English News

COVID-19 and Responses

Prof. Timila Yami Thapa

प्रकाशित |

COVID-19 instructions, such as asking elderly persons above the age of 60 to stay home, are being broadcasted on popular social media like Google and YouTube. However, the vast majority of our elderly citizens of Nepal are unable to understand or access social media due to the language barrier, lack of education, lack of Internet access, and/or unavailability of computers and laptops. The majority of the people are not educated to understand the complexity of the pandemic and care system for elderly is poor. They are unaware of precautionary measures to be taken during this COVID-19 pandemic period. While lack of education is caused by cruel rules under Rana’s regime, we still have to get rid of age-old rules managed by Manubadis, which promotes ignorance and silly beliefs, hindering medical education and following the instructions of medical care teams.

This continuously changing knowledge and instructions about the COVID-19 pandemic require everyone to be able to read, listen, and comprehend international news, especially from health experts and researchers, to stay safe and survive. However, elderly citizens are seriously handicapped and depend on their grandchildren for the required information. Prevailing a lack of education has become a bottleneck. Asking grandchildren to get educated and develop knowledge is a late realization and not achievable. As a consequence, these elderly citizens cannot benefit from materials available from researchers and experts of COVID-19.

In the Manubadi (Manusmriti) system of Nepal, most of the COVID-19 patients also believe in 33 crores “Devis and Remaining Muslims and Christians believe in blind superstitions not founded on scientific knowledge, thus unable to comprehend the true complexities of this deadly disease. They were unfortunately overpopulating around temples, churches, and mosques and infecting more people around and spreading this deadly disease. They also cannot differentiate between misinformation floating on various print media, television, and social media. They are dying because of a lack of knowledge of such sensitivity of COVID-19 complexities.

COVID-19 pandemic requires everyone to be able to read, listen, and understand international news, especially from health experts and researchers, in order to stay safe and survive. Now, these elderly citizens are realizing disadvantages due to the gap in knowledge and are now focusing on their grandchildren, asking them to work hard on knowledge development; as people rightly say, "Necessity is the mother of invention". Late realization!

The government is asking to isolate elders above 60 years and children below twelve. The college and school-going children should be all the more connected with grandparents during this pandemic period and take good care of the emotional complexities of elderly people at home. Most of these young siblings at home are technology savvy. They should train and make elders capable of using smart devices like mobiles, iPad, or laptops, and social media like Face book, Instagram, WhatsApp  etc. and get digitally connected. This is very important to keep elders' emotions and health strong. Psychotherapy becomes very important, especially during this pandemic period, which can be handled easily through social media within residential premises. The integration of concerned stakeholders, including health workers, researchers, the aging population, youth, and technology can solve a lot of critical problems of the COVID-19 pandemic.

Lack of transparency and communication of the trending COVID-19 is already bringing havoc, as seen from certain countries' ways of handling operation and delivery processes. The learning lessons should be shared among global communities for faster and efficient response to arrest the spread of calamity. Such a crisis should be fought together globally.

 

Lack Of Health Resources

 

Demand for ventilators is rising in this mismanaged system, and infection rates are increasing at a high rate. Now, we are going to suffer more from hunger than the pandemic. Many have already committed suicide. Many families have hungry mouths at home and are unable to pay back loans. People are attacking health workers and security forces. Nepal has a long way to go, and without investment in human capital development, such as professional functioning among policymakers and implementers at the field level will not be possible.

 

 

Is Government Data Public Property?

The government is not serious about collecting data on mentally affected people and suicide cases for preventive measures. There is also the dilemma of disclosure of PCR cases to curb infection. COVID-19 is spreading at a high rate in Nepal in the absence of surveillance systems and a lack of policy on public data. In order to verify correct data and educate elderly people, volunteers and social workers will have to go door-to-door and contact people. However, such a task is time-consuming and cost-prohibitive and puts social workers at risk of contracting the disease.

Data about migrants suffering in quarantines is equally important, so the concerned stakeholders can plan well to act effectively in the field. Ambulance service providers should also be given a chance to operate efficiently and effectively by providing data. These people certainly will contribute to stopping the spreading of the deadly disease. They, too, have not been provided with necessary local data by the government.

Talented young graduates are going around presenting mobile apps for silent surveillance systems towards, municipalities, health ministry, local communities, and concerned NGOs/ INGOs. However, they are disappointed with the attitude shown towards them. These surveillance systems certainly will contribute to stopping the spreading of the disease.

