Updated: August 28, 2020 7:20:36 pm
When a 23-year-old resident of Newtown, a satellite township near Kolkata, realised his father had symptoms of fever in July, the family hoped it would be seasonal flu, arriving with the onset of the monsoons. Though the fever subsided for all three, within days he and his mother lost their sense of smell, causing them to frantically start searching online for coronavirus symptoms to see if this was one; it was. Then the family desperately started making phone calls to testing laboratories listed on the website of the Indian Council of Medical Research (ICMR). “They all said home testing was not an option and asked to call back in three to four days. Waiting lists for tests in top city hospitals was between 10 days to a month,” the Newtown resident said.
The difficulties that the family faced with getting tested for coronavirus just scratches the surface of the multitude of challenges that patients have been facing in West Bengal. Since August, the state has been recording more than 3,000 new cases of coronavirus every day. According to data provided by the West Bengal Department of Health and Family Welfare, till August 22, approximately 15,24,162 people have been tested in the state in the 70 registered laboratories.
Confined in their apartment, the Newtown family finally found a testing centre in Kolkata, not approved by the state government, that was willing to take samples and send them to an ICMR recognised centre in Hyderabad. The family received their results by text message within a day and only the son was positive. The family informed the Bidhannagar Municipal Corporation, the local civic body, and went into home quarantine while their apartment building was sanitised and their neighbours informed.
A representative operating the COVID-19 hotline service at AMRI Hospital in Salt Lake, one of the hospitals where test slots were hard to come by according to the family, confirmed that in July they experienced shortages in testing kits, resulting in fewer available time slots. “However, that has been resolved and now testing is being conducted seven days a week between 9 am to 4 pm. Test results are available in 72 hours,” the AMRI Hospital representative said.
Despite increasing rates of infections, the paucity of timely access to tests persists for many in the state, putting patients and their families in a state of constant anxiety. The situation is even more dire in the districts. A resident of Panchla CD Block in Howrah district faced a days-long wait to get test after developing a fever that did not subside. With approximately 12,193 infection cases recorded by the state government till August 22, Howrah has the third-highest number of coronavirus cases in the districts after the Kolkata metropolitan area and North 24 Parganas.
“Testing is severely delayed here and that can lead to a spread in infections,” he said, adding that in his village testing happens every few weeks. On an average, three to four villages share one local health centre, making this occasional testing also challenging. “The last testing happened on August 13 and then on August 22. There is no guarantee when the next test will be,” he added.
Chitra Das, an Asha worker in Howrah, told indianexpress.com that test kits are sent to village healthcare centres from the West Bengal Health and Family Welfare Department every week. Samples, with the exception of nasal swabs, are then sent back to Kolkata for analysis. On lockdown days in the state, testing does not occur in these villages, extending the gaps between testing dates.
The Kulai Gramin Hospital in rural Howrah is the largest medical centre in the area. For people without access to their own transport, the challenges include having to turn to public modes of transportation like rickshaws, and the risk of infecting several others in the process. The Panchla resident said the wait for the doctor is about three hours, after which he decides if a test is needed. “You have to return on the day testing is scheduled to take place,” the youth said.
At the local testing centre, he said, only 100 people are tested on any date. People who don’t make it to the list are asked to come back on another testing day. For the youth, his local Asha worker helped him get a slot in just six days.
Then there are those who refuse to get tested. “My maternal uncle had symptoms and while his family thought it was a common cold, my father, who is a doctor, recommended a test. But there was denial and they didn’t want to get a test done,” said Satyarup Siddhanta, a Bangalore-based mountaineer. Ultimately when they did manage to take him to a government hospital. “The doctors told us we had brought him in the nick of time.”
Six months after the first case of COVID-19 was recorded in West Bengal, there is still fear and stigma about the disease. Witnessing their own difficulties in navigating the complexities involving COVID-19 in West Bengal, Siddhanta and city-based model Madhabilata Mitra, whose mother had to be treated in May, decided to set up the COVID Care Network, a caregiving and consultation service in West Bengal in July.
Soon, senior doctors in Kolkata and infectious diseases specialists like Dr Yogiraj Ray joined the network. The service provides phone consultations by junior doctors and medical students, all advised by senior doctors, to people who are unable to find the medical assistance they need, as well as mental health support. Within weeks, the service expanded to the districts of Howrah and Siliguri.
The fear of and difficulty in getting tested, along with the severe social ostracism that people are facing in the state, is also taking its toll, doctors told indianexpress.com. Siddhanta recalls the case of a Sealdah resident who couldn’t even open his windows or go to the terrace to dry his clothes. “We had to go in person and counsel the people in the neighborhood. There was a state of panic.”
Dr Abhijit Chowdhury, a member of the state task force in tackling COVID-19 who is also associated with the COVID Care Network, emphasised that more than half the fight against coronavirus happens outside the hospital by addressing issues such as the spread of unscientific information and stigma. “Top-down, the imposition of action and information has been rigid rules and fear. The problem with non-participation of people is that it prevents us from dealing with this as a public health crisis,” said Dr. Chowdhury. “About 85 to 90 per cent of COVID-19 cases can be managed at home, but tremendous fear and stigma has occurred over the past few months.”
In Kolkata’s Naktala, when one member of a family turned positive, neighbours locked the family inside their apartment to prevent them from leaving. In desperation, the family reached out to the COVID Care Network, who urged the building residents to join a video-conference to generate more awareness of the situation. “In that call, coronavirus survivors began sharing their stories and we tried to explain that COVID-19 doesn’t mean death.”
Professor Diptendra Sarkar, a member of Kolkata’s SSKM hospital’s COVID-19 strategy team, who joined the COVID Care Network to provide his expertise and assistance, believes the psychological impact of the disease hasn’t been highlighted enough. “Everybody is forgetting the third pillar of pandemic management, which is community management. People can’t see the virus, and the infected person becomes representative of the virus,” explained Professor Sarkar. “So there may not be physical lynching, but the psychological lynching has been there. The stigma causes guilt and patients are excommunicated and made to feel they don’t have the right to live.”
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