TELANGANA: IN COVID DENIAL
As COVID-19 cases surged past the 16,000 mark on July 1, the Telangana government fell back on a failsafe option—extend the lockdown in containment zones till July 31. Severe restrictions were back on the movement of people, especially in capital Hyderabad, where a third of the state’s residents live. On the day, it recorded 945 new cases (16,339 and counting) and hospitals also discharged 1,712 people, who have either recovered or have mild symptoms. It was the first time since the pandemic raised its head in the state that the number of those discharged was higher than new infected cases.
For Chief Minister K. Chandrashekar Rao, it was a toss-up between going for a total lockdown in the state capital or containment zones only, with stringent restrictions. A Union health ministry team visited the state on June 29 and advised that testing be ramped up. The advice may as well have fallen on deaf ears: only 3,457 tests were done the following day. Other states with similar caseloads are conducting about 10,000 a day—Karnataka tests about 12,000, Andhra Pradesh 30,000 and Rajasthan 9,000.
The situation is so overwhelming that a leading private laboratory— which has three COVID-19 test labs— has stopped taking new samples till July 5 as it has to first clear the backlog. Though the first COVID-19 case was confirmed in Telangana as early as March 2, the management strategy pursued by the state has been downright inefficient. It now has the highest Covid positivity rate in India (27.7 per cent), and conducts the lowest tests per 1 million population anywhere in the country. The state relied on an opaque testing policy till mid-June, refusing to divulge details of tests done or augmenting test facilities.
At 32.1 per cent, Hyderabad has the dubious distinction of having the highest Covid positivity rate among major Indian cities. In the meantime, a state expert committee has levelled serious charges against private laboratories, including using untrained staff to collect samples (which may have led to contamination), not uploading the number of tests conducted, giving false positive reports and even of exposing people and staff to the virus. This, says the government, has led to Telangana reporting a much higher positivity rate than other states.
The state now says it plans to intensify Covid testing. All 10 government laboratories, already operating at optimal capacities, are to be further streamlined to test 6,000 samples a day. “Almost all the government laboratories have now completed recruitment of the trained microbiologists and scientists needed to conduct COVID-19 tests,” says Dr K. Shankar, superintendent, Fever Hospital and director, Institute of Preventive Medicine, Hyderabad. Government
HYDERABAD HAS THE DUBIOUS DISTINCTION OF HAVING THE HIGHEST COVID POSITIVITY RATE, 32.1 PER CENT, AMONG MAJOR INDIAN CITIES
epidemiologists say with a more efficient distribution of the lab workloads and a few more testing centres in the districts, the testing capacity can be augmented to 10,000 samples a day.
“Anybody who needs to be tested will be,” claims health minister Eatala Rajender. The government has ramped up capacities at collection points so that more swab samples can be sent to its laboratories. Till the first week of June, KCR was firmly against private laboratories conducting Covid tests and private hospitals treating such patients. Between March 2 and June 14, only about 42,000 coronavirus tests were done in Telangana. Of these, 4,974 tested positive. But after the sharp criticism for low testing, an additional 50,000 tests have been done across 30 assembly constituencies in and around Hyderabad since June 25. There are currently 16 private testing facilities and 10 governmentrun ones operating in the state.
There’s also a shift in strategy. Expecting a flood of cases, the state is banking on isolation of patients at home, arguing that increased testing will increase the patient load in hospitals. Epidemiologists say community transmission (till date not acknowledged by any state) is well entrenched and by limiting tests, the authorities are trying to ensure that the public health system is not overwhelmed. “Those with mild symptoms should opt for home quarantine and the medical personnel should enquire about their condition on a daily basis. Doctors will be sent to people wherever needed,” says Rajender.
As more cases get registered in the Greater Hyderabad Municipal Corporation area, particularly in the south and west of the city, surveillance and door-to-door surveys are being ramped up. Covid positive patients from the districts are being directed to nearby private medical college hospitals to reduce the burden on hospitals in the city.
There have been complaints on the paucity of beds, but health authorities deny any shortage, citing the 15,465 isolation beds, 3,537 oxygen beds and 2,000 ICU beds available now. Yet, every day there are reports of patients with breathlessness or end-stage respiratory stress unable to get a hospital bed. There is also no bed-tracking app, as in Delhi or Mumbai, or a website updating availability of beds.
For want of adequate testing facilities, many people with mild symptoms are opting for a CT scan and chest X-ray to find out whether they are infected. Though self-referred tests are costlier (Rs 5,0008,000), people are resorting to these to stave off anxiety ahead of the RT-PCR swab test.
Meanwhile, the arrival of the monsoon will bring with it seasonal health issues as well. The state health minister has already warned officials that complaints about lack of medicines at health facilities will not be tolerated. Clearly, these are desperate times for the state.