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Wednesday, June 03, 2020

Time stands still in Bhilwara

Medical staff among infected, 30 lakh including patients under screening, thousands of migrants out of work, 2,000 health teams, 6,400 people in quarantine, 149 high-risk possibilities, and one death. Why the COVID-19 watch in this Rajasthan district is monumental — and heartening

Written by Hamza Khan | Updated: March 29, 2020 8:52:16 am
Coronavirus infection, Covid-19 screening, migrants, health india lockdown, indian express news A deserted Bhilwara Railway Station, a week after Section 144 was imposed in the city. On March 21, largely concerned about the developing situation in Bhilwara, Rajasthan was among the first states to impose a total lockdown. (Photo: Shaukat Ahmed)

Around noon on March 20, police jeeps and buses spread out across Bhilwara’s city limits, announcing on loudspeakers that people should shut shops and head home. “Section 144 has been imposed in view of coronavirus.”

Within moments, the crowded markets of Bhilwara emptied out. By March 21, concerned largely over the situation in Bhilwara, Rajasthan became one of the first states to announce a total lockdown.

A little over a week hence, Bhilwara, a south-east Rajasthan district with an estimated population of 30 lakh and famous for its textile industry, is under a COVID-19 watch unsurpassed in India. The entire population is being screened by nearly 2,000 teams on the road, doing door-to-door survey. Almost the entire government machinery in districts has been roped in, including Sub-Divisional Magistrates, tehsildars, development officers, village workers, panchayat sahayaks, anganwadi workers, auxiliary nurse midwives and teachers.

Read| Tourist free of coronavirus dies of heart failure; panic in Bhilwara

By Friday, they had covered 21.6 lakh people in 4.2 lakh homes. As many as 6,445 have been put in home quarantine, and 3,450 additionally identified as showing flu-like symptoms (149 of them are in high-risk groups). Of the state’s 46 positive cases, 21 so far are in Bhilwara. Results of 121 are awaited. Both the coronavirus-positive deaths in Bhilwara, one 73-year-old and the other 60, had co-morbidities.

While the numbers are stunning, these alone do not make Bhilwara a coronavirus hotspot. Another reason is that at the centre of its infections is believed to be a doctor with relatives who had returned from Saudi Arabia, with the virus travelling from him to another doctor with a long list of patients in the town, and other medical staff since.

Says Additional Chief Secretary (ACS), Health, Rohit Kumar Singh, “Right now, the first doctor is the only identified source… the second got it from him. Patients were consulting the latter at his hospital, at their homes, at his home. So it led to the spread of the virus. But most of the patients are still medical staff.”

The second doctor, 58, now in a hospital in Jaipur, denies this. Speaking over the phone to The Sunday Express, he said, “That is absolutely wrong, no such relatives (of his colleague) arrived… We serve day and night, so we might have come in contact (with a coronavirus case).” In fact, a report by Bhilwara District Collector Rajendra Bhatt also calls this doctor, a personal physician of some VIPs, Bhilwara’s first coronavirus case, and makes no mention of the other doctor.

BJP Bhilwara MLA Vitthal Shankar Awasthi has another theory. According to him, the hospital knew it may have a coronavirus case on its hands by March 15. “There was a suspected case that it referred to Jaipur, who tested positive on March 15. Yet, the doctors at Bhilwara hospital was selfish and continued to function till March 18. Why has the government not taken action against the hospital doctors yet?”

At its health update Thursday, the Indian Council of Medical Research underlined that all cases in Bhilwara could be traced back to “one person who had travelled”. “There is no community transmission.”

But the uncertainty means Bhilwara is on edge. Bhatt said that between February 22 and March 19, when the services at the hospital were being wound up, 5,580 OPD patients and 613 in-patients had visited it. Since they came from across Bhilwara, and around 500 of them from other districts, the decision was taken to screen the entire population of Bhilwara along with their contacts.

