Meerut: Covid-19 was a distant reality for a kasba of Pathans in Shahjahanpur, Uttar Pradesh, until last month. It hit home on 8 April, with the death of Asim Khan, 46, who had returned to the kasba from Delhi five days before.
Asim had had high fever, cough, body ache and breathlessness, all of which are Covid symptoms. On 6 April, his condition worsened and he was admitted to Anand Hospital in Meerut city, 25 km away. His Covid test report, confirming infection, arrived a day after his death. In the days since, residents say, there have been over 25 other deaths in this kasba where everyone is related to one another.
“It all started with Asim, he came home sick. After that, another person — Shujat Mand Khan, 57 — died of Covid (he tested positive) in hospital. Since then, there have been around 25 deaths in the village. Others who have died didn’t undergo tests,” said Shanu Khan, a resident.
Pointing towards two houses, he added: “Musaheeda Khan died a week back, she had severe symptoms. Two-three days later, Mumtaz Begum died of breathlessness.”
The spate of recent deaths in the kasba is laid bare by fresh burials in tiny kabristans (cemeteries) at almost all intersections of the village. However, in many cases, the absence of tests meant they were not recorded as Covid fatalities.
Doctors on the ground in Shahjahanpur say residents of the kasba are reluctant to get tested — “paranoid” that a positive diagnosis will send them to hospitals, which they see as a ‘death sentence’. Many families, they say, thus choose to treat patients at home if they show Covid symptoms.
But a different account emerges from conversations with residents of the kasba, who say the health authorities are not conducting enough tests. They also claim that testing often seems futile because results take up to 4-6 days to come, by when some patients are already dead.
The local authorities admit to the charge of delayed test reports. It is a matter of grave concern, they say, and cite the district’s strained testing capacity amid the surge in infections.
Taken together, these factors have thrown a question mark over the fatality figures coming out of Meerut, which recorded 65 Covid deaths in April.
‘Bathing the body’
According to the 2011 census, Shahjahanpur, named after Mughal emperor Shah Jahan, has a population of over 17,000, of which 80 per cent is Muslim. Nearly 60 per cent of the Muslims are said to belong to the same family of Pathans that resides in the aforementioned kasba, which has no name as such.
There appears to be near consensus in the kasba about the fact that Asim was ‘patient zero’, the first in the area to be infected. They say the infection spread because his immediate family violated the protocol laid down for handling a Covid patient’s body.
The bodies of people who have died of Covid-19 need to be put into a leak-proof body bag in order to mitigate risk of infection for those in their vicinity. Bathing of the bodies, a funeral ritual among many communities, is not allowed, and any physical contact with the corpses is barred as well. Family members conducting the funeral and workers handling the body should be in PPE.
According to multiple local residents, Asim’s body was taken out of the body bag and bathed before burial.
“Asim bhai’s family members opened the body bag and bathed him. They wore masks and gloves, but the virus cannot be stopped like this,” said Naseem Khan, 45. “Since then, this entire Ramzan, we have only seen dead bodies, people who have died from Covid.”
Shoaib Khan, 43, said the body was bathed in keeping with Islamic rituals. “Since then, people have died of Covid, complaining of breathlessness, fever etc,” Shoaib added. “Now almost every house has one patient who has a fever and cough. They are all looking for oxygen cylinders throughout the day,” he said.
Dr Mohd Yusuf Khan, who holds a Bachelor’s in Unani Medicine and Surgery and runs a clinic in Shahjahanpur, said Asim’s wife, her brother Zakir’s wife, and Asim’s elder daughter aged 14 tested positive for Covid-19 after his death. “Zakir tested positive for Covid-19 later. They have recovered now,” he added.
Taleman Khan, the brother of the second confirmed Covid fatality, Shujat Khan, tested positive and he is admitted in a Meerut hospital, Dr Khan said. “The rest of his family, including his wife and son, tested negative but were in quarantine,” he added.
Speaking to ThePrint, Zakir initially denied opening his brother-in-law’s body bag and bathing the corpse, and also the fact that he and other family members tested positive, but later conceded when coaxed by local residents.
‘Living in denial’
All the residents of the kasba, Dr Khan said, are scared.
According to Khan, the Pathans here are “living in denial” and have to be forced to get themselves tested.
“People are dying here every day. They just don’t want to get tested. We have to force them, pressure them. After Asim’s death, they are all shaken and think that if they test positive, they will have to be admitted in hospitals. Yahaan logo ko lagta hai hospital jaane se maut hoti he (people here think hospitalisation means death),” Dr Khan said.
