COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, >69% of the patients were male and patients ≥54 years accounted for 67.9% (n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy campaign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.

Background: Preparedness, readiness, and response status of any country is integral in identifying, managing, and preventing COVID-19 pandemic. The objective of this study is to assess the status of the Government of Nepal designated COVID hospitals and COVID clinics to respond against COVID-19. Methods: A cross sectional study was conducted with the focal persons of COVID hospitals and COVID clinics using a semi-structured questionnaire from April 26, 2020 to May 27, 2020 via face to face interview with onsite observation and telephonic interview in few unreachable health facilities. Results: Government of Nepal designated COVID hospitals and COVID clinics demonstrated efforts in establishing preparedness plans and committees such as COVID management core team (96.7% and 86%), provision of coordination with the government authority (both 100% ), preparedness response plan (93.3% and 84%), and infection prevention and control committee (63.3% and 65.6%) to respond to COVID-19 respectively. The participants reported differences in training provided to their health care workers with maximum COVID hospitals (80%) providing training on use of personal protective equipment and least (43.3%) on handling dead bodies. Only half of the COVID clinics (49.5%) had provision of triage systems.Conclusions: COVID hospitals and COVID clinics in Nepal demonstrated different status of COVID pandemic preparedness and readiness. In case of surge, Nepalese hospitals would struggle due to lack of trained workforce and infrastructure.  Interdisciplinary, multi-sectoral collaboration with various focused strategies, including in-service training to staff, is paramount to increase preparedness and readiness. Keywords: COVID-19; Nepal; preparedness; readiness

No abstract

Background: The emergence of SARS-CoV 2 pandemic is the greatest public health concern of the century. Healthcare workers are the front liners of pandemic management. Their knowledge, attitudes and practices can influence the outcome of pandemic. The study aims to determine the knowledge, attitude and practices among healthcare workers.Methods: Knowledge, attitude and practice related questionnaire based online survey through Google forms was conducted from Healthcare workers, following ethical approval from NHRC (ERB protocol registration number: 297/2020 P). Online forms were disseminated via Facebook, Instagram, Whatsapp, Viber and personal messaging. Responses containing anonymized data was collected analyzed in using SPSS-version 26, (Year: 2019). The results were interpreted in terms of percentage response, knowledge score, and practice and discussed on the possible solutions in improving the infection prevention and control practice.Results: 473 HCWs responded to the questionnaire, out of which 426 responses met inclusion criteria which is 90% of the total responses. The mean score for knowledge was 3.20 + 1.15 out of maximum seven; with 45.7% correct answers. 70.4 % (300) participants felt that Nepal will be unable to contain the pandemic, 64 % of the total employed participants felt that there was inadequate institutional preparedness to protect HCWs from exposure. 91% participants reported practicing hand hygiene after every patient encounter; whereas 31.7% (77) and 22.1% (59) participants did not know how to check sealing of the N95 masks and use personal protective equipment’s respectively.Conclusions: The survey findings showed deficiencies in knowledge and appropriate practice among the HCWs, in prevention of SARS-CoV-2 transmission. Attitudes towards COVID19 were a mix of both positive and negative viewpoints. Even in health care workers with access to internet, there is significant gap in universal infection prevention and control practices required for self-protection and limiting untoward transmission. Keywords: Attitude and practice; COVID-19; healthcare workers; infection prevention and control; knowledge, Nepal; SARS CoV 2