Dr. Prajjwal Pyakurel (Assistant Professor, School of Public Health & Community Medicine, BPKIHS, Nepal)

1. What is stealth transmission?

Ans: Cases of the new coronavirusdisease (COVID-19) that fly without being detected or diagnosed may have fueled the rapid spread of the disease in most of the countries where infection is found to be high which is also known as stealth transmission. As per the latest research the explosion of COVID-19 cases in China was largely driven by individuals with mild, limited or no symptoms who went undetected. Undetected cases exposed a far greater portion of the population to the virus than would otherwise occur. So, this may be challenge in our country as well for the spread of the disease.

2. What is the difference between lockdown and curfew and need in Nepal?

Ans: A lockdown is an emergency protocol that prevents people from leaving a given area. A full lockdown will mean you must stay where you are and not exit or enter a building or the given area. This scenario usually allows for essential supplies, grocery stores, pharmacies and banks to continue to serve the people. All non-essential activities remain shut for the entire period. The lockdown in Nepal is based on Essential Services Operation Act,2014.A curfew, whose laws differ in every country, means keeping people off the streets for pre-decided hours. Any violations are met with a fine or arrest. Curfew includes complete closure of markets, shopping malls, cinema halls and other places of social and cultural gatherings.

3. What should we do to maintain good mental health during this period of lockdown?

Ans: Disclaimer: I want to let you know that I am not mental health expert. But I have few points to share.

1. Make a daily routine 2. Make plan for home exercise 3. You can revolve outside your house or in a garden or park 4. Work from home if it can be done through computer 5. Breathing and meditation helps 6. Make social connections 7. Serve other with via small act of kindness. This will definitely make your day.

4.  Does garlic prevents corona virus transmission? (Ref: EDCD, Power point presentation)?

Ans:  Garlic has antimicrobial property. But there is no concrete evidence that garlic prevents COVID-19 infection.

5.  Was COVID-19 stable in aerosol?

Ans: A recent research done showed that COVID-19 remains stable in aerosolized environment under experimental condition for 3 hours with a reduction in infectious titer with the movement of air.

नमस्ते सबैजनालाई,

आज हामी चौथौदिनमा छौ कोरोना भाइरसको बारे बुज्ने क्रममा । पाचौ कोरोना भाइरस सक्रमण भएको कैस नेपालमा फेलापरेको छ । अभ अजै हामीहरुले सावधानीका साथ अगाडी बढ्नु पर्ने जरुरीछ। आजको दिन म संसार को धनि मान्छे मध्ये पर्ने उधमी र Microsoft  को संस्थापक Bill Gates  ले भनेको कुरा कविता को हरफमा प्रस्थुत गर्न चाहन्छु । तपाईहरु केहि प्रस्न छ भने राखदिनु होल, सक्दो उतर दिने कोसिस गर्ने छु । Stay safe everybody and Happy Reading !!!!!!

१. Stealth transmission भनेको के हो?

उतर: कोरोना भाइरस सक्रमण भएको  थानै नभएको वा ठम्याउन नसकेको ब्यक्तीहरुले नथापाई कन भाइरस फैलारएको हुन सक्छ । यसलाई stealthtransmission भनिन्छ। चिनमा भएको अनुसन्धान अनुसार धेरै मानिसलाई येसरीनै कोरोना भाइरसको सक्रमणभएको हुन सक्छ भनेर अनुमान गरिएको छ। पत्ता नलागेको ब्यक्तीहरुले  धेरै मानिसमा रोग फैलाउछ। नेपालमा पनि यो हुन सक्ने सम्भाभना छ।

