Mumbai: Two months ago, Goa, which has a population of 14.57 lakh — less than 12 per cent of Mumbai’s population — was reporting about 50 to 75 new Covid-19 cases every day, with a test positivity rate of about 5 per cent.
The recovery rate was at a healthy 97 per cent, and the active cases were roughly 700.
On the quaint, palm-lined streets of Goa, on its vast golden beaches, the many beach shacks, floating casinos and glitzy resorts, the crowds of tourists — without masks — boosted by these statistics, made the pandemic seem like an event in the past.
Now, the small state is scrambling to contain a mammoth Covid caseload, adding more than 2,500 new positive patients each day with a test positivity rate in the range of 42 to 51 per cent.
In the past week alone, from 4 May to 10 May, 389 people have died of Covid, with the state recording its highest daily Covid death toll of 75 Tuesday. Of these, 26 patients died at the state-run Goa Medical College and Hospital between 2 am and 7 am, due to a suspected shortfall in oxygen supply.
However, neither Chief Minister Pramod Sawant nor State Health Minister Vishwajit Rane made any strong statement explaining the reason, with the former insisting that the supply of oxygen in Goa is not erratic and the latter asking for an inquiry by the high court.
As of Tuesday, active cases have spiralled 46 times to 32,836, and the state’s recovery ratio is one of the country’s poorest at 72.24 per cent.
The BJP government in Goa is facing fire for not waking up to the impending crisis earlier.
Experts and political rivals say the government failed to enforce wearing of masks and social distancing among Goa’s tourists and the local population; add medical infrastructure to be prepared for a second wave; or streamline testing, hospital admissions and medical triage.
With the statistics stacked against the state, and a severe shortage of Covid beds, the government is resorting to measures such as using a chemoprophylactic for all adults, introducing early use of steroids in Covid positive patients and administering doxycycline to everyone with symptoms, doctors advising the Goa government told ThePrint.
‘No screening of tourists at entry points, lockdown too late’
Speaking to ThePrint, Suyog Samuel Arawattigi, president of the Goa unit of the Indian Medical Association, said, “We were lax about a few things, and now we have reached a situation where the virus has just spread too deep within the community.”
He added, “There were a large number of parties, marriages in Goa with domestic tourists coming from all over. There should have been some control. The government should have also restricted crowds in places such as casinos, fish markets. Now, there is a community spread and a lockdown is not going to help.”
The Chief Minister Pramod Sawant-led Goa government started imposing restrictions only towards the end of April.
The government started with a night curfew from 21 April, and subsequently put in place a weekend lockdown. As cases continued to climb and positivity touched 50 per cent, many village panchayats started imposing local lockdowns earlier this month.
CM Sawant eventually imposed a full lockdown for two weeks only on 9 May.
Congress MLA Alex Reginald said, “The state government and the hotel industry is responsible for the state that Goa currently is in. There was no lockdown earlier as the hospitality and mining industries wanted to continue. Although neighbouring Maharashtra, Karnataka were full of cases, the government allowed everyone to come in without any checks.”
The state government made it compulsory for visitors to show a Covid negative to enter Goa only from Tuesday, after the Bombay High Court’s Goa bench ordered the government to do so. The state government had initially resisted, saying it will affect the supply of essential services for which Goa relies on bordering Maharashtra and Karnataka.
Reginald added home quarantine is also not strictly enforced. A case in point was when a Covid-positive Independent candidate, Arthur D’Silva, was seen campaigning for the Margao municipal polls. The Goa Police later booked him under the Epidemic Diseases Act.
‘Sometimes administrators make errors in judgment’
Even though Goa increased testing five times to an average of 6,986 a day between 4 May and 10 May from 1,400 a day between 5 March and 11 March, it could not keep up with the surge, resulting in nearly every one in two persons testing positive.
A doctor at a government hospital said, “Hospitalisations are not streamlined. There is no triage for the patient, so often they go and get a CT scan done on their own, which is not advisable. We are telling people to report to hospitals early, but when they come we don’t have beds.”
On Wednesday, the Goa government’s dashboard for Covid beds showed that only 14 of the 2,159 Covid beds were vacant. None of the 238 ICU beds were vacant.
ThePrint reached Goa Health Minister Vishwajit Rane via calls and texts but there was no response until the time of publishing this report. Goa Health Secretary, Ravi Dhawan, also didn’t respond to calls and texts.
However, in an interview to CNN last week, Rane said, “This (the lockdown restrictions) should have come much earlier. If you go through my tweets, I had suggested a stringent lockdown more than 15 days back.”
He added, “Anyway, 15 days back was also too late, we needed the lockdown more than a month back. Sometimes, administratively, economically, we need to take decisions that have a balance. Sometimes as administrators we make some errors in judgment and I think this is one of those cases. At the moment, we are managing, but I am not very happy with the situation in front of us.”
Preventative measures — ivermectin, doxycycline
Dr Pravin Bhatt, a pulmonologist based in south Goa, and on the state’s panel of experts set up to advise the government on measures to contain the virus, said, “We could have been able to save many more lives if we just had more beds. We are changing our SOPs from time to time to try out anything that might work.”
One such method that has raised some eyebrows within the state is to give anti-parasitic drug ivermectin to everyone above 18 years irrespective of symptoms to attempt mass chemoprophylaxis, which involves administering a drug to prevent the development of a disease.
The World Health Organization has advised against the use of the drug ivermectin for Covid.
“We debated this a lot and there are many within the Goa IMA too who are critical of the decision. But there are many papers on this. Moreover, it is an inexpensive, well-tolerated drug with not too many side effects, so there is no downside as such,” Bhatt said.
The doctor, who is director at the private Horizon Hospital in Margao, said symptomatic patients presenting themselves for testing are also immediately being administered doxycycline, an antibiotic, and vitamins.
The use of doxycycline to treat Covid cases has been contentious. Similarly, some doctors have recommended to the state government about starting Covid patients on steroids early, on the sixth or the seventh day itself.
“There is no blame game. Everyone is equally responsible… But now, the serious cases are spiking, there are simply no beds and the positivity rate is too high,” he said. “It is a battle, and we have to fight it whatever way we can.”
(Edited by Amit Upadhyaya)