A combination of complacent approach, consistently poor testing, and refusal to heed to experts’ advice appears to have pushed Hyderabad into a serious public health crisis.
Is the city of one crore population sitting on a ticking COVID-19 time bomb?
A sharp surge in the number of coronavirus positive cases, high positivity rate, and growing resentment among the medical community over inadequate preparedness and hospital infrastructure have turned the public mood grim.
“We are sitting on a ticking time bomb. Many doctors and frontline workers are at risk. The government should at least now step up testing, contact tracing, and isolation,’’ said Dr K Mahesh Kumar, the president of the Healthcare Reforms Doctors Association.
The Doctors for Sewa, an NGO of medical experts, had submitted a representation to the Inter-Ministerial Central Team last month, highlighting the low testing rate in the state.
Apart from epidemiologists, doctors, medical students, and the high court, the State Governor Tamilisai Soundararajan, herself a medical professional, had openly disagreed with the government’s strategy on COVID-19 testing. She has also advised the government to increase the testing.
With one of the lowest testing rates in the country, Telangana may well be sitting on a huge crisis. According to the ICMR data, it has conducted 652 tests per million population, compared to the national average of around 1,600.
With the highest single-day jump of 1,087 COVID-19 cases on Sunday (June 28), Telangana’s tally crossed 13,000, overtaking Madhya Pradesh and Haryana. Of the fresh cases, 888 were reported in Hyderabad, the biggest hotspot. As many as 247 people have died so far.
Panic grips city
A sense of panic is palpable in the city with several merchants’ associations deciding to down the shutters voluntarily to check the spread of the virus while the residents in several localities opting for self-lockdown barricading themselves in and closing entry for outsiders.
Several major wholesale markets including Begum Bazar, Lad Bazar, Pathargatti, Rani Ganj, Troop Bazar, and General Bazar have voluntarily announced the closure amid the growing criticism that the Telangana Rashtra Samithi (TRS) government had been lackadaisical in its approach towards checking the spread of the virus.
“All the merchants have unanimously decided to voluntarily enforce complete lockdown of commercial market in Begum Bazar in the wake of rising number of cases,” said Laxmi Narayan Rathi, president of Hyderabad Kirana Merchant Association.
A similar decision was taken by the textile traders of General Bazar who announced closure of shops till July 5. “In the interest of safety of our customers and our workers, the General Bazaar Silk Cloth Merchants Association has decided to close shops,” a notice released by the General Bazaar Silk Cloth Merchant’s Association said.
Pressure on government
It is this public pressure that seems to have forced the government to rethink and reconsider its strategy. It has indicated that lockdown would be re-imposed in Hyderabad and surrounding areas in a couple of days after a discussion at the cabinet meeting.
A total curfew, with a two-hour relaxation during the day to enable people to buy essentials, is on cards. Train and flight services to and from Hyderabad are also expected to be suspended for at least two weeks.
The medical experts have recommended that lockdown be imposed to check the spread of the deadly virus.
“The lockdown will be more or less similar to the first phase of nationwide lockdown imposed in the last week of March,” the Medical and Health Minister E Rajender said.
The lockdown is likely to be limited to the Greater Hyderabad Municipal Corporation (GHMC) area, which covers parts of Ranga Reddy and Medchal-Malkajgiri districts.
“Hyderabad is a metropolitan city having more than a crore population. It is but natural that like in other cities the spread of the virus is high after relaxation of the lockdown,” the Chief Minister K Chandrasekhar Rao said after a review meeting to assess the situation.
He pointed out that cities like Chennai have opted for re-imposing lockdown following surge in cases. The chief minister said that re-imposition of lockdown was a very major decision, which had to be discussed in the state cabinet.
“The government machinery and people should be prepared for this, especially the police department. There is no need for fear. Necessary treatment is given to the positive patients. There is no shortage of beds, PPEs or other equipment,” he said.
At present, 17,081 hospital beds are available in the state to treat COVID-19 patients. At least 10,000 of them will have oxygen connection ready in a couple of days, the officials said.
Low mortality rate
Meanwhile, the health minister has claimed that compared to the national average, the death rate in Telangana was less and there was no need to fear.
“We have kept thousands of beds ready in both government and private hospitals and colleges. Patients in critical conditions are being treated in the hospitals. Asymptomatic patients are given treatment in their homes,” Rajender explained.
The Special Chief Secretary (medical and health) Shanta Kumari said that the mortality rate at the national level was 3.04 while it stood at 1.52 in the state.
A central team, led by Joint Secretary of Union Ministry of Health, Medical and Family Welfare Luv Agarwal, arrived in Hyderabad on Monday (June 29) to review the state government’s response to the pandemic.
The team visited the containment zones, the state-owned Gandhi Hospital, and the newly created Telangana Institute of Medical Sciences (TIMS) in Gachibowli.
Private labs blamed
Facing widespread criticism over massive surge in the number of cases, the TRS government has pushed the blame on private diagnostic laboratories for allegedly violating norms and not following the guidelines of the Indian Council of Medical Research (ICMR) in conducting tests for COVID-19.
The state director of medical and health G Srinivasa Rao said as many as four teams comprising senior microbiologists and senior officers from the medical and health department, which conducted inspections in 16 out of 18 private laboratories in the state, found large-scale violation of norms in conducting the tests.
Rao said the inspection teams looked at various aspects like infrastructure, human resources, infection control measures and other facilities including general hygiene.
“The teams went through the registers and data uploaded by the labs into the ICMR and Telangana state portal and found a lot of discrepancies in the data,” he said.
According to the numbers uploaded by the private labs, tests done by them were 9,577 and COVID-19 positive cases detected were 2,076 as per the ICMR portal since they got the permission. But in the state portal, the uploaded figure was 6,733 tests and 2,836 positive cases.
“But during the inspection, it was revealed from the records available with the labs that the total number of tests done by them was 12,700 and the positive cases were 3,571. At one of the labs in a major hospital, the actual number of tests conducted was 3,940 but they uploaded only 1,568 tests and showed 475 as positive,” the director said.
The inspection report submitted by the expert teams revealed that many of the labs were not taking safety measures such as the staff not wearing personal protection equipment (PPE), safety cabinets not being available and lack of proper hygienic conditions. The staff conducting the tests for COVID-19 has not been trained properly in RT-PCR testing.