COVER STORY: COVID-19

COVID: Swift spread of Omicron variant across States in third wave

Print edition : February 11, 2022

A ward in the jumbo COVID Care Centre at Vashi in Navi Mumbai on January 11. Photo: KUNAL PATIL/PTI

Kerala Health Minister Veena George during a COVID-19 vaccination drive at Manacaud Vocational Higher Secondary School, in Thiruvananthapuram on January 19. Photo: S. MAHINSHA

A COVID victim’s body being wheeled out of a government-run COVID hospital in Kolkata on January 18. Photo: Swapan Mahapatra/PTI

The Tamil Nadu police distributing masks and hand sanitisers as part of an awareness drive in Ramanathapuram on January 12. Photo: L. Balachandar

At the launch of a walk-in/drive-through COVID-19 testing centre in Bengaluru on January 19. Photo: SHAILENDRA BHOJAK/PTI

Health workers distributing home isolation kits during a door-to-door survey to identify people with COVID symptoms in a slum area in Hyderabad on January 21. Photo: NOAH SEELAM/AFP

The surge in test positivity rate across the country in early January signals the arrival of the third wave of the SARS-CoV-2 virus, helmed this time by the Omicron variant marked by high transmissibility and low intensity in the double vaccinated population and a lower death rate. Reports from some of the States.

AHARASHTRA

Revelry and rise

NEW year’s eve 2021-22. The location: the trendy restaurants in the erstwhile mill compounds in Mumbai’s lower Parel. When would-be revellers call to make bookings, they are given the official line: “Yes, we are open, but only every alternate table will be booked. Guests will have to be masked. There is no live band and the dance floor is closed.”

Desperate for entertainment and convinced they deserved a celebratory new year, the guests were delighted to learn that the guidelines on the phone were a necessary facade. Parties were in full swing with live bands, dance floors were packed, tables crammed together and not a mask in sight. A partygoer who was at one of the restaurants said that at one point the management announced on the microphone that everyone should put on their masks immediately because the police had arrived. The law had indeed arrived, but the party rooms were not checked. After a brief conversation with the management, they moved on to the next establishment, allowing the celebrations to go on until the early hours of January 1. It was a common scene all over Mumbai. Despite restrictions that prohibited the assembly of five or more people and allowed gatherings in closed places with only up to 50 per cent capacity, the city heralded the new year as it had in pre-pandemic times.

By the end of the first week of the new year, it was clear that the city was paying for its celebrations. On January 7, Mumbai reported 20,971 positive cases, its highest one-day spike, and a 28.9 per cent test positivity rate (TPR). This far surpassed the high of the second wave in April last year, which was 11,573 with a TPR of 23 per cent.

When the number of cases started rising, the Brihanmumbai Municipal Corporation (BMC) pronounced the spread as the third wave. On January18, BMC Commissioner Iqbal Chahal announced that Mumbai had crested the peak of the wave. He substantiated this by saying the daily caseload had been falling consistently and was expected to fall further. According to the BMC, the third wave peaked around January 10. After that, there was a continuous drop in the number of cases. On January 15, it was 10,661; the next day it was 7,895, followed by 5,956 and 6,149 on January 17 and January 18 respectively. The TPR fell in the same period from 29.9 per cent to 12.9 per cent. (Maharashtra recorded 74.2 lakh positive cases and 1,42,023 deaths between December 4, 2021, and January 21. There were 48,270 new cases in the 24-hour period on January 21 and 52 deaths. The figures for Mumbai for the same time period were 10,27,000 positive cases and 16,512 deaths, and in the 24-hour period on January 21, there were 5,008 cases and 12 deaths.)

There was scepticism about the Municipal Commissioner’s claim. Critics questioned whether the drop in numbers could be because of a fall in testing or because of asymptomatic cases or because people testing at home were not reporting positive cases. The frequency of testing dropped from 72,442 samples collected on January 7 to 47,700 on January 18. This apparently was a reflection of the number of people coming forward for tests, which gives rise to the fear that people are possibly avoiding testing because they do not want to come under the BMC’s radar.

If a test is positive, it is mandatory for the laboratory to first report it to the BMC. Then, the BMC informs the patient. One of the first questions asked is whether the patient has access to a separate bathroom. In Namrata Kasbale’s case, the answer was no. The newly married 31-year-old lives in a chawl that has a common bathroom. Even though she had mild symptoms and could have stayed home, she had to go to a place called Kanjivaram hall in south Mumbai, one of the lesser-known COVID care centres with none of the hygienic facilities and cubicles with well-spaced beds and nightstands that have become a part of the BMC’s photo publicity arsenal. She said she was horrified that she would have to spend the next seven days there. It was a woman’s centre and the beds were placed closed to each other with no cubicles or curtains. There was no water in either the bathing room or the lavatory. After one night there, Namrata Kasbale shot a video of the deplorable conditions, called the BMC control room and threatened to post the video on social media if she was not given a single room. Her demand was promptly fulfilled and she spent the rest of her stay in a single room.

