Having spent the first two months of the pandemic and nationwide lockdown in politicking, to first grab and then stay in power, the Shivraj Singh Chauhan-led BJP government has now launched a 15-day state-wide “Kill Corona” programme from July 1st. The programme includes door to door surveys in urban slums and low-income households having high population density and poor municipal management as a majority of positive cases in both cities have been reported from these areas.
As per data from the government’s smart city portal, Indore has the second highest slum population (30%) in the state, followed by Jabalpur (46%) and Bhopal (26%). Health officials have had a hard time controlling the spread in these areas. Experts have also suggested that these areas are witnessing instances of community spread.
Under such circumstances, the survey can prove to be a handy management tool. But ground workers are being offered no incentive or protection. For instance, the Kill Corona Campaign does not mention any incentives for the ASHA and Aanganwadi workers who will be putting their lives at risk for the survey and are overstretched at the moment. They are not even being given proper PPEs but are only being advised to wear a face cover or masks at all times and observe appropriate social distancing while conducting the survey.
The survey will be implemented under the supervision of District Crisis Management Groups. About 10,000 groups of ASHA – Aanganwadi workers, municipal, health and police staff members have been formed, who are being trained to conduct the survey.
These 10,000 groups are expected to survey 10 lakh houses daily collecting information on number of family members, types of profession, whether they use public toilets or individual toilets, and whether they face any problem of dry cough, body pain or other symptoms. They are also checking for waterlogging outside and inside homes.
The groups will not only look out for symptoms of cough and cold, but will also keep an eye on malaria and dengue-related symptoms as the monsoon season has started.
Carelessness and indifference
On June 30th, Bhopal completed 100 days since the first case was reported, while Indore did that on July 3rd. Both cities have been receiving awards for ‘swacchata’ as the cleanest capital (Bhopal) and cleanest city (Indore) for the last two years, in the Swachh Survekshan organized by the MoHUA.
In fact, Indore had become a case study for global practitioners on waste management and hygiene. This had experts, government officials and citizens wondering what could have caused such an exponential rise in cases despite having such modern and robust cleanliness systems.
In the end, it turned out to be the carelessness and irresponsibility of a few citizens (and officials) in the initial stage who failed to disclose their travel history and the Tablighi Jamaat fiasco. that set off the intense outbreak in both cities.
By the end of April, MP had around 2600 infections. By May end that number had shot up to 8000, which placed the state at third position in the rising tally of total cases, behind Maharashtra and Delhi.
And as cases continued to spike especially in Bhopal and Indore, two of the country’s supposedly cleanest cities, it was only in June that the state government implemented a number of steps, like setting up of fever clinics, to curb the spread of virus, which brought MP to the 12th spot in total numbers, with Indore and Bhopal contributing 50% of the total positive cases reported in the state so far.
However, the situation has turned ugly in the last ten days of July as the infection continues to grow in the cities of Indore and Bhopal, still contributing around 50% of the total caseload. Not only this, the cities of Gwalior and Morena have also become the new hotspots in the central state. From July 1st to 12th, Bhopal has registered 713 new cases, followed by Indore (551), Gwalior (538) and Morena (537).
The tale that the numbers tell
In April, Indore registered the highest number of positive cases in the country per 10 lakh population — 117. That figure reached 683 in May.
The scenario changed a little in early June. The graph showed a decline in new positive cases, pushing it below the list of top five cities which account for more than half the all-India coronavirus count. During the first 14 days of June, Indore registered only 530 cases from 23,600 samples.
However, this decline was short lived. Between June 20-30th, Indore registered 13% more cases than Bhopal. Indore lagged in recovery numbers too, just 249 as compared to 473 in Bhopal. Sadly, these ten days also witnessed 36 per cent more deaths in Indore as compared to Bhopal.
In April, Bhopal had 33% less cases then Indore. Moreover, it had a recovery rate of 34% in comparison to Indore’s 12%. In May, Indore touched 2238 cases, over 50% of the state’s total caseload, while Bhopal had 900 cases, 20% of the total caseload. At this time, the recovery rate in both cities was pegged at 57 per cent. However, Indore had 683 cases per million population as compared to Bhopal’s 380.
But things have taken U-turn for Bhopal since the start of July. In the first ten days of July, Indore has registered only 551 cases compared to Bhopal’s 713.
Another worrying trend for Bhopal is its positivity rate, which reached the maximum in the first ten days of July. At present, Bhopal’s positivity rate is 6%, up from 3.7% during the unlock phase I (from June 1 to 30). On the other hand, Indore’s positivity rate has come down from 11% to 2% now, as compared to Bengaluru’s 8%, Delhi’s 11% and Mumbai 23.7%
Indore’s lower positivity rate from tests has kept it, for now, from becoming another Mumbai or Delhi.
