West Bengal: Of random lockdowns and tall claims

A weak health infrastructure despite the government’s claim to the contrary raises serious concerns about the administration’s ability to deal with the crisis amid a spike in cases.

In Kolkata, a health worker ties a 'rakhi' on the wrist of her coworker on the occasion of Raksha Bhandan on August 3 before collecting swab samples for COVID-19.

With over 2,700 new COVID cases surfacing every day and the daily deathsaveraging 50, the West Bengal government faces uncomfortable questions on its preparedness to deal with the pandemic. Allegations of harassment faced by patients make things worse. The State government claims that the health service it provides is among the best in the country and that there is enough redundancy with over 60 per cent of the beds allocated for COVID-19 patients unoccupied (as of August 4). In a video conference with Prime Minister Narendra Modi on July 27, Chief Minister Mamata Banerjee claimed that only 42 per cent of the State’s 11,250 COVID beds were occupied, showing that the "availability of beds is as yet greater than the demand of the hour". Yet, stories of patients running from pillar to post in search of treatment and trying to get admission in government and private hospitals keep surfacing, suggesting a different reality. Many doctors and virologists are not convinced by the government’s claim of having adequate infrastructure.

There is no sign of the contagion abating. As of August 4, a total of 80,984 people had tested positive, a number that included 22,947 active cases. On August 4 itself, a record of 2,752 new cases were recorded and 54 people died (the highest single-day mortality so far), taking the total number of deaths to 1,839. However, the discharge rate, which had dropped to less than 60 per cent just two weeks earlier, went up to 70.24 per cent on August 4. The State government has also stepped up its testing to over 22,000 samples per day. As of August 4, a total of 9,78,980 samples had been tested, including 22,321 on that day. According to the government’s latest statistics, 8.27 per cent of the total samples tested were positive.

The State now enforces a lockdown for two days every week. After much deliberation and several changes in dates on account of religious festivals, the State finally fixed the dates for the current month − August 5, 8, 20, 21, 27, 28 and 31. However, doctors and experts do not believe this is going to help. According to Archana Majumdar, Senior Chief Medical Officer in eastern and north-eastern India, it is pointless at this stage to enforce 24-hour lockdowns. "If this was done earlier, in May, then it would still have worked, perhaps with a 72-hour lockdown breaking the chain of the virus," she told Frontline .　

Partho Sarothi Ray, eminent virologist and molecular scientist and an Associate Professor at the Indian Institute of Science Education and Research, Kolkata, feels that the decision betrays a "lack of direction". "It seems like this is simply to show that they are doing something, that is all. There is clear community-level spread, and such intermittent lockdowns will really not help in any way," he told Frontline . He reiterated a suggestion that he has been making for a long time that there should be localised testing in order to isolate the source of the outbreak in a region, and antigen-testing should start as soon as possible.

"Antibody testing should also be increased because some sero-survey reports are showing that in certain densely populated areas in Mumbai, the sero-positive level is very high. This can mean that something like herd-immunity may be coming up. This antibody surveillance, if ramped up, can point whether it is actually moving in that direction," said Ray.

Talking of the occupancy rate of COVID beds presented by the State government, Archana Majumdar said: "I don’t think this is an actual fact. If this was the case, then so many cases of death without treatment and people being unable to find beds would not be taking place. Either the State does not have that many beds, or it has them but for some reason patients are not being allowed to use those beds. Whatever may be the reason, the way the number of patients is increasing, we have to increase the beds at any cost." She suggested that the State government should coordinate with the Centre in order to improve infrastructure. "But please do not let people die in the streets," she said.

She disputed Mamata Banerjee’s statement to the Prime Minister that COVID-19 treatment, including ambulance services, was completely free in all government and government-requisitioned hospitals in West Bengal. "The Chief Minister’s statement that everybody is getting free treatment is also not a fact. A patient may get a bed after a period of time, but in the State government-requisitioned private hospitals, unless a waiver is sanctioned from the Swastha Bhavan [headquarters of the Health Department], one has to pay the entire bill charged by the hospital," she said.

There is a persistent complaint about phone helplines provided by the State government – either they keep on ringing or they are continuously engaged. Patients desperate for help are forced to go to private hospitals, which charge exorbitant rates that are beyond the means of low-income groups.

Partho Sarothi Ray pointed out that the lockdown period was when health infrastructure should have been strengthened. But that did not happen. "The medical infrastructure in West Bengal seems to be breaking down. The total number of people requiring medical care is not much, but even that cannot be done because of complete lack of planning. The government websites are showing vacancies in the hospital beds, yet people are not getting admitted…. What the government can do is strengthen the infrastructure in both government and private establishments, but that effort is woefully lacking," he said.　

There is an urgent need for better infrastructure in view of a possible dengue outbreak, which is not uncommon at this time of year. The State government has been increasing its COVID bed capacity to meet the growing demand. At present there are 83 dedicated COVID hospitals, 28 of them government and 55 private. The total number of COVID beds stands at 11,560, of which 38.78 per cent is occupied. The government has set up 582 quarantine centres, in which there are 2,911 people at present. The State has also set up 106 Safe Homes with a total of 6,908 beds. At present there are 1,653 people in them.