AS COVID sweeps rural Rajasthan, every second case in the state is now being reported from villages. A recent door-to-door survey by the state government detected 7 lakh people with ILI (influenza-like illness) symptoms among the 7.25 crore people surveyed (comprising 92% of the state population).
An analysis shows that Rajasthan’s 26 rural districts accounted for 51.26% of its Covid cases in the week ending May 8 and 43.01% of the deaths. In comparison, in the week ending November 28 last year, the peak of the first wave, these districts accounted for 45.06% of the cases and 37.5% of the deaths. Only seven of Rajasthan’s 33 districts are categorised as urbanised as per the state Economic Survey. Three-fourths of the population lives in rural areas.
Given the situation, described as “unprecedented” by officials, the Ashok Gehlot government has shifted focus from tracing contacts in the first wave, to door-to-door survey to identify ILI patients. They are put through Rapid Antigen Tests and handed over medical kits (containing azithromycin, paracetamol, levocetirizine, zinc sulphate and vitamin C tablets). There has been some relief since May 10, with a decline in active cases from 2.03 lakh to 1.76 lakh Monday, amidst a lockdown.
In a recent interview to The Indian Express, Health Minister Raghu Sharma had said the situation was under control and community health centres (CHCs) were being strengthened to handle Covid. On Monday, the government said oxygen concentrators and cylinders had been provided to turn 350 of the 571 CHCs into Covid care centres.
In Bundi district’s Devji Ka Thana panchayat, comprising four villages with a population of 6,000 and 42 known active cases, sarpanch Shivaji Ram Meena said there had been 12 suspicious deaths recently. “This is the time of seasonal flu. How do you differentiate between coronavirus and normal fever unless people are tested?” Meena asks. The samples are collected once or twice a week at the local primary health centre (PHC).
The government survey identified over 10,000 people in Bundi villages with ILI symptoms over the past month.
Block Chief Medical Officer (BCMO), Hindoli, Jagbeer Singh said they know of only three deaths due to suspected Covid. “We have tested 8,666 samples since March, compared to 8,879 between March 20 last year and February 21 in Hindoli,” he added, while admitting that while the three CHCs in the block are testing daily, the six PHCs collect samples once or twice a week. The district is yet to receive RAT kits.
Bundi District Magistrate Ashish Gupta said 13 CHCs in the district have been equipped with five oxygen concentrators each and oxygen cylinders for back-up. On those who had been identified by the ILI survey, he said a follow-up was done every week. “If their condition worsens, they are tested and, if need be, admitted to PHCs or CHCs.”
Around 100 km southwest of Bundi, Nepali Meena of Pilauda in Sawai Madhopur district recently drew the government attention through a journalist’s tweet featuring him. After the tweet was circulated widely, a medical team was sent to the village. A health worker at the Pilauda CHC confirmed 40 active cases in a population of 2,000.
Meena told The Indian Express there were 300 others in the village with ILI symptoms. “First, people are not willing to get tested due to stigma and the 14-day quarantine. Second, testing is irregular.”
Sawai Madhopur DM Rajendra Kishan said 28,000-30,000 ILI patients had been detected in the district, and they were testing all such cases for Covid, an average of 1,000 samples daily. “Our teams check on these patients every five days. At least 39 patients are admitted across 14 CHCs.” However, he said, it was difficult convincing villagers to undergo Covid tests as they fear ostracisation.
In Sikar’s Kheerwa village, at least 24 deaths have been recorded since last month. “Four were Covid positive. One of the dead was 31 and the rest above 60, with comorbidities,” said Sub-Divisional Officer Kulraj Meena. Populated by former and serving Armymen, the village has 47 active cases, said sarpanch Hakam Ali.
Sikar DM Avichal Chaturvedi said nearly 60% of the cases in the district were from villages. “We have distributed 20,000 medical kits to ILI patients. As far as Kheerwa is concerned, yes, deaths occurred. We tested the families of the deceased and three to four were Covid positive,” said Chaturvedi.
Also talking of cases slipping through their net due to villagers hiding symptoms, Chaturvedi said, “Our first priority is treat patients so that they don’t have to wait until the test result is out.” On Tuesday, the district received its first batch of 4,000 RAT kits.
Claiming official “apathy”, a village in Churu district has taken upon itself to buy medicines for ILI patients and distribute “kadha”. Jay Singh, the brother-in-law of Jasrasar village sarpanch, said of the 60 samples taken in the last one month, 40 had returned positive. He blamed 10-12 weddings in the last one month and violation of Covid guidelines by families of patients. At least seven people, including two patients (in their 40s), have died in the last two weeks in the village, of which three were officially attributed to Covid.
BCMO Vishwas Mathuria said, “All villages in my block are reporting around the same number of cases — 60% from villages and 40% from urban areas — with a positivity rate of 24%.”
In Dausa’s Jaun Mishro Ki Dhani, with 150 households, an engineer, who did want to be named, said nearby areas had stopped supplying the village essentials because of a high number of active cases. The sarpanch’s brother-in-law, Vijayant, blamed a wedding on April 20 for the spurt.
Additional DM Ramkhiladi Meena said that of the total 50 cases reported in the second wave in the village, around 10 were active. “We are sanitising the village and the situation is under control,” said Meena. Chief Medical and Health Officer Manish Chowdhury said, “More than 18,000 medical kits have been distributed in the last one month. The situation is bad at some places, but we are ramping up oxygen facilities (at CHCs and PHCs).”
In Jodhpur’s Phalodi rural block, Sanjay Bohra, a volunteer with an NGO helping Covid patients, said the CHC was stretched to its limits with patients from over 300 villages. “Many villagers here work as gas cylinder delivery boys across India. In the last one month, they have returned to their village. This may have led to a spurt in cases, aided by weddings,” said Bohra. The district is also logging 50% cases from rural areas.
BCMO Mahaveer Singh said the block was seeing 100 positive cases daily. “For example, at SS Nagar in Phalodi, 38 of the 50 samples recently tested positive.”