BMC’s COVID centres

The BMC has revived its COVID care centres equipping them to handle 40,000 to 50,000 cases a day. But it reiterates that the worst is over and the situation will improve if basic protocols are followed. The BMC, confident that the number would drop to less than 2,000 a day, recommended the reopening of schools on January 24. Although offline classes will resume, it is not mandatory for parents to send their children to school. A decision on reopening colleges is expected soon. Schools in the State had reopened on December 15, 2021, and were set to continue after the Christmas vacation, but the rise in COVID cases resulted in a return to online teaching. There are, of course, fears of increased infections if schools reopen since those below 18 years are not vaccinated yet. During the second wave, a number of schoolchildren got infected. Between March and December 2020, 67,110 children in the 1 to 10 age group got infected. In the second wave, from January to August 2021, the number of children affected in this age group was 1,36,975. Fatalities remained low in both instances, at 0.16 per cent.

Mumbai started vaccinating those in the 15 to 18 age group on January 3, but the BMC’s data show that the process is slow with approximately 12 per cent (1.08 lakh) of the eligible population (9 lakh) getting their shots until January 13. This will set back the BMC’s target of completing the vaccinations by February.

The Union Health Ministry has chosen to focus on the decrease in testing and has hauled up several States, including Maharashtra, because of the drop in the number of tests carried out.

Also read: Understanding the third wave of the COVID-19 pandemic in India

On January 13, Chief Minister Uddhav Thackeray skipped the online meeting of Chief Ministers with Prime Minister Narendra Modi citing health reasons. This fuelled rumours of yet another battle between the State and the Centre. But apparently the reason was more straightforward than that. The Chief Minister had recently undergone a cervical procedure, and had been advised against being seated for long. Public Health Minister Rajesh Tope, who represented the State at the meeting, told the media: “We demanded 40 lakh doses of Covaxin and 50 lakh doses of Covishield. Covaxin is required for vaccinating the 15-18 age group and Covishield for people over 60 years of age and for our front line workers.”

Tope said Maharashtra had written to the Centre asking it to create a strategy to deal with vaccine hesitancy. The use of home kits and rapid antigen tests (RATs) has been a matter of concern. The Minister acknowledged that these tests aided the under-reporting of those who test positive. “Many people are using home kits and RATs to get tested … but the positive cases are not being reported…. The State has instructed pharma companies and shops to keep records of those purchasing such kits so that they can be tracked.” He informed the Centre that the Delta variant was still strong in Maharashtra. “Four thousand samples went for genome sequencing in our State, and of these we found 1,300 samples were infected with Omicron and 2,700 with Delta. This means that Delta is still dominant in Maharashtra,” he cautioned.

While the party politics behind the Centre needling Maharashtra is something the State has had to contend with since the start of the pandemic, it is undeniable that there have been lapses. In December, when there was a surge in cases, the State Public Health Department slacked off in conducting tests. Between December 26 and 28, when there was a surge that surpassed that of October’s, the number of tests fell to the lowest recorded for the months. Thus, up to December 28, statistics show that an average of 1,11,932 tests had been conducted in the State. But between December 26 and 28, this dropped to 97,414 tests. Active cases in the State soared from 7,391 to 11,492 from December 1 to 28, but the administration’s response was a mere 1.9 per cent increase in testing. This inverse proportion is puzzling for an administration that has largely been on the ball in its handling of the pandemic. It is also at odds with the cardinal mantra of “Test Treat Vaccinate” that guided the State through its worst days.

In January, Sneha Marjadi, a lawyer, filed a public interest litigation petition in the Bombay High Court alleging improper management of the pandemic in the State. On January 19, the BMC assured the court that there had been a gradual decline in cases under its jurisdiction, saying “the situation is under control” and “there is no reason to panic”. The corporation’s advocate told the court: “[O]n January 15, out of a total of 84,352 active cases, only 7 per cent were admitted to hospitals, 3 per cent were on oxygen beds, 1 per cent were in the ICU and 0.7 per cent were on ventilators.” He reassured the court that though there had been around 20,000 daily cases between January 6 and 9, the numbers had been steadily declining. As of January 18, the numbers had already fallen to 7,000 a day.

Updating the media about the BMC’s Omicron preparedness, Iqbal Chahal said there were nine active jumbo COVID care centres with a total of 35,000 beds. The BMC has also floated a tender for oxygen supply and medicines. Two oxygen bottling plants were inaugurated in Mumbai on January 17.

Rest of Maharashtra

While Mumbai is being well monitored, there are concerns about the rest of Maharashtra. Daily high recordings of cases are being reported from the districts of Pune, Nasik, Aurangabad, Nagpur, Satara and Sangli. Officials say it is a classic case of the surge starting in heavily populated cities and then gradually fanning out to the rural areas as restrictions are relaxed.

Maharashtra detected its first patient with the variant B.1.1.529, commonly known as Omicron, on December 4. While Omicron transmits faster, it was soon realised that the variant had a rapid incubation period (that is, a small period between exposure to the virus and developing symptoms of infection). The administration reported 2,445 cases on December 29 and 3,555 on December 30. Eighty per cent of Omicron patients had had both doses of the vaccine.

 

ERALA

A strained system

Kerala recorded its highest ever single-day increase in coronavirus cases on January 20, with 46,387 people testing positive that day, surpassing the 43,529 cases reported on May 12 last year.

A total of 54,64,457 cases have been confirmed in the State. There were 1,683,84 active cases on January 20. The seven-day average TPR, which was 6.4 on January 8, rose to 29.55 on January 19. The TPR on January 20 was 40.21, the highest in the country.

