Interview | “We might not be much far from another lockdown due to Covid-19,” says Dr Sandesh Lamsal

NL Today

  • Read Time 4 min.

Kathmandu: Amidst a surge in new Covid-19 cases and the identification of the novel JN.1 strain in India, health authorities in Nepal are closely monitoring the situation in their southern neighbor. While Nepal has not experienced a resurgence of coronavirus cases, officials are intensifying surveillance measures, including increased testing and gene sequencing, in the upcoming days.

In this regard, Nepal Live Today caught up with Dr Sandesh Lamsal of Rapti Provincial Hospital, Tulsipur Dang, to talk about the new variant of Covid-19, among other issues. Excerpts: 

There is news buzzing around South Asia about Covid-19. What is the real reason for it?

As we know the mutation of Covid-19 is not a new phenomenon over the years. But, among different variants of Covid-19, in India, we have recently noticed a surge in the cases of a new sub-variant JN. 1, a descendant of BA.2.86, which is a highly mutated variant of the Omicron. The first case related to the JN.1 variant was registered in the United States in September 2023. But in India, it was discovered on December 8 in Kerala. Till today it is reported that there are more than 4,000 active cases.

What are the most common symptoms of Covid-19? Are there any new symptoms reported along with this new variant?

The symptoms of Covid-19 are similar to those seen in the previous waves of infection such as cough, runny nose, nausea, muscle ache, fatigue, shortness of breath, headache, sore throat, loss of taste and smell, and diarrhoea. But, along with the new variant JN. 1, the UK’s Office for National Statistics (UK ONS) have identified two new symptoms, trouble sleeping and anxiety in the patients. This indicates that adequate sleep is crucial for a healthy immune system and can be a useful tool to fight back against this newly emerging threat.

And what about the transmission? Is the transmission timeline of this new sub-variant JN.1 different or is it similar to previous variants?

Once you get exposed to JN.1, it may take about 5-7 days to develop symptoms. But a person can transmit the virus 1-2 days before the development of the symptoms and he/she continues to be contagious for at least 2-3 days after these symptoms develop. Whereas the live virus can be detected in the patients even up to a week after the onset of these symptoms.

Many people have received the second dose and few have received booster doses of the Covid-19 vaccines. Is this enough to protect us from this JN. 1 too?

According to some new research in the field of mRNA Covid-19 vaccines, it has been found that they provide effective immunity for about 6 months. Also, the second dose of Covid-19 vaccines was distributed among people a long time back and many people might have not taken the booster doses. Similarly, these old vaccines were based on SARS-CoV-2 variants which are very different from the new variants of Covid-19 that are circulating currently. Summarizing all these points, it’s clear that if we depend upon the vaccines which we received years ago, we are not much protected from Covid-19. We should also develop vaccines according to the evolving new variants of the virus that are causing infection currently and might do in future.

How can this new variant of Covid-19 affect the lives of people in Nepal?

Nepal has been reporting a few cases of JN. 1. This might be a significant signal for us either to be prepared with all the possible ways to fight against the Covid-19 and stop the transmission in early stages until it isn’t too late or wait for the fourth wave. For a developing country like Nepal with a weak economy, it’s very difficult to upgrade the health system along with the needs and evolution of diseases. It is not quite possible to arrange all the modern vaccines and medical equipment on time due to the lack of manpower and economic support from the government. Also, modern medications such as Nirmatrelvir or Ritonavir aren’t widely available and prescribed in every hospital in Nepal. With the evolution of the new subvariants, the immunity of Nepali citizens against Covid-19 is declining, increasing the chances of a fourth wave leading to another inevitable lockdown if we don’t act accordingly on time.

Apart from medicines and vaccines, is there anything we should take care of to fight against Covid-19?

As you know, prevention is better than cure, various precaution measures such as social distancing, maintaining good personal hygiene by avoiding touching surfaces with our bare hands, washing them frequently with soap and water, and sanitizing with alcohol-based sanitisers can also play a vital role to stop the transmission of Covid-19. Nevertheless, a healthy balanced diet and light physical exercises also help to build up our immunity to fight against infections.

At last, what is your suggestion to the government and public to fight this upcoming threat?

Well, the terror of Covid-19 isn’t as it used to be in the past and death is rare in present days, but still, we can’t say that there is no chance of another wave concluding in another lockdown. The number of cases is likely to go up as this is a time of increased travel and holiday gatherings in India and Nepal. In winter, along with the common cold, influenza and different respiratory problems, there is always the possibility of transmission of Covid-19. Nepal is a landlocked country that shares an open border with India from east, west and south. So, it’s just a matter of time for the cases of JN. 1 to erode from every corner. The Nepal Government with joint support from the Government of India should prioritize the installment of medical desks equipped with all necessary screening tests at both sides of border points and put the medical institutions on standby for the necessary treatment of Covid-19 along with quarantine facilities.

It is a known fact that the vaccine doesn’t prevent us from being infected by Covid-19, but it certainly decreases the severity, and post-Covid-19 complications and disabilities. So, the government should focus on distributing Covid-19 vaccines and booster doses for the people who were left.