As the migrant exodus from urban centres continues towards rural areas within Maharashtra too, 17 districts that had zero or very few cases are witnessing a sudden spike in Covid-19 cases. The Indian Express spoke to authorities in 35 districts in Maharashtra between May 29 and May 31, and found that in 17 districts more than half the Covid-19 patients are returning migrant workers, who came back home in the last one month, travelling by train, trucks or lorries. Maharashtra has 70,013 Covid-19 cases, 35.7 per cent of India’s burden. In four districts, the entire Covid-19 load is of migrants.
A gradual shift of Covid-19 cases from urban to rural regions is taking place. People travelling from Mumbai, Pune, Thane and Malegaon have been the main source of infection in other districts in the state. Till April 30, Mumbai and Pune, the two Covid hotspots, accounted for 78.4 per cent of total cases in Maharashtra. Their share had reduced to 70 per cent by May 31.
The bulk of the migrant movement began since May first week. In at least 17 districts, the cases have shot up in the last 20 days. District officials said Mumbai remains a major source of transmission. “We are seeing more people returning from Mumbai turn positive than from any other city,” said Dr Radhakishan Pawar, district health officer (DHO) in Beed.
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Beed has 62 Covid-19 cases, all of them daily wagers who worked in Mumbai. The situation is the same in Wardha, Akola, Sindhudurg and Ratnagiri, where all migrants who tested positive travelled from Mumbai, district officials said.
“The question is why labourers weren’t tested and treated in Mumbai first? They were in Mumbai for two months which gave the government time to prepare the health infrastructure. Why were there no labour camps to aggressively screen them,” asked Professor T Sundaraman, former dean of School of Health Systems Studies, Tata Institute of Social Sciences. “In entire Mumbai there is no primary care system that looks at migrants. These migrants are not vectors of diseases, they are the victims,” he said. Mumbai has over 41,000 Covid-19 cases now.
State officials said they had two options when the first lockdown was announced in March, to either allow migrants to return home in buses or provide them shelter in migrant camps. “Providing transport just before the lockdown to lakhs of migrants was difficult, so we decided to go ahead with the lockdown and keep them at camps,” a senior official said.
Dr Soumitra Ghosh, Assistant Professor, Centre for Health, Policy, Planning and Management, TISS, said the government’s aim to not let the virus spread to other districts has “clearly failed” despite the two months’ lockdown. “Public health experts have demanded better acute care, we know from Mumbai that ICUs are not enough. We have failed in detecting the source of the virus, if the government did proper contact tracing the transmission would have been contained and the problem of migrants getting infected would be limited,” Ghosh said.
As cases now surge in rural regions, district officials are rapidly scaling up their capacity by repurposing existing beds. The state public health department aims to have 100 beds per million population for Covid-19. Currently the state has 2.70 lakh isolation beds.
Most migrants returning home are kept in institutional facility for 14 days, but in some cases they are allowed to go home and tested when they develop symptoms. In Kolhapur, DHO Dr Yogesh Sale said they went a step further and decided to test all migrants returning from red zones. “But that led to delay in results up to 10-12 days,” he said. Of 40,000 migrants who have so far returned in Kolhapur, 20,000 have been tested.
In Osmanabad, 3,000 beds have been prepared for Covid-19 cases. Currently there are 69 cases, 67 of them migrant labourers. “Most migrants returning home have been asked to stay in their farms away from family. In 30 per cent cases, we have kept them in government schools,” said Dr HV Wadgave, DHO.
“In the last ten days, the cases have suddenly risen in our district. Earlier there was just one case, who was also a migrant, but since trains for migrant workers have started, the cases have started increasing in our area,” said DHO Dr Shyam Nimgade, from Gondia.
Solapur DHO Dr BT Jamadar said, “In our rural areas, there are about 37 cases and everyone is either a migrant or a close contact of a migrant.”
In Raigad district, Collector Nidhi Chaudhary said exact figures were not available.
“But we were aware that being close to Mumbai may bring lots of patients to Raigad, so we had started planning accordingly. So far every person infected are either people who have come from Mumbai or Dubai or their close contacts.”
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