Five people suffocated in a Nepal hospital after oxygen ran out this week, just the latest victims of a vicious COVID-19 surge that risks devastating the impoverished country and its ill-equipped healthcare system.
Daily new cases have risen 60-fold since 1 April and nearly a thousand people have died in the past 10 days, according to official figures which, as in neighbouring India, are seen as under-reporting the scale of the virus.
The mountainous country of almost 30 million is now seeing severe cases flood hospitals as oxygen cylinders empty faster than they can be refilled and almost half of those tested return positive.
In the capital Kathmandu, several hospitals have said they can no longer admit new patients, turning away desperate relatives looking for beds for infected loved ones.
And Nepal's prime minister now faces accusations that he missed a window of opportunity to stem the virus' spread - allowing public gatherings and international travel even as cases soared to devastating levels across the border in India.
Nepalese relatives of a person who died after contracting COVID-19 mourn at Pashupati crematorium in Kathmandu, Nepal, on 11 May, 2021. Source: AAP, EPA
Samir Kumar Adhikari, chief of the Health Ministry's Heath Emergency Operation Centre, said that the country is now in a "crisis situation".
"If even 20 per cent of the thousands in home isolation require hospital beds and care, it might reach a point where we will not be able to handle it," he said.
The five COVID-19 patients who died this week were being treated in the intensive care unit of a hospital in Rupandehi in southern Nepal.
"Our vehicles were queueing with cylinders to refill at three different refilling stations, but none were able to do so on time," Bishnu Gautam, a doctor at the Lumbini Provincial Hospital, told AFP.
A COVID-19 patient receives oxygen outside an emergency ward at a government-run hospital in Kathmandu, Nepal on Thursday, 13May, 2021. Source: AP via AAP
Gaurav Sharda, president of Nepal Oxygen Industry Association, said that demand is outstripping production capacity.
"All oxygen plants in Kathmandu are operating 24 hours and supplying oxygen in their full capacity. We can refill only 8,000 cylinders a day but demand is much higher."
'Lost opportunity'
Nepal has one of the world's worst-funded health systems, with the number of doctors per capita lower even than India.
The reasons for the surge in cases is similar to its huge neighbour - Nepal began recording a rise in cases in early April, a month after India, but the government continued to allow, even organise, large religious festivals and political gatherings.
Many Nepalis attended India's Kumbh Mela festival alongside millions of local Hindu devotees - including the former king and queen who were later hospitalised after testing positive.
Indian travellers also flocked to Nepal to fly on elsewhere as the world restricted flights from India, until a ban was enforced.
COVID-19 patients breath with the help of oxygen as they wait to be admitted at the Sukraraj Tropical and Infectious Disease Hospital in Kathmandu on 13 May. Source: AFP via Getty Images
Former health minister Gagan Thapa, now an opposition lawmaker, said that Nepal had wasted two crucial months in which it could have stemmed the outbreak.
"No matter the mistakes we made earlier, if we had used that window of opportunity, the damages would be much less than what we are seeing right now," Mr Thapa said.
Prime Minister KP Sharma Oli has faced fierce criticism over his handling of the pandemic.
As cases rose, he suggested gargling with guava leaves would cure the virus - topping his comments last year that spices would strengthen Nepalis' immune systems.
Mr Oli on Monday lost a confidence vote in parliament - due more to political infighting rather than the pandemic - and talks are now on to form a new government.
The Nepal Medical Association has appealed to politicians to "postpone their political calculations" and prioritise saving lives.
'Terrible situation'
Nepal typically relies on India for most of its medical supplies, but its powerful neighbour is now busy fighting its own crisis.
In March New Delhi effectively froze exports of vaccines to focus on its own needs and has only delivered half of what Nepal had ordered.
Only 2.4 million shots from India and China have been administered, and just over one per cent of people have received both doses.
That's even worse than India, which has fully vaccinated around three per cent of its population.
Nepal has now turned to China for help, this week sending an aircraft to pick up the first 400 out of a promised 20,000 oxygen cylinders and other supplies.
Beijing has also provided 800,000 coronavirus vaccines to Nepal.
Nepalis abroad have been rallying to get urgent help for the country, with #vaccines4nepal trending on Twitter on Wednesday as US senators discussed aid to the country.
The UN resident coordinator in Nepal Sara Beysolow Nyanti said that the country needed help "urgently".
"We have a similar burden to India but less capacity to cope," she told AFP.
Nepal army personnel wait to transport the body of a person who died from COVID-19 to a crematorium in Kathmandu on 5 May, 2021. Source: AFP
"(It) is important for international community to realise the vulnerability of Nepal differently from India."
On Monday, the government made a formal call on development partners for support, prioritising oxygen, ICU equipment and vaccines.
"If the help that we are seeking does not arrive, we will head towards a terrible situation which will be very difficult for us to manage," health ministry official Dr Adhikari said.