Health Minister Veena George said Kerala was witnessing the third wave of COVID-19, which was more severe than the previous ones, and that the Delta and Omicron variants were contributing to the new spread. Unlike the first and second waves, a rapid spread of the infection has been in evidence from the beginning of the third wave. The Minister said cases were likely to peak in the following days and that the ensuing three weeks would be critical for the State.

The spike in cases and the worsening transmission pattern noticed since the Christmas-New Year holiday season has been continuing in Kerala. The strong and effective public health measures Kerala had adopted during the first and second stages of the pandemic to “flatten the curve” and effect a slow peak in the number of cases were no longer in practice. Moreover, people have been generally lax in following COVID-appropriate norms.

The number of active COVID-19 cases in the State, which was fewer than 20,000 at the start of the year, rose to 1,99,041 (3.08 per cent) by January 20. Of the 46,387 people who tested positive on January 20, 43,176 got the infection through contacts and only 172 people had travelled to the State from other places.

Thiruvananthapuram, Ernakulam and Kozhikode, the districts with the three major cities of the State, were the worst affected, with a daily increase of 9,720, 9,605 and 4,016 cases respectively. In Thiruvananthapuram, there were 55 active clusters in the first two weeks of January, over 60 per cent of them in educational institutions. On January 20, 9,720 people tested positive, 48,712 patients were under treatment and the TPR rose to 46.68 per cent in the district. In two rural panchayats in the districts, the daily TPR was above 75 per cent.

Health care workers infected

Shortage of staff on COVID-19-related work has affected the functioning of hospitals, educational institutions, hostels, police stations and government offices in the State. The Omicron/Delta surge has exacerbated shortages in hospitals in the badly affected districts, with 385 health workers testing positive on January 20.

At a press conference in Thiruvananthapuram, Veena George said 1,508 health care workers, including doctors, were infected in the third wave. All health care workers have been asked to take the booster doses immediately. People have been requested to avoid hospital visits for routine check-ups and mild illnesses. She said the Health Department had launched several precautionary steps and that special wards, oxygen beds and ICUs had been kept ready in all major hospitals. There are 3,107 ICUs in the government sector and 7,468 in the private sector. In addition to this, 2,293 ventilators have been kept ready in the government sector and 2,432 in the private sector, she said.

COVID-19 clusters have been reported in private and government hospitals and many government offices in the State, including the State Secretariat, where the functioning of the offices of several Ministers were affected. State Education Minister V. Sivankutty tested positive.

After some hesitation, the government decided not to close schools entirely but conduct regular classes for standards 10, 11 and 12, and online classes for standards 1 to 9 for two weeks from January 21.

An online pandemic review meeting chaired by Chief Minister Pinarayi Vijayan (who is in the United States for treatment) on January 20 decided to go slow on imposing severe restrictions and impose lockdown-like curbs on Sundays (January 23 and 30) for the next two weeks, allowing only essential services to operate on these days throughout the State. The government has announced a list of essential activities and services permitted on Sundays.

Also read: Omicron spread: Down but not out

Shopping malls and tourist places, such as beaches, would be allowed to function but their operations would be monitored closely to prevent overcrowding and to ensure that COVID-19 protocols were followed. The government has decided to allow mothers, with children below two years of age, employed in government and private sectors, cancer patients, and persons suffering from other severe diseases to work from home.

Kerala has also decided to give up the practice of using TPR figures as the yardstick to decide the restrictions needed in districts/specific areas. It would instead use the number of hospital/ICU admissions in each district to decide the kind of restrictions that would be required there.

The districts are to be categorised as A, B and C on the basis of the number of hospital and ICU admissions there as per benchmark set. For instance, in A-category districts, a maximum of 50 people can participate in social, cultural, religious-communal, political, public events, weddings, and funeral ceremonies. No social, cultural, religious, communal, political, or public programmes will be allowed in Category B districts. In B districts, religious ceremonies should be conducted online and only a maximum of 20 persons will be allowed at weddings and funeral ceremonies. And in districts under C category, in addition to all the restrictions imposed in B category districts, there will be curbs on the functioning of cinema theatres, swimming pools and gyms and on the conduct of regular classes in most educational institutions.

No district has been included in the C category as of now. According to a government announcement, Thiruvananthapuram, Palakkad, Idukki, Pathanamthitta, and Wayanad districts are in the B category and Ernakulam, Alappuzha and Kollam are in the A category.

According to State Health Department data, from January 13 to January 19, the average active cases in the State were 1,09,745 of which an average of around 0.7 per cent needed admission in beds with oxygen support and 0.6 per cent in ICUs. During this period, there were around 1,01,578 new cases. The new cases increased by 204 per cent during the week compared to the previous week; the number of active patients increased by 201 per cent; the number of those admitted in hospitals by 70 per cent, in field hospitals by 126 per cent, in ICUs by 48 per cent; and those in beds with ventilator and oxygen support by 14 per cent and 64 per cent respectively.

However, officials say it is a big relief that of the 1,99,041 cases of infection only around 3 per cent of the active cases are admitted in hospital/field hospitals.

