Why India’s urban outbreak is turning into a rural health crisis?
Country overtakes Italy’s coronavirus cases to become sixth worst-hit by pandemic
Rural parts of India have begun to see a surge in coronavirus infections, as millions of migrant workers returning from big cities and industrial hubs bring the virus home with them, according to data collected from seven Indian states.
Officials said the spike in cases was a fresh challenge for the country’s health authorities, even as they struggle to check the outbreak in cities and experts fear that a peak remains weeks away.
The damaging data came as India reported a record 9,887 new coronavirus cases in one day yesterday and overtook Italy as the world’s sixth-biggest outbreak, two days before the relaxing of a lockdown with the reopening of malls, restaurants and places of worship.
With its total number of cases rising to more than 236,000, India now has fewer infections than only the US, Brazil, Russia, Britain and Spain. However, India’s toll of deaths from Covid-19 stands far lower when compared with those other countries.
How is the government easing the lockdown from tomorrow?
Prime Minister Narendra Modi’s government, anxious to jump-start an economy crippled by the epidemic and put millions of people back to work, is easing its lockdown of the 1.3 billion population imposed in March, which the government says helped avoid an exponential rise in cases.
The lockdown is now largely being enforced in high-risk areas while authorities have partially restored train services and domestic flights and allowed shops and manufacturing to reopen. Restrictions will be further loosened from tomorrow but some experts are worried it is too soon.
Giridhar R Babu, epidemiologist at the Public Health Foundation of India, questioned the reopening of religious places. “We can survive and sustain the gains without ... opening up religious places for some time,” Babu said on Twitter.
People visiting places of worship will be asked to wash their hands and feet, and there will be no distribution of food offerings, sprinkling of holy water or touching of idols and holy books. Concerts, sporting events and political rallies are still banned.
Why are so many workers returning to villages from cities?
Most of the new cases are in rural areas following the return of hundreds of thousands of migrant workers who left cities and towns after the lockdown in late March left them jobless and even shelterless as businesses came to a halt.
Where are the spikes in cases being seen across the country?
Most of those workers who tested positive in Bihar came from India’s capital New Delhi and the more industrialised western states of Maharashtra and Gujarat, the data showed.
Workers returning from western India also triggered a massive spike in cases in Jharkhand, an eastern state that borders Bihar, its top health official Nitin Madan Kulkarni said. “After May 2, whatever positive cases we have got, almost 90 per cent of them are migrant workers,” he added.
As migrant workers fan out to their villages, some states with an existing heavy burden of cases are facing a second wave of infections. In Maharashtra, which at nearly 75,000 infections accounts for a third of the total cases in the country, officials in some rural districts said their state-run health centres were struggling with the influx. “If this pace continues for the next few weeks, then we will have no choice but to take control of private hospitals to treat severe patients,” an official in the rural western district of Satara said.
Why are scientists so worried about rural infections?
Dr Naman Shah, an epidemiologist and physician advising a federal government coronavirus task force, said rural outbreaks could be “devastating” given the inadequate number of doctors and health facilities. “High levels of comorbidity, high levels of under-nutrition and a weak health infrastructure, that’s just the recipe for high mortality,” said Shah.
In Bihar, official data showed that of the 3,872 coronavirus cases recorded until June 1, 2,743 were linked to migrants workers.
So where are the problem areas to watch out for?
The most acute problem seems to lie in the cities rather than villages. While the federal government and health experts have been pushing for aggressive testing, Mumbai — which accounts for 20 per cent of India’s Covid-19 caseload — surprisingly kept its testing numbers almost stagnant in May. The city tested between 4,000 and 4,200 daily, even as the number of positive cases detected rose steadily. Mumbai has the capacity to carry out about 10,000 tests every day. The city’s stagnant testing numbers were in sharp contrast to the daily testing figures for Maharashtra as a whole, which saw a 100 per cent jump over the same period — from 7,237 tests on May 1 to 14,504 tests on May 31. This suggests that as Maharashtra increased its testing capacity, all of the new testing happened outside Mumbai in a bizarre priority for the government.