२. Lockdown र Curfew माके फरक छ?

उतर: Lockdown भनेको औपचारिक मुलपत्रहो जसले मानिसहरुलाईएकठाउँबाट अर्को ठाउमा जान रोक्छ। पूर्ण Lockdown भनेको चाहि तपाई जा बस्नु  भएको छ तेही बस्नु हो र बाहिर निक्लनु वा त्यो ठाउँ छोडेर नजानु हो। Lockdown को बेला अत्यावश्यक,  आपुर्ती,किराना पसल,औषधीपसल ,बैंक बाहेक अरु अत्यावश्यक नभएको ठाउ बन्द हुन्छ। नेपालको Lockdown को मुलपत्र Essential Services Operation Act,2014 अन्तर्गतपर्छ। Curfew भनेको चाहि मानिसलाई सडकबाट तोकिएको समय भन्दा टाढा राख्नु हो।  येस्को उल्लघंन भएको खण्डमा जरिवाना वा गिरफ्तार पनि हुन सकिन्छ। Curfew मा चाहि सबै ठाउँ बन्ध हुन्छ।

३. मानसिक स्वास्थ ठिक राख्न lockdown को बेला के गर्ने ?

उतर:म मानसिक रोग बिज्ञ होइन। तर हामीले साधारण कुराहरु घर बसीबसी गर्न सकिन्छ जस्तै

१. दिनचर्या  बनाउने२. घरमै कसरत गर्ने३.घर वरीपरि बगैचामा घुम्ने  ४. घरमै बसेर काम गर्ने 

५. लामो लामो सास फेर्ने वाध्यान गर्ने ६. सामाजिक सम्बन्ध बढाउने ७. अरु प्रति दयाको भावना राख्ने 

४. के लसुन खाए भने कोरोना भाइरसको सक्रमण रोक्न सकिन्छ ? 

उतर:लसुन मा सुक्ष्म जीवाणु विरुध्द काम गर्ने पदार्थ (antimicrobial ) हुन्छ । तर अनुसन्धान ले लसुन खाए भने COVID-१९ को  सक्रमणबाट बच्न सकिन्छ भनेर कुनै पनि वैज्ञानीकपुस्टि गरेको छैन ।

५.के COVID-१९ aerosol (कुनै झोल  तथा ठोस पदार्थ कुनै ग्यासमा मिलाएर छर्किने गरी प्रयोग गरिने कुनै औषधीजन्य पदार्थ)मास्थायी रुपमा बस्छ ?

उतर: भर्खरै गरेको अनुसन्धानमा COVID-१९ aerosol (कुनै झोल  तथा ठोस पदार्थ कुनै ग्यासमा मिलाएर छर्किने गरी प्रयोग गरिने कुनै औषधीजन्य पदार्थ)मा स्थायी रुपमा ३ घण्टासम्मबस्छ भनेर भनेको छ । तर यो अनुसन्धान नियन्त्रण गर्न सक्ने अनुसन्धानशालामा गरिएको हो । हावाको बाहाब संगै येस्को सक्रमण गर्ने शक्ति पनि घट्छ ।येस्को बारेमा अजै थप अनुसन्धानहरु हुदै छ ।

Dr. Prajjwal Pyakurel (Assistant Professor, School of Public Health & Community Medicine, BPKIHS, Nepal)

Hello everybody,

Welcome to Day 3 of our understanding about facts on coronavirus. Hope you all are not getting bored and enjoying with your family at home. I just want to update you that the Government of Nepal has till date has confirmed 4 positive cases of coronavirus. Please protect yourself. Keep sitting at your home and maintain social distancing. Today 5 points are based on questions and answers. Happy reading!!!!

1. Why this coronavirus was called COVID-19?

Ans: Co and Vi comes from coronavirus with D meaning disease and 19 meaning it was first detected in 2019. 2019-CoV is a bit like calling a daughter “the girl born in 2019.” Given that another daughter might be born in 2021, a name that might more easily distinguish between the two is probably in order.

