Hotspot in both waves, rural areas drove surge in pandemic this year

PUNE: Omkar Tupe, a 24-year-old delivery agent is one of the 1.4 million Pune residents who have recovered from Covid-19 as of July 25. But he almost didn’t make it: he was first detected with the disease caused by the coronavirus on June 4. Within three days, he was admitted to the district-run COEP jumbo facility, because although he did not have any severe symptoms, his tests indicated that the infection had spread widely in his lungs. Tupe stayed at the facility for a month — and recovered.

Pune has been the worst-hit district in the state in both waves of the pandemic. . From March 2020 to present, the district has seen two aggressive surges in Covid19 cases with peaks in September 2020 and April 2021.

In August 2020, Pune district crossed other districts in the country with the highest active caseload; on September 16, it recorded the highest single-day spike of the first wave adding 5,049 fresh positives and taking its active caseload to 82,172. In April 2021, Pune district reported over 100,000 active cases. On April 17, it recorded its highest single-day spike, adding 12,825 new cases. On that day, its active caseload went beyond 120,000.

As cases rose, the city experienced a shortage of oxygen beds, drugs like remdesivir, and RTPCR labs functioned at full capacity and led to delays in providing test results by almost 36 hours. Many witnessed scenes of desperation: relatives of patients approached pharmacies directly for drugs; many incidents of physical scuffles broke out. On April 10, the district collector directed hospitals to procure the drug directly from pharmacies and asked them not to give the task to relatives. Meanwhile, as the virus ravaged entire families at a go, the burden on healthcare facilities also became immense. Between January and April 2021, the district’s oxygen requirement went up from 67.5 metric tons (MT) to 310 MT (a 359% jump). The administration was forced to get oxygen from neighboring districts including Raigad. On April 4 the district positivity rate — which reflects the spread of the infection based on the number of positives reported for every 100 tests — was 41.2%.

The situation in Pune is certainly not as dire now. However, as July ends, Pune district still accounts for 19% of the total active cases in the state.

Understanding the spread

While the number of cases is declining, experts are unable to pinpoint exact reasons as to why Pune was a Covid hotspot in both waves.

Dr Pradeep Awate, state surveillance officer said that there were multiple factors that could account for Pune’s high infectivity: rural elections held in January saw more than 80% voter turnout, the lack of Covid appropriate behaviour and even population density. Almost 70% of the district’s one crore population is urbanized with nearly 40% of the population living in either slums or in congested localities. Pune’s population density is about 9,400 persons per square kilometre. By comparison, the state average is 603 persons per square kilometre. Even the decadal growth rate is higher than that of the state’s: 36 compared to 16.

Starting May 2021, rural Pune began reporting more cases than urban areas of the district [the Pune Municipal Corporation (PMC) and the Pimpri-Chinchwad Municipal Corporation (PCMC)].

While Pune city drove the surge in April, rural areas were reporting almost twice the number of cases the following month. On May 13, Pune rural reported 4,363 new cases, while Pune city reported 2,021 new cases and PCMC reported 3,152 new cases. By May-end, rural Pune’s daily positivity rate touched 19.6% which was more than urban Pune’s at 6.5%. At the time both PMC and PCMC reported an average of 400-600 new cases daily, while rural areas reported close to 1,200.

In July, the borders were reconfigured and parts of what earlier constituted rural Pune are now within the PMC, which makes it difficult to provide a similar comparison for July.

Different levels of lockdown

In June, Pune administrators decided to put rural parts of the district under Level 4 lockdown, while the city limits of Pune, including the cantonment, and Pimpri Chinchwad were categorised as Level 3. This meant that there were greater restrictions placed in villages to help prevent the spread of the disease. This dual categorisation remained in place as of July 30.

However, this has not stopped people from travelling between the rural areas and the city. With rural and urban borders being close-by, movement of people continues especially to access to non-essential services, as non-essential shops shut in a level four lockdown could remain open in the city.

Dr Shailesh Suryavanshi, nodal incharge of Velha taluka in Pune district, said, “The restrictions seem like they are just on paper. In April when the city saw its peak and the economic activities were shut, people started to travel back to their villages which meant that the infection also travelled from cities to the villages. And so the following month in May the villages saw its peak.”

As sowing season is on, farmers travel to cities or main trader hubs within the rural areas to purchase seeds, fertilizers or pesticides or even to sell their stocks. Rural Pune currently has an overall positivity rate of above 6%: higher than the state average.

In April, people went back to their villages which meant that the infection travelled from cities to the villages.

DR SHAILESH SURYAVANSHI,