Risk of a second wave of #SARSCoV2 infections in #Nepal is high due to the recent surge/second wave of #COVID19 cases in #India. Because of open borders and free movement of citizens, it is just a matter of time before we see a significant surge in cases in Nepal. 
Currently, India stands at 3.14% active cases, mostly concentrated in a few states. Some of these states in India are hubs for workers from western Nepal. Temporary workers may soon return home in part due to fear of previous lockdown experience or rise in COVID cases etc.
Looking at most recent waves of COVID infections in UK, South Africa and now several countries in Europe, the infections are mostly caused by #variants. It is likely that the recent rise in cases in India are due to variants, particularly 🇬🇧#B117 (UK) or 🇮🇳Indian Variant.
#India established SARS-CoV-2 Genomic Consortium (INSACOG) in Dec 2020 for genomic surveillance. They have sequenced 10,787 samples, but have not shared the recently sequenced data. Only 6,082 sequences are submitted to the public databases, thus the picture is not current.
About 10%, 771 out of 8,000 (3000 prior to Dec), of sequenced positive cases are variants. B.1.1.7 is the most common variant and specially very high in Punjab.
Samples from Maharashtra which accounts for 60% of daily cases have Double mutation 'E484Q and L452R' mutations. This could be an "Indian🇮🇳 variant". Strain with L452R mutation was also blamed for the recent surge in cases in California.
bbc.com/news/world-asi…
bbc.com/news/world-asi…
Nepal has sequenced a few isolates collected in August 2020 from various parts of the country. As the cases start to increase, it will be very important to start the surveillance sequencing again. Although the submitted sequences quality aren’t great but a very good start!
Indians is focused on testing, isolating the infected, contact tracing and quarantining exposure cases, encouraging mask wearing and avoiding crowds, and most importantly vaccinating everyone older than 45 years. Also delayed exports of AstraZeneca shots.
https://twitter.com/BijayaKDhakal/status/1374779468737298437?s=20
Nepal needs to watch the events transpiring in India, learn from it & immediately engage in diplomatic talks to secure vaccine doses. Citizens must listen to the Government's public health messages/mandates and follow them. If acted in time, the second wave might be preventable🙏
*India
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