Rural Pune hot spots put on alert to control Covid spread

On the evening of May 10, an auto rickshaw with a loudspeaker rode through the Bhigwan village making an announcement that the residents knew was coming: a complete lockdown starting from the midnight of May 12

On the evening of May 10, an auto rickshaw with a loudspeaker rode through the Bhigwan village making an announcement that the residents knew was coming: a complete lockdown starting from the midnight of May 12. Bhigwan, a business hub in Indapur tehsil located on the Pune-Solapur highway, and known for its fish market, had just come out of a Janta curfew, which was far stricter than the curbs imposed by the state government on April 15. In this Janta curfew, only medical shops were permitted to remain open.

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Bhigwan is among the 107 villages of Pune district that were recently put on a first-of-its-kind list brought out by the Rajesh Deshmukh, Pune’s district collector, on May 7. The list categorised the hot spots as “alert” (the caseload was high and not reducing) and “high alert” (the caseload was high and increasing). Bhigwan was among the former and at least 159 villages and/or municipal councils made it to the latter. On May 11, Pune district recorded 7,714 new Covid-19 cases and almost 48% came from villages and municipal councils.

Though the state government has imposed strict curbs, at least four of the 15 tehsils in Pune district (Baramati, Bhor, Maval and Indapur) have imposed week-long complete lockdowns last week.

As cases began to surge in Maharashtra starting February -- it remained the most affected state in the country for most of March and April – the spread of Covid-19 hit both densely populated urban centres as well as rural parts of the state which have little access to health care infrastructure. However, even as cases seem to have come under control in urban centres like Mumbai, the positivity rate in rural parts of the state have shot up in the last few weeks. For instance, rural Pune reported a test positivity rate of 28.07% compared to PMC, the district’s urban centre, which reported 18.18% positivity rate in the week of May 3-9.

PMC which has the highest number of confirmed cases in the district started to show a downward trend of positive cases from the third week of April. In the first 12 days of May, 47,542 new positive cases were recorded in rural Pune; by comparison, 32,546 new cases were recorded in PMC and 26,303 new cases recorded in Pimpri-Chinchwad Municipal Corporation (PCMC). Even if we were to take recoveries into account, out of 88,851 active cases in the district on May 12, PMC recorded 27,014, PCMC recorded 20,869, while rural parts of the district recorded 39,529.

Pandurang Salavade, the sarpanch (village head) of Dorlewadi village in Baramati tehsil (an “alert village”) expressed shock at the severity of the second wave. “There have been 185 cases in Dorlewadi [till date]. During the first wave, we registered 30-35 cases in the village. There were no deaths. This time, there have been 12 deaths, all in May. The entire village is terrified and is seriously following lockdown rules,” he said.

Shubhangi Nale is an ASHA (Accredited Social Health Activist) member in Dorlewadi. One of the tasks assigned to her at the start of the pandemic was to survey 50 families every day to detect early the onset of the Covid-19 infection. She was also tasked to monitor symptoms of Covid patients in home isolation and, since the beginning of this year, to spread awareness about the vaccination drive to curb the spread of the coronavirus. Nale said that last year she didn’t fear for her life, but this time around, the speed at which the infection has spread is terrifying to her.

“I have been working as Asha worker since 2009 and it is a completely different experience working in Covid pandemic. I was not scared of working last year. This time I am afraid of the way the virus is spreading. I can’t work from home. I have to go and interact with people. Most of the time we don’t even know that the other person has contracted the virus. I am taking more precaution this time,” Nale said.

Many villagers were lax about wearing masks and often visited weekly markets without maintaining physical distance. “It has been a year since the pandemic has begun. Why people haven’t adopted basic behaviour required to fight this disease is beyond me,” Nale said.

The health infrastructure in rural parts is under pressure to accommodate the caseload in the second wave. There are 56 hospitals and Covid Care Centres with 2,293 beds (1,190 oxygen beds; 137 ventilator beds), which serve all 14 municipal councils in the district; 138 hospitals with 5,911 beds (1,966 oxygen beds; 188 ventilators beds) must suffice for 1,866 smaller villages. But this isn’t evenly available.

Dorlewadi has a population of 6,500. Most households do not have equipment like oxymeters and thermometers and if symptoms are identified, Nale tries hard to convince villagers to get tested. However, for that, they must visit Baramati, six kilometres away as there isn’t a testing centre in the primary healthcare centre in the village. If someone needs to be hospitalized, they must visit Baramati town.

The administration has been trying to increase bed capacity and hire more medical professionals in order to improve the quality of treatment. “Our primary aim is early detection and early treatment. With this target we have shown results. We have hired additional medical personnel for Covid duty. We have continued the vaccination drive. There is a plan to build a pediatric hospital in each tehsil. Through CSR, the work to make oxygen plants operational has started at 17 places,” said Ayush Prasad, CEO Zilla Parishad-Pune.

Work orders to install oxygen generation plants at 10 hospitals have been issued and ₹50.14 lakh funds have been secured through District Planning Committee funds for this.