From April 1 to May 15: How it all turned from bad to worse, analysing the spread of the virus in Cachar
Today, the road that you see above is empty, but how crowded was it in March? January, February, March, the government forgot about the pandemic, the fatigued administration lowered the guards and for the general public, it was freedom after a forced lockdown.
April 1, all three districts of Barak Valley went for polls to elect the next government of Assam. Cachar District Health Department considers April 1 as the beginning of the second wave. The day when millions participated in what is called the festival of democracy, it is clear that the virus found its source to mutate. More than the outbreak of the second wave, it was Barak Valley hugging the catastrophe.
That is the time when Delhi, Mumbai began to bleed. Influential people were getting admitted using power. Multinational companies reserved beds, in case their employees fell sick. As the healthcare system chocked, thousands died in ambulances, on stretchers outside the hospital. Back in Assam, the discussion was if Covid is there in the state or not.
Assam has tackled the first phase better than most other states in the country. Both economically and medically. To be fair, the state’s healthcare system was awful. A research carried out by Geetanjali Kapoor, Aditi Sriram, Jyoti Joshi, Arindam Nandi, Ramanan Laxminarayan for the Princeton University’s Centre for Disease Dynamics Economics and Policy found that Assam had only 24,178 beds as of April 2020.
Out of that 17,142 beds were in the public sector and 7,036 in the private sector. But beds mean nothing without a proper supply of oxygen. Also, critical patients were slipping into ICU and under ventilator in no time.
The same Princeton’s research found that Assam has 857 ICU beds in the public sector 352 ICU beds in private hospitals which means Assam went to combat the Covid situation with a total of 1209 ICU beds. In terms of ventilators, there were 429 in the public sector 176 in the private which means 604 in total. With that in his arsenal, former Health Minister of Assam, Himanta Biswa Sarma laid the foundation for a revolutionary transformation of the healthcare system. He managed to a great extent. He personally visited hospitals, ICUs, crematories. Men, materials, beds, Sarma lead from the front and observed the virus from close quarters.
In the state, Himanta Biswa Sarma understands the pandemic more than epidemiologists and doctors. Yet, he missed the warning signs of the second wave. In April, he was debating the necessity of wearing a mask in an interview. Went on to say, “There is no Corona in Assam.” Roadshows and political rallies throughout March and April did not do the state any favour. The laxity took a fatal turn. Ventilators remain uninstalled in the hospitals of Karimganj and Hailakandi. In Silchar Medical College and Hospital, the construction work was stopped. 60 ventilators remain unused.
Active Cases
On April 1, 76 samples were tested using the Rapid Antigen Test kit. There were none carrying any infection. On that day, Cachar had 6 active cases. A week later on April 7, the number of active cases rose to 18 registering more than 2x growth. On April 14, 93 active cases were there in the district. A more than 5x growth. April 21, 249 active cases in Cachar started reflecting the massacre unfolding in central and western India. A week later, on April 28, the number of active cases in Cachar swells to 510. This is the time when deaths start to grow. Silchar Medical College and Hospital’s ICU work restarts. But Karimganj and Hailakandi remain indifferent.
May 6, the number of active cases in Cachar reach, 797. On May 15, Cachar stands with 1350 active cases in Cachar.
Positivity rate (Only RAT)
The Cachar district administration does not reveal the statistics of samples collected for RT-PCR. RT-PCR tests are done mostly at Tikal Model Hospital for air passengers, SMCH, and a private accredited laboratory, Dibascan. According to our estimates based on our interactions with various institutions, Cachar would roughly report a 30 – 40 per cent positivity in RT-PCR samples if the Tikal numbers are excluded. RT-PCR tests are voluntarily done by people when they realise they are sick and showing symptoms.
Going by the RAT data, in the first week of April, 5083 samples were tested in various parts of the district, nine of them tested positive. The number of RAT tests done trebled to 16,365 in the following week but the positivity rate remains below 1% as 47 individuals tested positive. April 15 – 21 is where it started tipping, as 132 samples tested positive out of 7536. It is worth mentioning here that the number of tests done on RAT reduced by 50%. Now the RAT positivity rate of Assam is 10.38% higher than Assam’s positivity rate.
Deaths
On May 15, the experts in Silchar say the peak has begun. In January, there were two Covid related deaths in SMCH, in February there were none and in March only one. April, the number skyrocketed to 16. 33 Covid related death have been reported this month till May 15. 49 individuals have lost lives so far in just one hospital. The deaths in home isolation, private hospitals remain unreported which indicates the number could be two or three times higher.
The biggest worry
Silchar Medical College and Hospital is at the core of this war against Covid. Taking the load of 40 lakh people, the SMCH is choking. Before the pandemic broke, SMCH had 29 ICU beds. Now it has 129 with 100 earmarked for Covid patients. On May 10, 36 patients were in the ICU of SMCH. On May 11 it dropped to 26, back to 36 on May 12 and on May 13 it went up to 39. May 14, the number of patients in ICU shots up to 87 and 95 on May 15 leaving only five ICU beds vacant in the government hospital. As it stands, Hailakandi and Karimganj continue to be dependent wholly on SMCH.
With shops shutting at 11:00 am and a ban on the movement of individuals from 12:00 noon, this is by far the stringent restrictions that the government of Assam has imposed in 2021. The next step is a lockdown. However, awareness still lacks among the general public. After testing positive, many individuals are returning home using public transport. In the vaccination centres, social distancing is breached as one stands on the shoulder of another. The new issue that has emerged is second-time testing. Yesterday, the Cachar district administration flagged off the issue. After testing positive in one centre, people are traveling to another to confirm if it was a fake positive.
While it is true that there is room for the police to intensify patrolling, but unless the general public behaves more responsibly, the wave will continue to take a disastrous shape.
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