2. Who should be suspected for COVID-19 infection?

Ans: Every country has given their guidelines. However, for our country Epidemiological and Disease Control Division (EDCD), Ministry of Health and Population, Department of Health Services, Government of Nepal has released its guidelines. This is the most authentic guidelines and I request all the people to follow this guideline. The guidelines says that any person with fever and at least one sign or symptoms of respiratory disease (cough or shortness of breath) with no any etiology that explains the clinical presentation and  1.Who had a history of travel or residence in a country, area or territory that has reported local transmission of COVID-19 disease during the 14 days prior to onset of symptoms? 2.Who had been a contact of a confirmed or probable case of COVID-19 disease during the 14 days prior to onset of symptoms 3. Who requires hospitalization AND who has no etiology that fully explains the clinical presentation. Isolate such people and take to the hospital where such COVID-19 test is available

3. What is the best measure to control Coronavirus Pandemic in Nepal?

Ans: In low resource country like Nepal, even with the best hospital preparation if the number of serious case increases, we will be short of all medical supplies within few weeks of time. So, we must prevent case transmission and decrease the severe cases so that number of hospital admission get reduced as 82% of cases are mild as per clinical severity. It will be possible only with epidemiological measures which include widespread testing of suspected coronavirus cases, tracing their contacts, quarantine and social distancing. All people should be cautious enough to understand the risk and let the concerned authority know or test for COVID-19.

4. How can one get protected from coronavirus?

Ans: 1) Avoid close contact with the people who are sick 2) Avoid touching your nose, mouth with unwashed hands. 3)Wash your hands often with soap and water for at least 20seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

5. What is basic reproductive number (Ro) and what is the basic reproductive number for coronavirus?

Ans: Basic reproductive number (Ro) is an average number an infectious person will infect with an agent in a completely susceptible population. As per the preliminary prediction of the basic reproductive number in China it varies from 2.8 – 3.9. But robust evidence is still lacking. So, breaking the chain of transmission is only the solution at the moment where vaccine and drugs are not available. Hence the lockdown has been enforced by most of the countries to break the chain of transmission

नेपाली शब्द युनिकोडमा टाईप गरेकोले केहि शब्दहरु तलमाथि परेकोमा क्षमापार्थि छु !!

१. योकोरोनाभाइरसलाई COVID-१९किनभनिएकोहो?

उतर:  योCO चाही CORONAVIRUS को  C0 बाटर VI चाही Virus को VI बाट आएको हो । D भनेको disease अथार्त रोग हो। यो १९ चाइने २०१९ मा पहिलो पटक पता लगाएकोले  भनिएको हो ।

२. कसलाई COVID-१९भएको आशंका गर्ने ?

उतर: हरेक देशको आफ्नै निर्देशिका हुन्छ। हाम्रो  देशको लागि इपिडिमियोलोजी तथा रोग नियन्त्र्‍ण महाशाखा, स्वास्थ सेवा बिभाग, स्वास्थ तथा जनसंख्या मन्त्रलायल, नेपाल सरकार निकालेको निर्देशिका छ। यो सरकारको तर्फबाट निकालेको निर्देशिका हो र सबैलाई येही निर्देशिका हेर्न अनुरोध गर्दछु। येसनिर्देशिकामाकेभनिएकोछभनेजसलाईजोरोआएकोछरस्वासप्रस्वाससम्बन्धिएकसंकेतवालक्षणजस्तैखोकीरसासफेर्ने  समस्या  छरउहाकोजोरोकोकारणनिर्णयमापुग्ननसकिनेछर 

१.उहाबाहिरबाटआएकोहुनुहुन्छजहाँ COVID-१९कोसक्रमणरोगकोलक्षण  देखिनुभन्दा१४दिनअगाडी  भैरएको    छ 

२.उहा COVID-१९सक्रमणभएकोसम्पर्क  प्रमाणीतभएकोवाशंकाभएको  ब्यक्तीकोसम्पर्कआउनुभएकोछ

३. जसलाईअस्पतालमाभर्नाको  जरुरतछरउहाकोजोरोकोकारणनिर्णयमापुग्ननसकिनेछ 

यस्तोबिरामीहरुलाईअलग गरि COVID-१९कोजाचगर्न  जरुरीहुन्छ।

३.  नेपालमा  कोरोनाभाइरसकोसक्रमणकमगर्नकेगर्नुपर्ला ?

