Meerut: Outside the Community Health Centre in Meerut’s Kharkhauda Monday, a man in his 30s and a UP health department official stand discussing how to care for the former’s Covid-positive sister. Since her symptoms are mild, she has been advised to stay at home; and the five-member family living in a four room house could do it easily, but for the fact that they all share one bathroom.
The official, in a hushed tone, asks the man from a nearby village, who did not wish to be identified, to “manage it”.
Kharkhauda block in Meerut district of Uttar Pradesh is home to 39 villages that house over one lakh people. Since the first week of April, Covid cases have been rising exponentially in not just this block, but the whole district.
On 10 May, according to UP’s daily health bulletin, Meerut overtook Lucknow as the district with the highest case load in the state, reporting 2,269 cases to the capital’s 1,274. The total number of cases in Meerut district now stands at 14,007, and 586 people have died.
The district has 1,155 oxygen beds, of which just 182 are vacant, and 599 ICU beds, of which 20 are vacant.
Asked about the oxygen stocks in Meerut, District Magistrate K. Balaji told ThePrint: “The demand and supply of oxygen in Meerut is a dynamic figure and continues to change on a daily basis. Any specific number will not be reflective of the real situation.”
Pandemic in the villages
There have been several reports of a Covid crisis in UP’s rural areas, apparently due to the recently conducted panchayat polls in the state, and Meerut is no exception. DM Balaji said 25 per cent of the district’s active cases are from the rural areas, up from 15 per cent during the first wave.
According to the 2011 Census, Meerut’s 34.44 lakh people are pretty evenly split between urban and rural areas — 51.08 per cent and 48.92 per cent respectively.
However, authorities say rural areas did not show a noticeable rise in Covid cases till May.
“In this wave, we have noticed two things. If one person in a family tests positive, the whole house is positive. The second thing is that patients’ condition is turning serious very fast, and they need to be hospitalised,” Dr R.K. Siroha, who heads the Kharkhauda CHC as well as the nearby NCR Institute of Medical Sciences, told ThePrint.
“During the first wave, there was only one death in (NCR) hospital. The patient required L3 care, but we only have L2 facilities. During the second wave, at least 8-10 patients have died already. There is also a greater demand for oxygen this time, and it is a high-level requirement. Last time, most of our cases were in the general ward,” Siroha added.
As on 10 May, there were 677 Covid cases in Meerut’s rural blocks — Hastinapur had the most (165), followed by Rajpura (102) and Daurala (76). Kharkhauda had 27 cases. However, comparing the block-wise data to the state health bulletin showed discrepancies — the former recorded 2,190 cases Monday, while the latter showed 2,269.
Ashok Talyan, divisional and district surveillance officer for health in Meerut, explained the discrepancy by saying: “Some cases are recorded belatedly owing to follow up, while others are cross-notified under Meerut’s ID.” Cross-notification refers to people from nearby districts testing positive in Meerut’s jurisdiction.
Survey paints positive picture, people afraid of getting tested
From 5-9 May, the Uttar Pradesh government conducted an intensive state-wide survey to gauge how deep the pandemic had gone into the rural areas, borrowing the door-to-door micro-plan from the polio eradication mission.
“We started a campaign that targeted homes in rural areas to screen everyone for Covid symptoms. An antigen test was done on the spot. If that was negative, we then conducted an RT-PCR test and gave them medicines as part of the ‘Corona kit’. This was done to put in place an early-warning system,” said Talyan.
In Meerut’s 12 rural blocks, covering around 740 villages, nearly 1,300 teams of Accredited Social Health Activists (called ASHA workers) and anganwadi workers were deployed. By 9 May, 6,053 symptomatic people had been identified, of whom 100 tested positive. Of these, just 10 were hospitalised, while the rest are in home isolation, Talyan claimed.
However, the ground reality is different.
Santoshi, a resident of Bijauli village in Kharkhauda, had fever and fatigue last week. While the fever has since come down, she continues to feel weak. An ASHA worker provided her medication and asked her to get tested, but she didn’t, and refused to specify why.
Next door to her, Munni’s husband Madan had reported similar symptoms. He too has taken medication, but hasn’t gotten tested. “His fever came down, but he had a little temperature again this morning. He has gone out right now; he isn’t at home,” Munni said.
ASHA workers’ woes
ASHA workers have been at the forefront of the fight against Covid in many states, but their troubles have risen in the last one year.
“The biggest issue we face is that we can no longer talk to people face-to-face. We have to maintain a distance to speak, and this is hindering our ability to convince them to get tested, vaccinated and spread awareness,” Beena, an ASHA worker in Bijauli, said.
“It’s better if we go near them and explain, we feel an affinity (apnapan in Hindi). If we speak from afar, people feel distant — they think we have come for our own sakes, and for the financial benefits of the job,” she added.
She explained that people like Santoshi and Madan did not get tested because of an underlying fear of going to hospitals, fuelled by the increasing number of deaths they are seeing on television news.
“They see people going to the hospital with Covid and not returning alive. They question why those who succumbed to Covid are brought out of the hospital are sealed in plastic. Many fear that organ harvesting is going on in the name of Covid treatment,” Beena said.
Cases ‘plateauing’ in urban Meerut
Twenty-four static booths have been deployed in Meerut’s urban areas for collecting samples every day. Primary healthcare centres and rapid response teams are constantly monitoring around 6,000 home-isolated cases across the district.
However, even on the day Meerut became the No.1 district in terms of caseload, 10 May, the waiting area of the 400-bed capacity Superspeciality Hospital in Meerut city wore a deserted look.
“I think the cases are beginning to plateau. The situation is not as bad as it was a few days ago when patients and their relatives were scrambling to get beds. This area used to be full, the waiting queue was huge, and ambulances were doing the rounds constantly,” said Dheeraj Raj, a doctor at the Superspeciality Hospital.
(Edited by Shreyas Sharma)