Kerala’s COVID-19 death toll crossed 50,000 in early January, and in about 20 days, 1,501 more deaths were recorded officially, including 309 deaths recorded as per the Supreme Court’s guidelines. On January 19, hearing a group of petitions, the Supreme Court rapped Kerala and some other States for the low number of claims received for ex-gratia payment for death due to COVID and the high number of rejection of applications. The court said that while Kerala had over 49,300 recorded deaths caused by COVID, only 27,274 claims had been registered. It directed the State government to issue necessary directions to its officials to reach out to the next of kin of those who died of COVID and ensure that they were paid compensation.

Kerala is one of the States with the highest percentage of COVID-19 vaccination in India with 99.9 per cent of its eligible population already vaccinated with a single dose (2,66,89,763) and 83 per cent with the second dose (2,21,29,768) until January 20. Sixty per cent of the population in the 15-17 age group has been administered a single dose. More than 97 per cent of people aged above 45 have got a single dose and 84 per cent have received the second dose. But with the number of positive cases rising at an alarming rate, there is a growing concern over the declining rate of vaccine protection, especially among sections of the population that were vaccinated in the initial phases, and the likely burden on the health care system.

WEST BENGAL

Rising confusion

B

WEST BENGAL emerged as one of the worst affected States as the third wave of COVID-19 spread across the country. With the TPR rising to 30 per cent in the State and 50 per cent in Kolkata, the situation appeared to spiral out of control. Lack of foresight on the part of the State government and irresponsible behaviour of the public exacerbated an already grim situation.

As of January 20, the number of new cases stood at 10,959—a sharp decline from 23,469 just seven days earlier; but the daily death count showed no sign of coming down. According to sources in the health sector, most of the ICU beds in the COVID wards of hospitals were full. On January 20, 37 people died, against 26 people seven days earlier. In fact, even when daily cases were increasing at an alarming rate, the number of deaths had remained under 20. On January 9, when Bengal recorded its highest ever single-day spike with 24,287 people testing positive, the number of deaths was 18. The daily deaths started increasing steadily from January 12, with 23 deaths recorded on that day. The numbers have remained over 30 since January 15, when 39 deaths were registered. As of January 20, the total number of COVID deaths in Bengal stood at 20,267.

According to Dr Punyabrata Gun, convener of the Joint Platform of Doctors, most of the deaths are caused by comorbidities. “People are not getting themselves tested. If they did, then the number of cases would be much higher. Almost all the patients who have died had comorbidities. This particular COVID variant is quite mild and those without comorbidities are recovering,” Dr Gun told Frontline. The spike in the number of daily deaths could be a reflection of the surge in COVID cases a week earlier.

According to official figures, the number of cases has been on the decline in Bengal since January 16, when for the first time in 11 days the State recorded fewer than 15,000 cases in a single day (14,938). However, according to data released by the Union Health Ministry, the positivity rates in the period between January 5 and January 12 in West Bengal and Kolkata were the highest in the country. At that time the State’s positivity rate stood at 32.18 per cent, followed by Delhi’s 23.1 per cent and Maharashtra’s 22.39 per cent. With 1,02,236 active cases, Bengal was second only to Maharashtra, which had 2,25,199 active cases. The situation in Kolkata looked particularly grim that week with the positivity rate at 60.29 per cent—the highest in the country followed by Thane (31.54 per cent) Mumbai (26.95 per cent), Pune (23.44 per cent), Chennai (23.32 per cent) and Delhi (23.1 per cent).

Lack of foresight

Doctors in the State feel that the massive surge in cases could have been checked had the government taken certain pre-emptive measures. The first few Omicron cases were recorded in the State around the middle of December. The State government, instead of exercising greater caution, decided to lift the night-time curfew in the last week of December for Christmas and New Year celebrations. The unrestrained merriment that followed, with huge crowds gathering in the streets without masks and in flagrant disregard for social distancing and other COVID protocols led to a steep spike in cases. On December 24, the day the night-time curfew was lifted, the total number of new cases was 550, with five deaths on that day. By the time the night curfew was reimposed on January 3, the daily spike had gone up to 6,078; the number of deaths on that day was 13.

Also read: Calcutta High Court allows Gangasagar Mela, doctors fear COVID crisis will worsen in Bengal and across States

Although cases continued to rise, Chief Minister Mamata Banerjee made it clear that the State would go ahead with the Ganga Sagar Mela between January 8 and January 16, and that too without any restriction on the number of people going there. Lakhs of pilgrims visit the Ganga Sagar Mela in South 24 Parganas district every year, and this year was no exception. The Kolkata Municipal Corporation (KMC) election took place on December 19, with all its related political activities and election campaigns.

Doctors' warning

In a strong warning to the government, the Joint Platform of Doctors of West Bengal wrote to Mamata Banerjee ahead of the Ganga Sagar Mela, urging her to stop the religious festival. The letter pointed out how doctors’ warnings had been ignored during the KMC election. All political parties had campaigned without any regard for COVID protocol. The doctors’ letter also mentioned how the government itself had encouraged people to celebrate in the streets for Christmas and New Year. “In this scenario, one does not need experts to realise that if the Ganga Sagar Mela takes place, the situation will become terrible…. We know from past experience how such events lead to the spread of the infection. If this Mela is supported at the government level, then this government alone will have to bear the blame and shame for spreading the infection across the country,” the letter stated.

