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www.jogh.org • doi: 10.7189/jogh.10.020367 1 December 2020 • Vol. 10 No. 2 • 020367 COVID-19 pandemic has affected the health, social and economic integrity of lowand middleincome countries (LMICs) in an unprecedented way [1]. Income losses are projected to exceed $220 billion in these countries where 55% of the global population lives. As high as 75% of the population in LMICs simply lack the access to soap and water for minimal hygiene which is now more critical for COVID-19 prevention [2]. In Nepal, 18 752 cases of COVID-19 were reported until 27th July 2020, however, the impacts are far beyond these numbers because of the cumulative impacts due to COVID-19, lock down and the damages due to earthquakes (Figure 1). In 2015, Nepal’s two earthquakes claimed 9000 lives and left 23 000 injured, and surprisingly profound and sustained impacts on health system persisted even after five years of earthquakes [3,4]. Moreover, mobility restriction against COVID-19 has put a tremendous pressure on poor and vulnerable population who struggle with the daily wage for food in Nepal. In this piece, we attempt to explore long-term imEarthquake rebuilding and response to COVID-19 in Nepal, a country nestled in multiple crises