Mandya: On 10 May, the primary healthcare centre (PHC) at Hallegere village in Karnataka’s Mandya district tested 75 people for Covid-19 — 36 were found positive, recording a positivity rate of 48 per cent.
On 11 May, however, the number of positive cases dropped to just 12. Reason: only 20 people were tested on the day, and the PHC recorded a positivity rate of 60 per cent.
Since then, the Hallegere PHC, which officially caters to around 10,000 people in 12 villages, has been testing just 10 people a day. The number is even starker if one considers that unofficially 20 other villages in the district also depend on the health centre.
The Karnataka government’s handling of the Covid-19 spread at Hallegere village in Mandya — part of the fertile Kaveri basin and home to the powerful Vokkaliga community — is an unflattering microcosm of its efforts in tackling the pandemic in rural areas where cases are surging.
The government, it appears, has simply reduced testing.
According to an official at the Hallegere PHC, who requested anonymity, the health centre used to conduct 200-300 tests every week in April but that has reduced to 50-60 in a week now. “The entire Mandya taluk has a target of around 490 tests (a week); so how can we conduct more tests? We have further reduced testing.”
Dr Sudarshan C.S., the doctor at the Hallegere PHC, also admitted that testing had dropped.
“On 10 May, we conducted 75 tests and found 36 positive; the following day, 20 tests were conducted and 12 were found positive,” he told ThePrint. “The government has asked us to reduce the tests as people who can afford it are taking up beds in government hospitals. So we are trying to discourage them. Even in mild cases, they are taking up a bed that can go to someone in greater need.”
Mandya health inspector Ravi Kumar also said barely 10 tests are conducted in a day. “We can do 100 tests too but we need kits. How else can we do it?”
Health Minister K. Sudhakar, however, denied suggestions that the government had drastically reduced testing.
“Karnataka has been testing about 1.25 lakh samples on an average every day. So far we have conducted 2.84 crore tests across 192 labs in the state, of which 2.36 crore tests are RT PCR,” he said. “About 41 lakh tests were conducted in April 2021. More than 83 per cent of the tests in Karnataka are RT PCR, which is one of the highest in the country.”
He added that testing has reduced slightly for a specific reason.
“The number of tests has decreased slightly because we are now focusing more on targeted testing,” he said. “Since the last week of April, strict restrictions have been imposed in the state and hence random testing that was earlier conducted in crowded public places like rail and bus stations has reduced. The focus is now on testing all primary contacts and symptomatic patients.”
A dire situation
The low testing and high positivity rate underlines the high incidence of Covid-19 in Karnataka’s rural population.
It has also prompted villagers to question the steps taken by authorities to deal with the pandemic.
“We used to see on TV that states like Bihar and Uttar Pradesh are struggling. But in reality we are not in a better situation either,” said 43-year-old Vishwanath H of Chikkaballi village. “It is just not being reported. Community spread has already happened and in every house in the village there is someone who is unwell.”
Vishwanath, whose village also relies on the Hallegere PHC, said residents come for testing and then return home disappointed.
“We have not been vaccinated and the prospects also look grim,” he said. “Whenever we come here for testing, there are huge queues and it is not the fault of the doctors. They are just not being given the kits. For every 30 people who are tested, 70 have to return without a test.”
Shankara Gowda, 55, another resident of Chikkaballi village, accused the government of trying to hide its failure. “In a day, sometimes they just do 10-12 tests to ensure the numbers are kept in check,” he said. “If they seriously start testing the villagers, they will realise 50-60 per cent are positive.”
According to the official website of the Mandya district administration, positive cases in the entire district increased from 10,427 in April to 23,287 in May.
H.B. Sidde Gowda, 51, a former president of the Hallegere gram panchayat, said sufficient RT PCR kits are not available and hence testing is low.
“Many are able to get tested only when they are in a condition of being hospitalised,” he said. “At the same time, when the government should be increasing vaccination, for the past 15 days, no first dose has been administered.”
According to Dr Sudarshan of the Hallegere PHC, reduced testing has meant a number of villagers are approaching hospitals when their oxygen saturation levels have already reached an “alarming level”.
“Testing has been reduced and at the same time there is lack of awareness and a stigma attached to the disease,” he said. “People are in their houses when their (oxygen) saturation is down to even 40 per cent, which means a stage of total lung damage. We need to act at the stage of inflammation.”
The doctor said the PHC building also requires urgent intervention. It has been earmarked as dangerous and needs to be demolished.
“This PHC officially caters to 12 villages but in reality it gets people from 20 more villages,” he said. “So the pressure is a lot but we can’t even get new equipment because a new building has to be constructed. We don’t have wards for patients. Everything is ad hoc.”
Health Minister Sudhakar, however, said several measures are being taken to contain the spread in rural areas.
“The state’s positivity rate is around 25 per cent and about 15-17 districts have a positivity rate higher than the state average,” he said. “The government is aware that the infection is slowly spreading in rural areas. I am personally travelling to these districts and in the last two three days, I have visited Tumkur, Chitradurga, Davangere, Haveri, Hubli and Dharwad to review the situation. A Gram Panchayat Task Force is being formed at every gram panchayat to strengthen local management. The CM has already announced Rs 50,000 to each gram panchayat for Covid management.”
On vaccination, he said the state government has placed an order for 2 crore doses of Covishield and 1 crore doses of Covaxin.
“We are floating global tenders for an additional 2 crore doses. The Centre has supplied 1.13 crore doses of vaccines,” he said. “Instructions have been issued to use 70 per cent of the stock to prioritise vaccination to those who are due for the second dose.”
Similar story across Mandya
The complaints, however, aren’t confined to just the Hallegere PHC.
ThePrint visited a number of primary healthcare centres in Mandya district and found doctors missing, reduced testing, vaccination not being carried out and villagers being forced to travel several kilometres to get primary healthcare.
At the PHC in Holalu village, Abhinandan, a gram panchayat member, alleged that the doctor doesn’t come to the centre regularly.
On 14 May, when ThePrint visited the centre, the doctor was on leave according to the PHC staff.
“The doctor simply doesn’t come. This PHC caters to 10 villages so you can imagine what the condition is,” Abhinandan said. “If 40 people come to get tested, barely 10 are able to get tested. Many don’t come back as there is no guarantee that even after queueing up their turn will come.”
He complained that since 10 May, while the first dose of the vaccination is not being administered, even the second dose is not being given regularly.
The situation was rather alarming at Basaral village.
“For the past 8-10 days, one of the doctors is Covid positive and the other one has been deputed to some other area on Covid-19 duty,” said a nurse at the PHC. “We try to do 10-15 tests but it also depends on the kits and the manpower.”
At Keragodu village, testing and vaccines are low and the situation is only going to aggravate, villagers said.
“We have not been vaccinating those aged 18-45. Second dose is being administered but not a lot. Testing has been reduced,” said Savita B.H, an ASHA worker at the village.
Ramesh KR, a resident of Keragodu village, said there is no clarity on the number of tests that the government conducts.
“Some days they do 10 tests, other days 15 and then it is even shut for days due to unavailability of stock. Villagers returning to their homes without getting tested is a routine affair,” he said.
Ranjithaa, a junior health assistant at the Keragodu PHC, said earlier the government used to ask them to do at least 50 tests which has now been reduced to 10 tests per day while the first dose of the vaccine has been stopped completely.
(Edited by Arun Prashanth)