Telangana feeling the strain of rising cases, vaccine shortage

Non-availability of doses is hampering the State’s vaccination drive even as the sudden increase in cases, attributed to a new strain of the virus, has led to a big jump in the number of patients needing hospitalisation and intensive care.

Elderly people waiting to receive the Covishield vaccine dose, at a government high school in Hyderabad on April 5.

In Telangana, the second wave of the COVID-19 infection hit home on April 15 when the State-run Gandhi Hospital in Hyderabad reported that all its 350 intensive care unit (ICU) beds were occupied. The State also saw a 71 per cent jump in the number of people hospitalised in the first two weeks of April, from 2,420 on April 1 to 8,567 on April 14.

Further confirmation of the second wave of COVID-19 came from Dr G. Srinivasa Rao, Director of Public Health and Family Welfare, who said: “From now on, wear a mask even at home; if you return home from outside and remove your mask, there is a possibility of infecting your family members. (The) situation (is) severe. The present strain of the virus is spreading at a very high pace.”

Confirming that the State had been hit by a new and more powerful strain of the novel coronavirus, which was spreading rapidly across the State, Dr Srinivasa Rao warned that the situation would worsen quickly if people did not follow restrictions and precautions. He said: “For the past four weeks, COVID-19 cases have been increasing rapidly. The situation will be the same for the next 4-6 weeks. If the situation continues like this, Telangana will also turn into a Maharashtra. Already some people are struggling to find beds. If this rate of infection continues, even if the government makes necessary arrangements there is a possibility of bed shortage.” The State has been clocking an average of about 3,000 fresh cases every day since April 11.

According to well-informed sources, the number of daily infections far exceeds the numbers being officially declared. 

Variants of concern

The surge of cases in Telangana also includes variants of concern of the coronavirus. Genome sequencing of COVID-19 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 South African variant, B.1.351, in two samples. Both samples had been collected from the capital city, Hyderabad.

The capital city also reported the presence of another variant of concern: a study conducted by a private diagnostics laboratory in Hyderabad indicated the presence of the United Kingdom variant, B.1.1.7.

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.

As of the morning of April 15, the number of active COVID-19 cases in the State stood at 25,459. The total number of cases in the State was 3,38,045, with 1,780 fatalities. As of April 15, the State had administered 1,12,53,374 tests. Its 9,082 confirmed cases per million still compares favourably with the national average of 10,556.8.

The Greater Hyderabad Municipal Corporation continued to record the highest number of cases, at 361—with the highest numbers coming in from the old city—followed by Medchal-Malkajgiri and Ranga Reddy districts at 245 and 206 cases, respectively.

Non-availability of vaccine

Even as the number of cases shoots up, the State has not been able to ramp up its vaccination programme because of the non-availability of doses. On April 10, Telangana requested the Centre to release at least 30 lakh doses of vaccine over a 15-day period. The State said that it was administering an average of 1.15 lakh vaccine doses every day and wanted more as it planned to administer over 2 lakh doses a day.

However, the Centre released only 4.60 lakh doses—2 lakh doses of Covaxin and 2.60 lakh doses of Covishield. As of April 15, Telangana had administered 25,16,939 vaccinations. Of this, 21,86,269 persons received the first dose, while 3,30,670 had had two shots of the vaccine.

The government’s initial response to the first wave was ham-handed, with abysmally low testing and inaccurate reporting of figures. Its response to the second wave appears to be no better. The Telangana High Court, which had passed serious strictures on the government’s poor efforts to tackle the pandemic, once again took a dim view of the State’s response on April 8.

Voicing its displeasure over the government’s poor record in conducting reverse transcription polymerase chain reaction, or RT-PCR, tests, the court reiterated its directions to officials from the Health, Medical and Family Welfare (HMFW) department to ensure that such tests accounted for 70 per cent of all tests, as per guidelines issued by the Union government, rather than the less accurate rapid antigen test.

Instructing the government to conduct tests on all those entering Telangana from other States, the High Court suggested that only those who had undergone an RT-PCR test should be allowed into the State. The court even expressed concern over crowds at liquor shops, bars, pubs and cinema theatres, stating that liquor shops had turned into potential sources for the spread of the virus.

Despite the rapidly rising number of positive cases and the prevailing gloom, Etela Rajender, Minister for Medical, Health and Family Welfare, stated that the government and the people “were better prepared, braver, and not as frightened as they had been last time around”.

Speaking to Frontline , he said: “The government is trying its best. The problem is that this time, 95 per cent of the cases are asymptomatic. So, this gives us very little time to react, to test, trace and isolate. But we are better prepared, be it by way of oxygen, or drugs like Remdesivir, or even hospital beds.”

Reacting to reports that very few beds were available in the select super-specialty hospitals in the State, Etela Rajender said that the shortage persisted only in the corporate hospitals “where asymptomatic patients were occupying beds”. He said: “There are 14,000 beds in government and private hospitals, and all these beds will be utilised. There is no shortage in smaller hospitals in the districts. And since we are now aware of the line of treatment that is needed, we have given permission to doctors and hospitals from non-COVID-19 empanelled centres to treat patients, provided they follow COVID-19 treatment protocols.”

Commenting on the public’s refusal to wear masks, he said: “What can the government do if, at the individual level, the effort to prevent the virus is so poor?”

The sharp rise in cases and the resultant hospitalisation of many patients has resulted in a spike in demand for Remdesivir, causing a shortage across major hospitals. Patients complained that they were being forced to procure the drug on their own, paying an additional Rs.1,000-2,000 more for each vial of the drug, which normally costs Rs.4,500-5,000, depending on the brand. On an average, a patient needs about six to 12 vials.