New Delhi: For much of the Covid-19 first wave, cities and states with high population density had borne the brunt of the pandemic.
But as India scaled a new high in daily positives Monday morning, even states such as Chhattisgarh, where the total population is less than 3 crore, have been at the centre of the latest Covid storm.
In the last month alone, the number of active cases in Chhattisgarh has risen by over 1,000 per cent, with Health Minister T.S. Singh Deo attributing it to “complacency” and migrations from neighbouring Maharashtra, which has also seen an explosion of cases.
What is more, the state that had been vaccinating 3-4 lakh people a day for the last few days was forced to carry out just 20,000-30,000 vaccinations Monday after supplies ran out. It has now got a fresh batch of 3,25,000 doses, Singh Deo told ThePrint.
ICU beds are running out and despite a trend of more people from middle income groups being affected, the state is struggling to get them to hospitals on time.
“It is the nature of the virus. No country had one phase; most countries have gone through multiple phases,” Singh Deo said. “Active cases in Chhattisgarh were down to 2,000-3,000 at one point. But as positivity kept reducing in Chhattisgarh — it was 0.99 in early March — a sense of false security may have led to laxity in attitudes. Undoubtedly, the spike in Maharashtra too contributed. Feedback from doctors is that middle income groups are more affected this time. Earlier, it was mostly economically weaker sections who had come in from affected areas.”
He also said experts are yet to understand whether this is because there is now “much more immunity among those sections because of community spread in the first round”.
The health minister, however, admitted that the state is struggling with ICU bed availability.
“We have 80-90 per cent occupancy, and soon we may reach a point where we won’t have beds,” he said. “Additionally, this time people are coming late, often when their oxygen saturation is down to even 60 per cent. Somewhere there is a big hesitation to go to hospital as if you will get locked in a jail.”
With the situation spiralling, the Modi government late Monday night rushed 50 high-level public health teams to Maharashtra, Chhattisgarh and Punjab for Covid-19 control and containment measures.
The teams will monitor overall implementation of Covid-19 management, specifically in the areas of testing, contact tracing including surveillance, containment operations, Covid appropriate behaviour and its enforcement.
They will also look at the availability of hospital beds and sufficient logistics including ambulances, ventilators, medical oxygen among others.
Limited RT-PCR testing capacity
The stories in Maharashtra and Punjab have been similar during the first and second waves but Chhattisgarh with its limited RT-PCR testing capacity and a spate of recent deaths has emerged as a cause for worry now.
The three states were of particular focus in last week’s central government meeting with states on Covid-19, chaired by the cabinet secretary.
“Chhattisgarh has mostly been under the radar but the situation there is grim. For the last few days they have been reporting more deaths than states like Tamil Nadu, Karnataka and Rajasthan,” an official present in the meeting said. “The mining areas of Chhattisgarh have seen the worst outbreaks though the disease has not yet spread to places like Jhabua and Bastar. Their RT-PCR testing capacity is also low — they are doing just about 6,000 per day.”
In the last month (between 4 March and 4 April), the state saw 55,512 additional Covid-19 cases and 468 deaths (see box).
A month ago, the number of active cases had reduced to just 2,990, but it currently stands at 38,450 — a rise of 1,185 per cent in the last month alone.
All this in a state that has a population density of just about 189 per square km against a national average of 382 (2011 census data).
Though Chhattisgarh’s case fatality rate, at 1.23 per cent, is still lower than the national average, the absolute numbers of deaths in the last few days have caused alarm.
“Their healthcare facilities are clearly not prepared. That is what is causing the deaths,” the official quoted above added.
The state, however, is one of the leaders in vaccination coverage. Despite the initial reluctance to use Covaxin when the efficacy data for the indigenous vaccine was not available, Chhattisgarh has managed to vaccinate about 5.59 per cent of its population with at least one dose of the vaccine, against a national average of 3.72 per cent.
Singh Deo said the state has been pushing its limits in this department but the supplies from the Centre have become a limiting factor. “This month we did between 2,34,397 and 3,26,012 vaccinations every day. But today we hardly did any because there were no supplies,” he said. “Now we have got 3,25,000 doses but this restricted supply line also means every day from the districts one van has to go to collect the vaccines. We have told the Union health minister that if that’s what is needed, we will do it but give us a plan so that we do not get to a point where people come to get the shot and are told we have run out.”
Of the total 1,04,26,325 fully vaccinated Indians, 3,51,359 are in Chhattisgarh, according to data available with the Ministry of Health and Family Welfare.
The problem, says public health activist Yogesh Jain who is based out of Chhattisgarh, is that the Government of India declared victory too soon.
The political establishment and the scientific community has made mistakes by declaring premature termination of the pandemic in some of their utterances and through their decisions, and it is not fair to blame only the people at large for letting their guard down, he said.
“The supermodel commissioned by the Government of India had predicted that the pandemic would be over by February. We did not have any surveillance plan or strategy to predict or act early on and the second wave caught us off guard,” he added. “The entire pandemic response is being treated as a law and order thing and not a health issue. Why is the home ministry looking after health?”
In Chhattisgarh, he said, the disease is still mostly limited to the urban areas of Durg, Rajnandgaon, Raipur in the western parts of the state and there is an “incremental trend” in Bilaspur, Raigarh and Ambikapur.