 

Misinformation

The coronavirus outbreak has sparked off what the World Health Organization is calling, an “infodemic" – an overwhelming amount of information on social media and websites. Some are accurate and some are downright untrue. False claims on how to combat the deadly coronavirus epidemic are flooding the Internet. The misinformation continues to pollute social media platforms and messaging apps. The Nepal government is not well-equipped with the resources to face the "infodemic" impact, especially in remote areas. It creates havoc among the uneducated mass. Adopting digital tools for learning may be difficult for guardians who are not tech-savvy. Local bodies are not effective in engaging concerned local stakeholders in preparing the community for an appropriate response to the COVID-19 outbreak.

 

Technology, Youth Leadership, and Hope

Information technology is already amongst us through the use of mobiles, tablets, or laptops. Ample materials are available on social about collecting data on mentally affected people and suicide cases for preventive measures. There is also the dilemma of disclosure of PCR cases to curb infection. COVID-19 is spreading at a high rate in Nepal in the absence of surveillance systems and a lack of policy on public data. In order to verify correct data and educate elderly people, volunteers and social workers will have to go door-to-door and contact people. However, such a task is time-consuming and cost-prohibitive and puts social workers at risk of contracting the disease. Data about migrants suffering in quarantines is equally important, so the concerned stakeholders can plan well to act effectively in the field. Ambulance service providers should also be given a chance to operate efficiently and effectively by providing data. These people media and TV on how to stay safe. Coronavirus is already forcing us to find innovative ways of living and working. The industrial revolution forced people to get together and work. COVID-19 pandemic is also teaching people to function together. Information sharing through the Internet and knowledge-based industry has already increased decentralization and increased learning and working from home.

Social media giants have promoted their strategies to combat the misinformation. For example, Twitter has suspended auto-suggested search results that would likely produce untrustworthy content. People should Google and extract the correct information from trusted sources, such as national health services, and avoid sharing misleading information. People should follow the recommendations and instructions of the World Health Organization.

The current technological savvy younger generation takes the leadership role in society. Women, particularly, should be made more functional through the use of online technology, so that they become competent to handle any challenging crisis at hand. Our mindset has to change to adapt to new information-based working environments. The young generation is already functional, who are already empowered, and technology savvy. It is just a matter of promoting it to people and making them aware of the advantages of information technology. People of rural areas should engage all concerned stakeholders in solving the problem together, including empowering them with technology to reap the benefits.

Think tanks of Nepal are already actively organizing (ZOOM, MEET, TIME) online sessions engaging concerned stakeholders and domestic and international experts, which is helping them plan together for policies aligned with current national agendas, including the complexities of adoption of new disruptive technology for people’s benefits. People-centered content development through creative documentaries and films is also emerging as an important component in the adoption of new technology. Such visual products can be used for a quick citizen-centered transparent response system for cases like coronavirus, earthquake, flood, and landslides.

 

5G for Inclusive Development

Nepal started 4G Service in 2017. The 4G penetration is 16.04% as per NTA MIS  data of June 2020. As per an ITU Report, by the end of 2019, ninety-three percent of the global population could access the Internet through a 3G or higher quality network. If evidence of adoption of 5G networks in developed countries is any indication, unless planned properly, 5G is expected to worsen the current digital divide, as developing countries are likely to take much longer to implement 5G networks; these countries will be forced to make the best use of the existing ecosystems and networks to provide universal and affordable access to it. About half the world's population access and use the Internet. The other half cannot, and do not. Most of the unconnected are those who live in the least developed countries, and landlocked/sea locked developing countries. Despite the fact that over 1 billion new internet users have been added globally over the last 4 years, the digital divide between countries communities, and people connected more and less, continues to rise enabling all the world´s population to access and use the Internet and bridging the digital divide remains a challenge that needs to be addressed if the world community is to achieve the United Nations Sustainable Development Goals (SDGs) by 2030; For a country like Nepal, with the demonstrated unwillingness to invest adequate resources in utilizing ICT tools, achieving the SDG goals within the stipulated time remains a big question mark. Investment in modern technology and human capital development targeted at the delivery of quality health services in a sustainable and equitable manner has been a challenge in Nepal. A host of factors have impeded the access, quality, and utilization of health services, particularly for the marginalized and disadvantaged sections of the population.

