Punjab: Wider spread

Since mid June, the positivity rate has doubled in the State with COVID-19 cases, which were initially concentrated in the cities of Ludhiana, Amritsar and Jalandhar, now being reported from rural areas too.

Patients discharged after being treated for coronavirus infection at the COVID Care Centre in Jalandhar on July 3.

With the easing of lockdown restrictions, Punjab is not only confronted with a surge in COVID cases or increase in the positivity rate, but also the spread of the cases over a wider area. The majority of the cases were initially reported from the cities of Ludhiana, Amritsar and Jalandhar. The disease has now spread to Patiala, Mohali, Hoshiarpur and Ferozepur. Relatively smaller numbers are being reported from Moga, Pathankot, Fazilka, Bhatinda, Mansa and Fatehgarh Sahib. What this indicates is that the rural areas of the State, that is, the agricultural belt, which was hitherto considered relatively safe, is now as much prone to COVID-19 as the urban areas.

On July 5, Ludhiana once again reported the maximum number of fresh cases. Of the State’s 175 new cases reported on that day, 70 were from Ludhiana, 26 from Patiala and 16 from Mohali. Chandigarh reported five new cases, taking the city’s tally to 492, and one death. It was, however, the cases reported from Fazilka, Sangrur and Mansa that set the alarm bells ringing. Sangrur, in fact, became a new hotspot towards the end of June, reporting 81 fresh cases in 24 hours on June 25. This put a question mark on the State’s bid to bring back migrant labourers from their hometowns and villages to resume economic activities and presented a clear danger of attempts to open up the economy too soon.

Gurvinder Singh, Bharatiya Kisan Union (BKU) leader, however, allays such apprehensions. “The spread of the disease has little or nothing to do with the return of migrant labourers. The fact is that due to the government’s campaign, more people are aware of COVID-19. So, if anybody has any symptoms, that person goes to get himself examined. This is combined with a slightly better testing ratio. Testing is still on the lower side but it is still better than what it was in April. It results in more COVID cases coming to light from even small places.”

He said: “Until now, the government was sending anganwadi workers to check people. Now, when people see so many deaths being reported, there is an attempt to go to doctors, particularly in rural areas. People do not want to take a chance even in the case of a common cold.”

Ajmer Singh Lakhowal, BKU president, looks at it differently. “There has been a slight increase in testing which is throwing up higher numbers. But more importantly, it is the result of laxity during the easing of the lockdown. People in urban areas forgot about physical distancing; they started participating in parties, weddings, etc. Well-off people in cities and towns just forgot about the norms to be followed during the pandemic. The disease spread from there. It has nothing to do with migrant labourers coming back. None of them has reported sick. It is the urban people who have acted in an irresponsible way.”

That may be true, but this time, the numbers are coming from places that had hitherto not reported any cases. How does one explain that, more so when there had been no arrival of travellers from abroad in recent weeks?

Lakhowal said: “It is simple. There is interaction between people. When a small town man comes to Ludhiana or Amritsar or when a big city man goes to check his fields in a small village, there is the risk of transmission. Having said that, it would be unfair to blame people from rural areas for the spread of the disease. They have observed all norms, physical distancing, wearing masks, and so on. Even when they come to mandi [market], they take these precautions. It is in the cities that such norms are flouted. In fact, in villages, people ensure that nobody goes to bed hungry. Langar s, or community kitchens, are organised. And awareness programmes are held by local gurdwaras there. On the other hand, in cities everybody thinks of himself as a little prince.”

That could be one of the factors. Another is the lifting of most of the restrictions on week days. Punjab was among the first States to lift the curfew, allowing offices, shops and businesses to open from May 18. Most of the restrictions were reimposed on weekends to curtail family outings or people moving around without a sense of purpose. Cinemas, eateries, spas and gyms stayed shut. That, as it turned out, was not good enough. The latest data coming from Punjab show that the positivity rate has gone up significantly, and along with Odisha, Jharkhand and Chhattisgarh, Punjab is emerging as the new hotspot. Since mid June, the positivity rate, or total cases per hundred tests, has doubled in the State. The graph shows a steep climb from 0.8 cases per hundred tests in May to 2.15 cases per 100 tests between June 19 and July 2. While this is still below the national average, it shows a rise in the number of cases and the spread of the disease. Incidentally, Punjab’s testing rates are way ahead of the national average. The State does 10,257 tests per million people as opposed to the national average of 6,859.

Says Dr Rajesh Ghumman, who has been tackling COVID cases in and around Patiala, “We must remember that 71 per cent of the fresh cases continue to be from the districts of Ludhiana, Jalandhar and Sangrur, and that nine of the 11 containment zones are in these three districts. So, if there is a spread, it is a thin spread across other districts. While the new figures give us a reason for concern, they are not alarming yet. Which is a good sign. More so when you see the figures in relation to the numbers emerging from Maharashtra, Tamil Nadu, Gujarat or Karnataka. The infection may have spread to more districts now in Punjab, but the numbers from the new places are not high enough to cause alarm. That provides the medical personnel with the time and opportunity to ramp up the facilities in those areas. It is easier to do so if you have just half a dozen cases in a week from Fatehgarh Sahib or Mansa but much more difficult if you have scores of patients or new patients from the families already afflicted by COVID-19. Then the resources are stretched in trying to save lives in the present or providing facilities to those who might need them tomorrow. There are no easy choices.”

Time may yet be Punjab’s ally as it seeks to prevent a rapid increase in cases in hamlets with questionable infrastructure to tackle the crisis. Ghumman sums up the situation: “We have time, but it is constantly ticking. Whatever is to be done has to be done now.”