Influx of 14 lakh migrants in Rajasthan is posing new challenges to the desert state, where 31 of its 33 districts now have Covid-19 cases. State’s health minister Raghu Sharma speaks to Businessline about how Rajasthan is gearing up to tackle the recent spike in cases and spread of the virus to rural areas. Excerpts:

With Rajasthan starting the influx of migrants, what are the key challenges that the state is facing?

Till now, there were more infected persons in city areas. Villages were safe during lockdown, but over the past week, up to 15 rural districts have seen a sudden surge of cases due to the influx of migrant labour that have returned back to the state. Up to 935 Covid-19 cases were seen in 15 districts including Nagor, Pali, Rajsamand, Sirohi, Udaipur, Dungarpur, Jalor, Jodhpur, Jhunjhunu, Bikaner, Bhilwara, Dausa, Jhalwar and so on. These districts were green, which means they had no cases and have all of a sudden turned red. Of 33 districts in Rajasthan, 31 are now affected, only two districts have not reported cases. Bhilwara, which till recently had contained the pandemic has again recorded over 37 active cases whereas we had eased the curfew there only two to three days ago.

How many migrants are we looking at? What is the state doing to help those who are walking on highways to reach their homes?

Up to 14 lakh migrants have registered online to return back, of which eight to nine lakh have already entered the state. Two to three lakh are expected soon. Also of the five to six lakh migrants stuck in state who wanted to leave, most have left and there are 3,000 in camps across Rajasthan. We have instructed district officials to pick up any migrants who are walking on streets and lodge them in shelter homes, as well as arrange vehicles to drop them wherever they want to go. We need at least 1,000 passengers to run a train, so for lesser passengers we are plying buses.

In the light of rising cases, how are you ramping up your testing strategies?

We had no testing facility in state when the first case arrived on March 2. The swab was sent to National Institute of Virology in Pune. Since we have built testing infrastructure and conducted 2.55 lakh RT-PCR tests. We conduct 15,000 tests per day and plan to scale it up to 25,000 per day. Rajasthan has a population of 7.4 crore people. Up to 14 lakh migrants are expected. Testing everyone will take two to three years. But we are drawing samples of all Influenza-like illness cases, and also conducting random sampling where there are more positive cases. While centre has asked us to pool 25 samples for RT-PCR testing, we are conducting pooled tests with only three to four samples in one go. We are one of the few states where testing is being done on a large scale. Now we are prioritising testing in districts which are seeing an influx of migrants. Pali seen 3,500 tests, we are doubling Pali’s capacity. Jodhpur’s capacity is being tripled with COBAS 8800 machine which can test 4,500 samples per day by May end. Another such machine will be installed in Jaipur by June first week.

Recently Delhi government issued an order to not test dead persons for Covid-19? Your take.

In Rajasthan, we have instituted a death audit of all cases (suspected and confirmed COVID-19). We realised that the maximum cases are being brought dead, or die within three to five hours of coming to the hospital and samples taken after they died turned positive. It is a dangerous phenomenon. So, we are drawing the sample, because even if a person died, we need to know where he stayed and trace his contacts. For all the dead, we keep a record of the cause of death, in what condition did the patient come, in how many hours did they succumb, what was their age, what other illnesses were they seeking care for and so on. Most of these patients are suffering from co-morbidities like kidney disease, high blood pressure, heart issues and so on.

What is the fund outlay for tackling Covid-19? What is the way forward?

The central government had allocated ₹ 15,000 crore under the National Health Mission, of which Rajasthan has received ₹ 201 crore. We are upgrading health infrastructure, testing facilities, ICUs, ventilators and quarantine beds. Currently there are three patients in ventilators and 29 in ICU. Our recovery rates which were beyond 60 per cent have now dropped to 57 per cent due to new cases. We have robust surveillance through Department of Information Technology which tracks all patients that show up in the hospital, whether symptomatic or asymptomatic, by recording their mobile numbers apart from the door-to-door survey. Also, population in our villages are very vigilant to not breach protocol, wear masks, practise physical distancing and washing hands frequently.

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