It is high time the government brought in policies and programs aimed to encourage the use of current state-of-art information and communication technology which can be instrumental in solving societal problems,-- inadequate healthcare, uncoordinated education, and abject poverty, to name a few. The government needs to review essential healthcare services being provided by public health institutions, their progress, effectiveness, sustainability, equity, and efficiency, quality of care, and take appropriate measures to ensure inclusion of marginalizing and disadvantaged populations in healthcare services methods. 5G system can provide instantaneous connectivity to billions of Internet-connected devices. It provides the speed, low latency, and connectivity to enable a new generation of applications services and business opportunities that have not been seen before.

Nepal should learn lesions from regional countries. As the dangerous COVID-19 strain continues to spread outwards from the eastern city of Wuhan, China, experts from other parts of the country are now being called in—literally using 5G cellular technology—to support growing diagnostic and treatment efforts. A Chinese telecom equipment provider has launched a remote 5G diagnosis and treatment system between West China Hospital and the Chengdu Public Health Clinic Center of Sichuan University. 5G technology deployment could be expensive and would require special planning for designing delivery systems in a manner to include desired value-adding activities to benefit the society.

Investment in human capital development introduced by engaging all concerned stakeholders is also equally important in order to align with the strength of mobilizing the 5G network in the value chain.  Team-functioning with team-performance measurement tools, engaging all concerning stakeholders in collaboration has to be coordinated with smart devices and smart communication infrastructure system. Decision-makers in Nepal need to adopt the right policies and engage professional experts to execute professional delivery in crisis areas. A Governing system for such effective and efficient service delivery has to be in place. For the implementation of systems like 5G in Nepal, the government has to invest heavily in medical infrastructure and human capital development for effective functioning with smart devices, smart networks, and smart health infrastructure systems. So far, the reason behind poor service delivery is partly due to the problem of structural and institutional structure in the governing body of Nepal. The digital divide is evidenced not only in developing societies but also between countries. In 2019, nearly 87 percent of people were using the Internet in developed countries, compared to 47 percent in developing countries. Talking of Digital divides within countries, men, urban residents, and young people are more likely to be online than women, rural dwellers, and older people. The digital gender gap, in terms of internet penetration, is more pronounced in developing countries, as compared to developed economies. Divides often stem from insufficient or slow connectivity, the cost of connection, and a lack of relevant content in local languages. These barriers are therefore often related to age, gender, disability, socioeconomic status, and geography.

Efficient and affordable ICT infrastructure and services, combined with enabling policy and regulatory environments, allow businesses and governments to participate in the digital economy and countries to increase their overall economic well-being and competitiveness. Some 20 countries have made Internet access a fundamental or citizen right. Amidst opposition from several powerful countries, recently the UN declared that it considers the internet to be a human right. Addition made in Article 19 of the Universal Declaration of Human Rights provisions “promotion, protection and enjoyment of human rights on the Internet” and another recommendation that provisions the rights of those who work in and rely on internet access, is also applicable to women, girls, and those heavily impacted by the digital divide. Availability of affordable ICT infrastructure and services, and the right digital, language, and implementation skills like teamwork, individuals and businesses can participate in the digital economy. Digitally connected people and communities are empowered because they can access information, online health services, and life-saving disaster warnings. For the goods and services acquired, they can make mobile transactions, stay in touch with loved ones, increase productivity and obtain better-paid jobs that require digital skills.

The need of the hour is to ensure 5G networks are inclusive, affordable to all, and serve the public interest. 5G technologies and their application need to work towards accessibility and opportunities for minorities. In Nepal, over the last decade, smartphone ownership across the entire population has largely increased, as evidenced by the present percentage of mobile broadband users at over 55 percent, out of the 74 percent broadband users. The cost has always been one barrier to more options for internet access, more so to the disadvantaged population.

For the implementation of systems like 5G in Nepal, the government has to invest heavily on important priority sectors like educational and medical infrastructure, service sectors develop the sustainable business model by engaging potential users groups for effective functioning with smart devices, smart communication networks, and smart health infrastructure systems. So far, the reason behind poor service delivery is partly due to the problem of structural and institutional structure in the governing body of Nepal.

A Governing system for such effective and efficient service delivery has to be in place. Decision-makers in Nepal need to adopt right policies by engaging professional experts to execute professional delivery in crisis areas and this very, unfortunately, happening in Nepal. Citizens have to be mobilized towards building a prosperous nation in order to be able to afford the 5G system and future technology products.