उतर: नेपालजस्तोगरिबमुलुकमाअस्पतालकोतयारीजतिसुकैराम्रोभएपनियेदिगम्भिरकिसिमकोबिरामीहरुधेरैमात्रमाआएभनेहामीहरुलाई  चिकित्साविज्ञानसम्बन्धीकोसामानजस्तै mask,gown,ventilator,test kit, हरुकोक्रमिकरुपमाकमिहुदैजान्छ।हामीहरुकोलागिउतमउपाएभनेकोएकअर्कामारोगसक्रमणहुननदिनुरगम्भिरकिसिमकोरोगहरुलाग्नबचाउनुहोकिनभने८२प्रतिसदकोरोनाभाइरसको  रोगहल्काकिसिमकाहुन्छन।यसलाईरोक्नहामीहरुलेरोगसम्बन्धि बिज्ञान (Epidemiology) कोउपाएहरुअपनाउनुपरछजस्तै 

१. COVID-१९सक्रमण भएको शंकाभएको  ब्यक्तीकोजाचगर्ने,

२.उनीहरुको सम्पर्कमा आएको ब्यक्तीहरु पत्ता लगाउने  र अवस्था हेरेर जाच गर्ने 

३. अलग्ग (quarantine)  मा राख्ने

४. Social distancing (दुरी रक्न्ये,कम्तिमा पनि १ मीटर)

सबै मानिसहरु सजग भएर बस्ने । यस्तो किसिमको ब्यक्तीहरु भेटे भने नजिकको अस्पताल जहाँ कोरोनाभाइरसको जाच हुन्छ ,तेता जान भने ।

४. कोरोना भाइरस को सक्रमण बाट कसरी बच्ने?

उतर:  १. बिरामी भएको ब्यक्तीको सम्पर्कमा नाउने २. हात नधोइकन मुखनाक नछुने ३. बेला बेला मा साबुन पानी लगाएर २० second हात धुने। 60% मदिरामा बनेको किटाणु मार्न प्रयोग गरिने रसायनिक पदार्थ (sanitizer) प्रयोग गर्ने।

५.आधारभुत पुन उब्जने अङ्क (Basic reproductive number,Ro) भनेको के हो र कोरोना भाइरस आधारभुत पुन उब्जने अङ्क(Basic reproductive number,Ro) कति हो?

उतर: आधारभुत पुन उब्जने अङ्क(Basic reproductive number,Ro) भनेको एउटा सक्रमण भएको ब्यक्तीले कति जानामा भाइरस सार्न सक्छ भने हो। चिनमा भएको प्रारम्भिक अनुसन्धान अनुसार येस्ले २ देखी ४ जानामा सक्रमण गर्छ भनेर भनिएको छ। तर यसको अनुसन्धान अजै हुदै छ। यो कुरामा किन जोड दिन खोजिएको हो भने विभिन देशहरुले गरेको Lockdown को आदर येही सिद्धान्तमा आवद छ। Lockdown  गरे भने मानिसहरुको सम्पर्क एक आपसमा हुदैन र तेस्ले सक्रमणको सिक्रीलाई तोड्न मदत गर्छ र एक मानिसबाट अर्को मानिसमा भाइरसकोसक्रमण  हुदैन।

Dr. Prajjwal Pyakurel (Assistant Professor, School of Public Health & Community Medicine, BPKIHS, Nepal)

1. The recent work published by Imperial College of London has highlighted that social distancing be   maintained for 18 months or more until the vaccine is developed in order to mitigate the true effect of coronavirus. Is this possible?

2. This year coronavirus is the deadliest respiratory coronavirus after Spanish flu seen in 1918 which has killed approximately 50 million people.

3. Coronavirus lockdown has helped to reduce pollutions which has a positive effect in environment, aquatic animals, flora and fauna. This has given ideas for future work for scientist in order to mitigate the effect of climate change although lockdown is not the solutions.

4. There has been buzz going around the world that coronavirus is self-created. We can argue on this statement for hours and hours. However, virus also mutates itself. Occasionally, outbreak occurs when virus in animals and birds changes their structure and enter human body. Coronavirus may have originated in this fashion.

5.During coronavirus pandemic we are wearing mask and moving around. But the surgical mask we use may not be protective as it doesn’t tightly cover mouth and nose and the tiny infected droplets enters nose, mouth and eyes. Mask should be used by those people who have respiratory illness and can transmit infection to others. 