A public interest litigation seeking the cancellation of the Ganga Sagar Mela was also filed in the Calcutta High Court by a certain Dr Avinandan Mondal. However, the doctors’ pleas fell on deaf ears. As the number of cases began to rise exponentially, another crisis loomed over the State health infrastructure, with more and more doctors and health care workers testing positive.

The situation prompted the Calcutta High Court to suggest deferring elections to the Bidhannagar, Siliguri, Asansol and Chandannagar Municipal Corporations, which were scheduled to be held on January 22. On January 14, a High Court Bench comprising Chief Justice Prakash Shrivastava and Justice Ajoy Kumar Mukherjee directed the West Bengal State Election Commission (WBSEC) “to consider the galloping speed with which the COVID cases are increasing and also to take into account the issue of holding of elections in such a situation will be in the public interest and if free and fair elections will be possible on the dates notified, and take a decision in respect of the postponement of date of elections of aforesaid four Municipal Corporations for a short period of 4 to 6 weeks”. On January 15, the WBSEC deferred the elections by three weeks.

Interestingly, differences emerged within the ruling Trinamool Congress over the handling of the third wave. At a time when Mamata Banerjee allowed the Ganga Sagar Mela to take place and maintained a silence over the opposition's demand for postponing the civic election (this was before the Calcutta High Court's intervention), her nephew and party all-India general secretary Abhishek Banerjee publicly stated that it was his personal opinion that all religious and political activities should be put on hold for the time being. This led to a war of words between different party factions. In what is being perceived as further cause for embarrassment for the State government, Abhishek Banerjee, who is also the Lok Sabha MP from Diamond Harbour, promoted his own model of containing the COVID situation in his constituency, which was dubbed the “Diamond Harbour Model”. Abhishek personally oversaw that testing and vaccination was stepped up in his constituency— which many felt highlighted the lack of testing in the rest of Bengal. His detractors within the party, including Serampore Lok Sabha MP Kalyan Banerjee, and the opposition parties were quick raise questions on Abhishek's claims of success.

Kalyan Banerjee pointed out that Abhishek had himself organised a much-publicised football tournament—the Diamond Harbour MP Cup—in the first week of January when cases were on the rise, and the event was attended by thousands of people. Communist Party of India (Marxist) leader Sujan Chakraborty remarked: “If the nephew’s [Abhishek] Diamond Harbour Model is a success, then that implies the aunt’s [Mamata Banerjee] West Bengal model is a failure.” Highlighting his success in Diamond Harbour, Abhishek proclaimed on social media: “We promise to continue our efforts towards BRINGING DOWN THE POSITIVITY RATE further, which is CURRENTLY at 2.16%. We will leave NO STONE UNTURNED in our quest to make Diamond Harbour PC #COVID free. Your well-being will always be our top priority!”

As of January 20, the positivity rate in Bengal stood at 16.27 per cent, though the testing was quite low with only 67,367 tests conducted on that day. Already the State government had announced a number of relaxations—allowing gyms to open and jatras (itinerant acting troops) to operate with 50 per cent capacity in case of an outdoor venue, and in the case of an indoor venue with a maximum of 200 people or 50 per cent capacity, whichever was lower. Marriage-related functions have been allowed with a maximum of 200 people at a time or 50 per cent seating capacity of the venue, whichever is lower; and mela or fairs can be held in open-air venues in a restricted manner, following COVID-appropriate discipline and protocols.

Those in the health sector, however, have warned that even though cases are coming down, there is no scope for complacency yet. A highly placed source in the private health sector told Frontline: “Now the situation is somewhat better, but there is still a misconception that serious COVID cases are not happening. In most of the hospitals the COVID critical care beds are full, and 95 per cent of the occupants have received both the vaccines. Planned surgeries have gone down drastically, and only emergency surgeries are being encouraged. In the case of surgeries, most hospitals are asking for an RTPCR report which will be valid for 24 hours, unlike 72 hours earlier.” He also said, however, that given the present number of cases, the health sector in the State is in a position to tackle the situation.

AMIL NADU

Treading cautiously

THE third COVID wave hit Tamil Nadu in late December 2021, as expected, and continues to infect more people than the first two waves. Hospitalisation and death rates, though, have been much lower than earlier. Doctors who have treated patients in the new wave, and bureaucrats handling policy, say the infections appear to be mild, and that home quarantining (as opposed to hospitalisation), was recommended in a majority of the cases. Dr P. Kughanandam, public health expert who once headed the only Communicable Diseases Hospital in the State, said: “The infected people, if they do not have any comorbidity, will experience body pain, sore throat, fever for a few days, and it will be over. There is no evidence of this virus affecting the lungs. That is the positive thing. People who have severe symptoms and the elderly and those with comorbid conditions are the only ones admitted to hospital.”

Even with this, the daily death toll remains worryingly high. On January 20, for instance, 39 people died of COVID-related complications. Government statistics say that of these, 27 were in the 60-plus age group, and the remaining were over 50. At 19.26 per cent, the TPR remained high in the State (TPR in Chennai was 27.4 per cent).

The real indicator

According to epidemiologists, the TPR is the real indicator of how the disease is progressing in the State, and not the total number of positive cases. This is because testing is done only for those who have symptoms, those who are over 60 years of age, and those suffering from comorbid conditions, especially non-communicable diseases such as diabetes and hypertension. There is no more random or mass testing as was done earlier. The government has also discontinued the practice of sending samples to Pune to test for the Omicron variant (Tamil Nadu does not have the facility to test for this variant) because the process took too long. Usually, by the time the results came in, the patient would have recovered.

