Even as metro cities of Tamil Nadu like Chennai, Coimbatore and Madurai show a downward trend in fresh Covid-19 cases, the public health department of the state and the health ministry begin to combat a surge in coronavirus cases in rural areas.

Lack of awareness in the rural areas coupled with the people not wearing masks and not undergoing tests is the major reason for the spike in cases.

State Health Minister Ma Subramaniam told IANS: "This is worrisome but the doctors and health officials are making maximum effort to bring it down and a major hindrance in rural areas of is lack of infrastructure. We are installing temporary health infrastructure on a war footing  in the hinterlands to counter this wave as fast as we can."

Several villages in several areas of Anamalai, Karmadai, Pollachi, Annur and Sullur in Coimbatore district have witnessed a sudden surge in fresh cases and several are turning fatal.

Muthuswamy Ranganathan 42, a farmer in Karmadai told IANS: "My neighbour, Raghavan passed away on Sunday after testing Covid-19 positive and we are afraid of contracting the disease. We did not know the gravity of the disease until now when the second wave of the pandemic hit us."

Sugunendran Parthiban, a doctor who lives in Anamalai told IANS: "There is indeed a lack of awareness but the state health department has woken up and is conducting several awareness programme and door to door testing is now taking place.

"However, the tribal people who live deep in the forest areas of Anamalai and Sholayar are moving further deeper fearing the tests and this has to be taken care of as they come back to the mainland and can turn super spreaders."

Similar situation is being witnessed in the rural areas of Erode, Madurai and Salem as well as in the villages surrounding Tenkasi, Kanyakaurmari and Thoothukudi.

As cases surge in rural districts, patients flock to the urban centres for treatment which are more than 100 km away from the villages.

Salem has witnessed a huge rush of patients from areas like Villupuram, Kallakuruchi, Dharmapuri and Krishnagiri.

Salem district collector Karmegam told IANS: "Covid-19 positive patients in rural areas are flocking to hospitals in Salem as they don't have other options and the administration is trying to erect temporary health infrastructure in rural areas on a war footing."

Another problem facing the government hospitals in rural areas are the lack of beds with oxygen facilities. A classic case was the Mettupalayam government hospital which has only 2 oxygen equipped beds.

In the first Covid-19 wave Madurai urban centre recorded 80 per cent of the cases but in the second wave the rural areas have recorded 40 per cent of the cases.

However, this rural trend is not unique to Tamil Nadu but also being seen in almost all the states of the country. The major reason according to the health experts is the return of a large number of people to their village homes amid ongoing lockdowns.

Vinaya Joshi, who is working in a hospital in Coimbatore suburbs told IANS: "The lack of awareness and the lesser number of tests coupled with a rush of urban-based people coming  back to homes in villages resulted in the sudden surge in cases.

"Anyways doctors and allied staff, including nurses are on the job 24 hours and unless the government jacks up the health infrastructure employing more doctors, nurses and more oxygen equipped-beds in rural hospitals things will not come under control."