Crisis & cover-up

Gujarat’s case fatality rate, the highest in the country, is proof of its inept handling of the COVID-19 crisis. But the BJP government is apparently not releasing accurate data and may be manipulating the death rate.

Published : Jun 28, 2020 07:00 IST

Diamond workers waiting to enter a manufacturing unit in Surat after the authorities eased restrictions on May 22. But the number of cases too are rising.

Diamond workers waiting to enter a manufacturing unit in Surat after the authorities eased restrictions on May 22. But the number of cases too are rising.

Gujarat shows no respite in COVID-19 infections, with Ahmedabad, its largest city, remaining the epicentre in the State. Worse, following the relaxation of the lockdown norms, especially with the opening of inter-district movement, the infection has been spreading rapidly to other districts too. For instance, Narmada, Kheda, Panchmahal and Patan districts, which had reported COVID cases in single digits in early June, are now seeing a steady rise in numbers.

Figures by the State Ministry for Health and Family Welfare (MoHFW) show that since June 20 Ahmedabad has seen a dip in its share of the total number of cases in the State, from 64 per cent to 48 per cent.

Gujarat is still in the fourth position, after Delhi, Maharasthra and Tamil Nadu, in the number of COVID cases. This is attributed to the State government’s incompetency in handling the pandemic. In spite of help from the Centre and a rebuke from the High Court, the administration has been unable to streamline its health care system, which is in a shambles.

Case fatality rate

On June 25, Gujarat’s COVID death toll reached 1,753 and the total number of cases crossed 27,000. According to the MHoFW, the daily average number of positive cases has been 483, which is 20 per cent higher than the average in May. What is more worrisome is Gujarat’s case fatality rate (CFR), which is the highest in the country, even among States that have registered more than 10,000 cases. The CFR is the proportion of people who die from a specific disease among all those diagnosed over a certain period of time. On June 25, Gujarat’s CFR was 6.25 per cent even as Maharashtra, which fared high in the list in fatalities and number of cases, reported a CFR of 3.73 per cent.

The State’s inept handling of COVID-19 has been an embarrassment to the Bharatiya Janata Party’s top leaders whose home turf is Gujarat. Sources in Ahmedabad say that in an attempt to cover up, the State government has not been releasing accurate data. It is believed that the testing numbers have come down and the cause of fatalities is not being documented. “I know of a case where they [a government hospital] deliberately did not put down the cause of death as COVID-19. They are doing this all over so as to manipulate the COVID death rate,” said a resident doctor at a public hospital on condition of anonymity.

A government directive to private laboratories to reduce testing rates from Rs.4,000 to Rs.2,500 is seen as giving some relief to citizens. This move is also expected to provide more accurate data.

The State government recently issued a statement saying the situation was looking up as the case doubling rate had gone up to an average of 31 days vis-a-vis the national average of 19 days. Significantly, the death toll, combined with the high positivity rate (8.01 cases per 100 tested, as per State government figures), has thwarted the government’s efforts in improving its image.

Gujarat is among the three States a high-powered Central government team visited to probe the high positivity rates. Health officials say poor contact tracing in the densly populated localities of Ahmedabad is one of the main causes for the rapid spread.

As of June 25, Ahmedabad accounted for 1,390 deaths of the total COVID casualty count in the State and 3,399 active positive cases. Surat came second with 142 deaths and 1,152 positive cases, followed by Vadodara with 48 deaths and 620 cases; Gandhinagar with 27 deaths and 157 cases; and Rajkot with five deaths and 98 cases.

Spike in Surat

The southern Gujarat city of Surat is proof of virus seeping through Ahmedabad. Following Unlock.1, Surat’s wholesale markets and diamond units began operations. However, this led to the city seeing workers too return, leading to a significant rise in the number of COVID cases in the last week of June.

By June 25, approximately 300 diamond workers tested positive for COVID-19. The Surat Diamond Association said even though intense sanitisation processes had been followed, the spread was inevitable. However, the industry had to restart as orders had been pending from pre-lockdown days, said the association spokesperson.

“There is a huge anti-Ahmedabad sentiment currently,” said Vijay Shah, a car dealer in Rajkot. “Buses, trucks and cars coming from that city are being stopped and not allowed into our district. In fact, in our residential area, if we know anyone who has come from Ahmedabad, that house is reported to the authorities immediately.”

Several social reasons

Ahmedabad was declared a hotspot from the early days of the lockdown. In spite of efforts to seal off containment zones, which were mainly in the walled city, the virus seems to have spread to Ahmedabad West, where the residences of the well-heeled and the elite of the city are situated. Recently, about a dozen buildings there were sealed off because of active cases.

While the scientific reasons behind Ahmedabad being a hotspot are yet to be known, several social reasons have been given for the city’s high numbers, from the density of the wards affected, the Namaste Trump event in February that led to the congregation of a large number of people, to the high rate of international travel. The stigma attached to COVID-19, which leads to late testing and treatment, is also being put down as one of the reasons for the high numbers in the city. Adding to the problem is the theory that Gujaratis could suffer from a high percentage of comorbities as 80 per cent of the deaths have been of patients with comorbid conditions.

Labour shortage

Yet another fallout of the pandemic is that the State’s vast industrial and agricultural zones are facing a drastic labour shortage because of the migrant exodus. Rights activists say it is unlikely that people will return until quarantine rules are relaxed. Until then, other than big industry, most factories would be operating at just 40 per cent capacity, which is a hard blow to the highly industrialised State.

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