As on January 20, eight districts had a TPR of over 20 per cent; seven districts had between 15 per cent and 20 per cent, and 27 districts had a TPR below 10 per cent. Officials point out that the State’s hospitalisation has been low, with not even 20 per cent of ‘oxygen beds’ or ICU beds occupied on January 20.

COVID claimed the lives of 35 people on January 19. The number of deaths in January has been relatively high—over 300 people. Compared with the delta wave, this is not alarming, but officials said they were working on strategies to reduce the number of deaths. Since January 7 (when eight people died of COVID), the State’s daily COVID death numbers have been in double digits: January 18 (29 deaths), January 17 (20), January 16 (22), January 15 (11), January 14 (26), January 13 (25), January 12 (19), January 11 (20), January 10 (11), January 9 (12), and January 8 (10).

Kughanandam, who is on a government advisory committee on COVID, said the government should avoid any more lockdowns. He said: “We have suggested that the government allow the conduct of business as usual. This is a milder form of the virus unlike the Delta variant. But we have to be very careful about the elderly people and those suffering from comorbidity. We will have to certainly continue masking, distancing and washing hands and mouth at least for the next two years. The disease is turning endemic.”

Vaccination drive

According to the State Health Department, as on January 20, as much as 88.6 per cent of the population in Tamil Nadu had received the first dose of vaccination. Only 63.4 per cent had received two doses. Tamil Nadu has also rolled out a ‘precautionary booster dose’ to eligible individuals, and will inoculate about 10 lakh people by the end of January. Besides, the State launched a vaccination drive for adolescents on January 3.

Ma. Subramanian, Health Minister, told the media on January 20 that of the 33.4 lakh people eligible in the 15-18 age group, 25 lakh had been vaccinated. He went on to say that the government was conducting special camps across the State to promote vaccinations. These special camps will be held on Thursdays in 600 locations across Tamil Nadu. Apart from this, now that there is additional vaccine available, he said the State would also organise mass vaccination drives. So far 3.32 crore people have been inoculated in such drives. On January 22, one such mass drive was organised in 50,000 locations.

According to Dr Kughanandam, given the current rate of vaccinations and efforts to control the infection, the wave will subside by the end of January.

The government introduced additional curbs earlier in January. This included lockdown on Sundays, night curfews, a ban on gatherings, closing of beaches and places of worship on days when a large crowd is expected, and hiking the fine for not wearing masks. Schools and other educational institutions have been asked to be shut until the end of January.

On June 21, K. Ponmudi, Higher Education Minister, conceded to a long-standing demand of the student community that examinations be held online. The semester examinations will be held from February 1 to 20. The final-year examinations will be held offline, he said.

‘COVID fatigue’

Many people in and around Chennai expressed their displeasure with the government’s control measures, and have been voicing their opinion on social media about the need to relax them. One major complaint was about schools remaining closed. Many parents are concerned that their children have not been learning much in online classes. A few pointed out that some States such as Maharashtra had already opened schools and demanded that schools in the State also be opened.

A few restaurateurs in the State who spoke to this correspondent complained that they were the worst affected because of the government’s severe restrictions on holidays—days when they earn a considerable sum. Cinemas, too, have been at the receiving end of the new restrictions, and have requested the government to ease the current seating limits.

Officials said they would rather err on the side of caution than regret opening up the entire State without restrictions. They are of the opinion that if data showed that the infection in the State was on the decline, the government would act accordingly.

High, but under control

THERE has been an explosive surge in the number of COVID-19 cases in Karnataka since the beginning of the new year, when the State began to report more than 1,000 cases daily. According to the numbers as on January 19, the State was reporting more than 40,000 cases daily. The daily positivity rate had climbed rapidly in the course of a week and stood at more than 20 per cent, up from around 10 per cent a week ago.

Genome sequencing, which helped identify the COVID variants in the State, showed that 766 persons had been afflicted with the Omicron variant. The only silver lining in this serious situation is that the hospitalisation rate continues to be low, with only 4,795 beds occupied by COVID patients all over the State as on January 19. This includes the general, oxygen and ICU beds across both private and government hospitals. .

Gaurav Gupta, Chief Commissioner of the Bruhat Bengaluru Mahanagara Palike (BBMP), said that among the active cases, only around 1.3 per cent of patients were being admitted to hospitals, with very few needing critical care.

Compared with the seriousness of the situation during the second wave of the pandemic, when there was a shortage of hospital beds and oxygen, these numbers show that the situation is under control in Karnataka.

The case fatality rate (CFR) is also low at 0.04 per cent, meaning that for every 2,500 persons affected in the third wave, one person has died. On January 19, for instance, the State reported the death of 21 persons from COVID. During the peak of the second wave in May last year, when Karnataka had more than 2 lakh active cases, more than 200 persons died on an average every day. Cumulatively, COVID has affected 33,29,199 persons in Karnataka so far since the start of the pandemic; the number of active cases now stands at 2,67,650. More than 38,000 deaths owing to the deadly virus have been recorded so far in Karnataka.