Nationally, Bhopal (3.4%) stands in a much better position than other cities in terms of fatality rates. Ahmedabad has the highest fatality rate of 7%, followed by Mumbai (4%), Indore (5%) and Bengaluru (1.7%).
Achievements of the campaign so far
A key part of the “Kill Corona” campaign is to focus on accelerating the testing drive in these districts (the state currently has 78 testing labs). The government has set a target of 2.5 – 3 lakh tests during the 15-day campaign. This will also increase the number of tests per million population, which is currently stagnant at around 4000, with just 8000 total tests per day.
Until now, the survey has been completed in 24 lakh 60 thousand households, covering 1 crore 23 lakh population in the state. The survey has identified close to 12,000 patients with COVID-19 like symptoms. So far, 120,709 tests have been conducted throughout the state, with two days remaining for the campaign to end.
The increased testing can help the fight against COVID-19 in Bhopal, Morena, Gwalior and Indore with early identification of cases, their isolation and treatment which is the central government’s new strategy for the top twenty infected districts in the country.
Bhopal Municipal Corporation is conducting ward wise surveillance of positive cases. The Smart City authority has been carrying out ward wise and police station wise analysis of case load. It is also helping the Bhopal administration in handling the data of quarantined persons, persons under treatment, persons with foreign travel history and other data sets. The smart city authority has also formed a Citizen Support Team under the Chairmanship of its CEO for helping citizens and getting their feedback on the COVID-19 situation in the city.
Government vs private
At present, there are 11 COVID-19 testing facilities in Bhopal, out of which four are private. AIIMS Bhopal, Hamidia Hospital and Government Homeopathic College have been designated as dedicated government COVID-19 treatment facilities along with a single dedicated private facility, Chirayu Medical College & Hospital.
In May, local media had reported that the most number of referrals were made to the private Chirayu Hospital by the government. Moreover, several key IAS officials who were admitted in government-identified COVID-19 treatment facilities were transferred by the Shivraj Government to five star private hospitals, of which some were not even notified as dedicated COVID-19 treatment facility.
As of May, only 99 patients were admitted in the three government facilities as compared to 250 patients in Chirayu Hospital. In fact on June 2nd, the Health Minister congratulated Chirayu Hospital for successfully discharging 1000 COVID-19 patients. This was met with criticism by health professionals in the public sector who said that the state government should highlight the efforts of government heath institutions too.
The fever clinics have helped in early identification and isolation of cases. It has also helped authorities in saving beds for more critical cases. These clinics are the first point of care and counselling for persons having COVID-19 like symptoms and those who test positive.
So far, close to 1000 fever clinics have been established in 52 districts out of which around 50 are in Bhopal. More than 300 patients in Bhopal have been advised and counselled by fever clinics on home quarantining.
Some key concerns
This is not the first time that the state government is doing a door-to-door survey. It had done similar surveys earlier too, but the findings were never made public. Also, the incumbent government has received a lot of flak from citizens and opposition for toppling the Congress Government in the midst of the pandemic.
In fact, many blame the timing of BJP’s power politics for the pandemic getting out control in several districts like Indore, Bhopal, Ujjain, Khargone etc. Under the current circumstances, it is quite possible that the Shivraj Singh Chouhan regime would be more interested in managing the headlines rather than the outcome on the ground.
With by-elections in 24 assembly seats coming closer, on-ground campaigning is picking up pace, especially in the politically active Gwalior-Chambal belt which has 16 out of 24 seats that will go for by-polls. In the first ten days of July 2020, Shivpuri (172%), Datia (112%) and Morena (104%) (three of the six districts falling within the belt) have registered more than 100% growth rate. Gwalior’s growth rate is pegged at 93%.
It will be a major challenge for the BJP government to campaign and organize elections in this region of the state without creating new hotspots in the state and endangering the lives of masses.
Also, this is happening at a time when the flow of information and communication with citizens needs to be greatly improved. The state used to publish a daily analytical report by Atal Bihari Institute of Good Governance & Policy Analysis which had detailed insights on districts, number of tests, per million cases etc. But its last report was published on May 20th.
Also, the district administrations have not been sharing any data pertaining to tests, positive cases etc. The state bulletin is the only source for citizens to understand the COVID-19 situation. Unfortunately, political considerations of winning the coming elections look likely to outweigh this vital need for transparent data sharing with the public to successfully combat the pandemic.