 

Korea

 

COVID-19 and Technical Challenges in Korea had experience with MERS and SARS backed by institutional memory, and people were trained to solve such problems engaging concerned stakeholders at field and policy levels. South Korea has a national health insurance setup that includes a high per-capita number of doctors, clinics, and hospitals. Rather than suffering through a cold, they get their illness diagnosed and medicated in one visit. South Korea was using surveillance systems and knew where infected people were as soon as they sought treatment, limiting the spread. Testing facilities were ramped up as soon as the virus landed on Korean shores and church areas. Testing for COVID-19 is now automated, with results in hours, instead of days. Infrared screening for people with fevers at travel centers was a little slower, but they are available in most places now. A competent government, and a populace accustomed to (if not always comfortable with) that government wielding power. Team-functioning and team-performance, engaging all concerning stakeholders in collaboration with smart health infrastructure and smart communication infrastructure systems, helped them curb the spread and control of the disease.

 

Cambodia

 

In early 2020, at the onset of the global pandemic, many predicted that Cambodia would experience a substantial COVID-19 outbreak, due primarily to the extremely large number of mainland Chinese tourists, business travelers, and residents in the country.

Health experts have hypothesized that a number of factors may have contributed thus far too low case numbers, including the country’s relatively small, mostly rural population (16 million); relatively few enclosed public areas like indoor malls, arenas, and mass transit for people to gather (this comparison is also being made between New York with its high use of public transport and high case rates compared to Los Angeles with its high use of personal cars and low case rates); Cambodia’s tropical climate; mainland Chinese insular social behavior within Cambodia; and significant U.S. technical assistance in contact tracing, testing, and prevention.

“Cambodia’s relatively low population density may be one factor that has protected it from an outbreak,” an infectious disease expert from the U.S. Naval Advanced Medical Research Unit-2 (NAMRU-2) based in Cambodia related. Only 20 percent of Cambodians live in urban areas, and the country’s population density (212 people per square mile) ranks 118th in the world. Even in Phnom Penh, Cambodia’s capital and most densely populated city, there are only 8,120 people per square mile, considerably lower than cities like Bangkok (13,700) and Jakarta (40,400).

A lack of modern infrastructure, and relatively few large-scale, enclosed public gathering places, may also have been factors. While Phnom Penh has some public buses, it does not have a network of trains or subways that force people into crowded, enclosed spaces. Instead of modern mass transportation, the majority of Cambodians often rely on motorcycles and small open-air vehicles (tuk-tuks) with constant air circulation that hampers the transmission of the virus. Cambodia also has few malls with centralized air conditioning, which has the potential to circulate respiratory droplets within large groups of people. In contrast, Cambodian pagodas, a commonplace for gatherings, are mostly open-air buildings without air conditioning, built on spacious grounds.

As many Cambodians spend a significant amount of time outdoors, Cambodia’s hot climate and direct sunlight may be factors in slowing transmission. Colder climates also result in populations staying indoors through long periods of the day, attempting to maintain potentially contaminated warm air inside.

The government instituted screening for incoming visitors for fevers and closed schools and karaoke bars when there were only nine confirmed cases. In addition, these measures served to raise the public’s awareness about the disease. Not only are Cambodians mostly complain about government directives, but they have voluntarily taken precautionary measures. Cambodians know that the country’s poor healthcare system would not be able to handle a wave of serious illnesses and are comfortable taking measures to lower the risk of hospitalization at a personal or family level. The use of facemasks is common in Cambodia and is now widespread in Phnom Penh, and many businesses require temperature checks and hand sanitizer use prior to entering.

The ethnic assistance of U.S. health and medical agencies and ongoing support for Cambodia’s health system is another explanation for Cambodia’s apparent resilience to COVID-19 (at least for now). Beginning in January, Cambodian health authorities immediately turned to the U.S. Embassy experts unit for technical assistance with testing, disease surveillance, contact tracing, databasing, and planning to prevent community transmission.

Cambodia has a large percentage of its population under 30 years of age (a cohort that recovers quickly from COVID19). Prior to April 6, Cambodia’s testing protocols were rather strict and advised only for patients with an upper respiratory infection and either a travel history in a country with a COVID-19 outbreak or confirmed contact with an infected individual. This case definition may have resulted in indecisions not to test patients with COVID-19 that were infected through community spread.

