Unable to cope

There are 127 hospitals in the State with COVID treatment facilities, but the situation continues to be grim and private hospitals charge as they please.

A doctor wearing a protective face shield uses an infrared thermometer to measure the temperature of a child at his mobile health clinic, after his clinic and its adjoining areas were declared a micro-containment zone following the easing of lockdown restrictions, in Ahmedabad on June 15.

GUJARAT continues to be among the five States witnessing the highest numbers of COVID-19 cases and deaths in the country: 23,544 positive cases and 1,477 deaths, as of June 15. The contagion shows no signs of abating and the State machinery appears completely overwhelmed and the health care system seems to have broken down. Private hospitals are reportedly allowed to charge astronomical amounts for COVID-19 treatment. A social worker from the State said: “Three months into the pandemic, the State, for all its bombast on its development model, is in a shambles because it did not have the infrastructure to cope. Mumbai is in an equally bad condition, but it seems to be handling it much better than Ahmedabad.”

Ahmedabad, with 1,187 deaths, remains the epicentre. Community transmission is believed to be rampant in the city. Gujarat’s highest single-day tally was 517 cases on June 14, with Ahmedabad accounting for 311.With restrictions imposed on movement between districts, the spread is contained within the city, but that may change rapidly once the restrictions are removed. As of June 15, the three other major cities reporting positive cases were Vadodara (504), Surat (654) and Rajkot (59). “If there is a noticeable change in these cities’ figures, it could be blamed on Ahmedabad, and so the need to contain the disease here is critical,” the social worker said.

A doctor at Ahmedabad Civil Hospital, which has seen 60 per cent of the deaths take place in its wards, said: “Essentially, the lack of adequate health care facilities and stringent procedures in testing and treatment is causing much of the surge.” The Ahmedabad Municipal Corporation (AMC) has increased the number of hospitals dedicated to COVID-19 treatment. Yet there seems to be little improvement in the recovery rate, which hovers around 41 per cent. “The government hospital is being called the ‘dead body’ hospital. We are unable to cope with the numbers. We are exhausted and there is no end in sight,” the doctor said.

Gujarat government figures show there are 127 hospitals identified across the State to treat COVID-19 patients and provide isolation facilities, but doctors say this is not enough. Speaking of the absurdly high rates being charged by private hospitals, Dakshin Chhara, a film-maker who lives in Ahmedabad, said: “I heard somewhere that hospitals were taking a deposit of Rs.1 lakh to admit COVID patients. The pandemic has become a business opportunity for private businesses and the government. The rich will recover because they can pay, while the poor will die. We have filed an RTI [Right to Information] petition demanding to know how these amounts are decided.” He shared a photograph of a signboard posted outside a private hospital listing charges for COVID patients. It said: Single day charges for a general ward is Rs.9000, High Dependency Unit (HDU) costs Rs.12600 per day, Isolation plus Intensive Care Unit (ICU) is 18,050 per day, and the combination of ventilator, ICU and Isolation would be Rs.21,850 for a single day.

Chhara, who lives in one of Ahmedabad’s many low-income community ghettos, said residents of the area took matters into their own hands when the AMC failed to respond to the growing number of cases there and began disinfecting the streets and homes. That seemed to have helped, he said.

Stories of patients running from pillar to post in search of isolation beds and treatment appear every day in the local press. Mohammad Pathan, who owns a pharmacy, said: “I took my neighbour to the Civil Hospital. We waited for hours before being admitted. Meanwhile, people around me were being given the news of relatives passing away owing to COVID-19. I don’t think I will ever forget the tragedy that was unfolding in front of me.”

The State government had recently earned the Gujarat High Court’s ire over its mismanagement of the crisis.

Unlocking

Following the Union Home Ministry’s guidelines issued on June 1, Gujarat issued guidelines for a phased reopening. Businesses in the highly industrialised State have been asking for relaxations since mid May. In its “Unlock-1” guidelines, the State government has allowed industries to operate with 100 per cent capacity with mandatory safety processes in place. Additionally, all private and government offices, banks, shops, salons, and even coffee shops have been allowed to reopen under strict physical distancing and safety protocols. Local residents say that other than the display of masks, everything else seems to be back to normal, including the traffic jams.

Soon after the unlocking began, Chief Minister Vijay Rupani announced a Rs.14,000 crore relief package to revive the State’s battered economy. Terming it Gujarat’s plan for becoming “ atmanirbhar ” (self-reliant), Rupani said the relief measures comprised rebates on property tax, loan interest subsidies and sector-wise allocation of funds to support and promote businesses. A sum of Rs.466 crore has been earmarked for labour welfare; this includes Rs.35,000 for each tribal labourer who works as an intra-State migrant. Free rations and a direct transfer of Rs.1,000 to the accounts of families living below the poverty line are other relief measures. Most importantly, the government is giving Rs.100 crore each to the Health Department and the municipal corporations of Ahmedabad, Surat, Vadodara and Rajkot to improve health care facilities in order to combat the virus.

Surat’s famed textile markets and diamond cutting/polishing units are working with physical distancing norms in place. “While we are happy to restart, the problem is every time someone tests positive, we have to shut the unit,” says Manglesh Shah, who owns a diamond-cutting unit. “There is a slowdown in the economy, so the demand is low. Between labour and demand, I am not sure how we are going to survive this.” The construction industry has also restarted but it suffers from labour shortage, said a contractor.

A Vadodara businessman said: “All this seems good on paper. Hopefully, they will make the payouts, as it is critical for survival. While they have allowed us to operate fully, the problem is without labour most of us are working to about 50 to 60 per cent capacity. Gujarat absorbs massive skilled labour from other States. With their exodus, we are struggling with a labour issue. They need to do something about that. Unless quarantine rules relax, we will not be able to function fully. It is very easy to shut down. But not that easy to restart.”