COVID-19 update

Haryana: Shifting hotspots

Print edition : September 11, 2020

Accredited Social Health Activists protesting against slashing of their incentives, in Gurugram on August 11. Photo: PTI

The emergence of new COVID hotspots in hitherto unaffected areas in Haryana is attributed to people’s reluctance to report symptoms and seek treatment at public health-care centres.

Haryana was among the few States that enforced COVID lockdown measures strictly. Apparently, it even amounted to the harassment of migrant labourers on way to work and health workers moving from place to place. Inter-State borders too were sealed following a large number of cases being reported in districts that formed part of the National Capital Region (NCR), adjoining Delhi, on the grounds that the movement of people to and from Delhi into these districts caused the spike in cases. For most of April, May and June, Gurugram, Faridabad and Sonipat districts in the NCR, all of which are industrial and employment hubs, accounted for a high concentration of cases. But all these measures do not seem to have had the desired effect. Apart from a sharp rise in the rate of new cases of infections and deaths in these districts, the infection has spread to other districts too.

According to the State COVID-19 bulletin, as on August 18, as many as 557 persons had died (396 males and 161 females) and there were 896 new cases. Of those who died, 397 persons had other illnesses. On August 19, the number of cases went up to 994. As many as 155 patients were on critical care; 136 patients were on oxygen support and 19 were on ventilators.

Haryana was ranked 15 among among 35 States and Union Territories in the number of COVID cases. It had more cases, but fewer deaths, than Punjab, Madhya Pradesh and Jammu and Kashmir. Uttar Pradesh, Delhi and Rajasthan were on fifth, sixth and thirteenth positions respectively among States reporting a large number of cases. So the daily spike of more than 800 cases in mid-August in Haryana is worrisome.

Faridabad, Panipat, Gurugram, Rohtak, Panchkula, Karnal, Rewari, Sonipat and Kurukshetra districts account for 58.7 per cent of the cases now. The doubling time overall has been 30 days. That in itself is not worrying, but the fact that the infection rate is growing at 1.9 per cent every day is a cause for concern.

Spread to newer areas

From the more populated districts in the south of the State the infection has now spread to the less-populated districts in the north and north-west areas. With inter-State borders now open and attendance in government offices going up, the centre of infection has also spread accordingly. Yamunanagar, Panchkula, Panipat and Kurukshetra have recorded the sharpest growth in the number of cases in a month. For instance, on July 19, there were only 148 cases in Yamunanagar. Within a month, this went up to 830. In Panchkula, from 250 confirmed cases on July 19 the number went up to 1,313 in a month’s time. Kurukshetra and Panipat too displayed similar trends.

While almost all districts have reported an increase in the number of cases for most of August, in the districts designated as hotspots in the early phases of the pandemic the numbers seemed to be plateauing. The return of migrant workers is seen as one of the reasons for the spike in the less-populated districts, though to what extent it has contributed is not clear.

Testing in Haryana has also been inadequate compared with neighbouring States. It had done fewer tests than Rajasthan and Delhi, but was on a par with Punjab, Jammu and Kashmir and Telangana.

Victims of apathy

Frontline spoke to rural health workers who said district hospitals were in bad shape and people were averse to getting themselves tested because of the stigma attached to the disease. Sunita Rani, general secretary of the Accredited Social Health Activist (ASHA) union, told Frontline that health workers had been on a strike for one week as their incentives had been slashed. She said many ASHA workers had contracted the virus, but the government paid scant attention to their health or immunity requirements.

She narrated an example of a worker from Kaithal and her daughter who had contracted the virus. Neither of them received treatment at the Post Graduate Institute of Medical Sciences at Chandigarh, she said, but had to seek help from a hospital in Patiala in Punjab after a relative’s recommendation. “The government did not help her. Health workers have been helping each other,” Sunita Rani said.

She said there were four workers in her knowledge who were battling cancer and one who had a brain hemorrhage. The workers did not have health insurance nor was the government providing any help. The health workers were also asked to register themselves under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, which provides vulnerable sections cashless cover of up to Rs.5 lakh per family per year. “One worker who had registered under the scheme took her son to an empanelled hospital where the hospital administration said they would cover only Rs.20,000 of the costs. She had to shell out Rs.2.5 lakh from her pocket for the medical expenses,” she said.

Besides, the health workers routinely faced harassment when they went to collect samples for testing. “People are afraid to get tested as they do not trust government facilities. There are a large number of people who are definitely infected but are not seeking treatment,” Sunita Rani said. There were no proper facilities in district hospitals, including ventilators, medicines or medical staff, she said.

The problem was compounded for pregnant women who were unable to get regular check-ups as government hospitals had been converted into COVID centres. They had to get their ultrasound scans done from private facilities.

Just as in most of India, health care in Haryana is dominated by the private sector. Yet most of the critical cases are being treated in government medical facilities located in urban centres. The state of primary and secondary health care centres and that of district hospitals has not inspired confidence among people to report symptoms and seek treatment. With a high daily average of COVID cases, Haryana cannot afford to remain complacent, especially with the development of new hotspots.