The Public Health Centre (PHC) for Macchra block sends teams to the village every alternate day but testing is low because the “Pathans don’t cooperate”, he added.
Dr Alok Nayak, who runs the Machhra block PHC, agreed. “People here refuse to cooperate at all. Dr Khan explains to them regularly why it’s important to get tested but they don’t listen. Our teams go there regularly,” he said.
“Shahjahanpur has a lot of active cases. Since 14 April, 25 people have tested positive for Covid and these are only from people who we managed to convince,” Nayak added. “Most cases are from the Pathan families. While some say they don’t believe in Covid-19, others say they don’t want to break their fast by getting tested,” he said, referring to the month of Ramzan, which is currently under way.
Khan said people “here live in constant paranoia”. “Some complain about the behaviour of doctors and nurses at the hospitals. They just want to stay at home and manage oxygen cylinders,” he added.
‘Not testing people’
However, most other villagers of Shahjahanpur blame the government for not conducting tests.
“They aren’t testing people like they should be. Contact tracing isn’t done as it should be,” said Shahdullah Khan, a local resident,
There are also claims about patients being turned away by hospitals.
When ThePrint visited resident Mohsin Khan Saturday, his 23-year-old brother Atif was in dire need of an oxygen cylinder. Atif had been complaining of high fever and breathlessness but Mohsin couldn’t manage an oxygen cylinder for him.
Their mother Momeena Khan, diabetic, also had high fever but none of the family members had tested for Covid. “We haven’t got them tested because fever comes and goes. They take some medicine and it subsides,” Mohsin said at the time.
Both Atif and Momeena died — Atif after his oxygen level dropped Sunday night, and Momeena Monday afternoon.
Speaking to ThePrint Monday, Mohsin said they “didn’t get any tests done”. “What would have been the point? I took Atif to a Meerut hospital (Chhatrapati Shivaji Subharti Hospital) but they didn’t admit him. His pulse was low so we got him home.”
ThePrint called the hospital to ask about the case but there was no response till the time of publishing this report.
Asked if the family will now undergo tests, Mohsin said, “We just lost two people, we will see about testing, plan to get it done soon.”
Shoaib Khan, whose father-in-law and brother-in-law have symptoms and are in isolation but haven’t undergone tests, scoffed when asked about testing.
“Even if people get tested, what’s the point? Reports come 4-6 days later, the person already dies by then,” added Shoaib.
Senior government officials agreed that reports are taking 4-6 days, attributing it to the “high number of cases and samples” in Meerut city.
“Test reports are lagging, pressure is mounting on the labs and technicians. We have three government labs in Meerut district — Lala Lajpat Rai Memorial (LLRM) Medical College, NCR Institute of Medical Science and Chhatrapati Shivaji Subharti Hospital. There are 6-7 private labs but their capacity is way less than these,” said Dr Bipin Kumar, Deputy District Surveillance Officer.
“In LLRM, 4,000 RT-PCRs can be conducted at one go, the other two have capacity of 800.”
He added: “A lot of people from Delhi and other places have come back to Meerut, which has led to a surge in cases.”
Both Dr Khan and Dr Nayak said the delayed reports are a “matter of grave concern”.
Government data accessed by ThePrint showed that 2,17,951 tests were conducted in April (as of 29 April) in Meerut, and 1,10,005 in March. Meerut reported one Covid death in March, and 65 in April. Between 1 and 30 April, the number of active Covid cases in Meerut rose to 12,679 from 395.
Talking about the classification of Covid deaths, a senior official in the Meerut Chief Medical Officer’s (CMO’s) office said, “People have symptoms but die without a test, so we don’t add them as Covid deaths. In some cases, the RT-PCR report is negative.”
The official death data for Meerut has come under the lens, with Newslaundry reporting this month that the number of Covid deaths — as recorded by the CMO’s office and by Meerut’s biggest crematorium — is at variance by at least seven times. In the report, the CMO was quoted as saying that the “anomaly” was because some people who died of Covid in Meerut were from other districts, and yet others had symptoms but tested negative.
When ThePrint trawled through the CMO records for Covid deaths in Shahjahanpur, it couldn’t find the names of Asim and Shujat, even though both had a positive Covid diagnosis.
These reporters searched their names by different spellings, by the name of the hospitals where they died, the labs where their samples were sent, and even phone numbers.
Asked about this, Dr Kumar said, “Their tests were conducted in Noida labs, not Meerut labs. The hospitals probably didn’t upload it on the portal, so we don’t have the record.”
(Edited by Sunanda Ranjan)