Covid-19 cases surge, rural Nashik moves to city for beds

WITH PACKED food, bedsheets and bottles of water, they camp outside Nashik Civil General Hospital. They are relatives and close contacts of Covid cases admitted there.

There is Digambar Kad, who lives 10 km away in Mungsara village. He hired a vehicle and went to three hospitals with sister Poonam Bhoir (27), a blood cancer patient who is now Covid-positive, before finding a bed here.

Yogesh Barve lives 65 km away in Chandwad village but this compound has been his home for the past two days. Inside, his wife Meenal (38) is on oxygen support. Nyaneshwar Mahajan travelled 40 km from Niphad village to admit his mother Janabai (50) after other smaller public facilities, all full, turned them away.

As a second Covid wave rolls over Maharashtra, mainly the rural areas, patients are forced to travel long distances to seek treatment. At Nashik civil hospital, a nodal centre for rural areas, all the 110 beds are full.

Nashik has the fifth highest active caseload in Maharashtra. Officials expected the maximum number of active cases to reach 13,000 based on last year’s peak of 11,000 in September. But on Friday, the district surpassed 36,000 active cases.

Rural Nashik recorded 38,949 cases over the last year. But this March alone, it logged 16,042 new cases. “We did not expect such a steep rise, especially rural areas,” says civil surgeon Dr Ratna Raokhande.

Nashik Collector Suraj Mandhare says they have increased testing 30-fold and have been scaling up beds over the last month. “But we can no longer estimate by how much the active caseload will rise. Frankly, we cannot prepare infinitely. Infrastructure is just one component of Covid management,” he says.

On Thursday, in a meeting with the State Minister in charge of Nashik, Chhagan Bhujbal, Mandhare decided to add 1,300 oxygen beds in the city. But residents of surrounding villages complain of disparity. With the increase, the city of over 20 lakh people will have 4,300 oxygen beds while rural Nashik with 42 lakh people has only 1,050, with 700 occupied.

There are 75 ventilators in rural Nashik but with only eight patients. “We don’t have physicians and intensivists to handle all 75,” says a Health official.

Dr Anant Pawar, from the district health office, says specialist doctors prefer to work within the Nashik Municipal Corporation, which earns them about Rs 2.5 lakh per month, as against about Rs 75,000 in rural hospitals. Pawar says they have drafted 10 physicians from private hospitals who have agreed to treat Covid patients in rural hospitals — for now.

“Most villages have Covid care centres, but for any further treatment we have to travel till Nashik,” says Vijay Darade, of the All India Trade Union Congress.

The district is now planning to put in place 300 isolation beds in the civil hospital, more dedicated Covid centres in rural blocks, and a fine of Rs 500 to reduce crowding in markets. But until then, the load is on the civil hospital.

Deepak Pagare, co-ordinator for beds, says he comes across at least five patients declared dead on arrival every day, most of them from villages who didn’t get timely treatment — rural Nashik recorded 69 Covid deaths in the past week, the highest toll since the pandemic began.

Then, there’s the fear that is seeping into every village.

On Thursday, 80 km from Nashik, Karhi village in Manmad recorded its first Covid death, prompting a voluntary shutdown of shops. “Villagers think if they get Covid, they will die,” says Darade of the AITUC.

Inside a hut in Karhi, a family grieved over Asharam Dond (65) who fell ill two days ago and died Thursday. “The nearest sub-centre had no doctor, so we travelled 20 km to Manmad city but the hospital there was treating only non-Covid patients. From there, we went to Nandgaon. By then, his oxygen level was 80. The hospital asked us to buy Remdesivir,” says Dond’s brother Shravan.

“Not every village can have ICUs,” says taluka health officer Dr Ashok Sasane. “We plan to convert the Railway hospital into a Dedicated Covid Health Centre with oxygen and ICU support”.

As of now, Manmad and nearby villages, with a population of 82,000, have one Covid centre with 50 beds for mildly symptomatic patients. Says staff nurse Priti Kamble, “Once oxygen levels drop, I start calling all government hospitals. But beds are hard to find these days.”