13/03/2020 2:37 PM IST | Updated 14/03/2020 9:14 AM IST

Coronavirus In Maharashtra: Govt Fights To Stop COVID-19's Urban To Rural Jump

Maharashtra’s quest to halt COVID-19’s march in urban centres such as Pune and Mumbai mirrors India’s broader strategy against the virus.

NAGPUR, Maharashtra — The group of about 40 people from across Maharashtra had left Mumbai on February 24 as part of an organised family holiday package to Abu Dhabi and Dubai. Upon their return on March 1, members of this group have become the “patient zeros” as the state tries to contain the spread of COVID-19, popularly known as the coronavirus.

At the time of publication, 11 of Maharashtra’s 14 confirmed cases can be traced back to the people who were on board this flight. The first confirmed cases were of a Pune-based family, part of this tour group, who also passed on the virus to their circle of contacts in Pune. Included in this circle is a Mumbai-based taxi driver who ferried the family from Mumbai to Pune and returned with the illness, Maharashtra health officials told HuffPost India.

The repercussions of these positive tests in the megapolises of Pune and Mumbai were felt thousands of kilometres away in Yavatmal, a primarily agrarian district along the state’s eastern border, where at least nine people have been quarantined in a government hospital, HuffPost India has learnt. Some of those quarantined were part of the holiday tour, while others came into contact with them upon their return. HuffPost India is withholding the names of those quarantined, and the tour operator, to protect their privacy.

For state health officials, Yavatmal’s Government Medical College represents a crucial opportunity to contain COVID-19 before the virus spreads into rural Maharashtra’s vast expanse, where both information and proper medical attention are in short supply.  Thus far, at least 75 Indians have tested positive for the virus, while thousands more are either in quarantine or being monitored for symptoms. Across the world, more than 4,500 people have died while over 125,000 have tested positive for the virus (of these, more than 70,000 people have been treated).

Maharashtra’s quest to halt COVID-19’s march in the state’s urban centres mirrors India’s broader strategy of containing the virus to cities where the already-stretched public health system has a fighting chance of spotting potential patients and quickly placing them under quarantine. The efficient public health system of Kerala, which is now actively trying to contain a fresh round of infections, is an outlier compared with the rest of the country where the state-run health system is a shambles and private facilities remain unreliable.

All the positive cases were a result of out-of-country travel or contact with those who traveled out of India,” said Maharashtra chief minister Uddhav Thackeray, explaining that all cases detected thus far can be traced to patients who travelled abroad.

“Rural parts are hardly equipped to deal with this virus,” at least three doctors in Nagpur and Yavatmal have reiterated. 

Hindustan Times via Getty Images
Staff and visitors at Mumbai's Kasturba Hospital, which has been designated as the main isolation facility for COVID-19, on March 11, 2020.

Apart from the 11 confirmed cases connected to the Dubai-Abu Dhabi holiday package, three other patients have tested positive in Thane, Pune and Nagpur respectively. Officials are still working out their infection routes, but two of them had recently returned from the United States and the person from Thane had traveled back from France recently. All these cities, officials grimly noted, are well connected by road, rail and air.

And while the government seems to have done a good job tracking down potential carriers of the virus — the patients currently under observation say they were contacted relatively quickly by health authorities — those under quarantine say medical facilities even in Pune left much to be desired.

“Six of us were kept in one big room. Even those who haven’t contracted this virus will get it if such basic lapses are not corrected in time,” one person under quarantine told HuffPost India. “Such patients should be quarantined in a separate room.” The person and their spouse have both tested negative, they said over the phone.

In the event of an outbreak, it is essential to protect your first line of defence, which is the doctors and nurses.

The first line of defence

In Yavatmal, a district headquarter in eastern Maharashtra’s cotton belt, local authorities are scrambling to keep COVID-19 under check.  One ward in the district’s Government Medical College (GMC) has been turned into an isolation ward, while the district collector has issued strict orders to prevent the hoarding of vital medical supplies.

Yet, the hospital is severely short-staffed and, doctors say, does not have enough facemasks for all its staff. If COVID-19 cases were to suddenly spike, as they have elsewhere in the world, doctors fear the effects of the ensuing panic — if not the illness itself — could be devastating. 

“Don’t be surprised if class 3 and 4 employees including nurses go on strike if this virus spreads. They are going to deal with the positive cases and they are not equipped to do so,” said a doctor in Nagpur, the major city closest to Yavatmal, referring to the junior medical staff by their government designation.  

In the event of an outbreak, the doctor said, it was essential to “protect your first line of defence, which is the doctors and nurses.”

“At this point at least in Nagpur, they are not equipped to do so,” said the doctor, seeking anonymity as he is not authorised to speak to the press.  “There is a need to stop panic from spreading. People infected with this virus, have gone back home after being treated at hospitals in Kerala. It is important to stop this panic which could fuel even law and order issues.”

Those under quarantine have been left ruing their much-awaited, but ultimately ill-fated, family vacation.

“None of us showed any symptoms of this virus when we were in Dubai or Abu Dhabi,” said one such person currently under quarantine in Yavatmal. “I and my wife have not been ill even after returning to our home in Yavatmal but when the persons in Pune tested positive for this virus, the authorities contacted us and now we have been screened for this virus and awaiting the results.” 

The travel agency, in the meantime, believes their clients probably picked up the virus at the airport.

“Because had they contracted this virus earlier, we would have noticed it during the tour. All of them seemed in fine health and dined together and travelled together,” an executive with the travel agency said. “The only places I can think of where they may have contracted this virus is either Dubai or Mumbai airport or inside the plane.”