Urban virus goes rural in Jharkhand as epicentre shifts

Kolkata/Ranchi: Around 4pm on May 10, a sleepy Sunday, Hazaribag district officials called a press conference and laid out the plan for a post-Covid version of normalcy. The district — where all three Covid-19 patients had recovered and no new case had been reported in 20 days — would be declared a green zone the following day. Hours later, one man, a migrant worker who had returned, tested positive. The plan was junked and over the next week, 22 more cases followed.
Neighbouring Garhwa had seen this play out two days before that. It had been on track to become an orange zone till the morning of May 8. The district’s three Covid-19 patients had recovered and no one else had tested positive in 10 days. By midnight, a cluster of 20 people tested positive in one go. All of them had returned from other states.
When the Covid outbreak started, the one big hotspot in the state was Ranchi. It’s the state capital and urban clusters had been coronavirus hotspots across the country. Rural areas, it seemed, had been spared. But the epicentre has shifted. Ranchi, where the state’s first case was reported on March 31, has just 20 active cases now. Rural districts have 87. And the shift coincides with the return of migrant workers from other parts of the country.
When the lockdown was relaxed to send migrant workers back to their home states — in one of the biggest planned movements — people from other states started coming in, on buses, private vehicles and Shramik Special trains. Before getting on these buses and trains, there was minimal screening, public health experts said. And many had been returning from red zones in Gujarat, Karnataka, Telangana and Maharashtra. The first Shramik Special, after 40 days of lockdown, carried workers from Hyderabad to Ranchi at midnight on May 1. By May 17, more than 62,000 migrant workers had been brought back in 52 special trains to six stations across the state. More than 30,000 had returned on buses from neigbouring states. Most were from rural districts, where they returned.
Since May 7, six days after the first Shramik Special brought migrant workers home to Jharkhand, Palamu reported 12 cases (of 15), Giridih nine (of 10), Koderma five (of six), Dhanbad three (of five) and Deoghar one (of five). Four districts which had no cases added new ones — East and West Singhbhum (five), Latehar, Lohardaga and Ramgarh (one each). All of them had been inches from turning green, or safe, zones. In the same period, Ranchi reported just 11 cases.
Giridih sees the highest emigration in the state, with 2.5 lakh labourers moving out, followed by Koderma, Hazaribag, Palamu and Garhwa — all rural districts where the Covid graph has seen a sharp spike in the last two weeks.
“With thousands returning home every day, we just do not have the infrastructure to put all of them in institutional quarantine. Even if we take precautions, the movement is such that it will inevitably lead to a surge in the number of patients because we are testing people here, in Jharkhand, no matter where they got infected,” said principal health secretary Dr Nitin Madan Kulkarni.
Besides, these districts do not have the testing infrastructure needed to stay ahead of the curve. Bagodar MLA Vinod Singh, a CPI-ML leader who has been working for migrant worker welfare in Giridih, said only proper testing would make the scale of things clear. The figures bear this out.
“The state has just four facilities to test samples and none is in the districts that are now witnessing a spike. All samples have to be sent to Ranchi, Jamshedpur and Dhanbad. It sometimes takes days, even weeks, to get a report,” said Gurjeet Singh, state convener of Public Health Foundation of India. Of the 37,000 samples collected in the state, only 975 are from Giridih and the reports of 381 (40%) are pending. Koderma has collected 802 samples. Garhwa is slightly better with 1,268 (232 results pending). Hazaribag (2064 samples collected) and Palamu (3,600 samples) are comparatively better, but still too little.
Once cases are detected, these districts are also not adequately prepared to handle them. Especially serious ones. Though all district hospitals have been asked to prepare for Covid-19 cases, modern medical facilities like ventilators and critical care infrastructure are not available in any hospital in these remote areas.
The worst, public health experts said, is yet to come. Singh said, “The incubation period of the virus is at least 14 days, so the real picture will be known only by the end of the month.”