Three neighbouring districts of Indore — which reported the most COVID-19 cases in Madhya Pradesh — are fast emerging as the new hotspots. Three out of four patients to die of the illness in the State come from the four districts combined.
The alarming trend is prompting health experts to enquire into why 85% of the 99 deaths owing to COVID-19 have occurred in just four of the 52 districts. After Indore, the country’s cleanest city, Ujjain, Khargone and Dewas recorded the most number of fatalities in the State.
As of April 25, in Dewas district, having a population of just 15.6 lakh, as many as six, or 27.2% of all patients have died of the illness, registering one of the highest case fatality rates in the country. District’s Chief Medical and Health Officer R.K. Saxena said: “One of the recovered patients was a frequent traveller to a hotspot in Indore.” He unknowingly brought the virus upon seven members of his family, of which three have died.
The other three deaths were hastened by co-morbidities.
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In Khargone district, six or 10% of all patients have died so far. Whereas in Ujjain, 15 of 103, or 14.5% of patients who tested positive had died. The infection has inflicted the worst toll on Indore, where 57, or 5.25% of all patients have died of it.
Hospitals stretched
In the absence of enough government-run tertiary care centres in west Madhya Pradesh, patients from 14 districts are used to seeking treatment in Indore, whose own infrastructure is under stress now. “Our hospitals, both private and government, are overflowing,” said a professor at the government-run Mahatma Gandhi Memorial Medical College (MGMMC), Indore, requesting anonymity.
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The virus’s spread could majorly be contained by restricting mobility, including that of patients, said Salil Sakalle, associate professor, Community Medicine department at the college. “Shifting every coronavirus patient elsewhere for treatment increases the probability of infecting another 20-25 people, as they are accompanied by attendants too. Therefore patients from neighbouring districts are now being mostly treated there itself unless serious,” he said.
Health experts were considering whether carriers had taken the virus from the hotspots of Indore to other districts, said Lokendra Dave, member of the State COVID-19 Technical Advisory Committee. “The virus may have been carried by those violating the lockdown and travelling,” he said.
Moreover, he said, many patients were presenting themselves late at hospitals “Around 60 of the 80 initial deaths can be attributed to late reporting. People still do not take cold, cough and fever good enough a reason to see a doctor,” said Dr. Dave.
“The fear surrounding isolation further prevented the infected to approach the health system. There is social stigma and phobia attached with the coronavirus,” he said.
In addition, the MGMMC, on advice of the State government, is sending samples collected from the four districts, including Indore, to the National Institute of Virology, Pune, to ascertain whether a mutated, more virulent form of the virus is causing more deaths in the region.
There was no question of the virus travelling from Indore to neighbours as the lockdown was being imposed strictly, said Akash Tripathi, Indore Divisional Commissioner. “Only for essential services and emergencies are we relaxing it,” he clarified.
Still, the virus is spreading to at least two-three new areas every day in Indore, he admitted. “At least 10% of recent cases have come from newer areas. The epidemiological link is that doctors, police personnel and pharmacists, who often work in containment areas unknowingly carry it back to their residential areas.”
