COVID second wave: Odisha thinks ahead

As the number of fresh daily cases starts climbing in Odisha, the State government swings into action by announcing a slew of measures to combat the pandemic.

A view of the deserted Jagannath Temple in Puri on April 24. The temple will remain closed until May 15.

Even as most parts of the country continue to live in fear in the wake of the deadly second wave of COVID-19, there is a sense of relief in Odisha that the situation had not worsened However, people are worried about the immediate future since the number of fresh cases in Odisha is rising fast.

What reportedly delayed the second wave in Odisha was the lack of any large religious congregation in the State in recent months or major election, barring a by-election in the Pipili Assembly constituency. The by-election, however, was countermanded after Ajit Mangaraj, the Congress candidate, died of COVID-19. The by-election, which was scheduled to be held on April 17, was rescheduled for May 16.

The number of fresh daily cases reported during the first wave remained below 100 for several weeks in Odisha until mid-March this year. The number crossed the 100-mark on March 19 and fresh cases have been steeply rising ever since, with the possibility of a grave situation developing by the end of April.

The number of people testing positive jumped from 6,073 on April 27 to 8,386 on April 28. Khordha district was the worst-affected with 1,840 cases, followed by the western districts of Sundargarh and Jharsuguda with 933 and 433 cases.,The capital city of Bhubaneswar is located in Khordha district and it has been witnessing a steep rise in cases since it is the gateway to the State.

The total number of cases reported since last year stood at 4,35,513 on April 29. While 3,75,721 patients had recovered, the number of active cases stood at 57,710 and 2,029 had succumbed to COVID-19.

Western belt worst-hit

More cases were reported from the State’s western belt when the second wave hit the region in the second half of March as a result of its proximity to Chhattisgarh, which witnessed a rise in the number of cases in the aftermath of a major cricket tournament at the capital city Raipur.

The situation in many parts of western Odisha was worse in comparison with Bhubaneswar since the former lacked adequate health infrastructure. Reports from the western region indicated that several COVID-19 deaths were not being counted as such in official records. Low level of testing in the interior pockets also gave the impression of the number of fresh cases being low.

Barring the twin cities of Bhubaneswar and Cuttack, the situation was not alarming in several coastal districts until the last week of April. But things may turn worse in the northern and coastal districts in the near future with many Odia people returning from neighbouring West Bengal, which had started witnessing a sudden spike in the number of COVID-19 cases of late.

High vaccination target

The Naveen Patnaik government, which was largely successful in handling the first wave, is trying its best to fight the second wave. Apart from reopening dedicated COVID-19 hospitals that were set up last year, it has set for itself a target of vaccinating 1.93 crore people in the 18-44 age group. The State has already placed orders for 377 lakh doses of Covishield and 10.34 lakh doses of Covaxin, which will together cost approximately Rs.2,000 crore. Chief Minister Naveen Patnaik, who has been monitoring and reviewing the situation regularly, said: “People will not have to spend a penny for vaccines. This is the responsibility of the State government.”

Naveen Patnaik recently wrote to Prime Minister Narendra Modi asking for COVID-19 vaccines to be made available outside the government supply chain to meet the needs of those who could afford them. He suggested rationalisation of vaccine distribution with a focus on metropolitan cities that contribute to the spread of COVID-19 and cautioned against lockdowns in big cities as that would have a cascading impact on other areas. The Chief Minister has often reiterated that the imposition of lockdown was the last resort as it impacted the economy and the livelihoods of the poor. Odisha was among the few States that had not opted for a lockdown this time round.

With the number of cases shooting up across the State, there are cases of people in many districts requesting respective district administrations to announce lockdowns. In Nuapada district, the administration imposed a lockdown in Nuapada and Khariar towns following public appeal. Traders in Kalahandi district announced that they would not open their shops in a bid to break the chain of infection. In the fourth week of April, a lockdown was in place in nine towns of the district.

