The looming threat of a Covid surge in rural India was not unforeseen. As early as in June, WHO (World Health Organization) chief scientist Soumya Swaminathan had flagged the possibility and advised that India use the time the virus takes to reach the hinterland to ramp up its primary healthcare system. As of July 16, the pandemic had spread to 98 per cent of all districts in the country; only 13 of 640 had reported no cases. Many health experts believe the return of millions of migrant workers in June played its part. “With so many people being asymptomatic carriers of Covid, one will never know for certain the extent to which migrants carried the virus back with them. Many states did not test every returnee; they only isolated them or did symptom testing, which has been proven to be an ineffective way of diagnosing Covid. All it takes is a single [infected] person,” says Indian Medical Association chairman Dr K.K. Aggarwal. With prevention looking like a bit of a lost cause, policy guidelines are now focusing on cure and managing fatalities.
A Covid pandemic in rural India, if not tackled with targeted, decentralised and specific policy intervention, could become a national disaster. Co-morbidities such as diabetes and hypertension run high in rural areas and are often left untreated. Also, Census data points out that the proportion of old and elderly in the rural population is greater. Both these factors put the rural population at a higher risk from Covid. Again, most people in rural areas live far from diagnostic and healthcare services. Data from the National Family Health Survey-4 shows that only about 25 per cent have access to any kind of institutional healthcare—hospitals or even community health centres (CHCs) or primary health centres (PHCs)—for testing or treatment of Covid. “Health is a state subject and states have to be the first line of defence. The existing central guidelines for testing, treatment and prevention continue to be applicable,” said a spokesperson from the ministry of health and family welfare (MoHFW). That sounds like the states have to pretty much fend for themselves.
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August 17, 2020