 

India

Culturally, geographically, and historically, we cannot separate Nepal from India. Borders are also very porous. India, as a country, has failed to deal with the COVID-19 pandemic, partly due to mishandling by politicians and the media and partly due to the return of migratory labor force to their native land spreading the virus. Some states such as Kerala, Punjab, etc., as also, among urban areas, Mumbai’s Dharavi ( Asia’s largest slum) have taken early effective actions to control COVID-19. Everywhere else in India, the situation is as bad as in Nepal.

The spread of the virus can be controlled using self-discipline, social distancing, and following proper medical advice. The spread of fear and depression can be controlled using hope and positivity. Experts are saying that the corona pandemic can be managed. However, prevailing depression and panic are difficult to manage unless we put efforts to spread positivity and hope. All politicians, community leaders, and media have to spread correct knowledge regarding precautions to be taken and messages of hope rather than negativity.

 

Pakistan

Pakistan campaigned against the idea of a full lockdown, arguing that the country was too poor to afford one. This lax lockdown might have, paradoxically, helped Pakistan better contain Covid-19. The lockdown was so lax, workers still found work. And so there was barely any movement back to the villages. When the virus came to the big cities in Pakistan, it stayed there. Despite a claim of local herd immunity in Pakistan cities, the notion is a bit far- fetched as it requires a minimum of 60% infection of the population before herd immunity is acquired.

In contrast, India’s policy response was a total lockdown that trapped workers in the cities without any subsidy, food, and other support. The attempt failed spectacularly and resulted in a mass exodus of the labor class from industrial cities back to their native villages all over the country. Some described it as the biggest unorganized movement of people on foot since Indo-Pak Partition. India’s lockdown itself became the source of the virus’s spread. By having people huddle together, infecting one another, and then having the same people travel hundreds of miles, the pandemic has been made much worse. This  “lock down-and scatter” phenomenon caused a serious surge in the cases as well the spread of the pandemic into rural India.

 

China

The Chinese government has been investing in new high technology tracking systems as well. One example is the Smartphone application

which is based on a health code color system that categorizes individuals into three color groups based on their health status and travel history, and then determine whether they need to be quarantined. Another measure that helped in disease surveillance and controlling is the street camera system that can catch and fine individuals walking publicly without a mask and identify those showing symptoms. This system is known to be effective as it was previously used during the SARS outbreak but recently updated to include facial recognition and to cover all areas in China.

 

National Reporting System

Another measure taken is generating daily reports for the newly suspected, diagnosed, and asymptomatic cases and deaths. As soon as the a COVID-19 case is diagnosed or suspected, the responsible doctor is required to report the case electronically, where statistics will be generated for the total number in each area. These reports are generated through China’s National Infectious Disease information system (IDIS) developed in 2004 after the SARS outbreak and are based on the National Disease Reporting System (NDRS) between the National and Provincial Health Commissions, which covers the entire population of China. Each province is required to submit its report on a daily basis, where epidemiological curves will be generated for the whole country and for each province separately. These epidemic curves, in addition to the published literature and on-site visits to the affected areas, helped the epidemiologists in China to make epidemiological observations about the disease’s demographic characteristics, zoonotic origins, transmission dynamics, and progression.

 

China provides hope for the rest of the world and reminds other countries that even the most severe situations can be turned around. Their response to the COVID-19 epidemic and the high level of collective action in a modern city with more than 11 million people are to be appraised and have stunned the whole world. It is actually not easy to get this kind of passion, commitment, interest, and an individual sense of duty. t on the precautionary measures taken by the government.

 

CONCLUSION

Team-functioning supported by team-performance measurement tools and smart human capital, engaging all concerning stakeholders in collaboration with smart health infrastructure and smart communication infrastructure system helped implement the well-planned models of countries that had handled curbing the spread and control the disease successfully. There is an increased emphasis on the need to better understand the impact of technology, methodology, and effective use of skilled resources. Both leaders and the general public need to act responsively to mitigate the spread of the disease. Countries need to learn from those countries which have implemented successfully the models for response to the COVID-19 pandemic and start implementing prevention and control strategies immediately as each one is at risk of becoming the new virus epicenter. Considering that each community is unique, assessment should be done of the possible benefits and negative consequences of each strategy adopted. In addition, countries should work on enhancing their governing systems, health infrastructure, and human capital in order to be more prepared for future outbreaks and reduce outbreaks consequences when they strike. Nepal has to learn from the success stories of other countries and go through cultural, social, and political transformation for tackling the complexities of pandemics.

 

 

 

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