized. The Patan High Court had also ruled that journalists cannot be arrested for publishing news reports, but the police went ahead anyway.

Monday - The three Chief District Officers of Kathmandu, Lalitpur, and Bhaktapur decided to impose a lockdown in the Kathmandu Valley for a week beginning Thursday. Their decision was forwarded to the Cabinet, which then decided to extend the lockdown to 15 days.

Tuesday - Parsa district decided to follow suit with the Kathmandu Valley’s decision to impose a lockdown, instituting its own restriction beginning Thursday. Parsa is host to Birgunj, a large city with rising Covid-19 cases.

Wednesday - Government spokesperson Parbat Gurung announced that the government would begin withdrawing criminal cases against 120 members of the Janata Samajbadi Party (JSP), including those accused of violence during the Tikapur incident in 2015. As Prime Minister Oli has been wooing the party, the withdrawl of these cases is one of the JSP’s key demands.

Thursday - Thirty-five people died in a single day, the highest death toll yet from the coronavirus. The lockdown went into effect in the Kathmandu Valley, although enforcement was pretty lax. Although the main roads were largely empty, private cars and motorbikes were visible on the back streets and alleyways. Markets were crowded and busy in the morning as Valley residents rushed last minute to stock up on provisions.

Friday - Former Maoist and former prime minister Baburam Bhattarai underwent a successful operation to remove a neuroendocrine tumor at Bir Hospital.

Read of the week

Shallow fakes tell half-truths — Aishwarya Baidar investigates the proliferation of shallow fakes, selectively edited videos that remove context and present statements in a controversial light.

Announcements

This week, we welcome Marissa Taylor as a new addition to The Record team. Marissa comes to us from The Kathmandu Post, where she was Arts and Culture editor. She is now Assistant Editor at The Record and will be writing and editing, along with helping out with story ideas and conceptualization.

Editorially, The Record is:

Pranaya Rana, Editor
Marissa Taylor, Assistant Editor
Ishita Shahi, reporter
Aishwarya Baidar, reporting intern
Deewash Shrestha, photography intern

That’s all for this week. I shall see you Friday on the next edition of Off the Record.

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