Gujarat: The gloom lifts

The State seems to be in better control of the COVID situation now as aggressive testing and treatment measures start showing results.

A health care worker takes a nasal swab of a resident of a housing society in Ahmedabad for testing for the coronavirus infection, on July 24.

Gujarat seems to have taken control of its management of the COVID-19 pandemic, which until recently appeared uncontainable. The State’s aggressive "testing, tracking and treatment" drive, along with a few other measures, is perhaps paying off. The World Health Organisation (WHO) has appreciated Gujarat’s introduction of innovative methods in tackling the pandemic. Improvements, however, are seen only in Ahmedabad and a few bigger towns. The smaller districts, saddled as they are with inadequate health facilities, are unable to contain the contagion, which reached them late but is now spreading quickly.

In comparison with the massive spikes in Karnataka, Telangana and Uttar Pradesh, Gujarat’s situation does seem better. From being among the five worst affected States, Gujarat has dropped to ninth position in terms of positive cases. On August 5, Gujarat had 64,589 recorded cases, including 2,509 deaths. The doubling rate increased from 30 days at the end of July to 34 days on August 4. High daily spikes are still reported: there were 1,100 cases on July 31. However, State government data show a high patient recovery rate − 73.09 per cent, which is significantly higher than the national average of 65 per cent. But while the recovery rate is high, the case fatality ratio (CFR) is now 3.97 per cent against 3.85 per cent recorded in July. The national CFR hovers around 2.5 per cent, placing India among countries with the lowest death rates. (CFR is the number of people who die for every 100 people who test positive.)

A statement from Chief Minister Vijay Rupani’s office said that the "testing, tracking and treatment" formula, which was introduced in late April, was now showing results. The State had recorded a high death rate in the initial weeks of the pandemic because of inadequate testing. On the advice of visiting heads from the All India Institute of Medical Sciences (AIIMS) and the Indian Council for Medical Research (ICMR), the State ramped up testing in June and July. According to government figures, testing went up to 3,91,114 in July, which is impressive because in April there were only 64,700 diagnoses.

A private manufacturer of the RT-PCR test kit says the demand from the Gujarat government went up substantially around June-end. Additionally, the constant sealing of micro containment zones in Ahmedabad seems to have helped. Recent reports from the State Ministry of Health and Family Welfare and anecdotal evidence at the local level suggest that the State has indeed addressed the situation aggressively. Pressure from the Centre, followed by support in the form of various high-level inspection teams, has certainly helped.

On August 1, the Gujarat government told the media that the WHO had appreciated the State’s management of the pandemic in Ahmedabad and had suggested that the measures taken in the State could serve as a case study for other cities in India and abroad. These measures include the Dhanvantari Rath programme, which involves taking non-COVID treatment to doorsteps in vans in order to prevent unnecessary exposure to hospitals as well as overburdening of hospitals; the 104 fever helpline; the Sanjivani Van, which takes COVID treatment to the homes of those who have tested positive; and active participation of private hospitals in control and treatment of the disease.

However, as a doctor in a government hospital in Ahmedabad pointed out, there is still a long way to go before the situation stabilises. "With the State opening up and people not adhering to social distancing and compulsory mask-wearing rules, we are in danger of seeing another wave soon," the doctor said.

Ahmedabad is considered the State’s COVID epicentre. It recorded an unusually high number of cases from the beginning of the pandemic and remains a critical zone. It has 26,969 positive cases so far, including 1,609 deaths. Surat, another hotspot, reports 13,826 (446 deaths); the industrial town of Vadodara, 4,941 (86 deaths); Saurashtra’s Rajkot, 2,070 (31 deaths); and Bhavnagar, 1,516 (27 deaths). Southern Gujarat’s Baruch, which is near Surat and houses several industrial zones, also saw a spike following the opening of factories: 927 cases, including 11 deaths.

The smaller districts witnessing a late surge are Morbi, Mahisagar, Devbhoomi Dwarka, Botad, Chhota Udaipur, Aravalli and Gir Somnath. Although there are designated COVID hospitals in these districts, a government doctor says infrastructure is inadequate. There are not enough ventilators, for instance. A critical patient would have to be transported to a bigger town, and the consequent delay in treatment might prove risky.

As Gujarat opens up, there are fears of another wave of the contagion. Mahesh Shah, a car dealer, said: "People just do not follow rules. On Rakhshabandan day, the malls were packed with people. No one was observing social distancing norms. Some even had their masks down. It looked like we were back to normal. This is very dangerous."