Daily cases

Not surprisingly, Bengaluru leads the tally of COVID cases in the State, reporting around 25,000 new daily cases and having close to 2 lakh active cases. More than 70 per cent of the State’s daily caseload is being reported from Bengaluru. Some of the other districts reporting more than 1,000 daily cases are Bengaluru Rural, Dakshina Kannada, Mandya, Hassan, Mysuru and Tumakuru. The daily positivity rate has shot up for Bengaluru’s neighbouring districts such as Mandya, Kolar and Tumakuru, indicating that their proximity to the capital city is leading to a spillover of cases. Karnataka has been conducting around 2 lakh tests daily to detect COVID among symptomatic patients.

Data from the State’s Health and Family Welfare Department showed that as on January 18, 99.6 per cent of the eligible persons had received the first dose of the COVID vaccine, while 83.3 per cent had received their second dose. Some 62 per cent of teenagers in the 15-17 age group, for whom vaccination commenced on January 3, had received their first dose. Among the 21 lakh people eligible to receive the third (booster) dose, such as health care workers, frontline workers and senior citizens, 3.22 lakh doses had been administered so far.

Health Minister Dr K. Sudhakar said on January 18 that the number of cases would continue to rise and that the daily caseload “could probably touch 80,000 to 1.2 lakh in Karnataka over the next few days”. He added: “COVID is spreading four or five times faster than the rate at which it spread during the second wave, but we are in control of the situation in Karnataka as the symptoms are subsiding in three or four days. As per my discussion with members of the Technical Advisory Committee, the caseload will reduce by the second or third week of February.”

Also read: Omicron cases fuelling the surge in India’s third COVID-19 wave

The State government has implemented night curfew (from 10 p.m. to 5 a.m.) and a weekend curfew along with Section 144 of the Code of Criminal Procedure (which restricts the gathering of more than four people at one location) to prevent the spread of the coronavirus, but politicians of the ruling BJP as well as the opposition Congress have flouted these restrictions.

The Congress began a 10-day, 100-kilometre padayatra on January 9 demanding the implementation of the Mekedatu project across the Cauvery to provide drinking water to districts across southern Karnataka, including Bengaluru. The walkathon was significant for the Congress as this was deemed to be the launch of its election campaign for the Karnataka Legislative Assembly election, slated to be held in mid-2023.

While it was primarily Karnataka Pradesh Congress Committee president D.K. Shivakumar’s show, former Chief Minister Siddaramaiah’s enthusiastic participation in the padayatra was aimed at showing that there was no rift between the two leaders. Both are leading contenders for the Chief Minister’s post if the Congress returns to power.

The danger of mobilising huge crowds to walk along with Congress politicians, as the padayatra passed through areas of the Cauvery belt, became clear when several senior Congress leaders, including Mallikarjun Kharge, Veerappa Moily, H.M. Revanna, Priyank Kharge and C.M. Ibrahim were infected with COVID. Shivakumar himself was widely criticised after he refused to be tested for COVID and insisted that the padayatra would proceed as planned. Even as first information reports were filed against 41 Congress leaders for violation of the COVID protocol, Shivakumar stubbornly insisted that the padayatra would go on. The Karnataka High Court intervened on January 12 when it incredulously questioned the State government on how it was allowing this massive rally during a pandemic. Following this the Congress leadership called off the padayatra at Ramanagaram.

Former Chief Minister H.D. Kumaraswamy, whose Janata Dal (Secular) is the Congress’ main rival in southern Karnataka, blamed the padayatra for the rising COVID cases in the State. He said: “In the name of the padayatra, the Congress organised a fair. It also led the common man to break the rules. This has led to an increase in cases in Ramanagaram and across the State.”

Politicians belonging to the BJP have also been guilty of flouting COVID norms. On January 16, for instance, S.V. Ramachandra, the MLA from Jagalur in Davanagere district, celebrated his birthday in the presence of thousands of people. On the same day, N.R. Ramesh, president of the BJP unit in Bengaluru, also celebrated his birthday publicly and organised a day-long event at his residence in the city.

BJP politicians organised several such events across Karnataka in January. On January 18, Umesh Katti, Minister of Food and Civil Supplies, created a controversy when he refused to wear a mask stating that “it was his personal choice”. Congress leader Shivakumar accused the State government and the administrative machinery of turning a blind eye to such activities since the violators were BJP politicians. He wrote to P. Ravi Kumar, Chief Secretary, urging him to “take strict action against the district authorities and police officials who had not taken action against BJP politicians for violating COVID protocols in place”.

Commercial associations and senior BJP leaders have urged the government to end the night and weekend curfews since the situation was in control in the State as far as the provision of medical care was concerned.

Speaking to mediapersons in Hubballi on January 18, Pralhad Joshi, Union Minister of Parliamentary Affairs and Dharwad MP, said: “In the background of the third COVID wave in Karnataka, there is no need for any lockdown in the State. In fact, the State government must do away with the weekend curfew as well.”

Pratap Simha, the BJP MP from Mysuru, made a similar demand. He said: “People have had a tough time for the past two years and are just getting their lives back on track. A lockdown should not be imposed for any reason.”

H.D. Kumaraswamy too questioned the effectiveness of the curfews considering the exponential rise in the number of cases.