Calling Bhilwara measures “the largest screening exercise in the country”, Singh laughs, “We are more like Sherlock Holmes now, rather than health officials.”

****

Starting March 20, when the lockdown was announced, only shops selling essentials have been allowed to open for a certain hours in Bhilwara, borders have been sealed, and curfew imposed in city limits, says District SP Harendra Mahawer.

Bhilwara Municipal Council Chairman N L Meena says 13 teams have been disinfecting wards, starting with where the identified patients stay. Initially, a government hospital was converted into quarantine unit and since then, several other public and private sites as well as hotels and resorts have been approached for quarantine and isolation facilities.

Simultaneously, screening of the entire staff of 253 at the private hospital has been done. A 24-hour screening centre manned by Rapid Response Teams has been set up. Another centre collects samples 24 hours. Every evening, district officials hold at least one meeting to discuss feedback and decide the next day’s intervention.

The list of all the people who consulted doctors at the private hospital has been shared with Block Chief Medical Officers, to ensure home isolation. Similar lists have been shared with border checkposts, to ensure no name included in them leaves Bhilwara.

Rajasthan Health Minister Raghu Sharma says that after the outbreak, they rushed 300 medical personnel, the Medical Health Director, as well as representatives from the National Centre for Disease Control to Bhilwara. Dr Rommel Singh, Project Director, Child Health, is the nodal officer overseeing the containment efforts.

By March 26, about 88% of the survey had been completed.

Commending health officials, ACS Singh says, “Rajasthan has resource constraints and other issues compared to, say, Kerala. But Kerala’s cases have crossed100, even though it has excellent medical facilities, people are more educated, and they have a huge army of nurses.”

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Jugal Kishore Bagrodia, President of the Mewar Chamber of Commerce and Industry, dreads what will come next. Bhilwara’s textile industry employs roughly 1 lakh people. The lockdown was so swift, he says, that scarcely any of the tens of thousands of textile industry workers managed to leave for their homes in Uttar Pradesh, Bihar, Odisha, Assam and West Bengal. Now, all are out of work. “Everything is shut, the 400 weaving units, 19 process houses, 10 spinning units,” says Bagrodia.

Dr Indubala Bapna, Vice-Principal of Manikya Lal Verma Government College, says the absence of newspapers has fuelled public fears. “People only have TV and WhatsApp, which are unreliable.”

Sanket Modi, Deputy Labour Commissioner, Bhilwara, says they are doing their best to control the panic. “The Labour Department has directed factory owners that no workers should be fired and all given paid leave. We have also appealed that they be provided food.” Modi claims factory owners have been calling him, seeking permission to open their units to get attendance registers, so as to pay salary to the staff.

Collector Bhatt adds that they have identified eight Bhilwara slums to distribute food. “Apart from that, we are making meals and distributing 5,000-6,000 food packets. The SP and I are both monitoring this.” Besides, 18 mini-trucks carry vegetables and fruits daily to at least three other wards, with people lining up at a distance from each other to make purchases.

Om Prakash Vishnoi, who runs Hans Kirana Store, says the distribution of essentials is streamlined now. Officials have circulated over WhatsApp a list of 215 grocery and departmental stores across Bhilwara with their numbers. “You can place an order over the phone and I’ll call you once it is ready for you to collect. So there is no crowding,” Vishnoi says.

Rahul Ghiya, the owner of a popular restaurant in Bhilwara city called Kishmish, says, “We are all waiting for the 14-day period of incubation to end.”

On March 24, a male nurse, Nisar Mohammad, 52, posted at one of the quarantine sites in the district, died of a heart attack while on duty. Quickly, the Rajasthan Nurses’ Association rallied around him. Says its Bhilwara chapter president Narayan Lal Mali, “We want financial help for his family but we also want the status of a martyr for him. What we are doing, it is for the nation.”

All this is encouraging for those on the ground. When the dust settles, ACS Singh says, “Bhilwara will be a case study and will be taught in management schools.”

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