Covid-19 & India: The story from the states

A fortnight is an era in the age of Covid-19. From the 1,000-odd novel coronavirus cases late last month, India has crossed the 10,000-mark.

The virus is being battled by the Centre and the states. Some regions are doing better than the others, though every state faces a shortage — of personal protective equipment, masks, ventilators and hospital beds.

Take the Capital. Delhi has already exhausted 50 per cent of its bed capacity, going by the bulletins issued by the state government. Doctors fear that healthcare set-ups will soon spill over with patients. On March 29, Delhi had a 4.7 per cent share of the 1,024 confirmed cases across India; by April 14, it had risen to 15 per cent of 10,815 cases.

But there are some faint glimmers of hope. The one state that may be flattening the curve is Kerala. A young woman in-charge of the Kollam control room points out that the district has not recorded any new case in the last two days.

On March 29, Kerala, with 182, had 17.7 per cent of all cases in India. Maharashtra had 186. But Kerala has successfully reversed the trend with its timely steps. Maharashtra today accounts for 21 per cent of all cases, and Kerala, 3.5 per cent.

Though Kerala has achieved early gains, it cannot afford to sit back yet, says Rajeev Sadanandan, the state’s former additional secretary and a member of a committee that penned a lockdown exit strategy report for the state. Kerala is among the states planning to roll out mass testing through rapid antibody kits to check for possible spread in communities in even the districts where cases have not been reported. “But if the kits don’t arrive soon, testing strategies will have to be rethought,” he says.

In addition to asking for an extended lockdown, states also called for aggressive testing in half of India’s 720 districts that have not reported a Covid-19 positive case yet. Health experts fear hidden cases, if not detected, will blow up, creating new hotspots in the next two weeks.

While the first consignment of 500,000 rapid antibody kits — finger-prick blood tests with speedy results that are recommended for mass surveillance — arrived from China on April 16, it is yet not clear how these will be distributed among the states.

Gujarat, meanwhile, has extended its testing — with the available kits — from hotspots to remote villages that have not reported the virus. As a result of the random testing, two positive cases were reported in North Gujarat’s Banaskantha district, Gujarat health secretary Jayanti Ravi tells BL ink .

“We are going into those areas where there were no reported Covid-19 cases. As on April 14, we collected 660 samples from 14 districts, of which two were positive in Banaskantha. This way we are able to pre-empt the possible presence of the virus and take immediate action to contain the spread,” Ravi adds.

Another state that has been quietly fortifying itself is Chhattisgarh, though policy-makers are worried about the future.

The state set up a war room on January 26, much before other states had woken up to the danger. “We started creating awareness for all persons with foreign travel history to self-declare, and our first case was a student who had returned to Korba (an industrial town 200km from Raipur) from the UK and tested positive on March 18,” Chhattisgarh health minister TS Singh Deo says. Till April 14, the state had 31 confirmed cases, 10 of whom recovered.

A 16-year-old boy from Korba also tested positive. Deo’s worry is that health officials have not been able to pinpoint the source of the infection. It was first thought that the boy had been present in Delhi at a large meeting also attended by people who’d come from abroad. “It later turned out he had never gone to Delhi. He used to work as a bus conductor in the state transport service. After the lockdown, he lost his job and started working for a potato vendor, who took part in a festival in the neighbouring village of Khata Shyamli, attended by 80 other people. We are tracing each one of them now,” Deo says.

Authorities are examining how a small town such as Korba turned into a hotspot. “We have locked down Korba. A survey of 1,000-odd people in 200 houses has been conducted. Now, we are screening for the virus in remote villages of Dantewada, too,” he adds.

Citing official projections, Deo says that over the next six months, at least 15,000 patients may require ICU-care in the state. “We have only 622 ventilators. Aggressive prevention has helped us, but if the situation spirals we don’t have the health infrastructure to manage the disease,” he says.

While a few states have been making strides, in a galaxy far away is Madhya Pradesh, which has seen 50 (14 per cent) of the total 353 Covid-19 deaths in the country. Cases have been blowing up in Bhopal and Indore, and emerging in remote districts such as Dewas, Hoshangabad, Raisen and Khandwa. Testing rates remain very low; just 5,135 samples have been collected so far, half the number in other big states.

While 18 districts of MP have been affected, officials in regions where the virus has not been spotted yet are equally worried. A bureaucrat from Panna states that with no private hospitals in the area, the entire burden of cases will fall on government infrastructure. And all of Panna, he points out, has just one ventilator.

The picture is dismal, with the states taking baby steps. Most are tottering, but all eyes are on the ones that are managing to move on — one step at a time.

(With inputs from Rutam Vora)

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