COVID-19: Families vulnerable in Andhra Pradesh

In Andhra Pradesh, entire families are getting the infection owing to asymptomatic cases and patients are slipping into distress within days, leaving little time for treatment. The vaccination drive has been plagued by shortage of vaccines.

A huge number of people waiting to get tested for COVID-19 in Vijayawada on April 15.

The second wave of COVID-19 is ravaging Andhra Pradesh. The State had an overall test positivity rate of 0.25 per cent in February, which skyrocketed to an astounding 11.2 per cent on April 14. Last year, during the peak of the pandemic, the rate was just over 6 per cent. The State recorded 5,086 positive cases in the 24-hour period ended April 15, up from 4,157 on April 14 and 4,228 on April 13.

The April 15 numbers represent the highest single-day count in Andhra Pradesh since October 11, 2020, when the pandemic was raging across the State. Interestingly, on October 11, 5,210 persons tested positive out of 75,517 people who were tested, while the 5,086 cases on April 15 came from just 36,000 tests.

The number of confirmed cases per million stood at 18,041 on April 15. The all-India figure on the same day was 10,565. While the number of active cases on April 15 stood at 31,710, the highest since October 23, 2020, the State’s total number of cases since the pandemic began stood at 9,39,240. The number of fatalities was 7,353.

With a vast majority of these cases being asymptomatic, it is often too late before an infected person goes for a test, thereby shortening the time available to treat them in case of acute distress and for the implementation of steps to prevent the infection from getting worse.

Speaking to Frontline , Muddada Ravi Chandra, Secretary (Covid Management and Vaccination), said that the previous method of testing, contact tracing, isolating, and treating an infected patient was not as efficacious as it was last year.

He said: “During the first wave of the pandemic it took anywhere between five and eight days before an infected person went into distress. What we are finding out this time around is that infected persons are going into distress within two to three days. This is radically shortening the time to swing into action, do focussed testing, and take the necessary steps. Also, unlike during the first wave of the pandemic, this time entire families are getting infected.”

The accelerating numbers paint a dismal picture: Andhra Pradesh, which had just 725 active positive cases on March 1, saw the number double in 15 days. By April 1, the number of active cases had crossed 8,000, and by April 15 it had zoomed past 31,500.

Of the State’s 13 districts, nine have seen the infection spread fiercely. The worst-affected districts were Chittoor with 5,123 cases, Guntur (3,393), Visakhapatnam (3,209), Krishna (2,959), and Sri Potti Sriramulu Nellore (2,044).

Making matters worse for the State is the presence of variants of concern of the virus; the ‘double mutant’ variant, B.1.617, has been reported from Tirupati and Vijayawada. Genome sequencing of positive samples conducted by the Hyderabad-based Centre for Cellular and Molecular Biology (CCMB), which is part of the Indian SARS-CoV-2 Genomics Consortium (INSACOG), revealed the presence of the ‘double mutant’ variant. The data on these variants of concern have been submitted to the Global Initiative on Sharing All Influenza Data (GISAID), a non-profit, global science initiative that enables timely sharing of genetic sequencing data related to COVID-19 in a freely accessible database.

Officials from the State’s Health, Medical and Family Welfare (HM&FW) Department told Frontline that a vast majority of the population were not following safety protocols, including the mask mandate. Officials pointed out that even the threat of fines has not improved the situation (the State has been collecting an average of Rs.30 lakh a day from people disobeying the mask mandate).

Muddada Ravi Chandra said that the State had made available 37,000 beds for COVID-19 patients; of these, more than 5,000 were in intensive care units (ICUs), and a further 17,320 beds were equipped with oxygen facilities.

The government has also empowered district collectors to notify and empanel hospitals as COVID-19 hospitals.

Commenting on the government’s decision to recruit 31,000 frontline medical personnel, including doctors and nurses, last year, during the height of the pandemic, Ravi Chandra said that around 10,000 had been recruited on a permanent basis. He added: “The temporary frontline staff were taken on six-month and one-year contracts. We are offering an extension of three months to some of them.”

Vaccines and hiccups

As on April 16, the State had administered 46,01,935 doses of its targeted 1 crore vaccinations. However, its programme to vaccinate around 1.3 lakh people every day has been badly hit by a shortage of vaccine doses. Health officials said that they had been looking to double that number. During a recent review meeting attended by Home Minister Mekathoti Sucharita, Chief Secretary Adityanath Das, DGP Gautam Sawang, and other bureaucrats, Chief Minister Jagan Mohan Reddy reiterated that vaccinations were the only way to prevent the spread of the virus. The government has estimated that there are around 1 crore more people above the age of 45 years who are eligible to be vaccinated.

On April 7, HM&FW Department officials told Frontline that Sri Potti Sriramulu Nellore and West Godavari districts had run out of vaccines. They tided over the problem by procuring supplies from Chennai. On April 8, Andhra Pradesh was forced to procure COVID-19 vaccination doses from Chennai as the consignment promised from the Centre had not yet arrived. Subsequently, it received 6.40 lakh doses in two batches.

Again, on April 16, Anantapur and Srikakulam districts were unable to administer even a single dose owing to a lack of vaccines. The situation was quite bleak in three other districts—Kurnool, Prakasam, and YSR Kadapa, where just 11, 70, and 86 doses were administered, respectively.

HM&FW Department officials said the paucity in the supply of doses from the Centre was seriously hampering the State’s plan to immunise its residents aged 45 and above.

This was at a time when the State was seeing a huge jump in the number of positive cases. On April 16, the State reported 6,096 new cases, raising its cumulative tally to 9,48,231. The active cases breached the 35,000-mark to reach 35,592.

An official said: “Our target is to immunise 1 crore of Andhra Pradesh’s population who are aged 45 years and above before the end of April. As can be seen from the vaccination drive that we conducted on April 14, when we administered 6,25,815 vaccine doses in a single day, we are on a fast mode. But the Government of India has to make available the vaccine doses. Our secretariat system consisting of Asha [Accredited Social Health Activist] workers, ANM [auxiliary nurse midwife] staff, and village volunteers are all geared up to achieve the target.”

Explaining the secretariat process, the official said that every village in Andhra Pradesh’s 676 mandals had been mapped by ASHA workers, ANM staff, and village volunteers.

The official added: “For every group of 50 families in every village there is one village volunteer. The village volunteer along with ASHA workers and ANM staff have visited every village, identified the targeted population, motivated them, and registered them for the vaccine. Every day we have been choosing two villages from each mandal. The residents of these villages are all called at one particular time for vaccination.”

Jagan Mohan Reddy has written Prime Minister Narendra Modi twice seeking vaccine doses. On April 16 he wrote: “I request you, sir, to instruct the officials concerned of the Health Ministry to supply 60 lakh doses of COVID vaccine to my State.”