Dr. Prajjwal Pyakurel (Assistant Professor, School of Public Health & Community Medicine, BPKIHS, Nepal)

 1.  The Coronavirus can be detectable on copper surface for upto 4 hours, on cardboard for up to 24 hours, plastic and steel for 72 hours. However, virus decreased over time on each of those surfaces and so the risk of infection from touching them would decrease over time.

   2.There is the buzz going that chloroquine (antimalarial) drug is beneficial for COVID 19. However, use of chloroquine or its less toxic derivative hydroxychloroquine may be of benefit in people who are in quarantine after a contact with a confirmed COVID-19 case. But robust evidence is still needed.

3. The World Organization for Animal Health says that it doesn’t appear that fur of pets such as cats and dogs are responsible for spreading the coronavirus. However, further tests are being carried  out to understand if and how animals are affected.

 4. The Italy experience showed  that steps to isolate the coronavirus and limit people’s movement  need to be put in place early, with absolute clarity, then strictly enforced. We need to thank our  government for this initiative. But people need to understand the gravity of problem and follow 

          stringent measures. 

  5. People of Italy has shared what they wish they have done 10 days ago to prevent the spread of  coronavirus. Many people in the video messaged said that they wished they had listened to directives to stay inside the house and practice social distancing before it become mandatory. So strictly follow social distancing even at home so that we can prevent lot of infection.      

नेपाली शब्द युनिकोडमा टाईप गरेकोले गर्दा केहि शब्दहरु बिग्रेको हुनसक्छ । शब्दको भाव बुजेर नजर अनदाज गर्दिनु होला ।  

१.अनुसन्धानलेभनेअनुसारकोरोनाभारसतामा भएकोठाउँमा४घण्टासम्मबस्नसक्छ, टास्ने पाटी या   कडा कागज मा २४ घण्टा सम्म बस्न सक्छ, प्लास्टिकमा र फलम मा ७२ घण्टा सम्म बस्न सक्छ ।तर  समय अगाडी बड्धै गयपछी भारस बिस्तारै कम हुन्छ अनि त्तेस्ले  सक्रमण गर्ने शक्तीपनि घटाउछ ।

२. Chloroquine र  त्तेस्ले उत्पादित (derivative) hydroxychloroquine दबाई COVID-19 निधो भएको बिरामीको  सम्पर्कमा आएको व्क्ती जो अलगै (quarantine ) मा बस्नु भएको छ उहाहरुलाई फायिदा हुन्छ भनिएको छ । तर यो साचिकै प्रभावकारी छ भन्ने कुराको लागि अझै अनुसन्धानबाट पुष्टी हुन जरुरी छ ।

३. जनावरहरुको विश्व संगठनले जानकारी गराए अनुसार  घरपालुवा जनावर जस्तै कुकुर बिरालोको भुत्लाबाटकोरोनाभारस सक्रमण हुँदैन, तर पनि यस्मा अनुसन्धानहरु हुँदैछ ।

४. Italy मा देखिएको कोरोनाको महामारीले हामीलाई के सिकायको छ भने मानिसको गतिविदी सुरुमै कम गरेको भय धेरै मानिसहरुको ज्यान बचाउन सकिन्थ्यो होला भनेर ।हामीले यस्को लागी हाम्रो सरकारलाई धन्यवाद दीनैपर्छ  जस्ले तुरुन्तै Lockdown गर्‍यो । अभ जनता पनि उतिकै सजक भएर बस्नु पर्ने अवस्था छ ।

५. Italy को जनताहरुले  दियको भिडियो मेसजमा उनिहरुले के भनेका छन भने सायद  यस्तो महामरी हुन्छ भन्ने १० दिन अगाडी थाह भएको भए उनिहरुले पहिला देखी नै घरमा बस्थे र एक आपसमा दुरी(social distancing) राख्थे । त्तेसैले हामीहरु ले पनि उनिहरु सँग सिकेर घरमा बसौ र दुरी (social distancing) राखौ ।