Jaunpur: As Bamau Ram Kannojia, 70, of Jaunpur was gasping for breath in the emergency ward of the district hospital Tuesday, his attendant, a 25-year-old distant relative, was flummoxed.
Ticking off a mental checklist to identify the source of Kannojia’s Covid infection, the relative said, “He never stepped outside the village. Mostly remained around the house. How can he get Covid?” he asked.
Kannojia was one of several patients at the hospital — all from villages nearby — exhibiting Covid symptoms, primarily fever and breathlessness.
Like him, the potential source of infection was a question most struggled to answer because, as they claimed, they had never stepped out of their villages.
Next to the emergency ward, two doctors sat noting down each of the patients’ symptoms. Some of the attendants in the ward didn’t have their masks on, and the doctors were locked in a constant struggle to keep them at a distance.
“Look at the situation. It is exploding,” said one of the doctors. “Each and every person we are attending is Covid positive. These are coming from villages.”
Jaunpur, a rural district in Uttar Pradesh comprising 1,740 villages and 21 blocks, is witnessing a surge in infections amid the second Covid wave.
According to the district health bulletin, as of 27 April, Jaunpur had 5,000 active Covid cases, up from 867 on 11 April. This appears to confirm a disturbing observation made by the central government in March, that Covid, on the ascent again after a dip in infections, was “moving closer to rural areas”.
The district has a population of more than 44 lakh, but only one L1 government hospital — equipped with isolation beds and meant for mild Covid patients — and four L2 government facilities, with oxygen beds. The district has 28 ventilator-equipped hospital beds.
In light of the rising infections, the district administration has engaged six private hospitals. Altogether, there are 598 hospital beds for Covid patients in Jaunpur, including private and government.
But even as efforts continue to treat patients, much brainstorming is underway about the source of infection. One explanation the authorities offer is the return of migrants — as many as one lakh — from the cities since the days before Holi (29 March).
Return of the migrants
Jaunpur District Magistrate Manish Kumar Verma said there has been a stream of returning migrants over the past month.
“People started coming for Holi, then for harvesting, and then for the panchayat polls. Overall, one lakh migrants returned to the district,” he added. “Many of them did not isolate themselves.”
The Uttar Pradesh panchayat elections were due to be held in December but were postponed in light of the Covid pandemic.
The polls were eventually held in four phases from 15-29 April. Jaunpur voted in the first phase.
Anil Yadav, the former head of the gram panchayat at Chaktali, 5 kilometres away from the city, said their term ended in December, which means there was little oversight for those returning.
“We were not told to be prepared as our terms ended in December. Migrants kept coming and there was no screening or testing. Neither the gram sabhas were prepared nor the district administration,” he added. “In my own village, more than 20 people came for polling even when the Covid numbers were alarming.”
Manoj Yadav, former head of the Guhka panchayat, 40 kilometres from the main city, said they attempted to monitor the situation in their personal capacity.
“Our term ended on 25 December. We were then not responsible for the administration. When the second wave really hit the rural side, it was ASHA (accredited social health activists) and anganwadi workers who were closely working with the block development officers (BDOs),” he added.
More than 100 people returned to the village in the last month, Manoj said.
“The next panchayat head will be announced on 2 May. Till then, we don’t have a role assigned to us. But we are helping and monitoring the situation in our personal capacity,” he added.
Anita Yadav, an anganwadi worker from Chaktali, said everyone who arrived in the village before 10 April went unchecked “because we were not told” to monitor them.
“But since the 11th, we have been maintaining a register. We are going door-to- door and asking people to go to the block for testing,” she added. “But people are hiding their symptoms and are not opening up.”
Bhaiyalal Yadav, a Chaktali resident working in Mumbai, returned to the village on 14 April and said the district authorities had arrived to check on him.
“I was screened at the Allahabad railway station. I took a bus from there to reach my village. Some people from the district came to check me but I updated them that I don’t have any symptoms,” he added.
‘Nigrani samitis and targeted testing’
Jaunpur currently has more than 500 containment zones — areas where infection has been reported and thus are subject to certain restrictions — in blocks and villages.
District Magistrate Verma said they were carrying out “smart testing” to check the virus. “We will be conducting targeted testing of those who are more exposed to the virus, such as street vendors and those who are coming from Covid hotspots,” he added.
The administration has also set up 1,740 nigrani samitis (surveillance committees) in as many villages and 164 in urban pockets. Each committee comprises an ASHA and an anganwadi worker, among others.
“The committee is assigned the task of tracking people who are prone to the virus and alert the authorities. They will also provide a medical kit to those who are sick in villages,” said Verma. “We have kits ready comprising medicines prescribed for Covid.”
As the authorities accelerate their efforts to bring Covid under check, the patients are waiting to recover. Back at the Jaunpur district hospital, 14 Covid patients are plugged into oxygen. Amid the gloom of a hospital struggling against a pandemic, Kannojia, one of the patients on oxygen, offered a moment of levity.
As a doctor arrived to attend to him, Kannojia rattled off all his symptoms but added that his biggest worry was neither the fever, nor the breathlessness.
“Baaki sab toh theek hai, bukhar nahin ja raha, saans nhin aa rahi, khana kaisey khaunga (the rest is fine, fever hasn’t broken, and I am breathless. But how will I eat)?” said the self-confessed foodie.
“Jaldi hi (soon),” the doctor replied. “Jaldi hi theek hokar khana khayenge (we will eat food soon, after recovery).”
(Edited by Sunanda Ranjan)
This report has been updated to correct an error in the date Jaunpur voted in UP panchayat polls, and a typo in the spelling of the village Chaktali.