Testing at doorstep

NUMBERS do not lie. While the Telangana Rashtra Samithi (TRS) government of K. Chandrashekar Rao brazenly declared a total of 4,207 deaths due to COVID-19 in Telangana, more than 29,000 claims were received for the Supreme Court-monitored compensation package announced by the Centre. On January 20, the State recorded 4,207 positive cases, its highest single-day spike during the third wave. The previous day’s tally was 3,557 positive cases.

Even if one were to consider the fact that the apex court’s broader and more liberal guidelines—mandating that all fatalities, even those by suicide, recorded within 30 days of a person testing positive for COVID-19 be treated as COVID deaths—are likely to result in more claims than the State government’s official figures, the number of deaths in Telangana is exponentially high, seven times higher than what was declared. This indicates what was always an open secret: that the State government suppressed COVID-19 statistics. Telangana ranks behind Gujarat in the big gap between officially declared fatalities and those claiming compensation.

Telangana was one of the first States to admit the presence of a third wave. The government refused to impose lockdowns and curfews, with the Chief Minister maintaining that such measures only affected livelihoods. The government ramped up its tardy testing protocol after the High Court, on January 17 accused it of disregarding its order on mass testing. It directed the government to conduct one lakh reverse transcription-polymerase chain reaction (RT-PCR) and rapid antigen tests a day. The court also mandated that the government submit a compliance report on or before January 24. The testing has revealed the obvious. At the turn of the year, Telangana officially had just 3,650 COVID cases. That figure swelled to 26,633 by the evening of January 20. The State reported 18 casualties by the week ending January 20, but according to Health, Medical and Family Welfare Department officials the deaths were related to age, failure to get vaccinated, comorbidities or delay in seeking medical help. With cases rising sharply, government employees’ unions have requested the government to allow 50 per cent of the staff to work from home. Aranya Bhavan, the Forest Department’s headquarters, and several district collectorates are not allowing visitors. Health Department officials, however, told Frontline that the State’s overall recovery rate stood at 96.29 per cent, and the situation was well under control. Health Minister T. Harish Rao expressed confidence that “the government was fully geared to control the third wave”.

Dr M. Raja Rao, Superintendent of the State-run Gandhi Hospital, which was declared a COVID care centre during the first and second waves, told Frontline that around 140 patients were admitted to the hospital every day with a vast majority of them being pregnant women, children and those with comorbidities. He said: “The situation is not alarming. We are seeing around 140 patients being admitted, but an equal number [treated patients] are being discharged. We are also witnessing one or two deaths a day. Most of the patients come with a severe condition.” Raja Rao said that the Omicron variant was the dominant virus circulating now and that the infection was not severe. But maximum precautions would still have to be taken as the Delta variant continued to be active in several pockets. With the State having discontinued genome sequencing of COVID positive samples, doctors are unable to ascertain whether the fatalities were caused by the Delta or the Omicron variant.

Stung by criticism over its lackadaisical attitude towards preventing and mitigating the third wave, the reluctance of people to undergo a COVID-19 test despite showing symptoms of the infection and the rise in the number of cases, the government launched a door-to-door fever survey across the State. Said the Health Minister: “Instead of asking people to come to the testing centres, we have decided to take the facility to their doorstep. This will also ensure that there is no scope for spread of the virus because of people lining up for testing at clinics. It is taking health care to the doorsteps of the people.” Those identified with COVID-like symptoms would be provided home isolation kits and told to isolate themselves. According to Harish Rao, the survey is meant to identify possible cases and provide immediate treatment. The survey will also help officials ascertain the intensity of COVID-19 cases and enable them to initiate remedial measures.

According to Harish Rao, teams from the Health Department accompanied by Municipal Administration Department staff in urban areas and panchayati raj staff in rural areas, will visit every home in the State. He said: “The government has kept two crore testing kits and one crore home isolation kits ready. Though there is shortage of kits in the market, the Chief Minister has ensured their availability.” Harish Rao claimed that the testing kits were “positioned at all levels, right from major government hospitals to primary health care centres and ANM (auxiliary nursing midwife)-managed sub-centres at the village level”.

Fever surveys

Harish Rao said the government’s decision to conduct fever surveys “was lauded by the NITI Aayog and the Central government as a model and best practice for other States to adopt”. The government has written to the Centre requesting that the time gap between the administration of the first and second doses be reduced. At least 77 per cent of the State’s population has been administered two doses of the vaccine. The government felt the long gap between the two doses was the reason for the delay in administering of the second dose. Chandrashekar Rao has written to the Centre requesting that the State be allowed to administer the precaution or booster dose to people of all ages.

The Telangana Police, which was affected during the first and second waves with a number of personnel getting infected, has been hit by the third wave, too. The government has sought to classify police personnel as frontline workers and administer the booster dose to them on a priority basis. Senior officials told Frontline that over a thousand police personnel from across the three commissionerates had tested positive for the virus in the ongoing wave. Most of them are under home quarantine. Several police stations in Hyderabad have imposed restrictions on the number of people who can enter the station to lodge complaints.

Officials at the Burgula Rama Krishna Rao Bhavan, the temporary seat of the Telangana Secretariat, said several bureaucrats had developed COVID symptoms after taking part in a meeting called to discuss the allotment and posting of government employees in the Secretariat. Those who tested positive include Public Health Director Dr G. Srinivasa Rao, Health Secretary S.A.M. Rizvi, Education Secretary Sandeep Kumar Sultania, and Finance Secretary Ronald Rose.