At Bikrampur village, surrounded by the Kudalkiara forest in western Odisha’s Nuapada district, Muralidhar Kand, 52, is very relieved that 18 days have passed since he tested positive for COVID-19. His brother, Shyamdhar, 45, too appears to be recuperating well from COVID-19.
But, Mr. Kand said, “We were left puzzled when we tested positive for the coronavirus. We rarely go outside for shopping while vendors occasionally come to us. Our interaction with the outside world is limited.” A small forest patch has to be crossed to reach Bikrampur, home to about 50 families.
“If tests are conducted scrupulously, identifying people having flu-like symptoms, I am sure every home will turn into a COVID Care Centre,” Mr. Kand remarked.
While COVID-19 is creating havoc in urban India, in Nuapada, it’s infecting people and claiming lives silently. At Belpada village under Lanji panchayat of Nuapada’s Khariar block, 20 out of 30 villagers tested positive when rapid antigen tests were conducted. In Brahmanipada under Sinapali block, 29 positive cases were detected in early April. Several villagers under Komna block refused to get themselves tested after 23 persons there tested positive.
Till Sunday, COVID-19 had claimed 42 lives at the Nuapada COVID-19 hospital since April 8. If the deaths of COVID-19 patients referred from Nuapada to outside hospitals were taken into account, the toll would exceed 60 in the past 20 days.
Chief District Medical Officer Kalicharan Behera admitted that Nuapada had been clocking a test positivity rate of close to 40% in the past one week and its health infrastructure had come under severe strain.
Health experts are attributing the rapid spread to neighbouring Chhattisgarh, on which people in Nuapada are dependent for everything from employment to trade.
“When cases increased in Chhattisgarh in the month of March, people started returning home. At that time, people in Nuapada were complacent and were not adhering to precautionary measures. Soon the situation went from bad to worse,” said Annada Shankar Das, an Ayush doctor assigned to track COVID-19 trends in the community.
The district headquarters hospital, eight community health centres, around 20 primary health centres and 100 sub-centres of the district cater not just to the people of Nuapada, but also the bordering districts of Chhattisgarh.
Nuapada has 2,584 active cases after Khordha (7,969) and Sundargarh (5,981). The rising numbers have greatly strained the COVID-19 infrastructure in the district. There is one COVID-19 hospital having 165 beds at Nuapada, and a 50-bedded COVID Care Centre at Khariar. Of the five beds with ventilator facility, only two are functional at any given time.
If tests are ramped up, the number of positive cases in Nuapada is likely to shoot up. The present outcome from antigen tests is an indicator. On April 17, 221 (25.66%) out of 861 persons tested positive. On the next day, the test positivity rate (TPR) went up to 31.24%, when 249 of 797 persons tested positive. Subsequently, the TPR continued to hover between 35% and 40%. The TPR was estimated at 37.75% on April 23 and 39.75% April 24.
As Nuapada sends RT-PCR samples to Bhubaneswar for testing, it takes an average 10 to 12 days for results to be known. During this time, infected persons unknowingly spread the virus. Lack of space for home isolation contributes to further spread.
Though the local district administration claims to have enough test kits stocked up, a large population stuck at home with COVID-19 symptoms is estimated to be shying away from tests. Non-existence of public transport is a major reason. Symptomatic people are unable to hire vehicles. Even neighbours are unwilling to take people to testing centres by two-wheelers.
“A man with a family in Bendrabahal village in Bargaon panchyat tried everything to access a testing centre but he failed. After my personal message to a senior officer on April 14, the administration sent a team to his house. Two people from the house later tested positive,” said Ajit Panda, Khariar-based journalist.
“Though we have enough test kits to test people, we are facing staff crunch. Many staff have gone into home isolation after getting infected,” said Gopal Chandra Mallick, Nuapada district COVID officer.
“Most people from villages cannot afford to get treated in private hospitals outside the district. People here seem to be sitting ducks in the ever worsening COVID-19 pandemic,” said Rudra Patnaik, Nuapada-based activist.