Weekend Herald

Ru­ral surge pro­pels In­dia’s out­break

- India News · Infectious Diseases · Health Conditions · India · Tripura · Tamil Nadu · Tamil Nadu · West Bengal · Bihar · Uttar Pradesh · New Delhi · Mumbai · United States of America · New York City · Spain · Brazil · United Kingdom · Narendra Modi · Population Council · Michigan · University of Michigan

Slid­ing out of their rick­shaw, masks on, fresh sani­tiser smeared across their hands, a team of health work­ers ap­proached one of the mud- walled homes in Masli, a re­mote vil­lage in north­east In­dia sur­rounded by kilo­me­tres of moun­tain­ous rain­for­est.

“Are you Amit Deb?” they asked a lean, shirt­less man stand­ing in his yard. Deb nod­ded cau­tiously. Five days ear­lier, he had tested pos­i­tive for the coro­n­avirus. Now his fam­ily mem­bers needed to be tested.

They all re­fused.

“We can’t af­ford to quar­an­tine,” ex­plained Deb, a shop­keeper. If any­one else in his fam­ily was found pos­i­tive, they would all be or­dered to stay in­side, which would mean even more weeks of not work­ing, which would push the fam­ily closer to run­ning out of food.

The medical team moved on to the next house. But they kept meet­ing more re­fusals.

The de­fi­ance of the coro­n­avirus rules is be­ing re­flected across ru­ral In­dia, and it is pro­pel­ling this na­tion’s virus caseload to­ward the No 1 spot glob­ally. In­fec­tions are rip­pling into ev­ery cor­ner of this coun­try of 1.3 bil­lion peo­ple. The In­dian news me­dia is call­ing it “The Ru­ral Surge”.

In the In­dian megac­i­ties where the pan­demic first hit, vig­or­ous pub­lic aware­ness cam­paigns have left the pop­u­lace mostly on guard. But when it comes to gov­ern­ment ef­forts to con­tain the virus, ru­ral In­dia is re­sist­ing.

In many vil­lages, no one is wear­ing masks. There is no so­cial dis­tanc­ing. Peo­ple are re­fus­ing to get tested, and they are hid­ing their sick.

Hos­pi­tals are strain­ing; in the coro­n­avirus ward of one hos­pi­tal here in the state of Tripura, in­sects were left to crawl over corpses, ac­cord­ing to photos from a for­mer gov­ern­ment of­fi­cial.

In re­cent trips to more than a dozen ru­ral ar­eas spread across sev­eral states, from Tamil Nadu in the south to West Bengal in the far east, to Tripura, Bi­har and Ut­tar Pradesh in the north, the re­ac­tion to the pan­demic ap­peared to be com­pletely dif­fer­ent from that of the big cities like Delhi and Mum­bai.

Out in the ru­ral ar­eas, many peo­ple be­have as if there is no coro­n­avirus. Even many po­lice of­fi­cers who have been em­pow­ered to en­force the pan­demic rules are not wear­ing masks.

This in­tran­si­gence has helped In­dia catch up with the United States in terms of to­tal in­fec­tions. US cases are near 7.6 mil­lion, com­pared with In­dia’s 6.8 mil­lion, ac­cord­ing to a New York Times data­base. But In­dia out­paces new US cases by 30,000 or so each day, putting it on a path to po­ten­tially sur­pass the United States in the com­ing weeks.

Many peo­ple in In­dian vil­lages be­lieve their gov­ern­ment is over­stat­ing the sever­ity of the pan­demic and show­ing no sen­si­tiv­ity to the eco­nomic hard­ship that they are suf­fer­ing.

Gov­ern­ment of­fi­cials have tried to re­as­sure them that they are con­tain­ing the virus while strik­ing the best pos­si­ble bal­ance be­tween pro­tect­ing lives and liveli­hoods.

Of­fi­cials say In­dia’s caseload is ris­ing be­cause nearly 1 mil­lion tests are be­ing per­formed each day, five times the num­ber a few months ago. They also point to In­dia’s rel­a­tively low death rate, about an eighth or ninth of those of the United States, Spain, Brazil and Bri­tain.

Sci­en­tists say this is mainly be­cause In­dia’s pop­u­la­tion is younger and leaner, though they cau­tion that most deaths in In­dia, from any cause, are not in­ves­ti­gated. And In­dia’s deaths are steadily tick­ing up, by about 1000 a day, now to­talling about 105,000.

Prime Min­is­ter Narendra Modi has “spo­ken on all avail­able plat­forms and un­der­lined the need and im­por­tance of wear­ing masks and main­tain­ing phys­i­cal dis­tanc­ing”, said Man­isha Verma, a spokesper­son for In­dia’s health min­istry. The gov­ern­ment’s fo­cus, she said, has been on chang­ing be­hav­iour rather than en­force­ment.

In fact, even as the coro­n­avirus spreads through the ru­ral re­gions, other parts of In­dia are loos­en­ing con­tain­ment re­stric­tions to help the stricken econ­omy. This month, the cen­tral gov­ern­ment is al­low­ing movie the­atres to open. Schools can soon re­open if state gov­ern­ments agree.

Modi locked down the coun­try this north­ern spring, with four hours’ no­tice, to buy time for In­dia to scale up its pro­duc­tion of masks and other pro­tec­tive equip­ment and to open treat­ment cen­tres. But the se­vere lock­down spawned an ex­o­dus of mil­lions of mi­grant labour­ers who could not af­ford to stay in ur­ban ar­eas. Their move­ment to ru­ral com­mu­ni­ties helped spread the virus to nearly ev­ery cor­ner of In­dia.

“We are still in the first wave,” said Rajib Acharya, a New Delhi- based re­search as­so­ciate at the Pop­u­la­tion Coun­cil, a non­profit that works on health and de­vel­op­ment is­sues. “I don’t see any new strat­egy for the ru­ral ar­eas.”

Ru­ral ar­eas are not well po­si­tioned to cope. Nearly two- thirds of all hos­pi­tal beds in the coun­try are in ur­ban ar­eas, which are home to only one- third of the pop­u­la­tion.

Hos­pi­tals around the coun­try are strug­gling to pro­vide enough oxy­gen for the ris­ing num­ber of pa­tients. Many peo­ple, both in cities and in the coun­try­side, have strug­gled to find beds for sick fam­ily mem­bers.

“Fam­i­lies in In­dia are liv­ing in fear, grief, sad­ness, de­pres­sion, anx­i­ety and food in­se­cu­rity, de­lay­ing their care from other health con­di­tions,” said Bhra­mar Mukher­jee, an epi­demi­ol­o­gist at the Univer­sity of Michi­gan. “It is a tragic time.”

She at­trib­uted the spread of the virus to “ha­bit­u­a­tion, de­sen­si­ti­sa­tion, fa­tal­ism, fa­tigue, de­nial.”

 ?? Photo / AP ?? Ra­mananda Sarkar, 43, talks to his chil­dren from a dis­tance in Theng Bhanga vil­lage, in Mori­gaon district, In­dia.
Photo / AP Ra­mananda Sarkar, 43, talks to his chil­dren from a dis­tance in Theng Bhanga vil­lage, in Mori­gaon district, In­dia.

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