Although there is no blanket ban on public entry into temples and other religious places across the State this time, the government has started curbing the entry of devotees in temples where the footfall was very high. The governing body of the 12th-century Jagannath Temple has decided to keep the temple closed for devotees until May 15. Another major temple, the 11th-century Lingaraj Temple, was also closed after several priests tested positive. Subsequently, other temples and religious places also closed their doors to devotees.

Naveen Patnaik made an emotional appeal to the people to adhere to COVID-19 protocol. Stating that the whole country was going through a serious crisis and the health care system in major cities and metros was under intense pressure, he urged everyone to wear masks and maintain social distancing. He said: “If people remain alert, we will fight COVID-19 without resorting to lockdown.” The State is keeping a close watch on the movement of infected persons from neighbouring States. “Every life is precious and we are continuing our efforts to save each life,” Naveen Patnaik said, while urging people to behave in a responsible manner to win the long-drawn–out battle against COVID-19. He added: “We need to be prepared to deal with the worst situations, just as we have done while dealing with natural disasters.”

The Chief Minister directed District Magistrates, Superintendents of Police and COVID-19 observers to assess the situation at the grass-roots level and formulate a plan to fight the pandemic. He also stressed the need for the administration to work in partnership with all non-governmental organisations, trade unions and community-based organisations to face the challenge.

Chief Secretary Suresh Chandra Mohapatra said that senior officials were keeping a close watch on the situation, adding that COVID care centres and hospitals had been operationalised and steps were being taken to increase the bed strength in medical colleges and transform more private hospitals to COVID-19 hospitals. He also said that an online real-time bed management system would be implemented soon to streamline bed availability.

According to P.K. Mohapatra, Additional Chief Secretary (Health), 60 per cent of the total active cases were found in seven out of 30 districts. The government had identified 31,471 beds for COVID-19 patients and the State was also trying to arrange oxygen facilities in 17,495 beds, he said.

Oxygen supply

Odisha has been a saviour for many oxygen-starved States since it is an oxygen-surplus State. Against the current requirement of 40 tonnes a day, it produces around 350 tonnes and maintains a stock of 300 tonnes. It has been supplying 300 tonnes of oxygen to other States every day from Rourkela, Jajpur, Dhenkanal and Angul districts. Eight States have been regularly receiving oxygen from Odisha.

After Naveen Patnaik announced that Odisha would supply oxygen to other States, Y.K. Jethwa, Additional Director General (Law and Order), was appointed as the nodal officer for coordinated action for loading and transportation of medical oxygen to other States in need. A dedicated corridor was set up with round-the-clock monitoring and the police took charge of smooth movement of oxygen tankers. Despite being an oxygen-surplus State, the government has been emphasising judicious use of oxygen in the State where demand was growing fast and has formulated a standard operating procedure (SOP) for the same. According to the SOP, “The majority of COVID-19 patients have mild illness. Out of 100 patients, 80 are treated at home or COVID care centres. Out of the remaining 20, about 17 have moderate disease needing oxygen beds. Only 3 are in ICU and are treated with oxygen therapy by non re-breathing mask (NRBM), non-invasive ventilation (NIV), high flow nasal cannula (HFNC) and invasive ventilation.”

It recommends that the flow of oxygen be adjusted to the lowest possible level to target an oxygen saturation of 92-94 per cent for hospitalised COVID-19 patients. The SOP emphasised monitoring of safety and audit of oxygen stock at regular intervals. Besides, the government has invoked the Essential Services Maintenance Act (ESMA) in the case of oxygen distribution.

To assuage rising anxiety among patients regarding drugs, the government has said that sufficient stocks of remdesivir injection and favipiravir tablets were available in the State. Odisha State Medical Corporation was releasing life-saving drugs as and when required. The Centre allotted 21,000 vials of Remdesivir for Odisha for the April 21-30 period.

The Odisha government is taking proactive measures to defeat the pandemic and is banking on public cooperation to succeed in its mission.