Spike in cases

A spike in COVID cases does not take away from the fact that aggressive contact tracing and quarantining helped Karnataka contain the disease, but the manner in which it treated migrant workers will remain a blot on the administration’s COVID response.

Migrants from Odisha all set to leave in buses to board the Shramik special train in Bengaluru on May 16.

Karnataka saw its highest one-day spike in COVID-19 cases on May 19 (as of noon) when it recorded 127 cases. On May 18, 99 persons tested positive. With this, the State’s cumulative tally of positive cases reached 1,373, with 40 deaths and 530 having recovered.

Health officials stated that the number of cases had been increasing on a daily basis after inter-State travel was allowed. Of the 99 cases reported on May 18, 69 had returned from other States, a majority of them from Maharashtra. Among the 127 cases reported on May 19, 64 were from Mandya, all of them with travel history to Maharshtra.

Primary and Secondary Education Minister Suresh Kumar, who interacts with the media on issues relating to COVID-19, said: “People who are returning are being quarantined and tested. The increase in numbers in Karnataka is mainly due to these patients who are being monitored and treated at various COVID-designated hospitals.”

Chief Minister B.S. Yediyurappa announced that as a precautionary measure people travelling from Tamil Nadu, Kerala, Maharashtra and Gujarat would not be allowed entry into Karnataka. The government was not taking chances with international returnees as well, who are being compulsorily quarantined in designated hotels.

In Bengaluru, which has the highest number of cases in the State, a cluster emerged in mid May in the containment zone of Shivajinagar where one person, identified as P-653, was said to have infected more than 50 people. This patient was working in a hotel where P-420, an employee of a private hospital who had come in contact with a COVID patient in the hospital, had been quarantined. This was the only case of the disease spreading significantly in a containment zone. Bruhat Bengaluru Mahanagara Palike (BBMP) officials were confident that the spread could be controlled.

One of the positive stories from Karnataka is that of Mysuru district. The district was declared a “red zone” by the Central government after a cluster of 90 cases emerged in Nanjangud in late March, and it is now COVID-free. The last patient was treated and discharged on May 14.

Dr C.N. Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research and a member of the government’s COVID-19 task force, said “early screening of international travellers” and “aggressive contact tracing and quarantining” worked for Karnataka. Admitting that statistically the rate of death was slightly higher in Karnataka when compared with other southern States, he said that “85 per cent of the deceased had significant co-morbidities, including cirrhosis and respiratory problems”. “In Kalaburagi, the seven deaths occurred because the patients were taken to the hospital late,” he said. He said testing had been scaled up in the State. By May 18, in all 1,51,663 samples had been tested; random sampling was done only in containment zones on vulnerable sections of the population such as senior citizens.

Dr Devi Shetty, chairman of Narayana Health and a member of the COVID-19 task force, said Karnataka “implemented the lockdown very strictly”, which helped in restricting the number of cases. He said that a “marginal rise in the number of cases is expected once the lockdown is relaxed and people return to the State”. Dr K.R. Anthony, former director, State Health Resource Centre, Chhattisgarh, said, “The slight surge in cases after the State’s border was opened is natural in an epidemic like this.”

No community transmission

Manjunath rejected the idea that Karnataka was witnessing the community spread of COVID-19. “If you notice, only travellers returning from red zone areas have the disease, and it is spreading only in containment zones in the State, whereas those coming from green zones or the unaffected zones are not testing positive. So, we can say that there is a sub-community level of transmission but I don’t think there is community transmission still.”

This is a contentious issue. Dr Srinivas Kakkilaya, a Mangaluru-based physician who follows issues of public health, said: “…to say that there is no community transmission is premature. There is certainly community transmission in Bengaluru and Kalaburagi.” The “biggest problem” is that the State is not “randomly testing large sections of the population to ascertain the level of community spread”.

With Karnataka allowing considerable relaxation of lockdown outside containment zones and inter-State and international travel opening up, there is bound to be a rise in the number of cases. This was expected as the lockdown was merely a measure to give governments time to prepare strategies to deal with the public health threat. In this situation, medical professionals are worried that the government has not thought ahead and there is no clarity on how it is going to protect vulnerable sections as the disease spreads.

Dr Anil Kumar Avulappa of Bagepalli in Chikkaballapur district who is associated with the People’s Health Movement, said, “The virus is in the community. We have to live with this forever now. The problem is that the government is not thinking about the at-risk population like senior citizens. The whole strategy has to change. The government has to massively increase the outreach of its health care services like Kerala, mobile clinics should be created, and village- and ward-level rapid task forces should be formed with volunteers. I am not seeing any of this as part of the government’s planning.”

Kakkilaya said, “the biggest problem is not coronavirus now but managing people who have been rendered homeless”, meaning the government should focus on recovery measures. “There is so much confusion. People are stuck outside the State and not being allowed to return. They are going to be mentally and physically wrecked because of this,” he said.

Vinay Sreenivasa, a lawyer working with the Alternative Law Forum in Bengaluru, expressed similar concerns. He said: “The entire governance around the pandemic was focussed on making things safer and easier for the middle class and the rich. No thought was given to how the poor would cope.”

Sreenivasa listed some factors to support his statement that the governance was anti-poor. These include the breakdown of the public health system in the State as hospitals had been taken over for COVID-19 treatment, leaving poorer sections of the population bereft of medical care; the Indira Canteens charging for meals; street vendors not being allowed to come out on the streets; agricultural markets being opened up to private players through an ordinance (on May 14) amending the Agricultural Produce Marketing Act; labourers not being given adequate rations; the proposed changes to the labour laws; and the dismantling of the public transport infrastructure in Bengaluru.

He said: “During the lockdown, we [an informal alliance of activists called Naavu Bharateeyaru] proposed to the Labour Department that community kitchens should be set up and handled by local residents but the civic body has paid more than Rs.7.5 crore to Akshaya Patra [a non-governmental organisation] for procurement of foodgrain kits.”

“The relief measures announced by the Chief Minister for vulnerable sections are inadequate,” Sreenivasa said. Yediyurappa announced a relief package in three tranches, of Rs.1,610 crore, Rs.162 crore and Rs.512 crore, to help a wide cross-section of the vulnerable population.

The fact that domestic workers were not identified as “vulnerable” and offered relief under this package is worrying Geeta Menon, secretary, Domestic Workers Rights Union. “Since domestic work does not fall under the regular definition of labour, domestic workers fall through the cracks. A survey of around 8,000 domestic workers revealed that 87 per cent of them have not been paid their salary for April and have been asked to stay away in May and June. How are these people expected to survive without wages or any kind of compensation?” she asked.

Another vulnerable section is migrant workers. While Bengaluru did not witness an exodus of migrant workers, there has been a steady trickle of workers from other metropolitan cities, who, frustrated with waiting for transportation facilities and depleting savings, have begun to walk or cycle back home to States as far away as Uttar Pradesh.

Krishna Byre Gowda, former Rural Development and Panchayati Raj Minister and senior Congress leader, met many of these migrant workers on Ballari road on the outskirts of Bengaluru. He told Frontline that three issues highlighted the callous attitude of the government towards the plight of migrant workers. First, during the first 15 days of the lockdown, no attention was paid to their condition; second, when buses were started for workers from north Karnataka to return to their homes, they were charged for their travel; and third, inter-State trains started for the benefit of these workers were cancelled by the Yediyurappa government because of pressure from the real estate lobby and only restarted after pressure from the opposition and civil society. “They have been absolutely insensitive to the plight of the workers. They are getting away with criminal negligence because of the benevolence of a large section of the news media which are not reporting these issues,” he said.