Low testing, poor health services — how Odisha is scrambling to fight Covid after good start

Odisha was among the first states to shut down, but returning migrants and poor health infrastructure have left Naveen Patnaik govt scrambling to contain a Covid spurt.

Village residents at Balakati of Khordha district, Odisha | Photo: ANI (Representative image)

Bhubaneswar: Odisha was among the first states to adopt strict Covid-19 measures — on 21 March, three days before the nationwide lockdown began, Chief Minister Naveen Patnaik shut down five districts and eight towns to contain the pandemic. 

Since then, the Odisha government had effected several lockdowns, shutdowns and containment measures. It was also the first state to extend the nationwide lockdown up to 30 April. 

All of it, however, has done little to flatten the Covid curve in the state.  

Four and a half months after the first lockdown, the government is struggling to handle the coronavirus spread as positive cases and fatalities continue to surge. 

The test positivity rate in Odisha hovers around a worrying 10 per cent mark, higher than the national average of 8.8 per cent. 

July has been the worst month with more than 26,000 confirmed cases in the state. In all, as of 7 August, Odisha’s Covid tally stands at 42,500 cases, of which 26,500 are recovered patients. There have also been 247 Covid deaths in the state. 

And even those in the government admit that the worst is yet to come. The spokesperson (technical) of the health department, Dr Jayant Panda, predicted recently that the number of confirmed positive cases will rise by another 50,000 in August with an additional fatality of 200. 

“The government’s prediction is based on continuous analysis of anticipated increase in the positivity rate,” Panda said.

Since 40 per cent of the Covid beds remain vacant at any given point of time, experts monitoring the pandemic feel the predicted surge in positive cases could be managed with the facilities available now in the state — as a matter of precaution, though, measures are being taken to create additional infrastructure keeping the worst scenario in mind.

That, however, is just one part of the story. The real picture could be far worse as Odisha hasn’t been testing enough. The government collects 14,000 swab samples a day for testing in a state with a population of about 4.5 crore. This is about 12 persons per 1,000 population being screened each day. 

The government’s efforts have also been hampered by some inherent problems — a spurt in cases due to returning migrants, besides lack of doctors, healthcare infrastructure, testing kits, technicians and protective gear.

The Covid-19 spurt

The situation in the state took a turn for the worse in April and June when close to a million migrant workers returned in phases from Gujarat, Maharashtra, Tamil Nadu, Kerala, Rajasthan, Maharashtra, Andhra Pradesh, Telangana and West Bengal. 

The preventive measures in place by the administration proved to be inadequate as many of the infected returnees went on to become spreaders, particularly in Ganjam district, which accounts for nearly a third of Odisha’s caseload. 

According to Dr Subrat Jena, founder of the Aswini Group of Hospitals, who set up the first dedicated Covid hospital in the state, the situation worsened as people did not follow simple prevention measures. 

“Had people followed the simple protocol of washing their hands and protecting their mouths and noses, the positive caseload would not have gone up so drastically,” he said.

Dr Jena, who now manages four Covid hospitals in the state, isn’t particularly optimistic of the immediate future. “It is too early to say that the pandemic will stabilise within a month,” he added. “The virus is still an enigma to researchers and it would be foolhardy to expect a miracle to happen in too short a time.” 

Even as the Naveen Patnaik government claims to have already spent Rs 1,900 crore on Covid control and healthcare infrastructure, it has come under criticism for its handling of the crisis.  

Congress Legislative Party leader Narasingha Mishra has been unsparing in his assessment of the state government’s efforts. “The state government never took the people’s representatives (politicians) into confidence at all,” he said. “It mishandled the crisis because of over dependence on the bureaucracy.”

Lack of healthcare facilities 

One of the biggest handicaps for the Odisha government has been its historically poor health infrastructure. 

The state government has so far managed to secure 5,700 beds in 35 dedicated Covid hospitals, and another 21,000 in 178 Covid care centres, but only 455 of these are ICU beds. The state also has just 312 ventilators. 

But what is worrying the administration is the pandemic’s spread in many tribal-dominated districts where the health infrastructure and the communication network are in a shambles.  

Large scale vacancies and reluctance of doctors to work in underdeveloped districts and rural areas have thrown the healthcare system out of gear. 

Even after the state government had pressed more medicos into the service during the pandemic, the ratio stands at one doctor for every 5,500 people. There are many primary health centres in the far-flung areas that are managed by paramedics even today.

Healthcare professionals take a dim view of the facilities available given the disturbing spike in numbers. 

“It is not the question of how many are being screened or tested,” said a senior health department official, who did not want to be named. “The biggest challenge lies in the non-availability of competent human resources to deal with a dynamic virus. Creation of beds and other facilities are not enough. Do we have adequate personnel to provide proper treatment to those admitted in such centres?”

The reluctance of doctors to work in rural areas is another major problem. 

Additional Chief Secretary (Health) Pradipta Kumar Mohapatra, who took stock of the situation of the worst-affected Ganjam district Friday, warned professors and senior faculty members of Maharaja Krushna Chandra Gajapati (MKCG) Medical College and Hospital at Berhampur of serious consequences if they did not visit the two Covid hospitals and treat serious patients. 

According to sources, the faculty members, he was told during a meeting, were not even attending the patients in some critical departments in the college for fear of getting infected. He also had interactions with the patients and their attendants during his visit to various hospitals.

Mohapatra, however, told ThePrint that the situation was under control. “Nobody anticipated this, but prompt planning and strict measures initiated by the government have helped us to keep the disease under control,” he said.

Stating that the situation was dynamic and that there is no reason to panic, he was confident that the spike would stabilise within a month. 

“Efforts are on to create more Covid beds, strengthen the health infrastructure and increase the daily screening to at least 20,000 samples per day,” he said.