India Coronavirus Dispatch: Pandemic may persist longer in rural areas

Cases shoot up in Rajkot, MP's immunisation programme impacted, and urban middle class incomes hit--news on how the country is dealing with the pandemic

Disparty in numbers: Gujarat’s Rajkot has been witnessing a steady surge in cases. The state’s Principal Secretary (Health) explained the disparity in actual number of deaths in Covid hospitals and the official Covid-19 death count by attributing deaths to non-Covid reasons. The state government has now moved in a team of 15 doctors from other cities to Rajkot. Since June, there have been 308 deaths in Covid-designated hospitals in the area but the official figure shows only 89 deaths. Overall there has been a sharp rise in cases in the municipal corporation area and in the rural parts of Rajkot. For the past week, the district has been reporting over 100 cases daily. Read more here. 

MP’s immunisation programme: According to National Health Mission, immunisation programmes for children in Madhya Pradesh have been badly hit. This is especially true for the urban stretches of the state that have been ravaged by the pandemic. Indore, the district worst-hit by Covid-19, has fared the worst in terms of immunisation. The state’s target for April-July period has seen a dip this year compared to year-ago period. Shutting down of child-care institutions, diverting medical staff for coronavirus duties and inability of workers to visit the field have been the major hinderances in the way for immunisation. Nearly 50% of the staff, including ASHA workers and other on-ground medical personnel were engaged in work related to Covid-19 in the urban areas. However, the state is shifting its pandemic response from house-to-house surveillance to community participation. This is expected to get immunisation programmes back on track during the crucial monsoon season. Read more here. 

Karnataka’s youth drive the pandemic: Contrary to initial fears of elderly folk being the most susceptible to the virus, it’s the youth aged 21-30 that’s driving the pandemic in Karnataka. As on 28 August, the southern state had 318,752 cases. Of these, 71,936 were reported among those aged 21-30. Those aged between 31-40 accounted for 69,835 cases. Experts blame higher mobility among youth for this trend. People belonging to this age group also tend to recover fast and with lesser health effects than seen in their older counterparts. The silver lining to the situation is that this could lead to herd immunity quicker, says one doctor. Meanwhile, the mortality rate among Karnataka’s elderly is the highest in the state. Read more here. 

Interview

Rural India’s pandemic: The pandemic has been shifting steadily from urban to rural areas since quite some time. Commenting on this trend, an epidemiologist says that the spread in rural stretches won't be as rapid as seen in metros but will persist for much longer. He adds that India is now approaching a “state of a high-plateau”. He says that overall India probably has a large number of cases that have escaped the radar because of low-sensitivity antigen tests. He also adds that as far as the pandemic in rural parts goes, the official mortality rate may actually see a dip since deaths are underreported in villages. The fact that most villages are characterised by poor heath infrastructure may make the situation more difficult. He adds that the pandemic has offered an opportunity to rethink our approach to public healthcare. Read the interview here. 

Comment

The urban middle class: Middle class incomes and jobs have been hit pretty badly by the pandemic. The story of the pandemic so far has also been about economic hardships and huge job losses. The ruling BJP gets a huge chunk of its support base from this middle class. Despite unemployment and incomes coming down to a trickle, large swathes of the salaried working class continue to support Narendra Modi and his government’s policies. This is true even for traders who admit they were hit badly by demonetisation, GST and now nationwide lockdowns and a stimulus package that failed to deliver. Many of them blame their state administrations — some of them ruled by opposition parties — for disruptions in their lives. Chief among the factors that work in PM Modi’s favour is the feeling that the country does not yet have an alternative and that he is a ‘strong leader’. This encapsulates the personality politics that has taken shape over the past few years. Read more here. 

Antibiotic fears: Antibiotics are being employed in huge amounts in the fight against the pandemic. They are being used mostly to prevent co-infections. Studies have shown that while prevalence of bacterial infections in Covid-19 patients have been low, a majority of them have been administered broad-spectrum antibiotics. Ecological concerns from heavy antibiotic use are also abound. In particular, a higher load of antibiotics in wastewater can be expected in case of hospitalised Covid-19 patients that are treated with antibiotics. If sewage plants are not fully equipped to remove residual antibiotics then they can find their way into the larger environment, including surface and ground water. While these fears existed earlier as well, the particularly high concentration of antibiotic usage during the pandemic is now a concern. Read more here.