Health

COVID-19: Why the surge in Bihar's cases

Rise in cases in the state puts spotlight on worrying trend of migrant workers reportedly crossing border without telling authorities

 
By C K Manoj
Published: Thursday 30 April 2020
Children pose in front of a barrier at a village in Bihar Photo: CK Manoj

The number of novel coronavirus disease (COVID-19) cases in Bihar jumping four times within eight days has put the spotlight on an increasingly worrying trend in the state amid the nationwide lockdown: That of migrant workers reportedly crossing the border and returning to their villages without informing local authorities.

The number of cases of those who contracted the virus (SARS-CoV-2) in the state jumped to 403 from 113 cases, between April 21 and April 29, 2020 and the number of districts that reported cases doubled as well, to 29 out of a total 38.

Health officials said two to seven cases were reported every day, on an average, from March 22 — when the state’s first case was reported — until April 20.

The number of cases, however, shot up suddenly, beginning April 21.

The disease spread to villages in the remote corners of Bihar, with several instances of border authorities unable to track down migrant workers who returned to the state from across the country on time.

Villagers, in some instances, claimed migrant workers returned in this manner — without informing authorities — putting their villages at risk.

A health department report said just six individuals were responsible for infecting 164 in Bihar. Two individuals in Munger infected 92, while one person each infected 19 in Nalanda, 22 in Siwan, 17 in Patna and 14 in Rohtas, according to the report.

An incident allegedly involving a 65-year-old from Munger is worth mentioning: The individual was said to have infected 65 people after he reportedly hid his travel history and mingled among people.

The man returned to Bihar from Delhi on March 27, after moving from one place to another in the next fortnight, K Purushottam, a civil surgeon in Munger, told Down To Earth.

“By the time he was admitted on April 15, more than 60 people connected to him were in hospital beds as well,” he said. “We humbly request the people not to hide their cases,” he added.

Villagers in Bihar’s Arwal district, in one instance, claimed that a youth in his late 20s returned to the village from Jharkhand’s Garhawa town earlier this month and stayed with his family and met his friends reportedly without anyone's knowledge.

The locals went to the authorities, after which a team of healthcare workers reached his home and admitted him to hospital for a test. He tested positive on April 24. He had reportedly infected several others by then.

Villagers in Pawai village in Aurangabad district claimed that they found a 40-year-old truck driver, a resident of the village, returned from Chhattisgarh last week without informing anyone and continued to stay at home, until they informed the local district administration.

The driver was then admitted to hospital, where he tested positive for SARS-CoV-2 on April 24.

Migrant workers across the state secretly returned home without following mandatory quarantine procedures or asking for tests, said Ajay Kr Sinha, a nodal officer in Nalanada Medical College and Hospital, the designated hospital for COVID-19 patients in Patna.

“This might have complicated the entire situation, though screening has also picked up momentum in recent days,” he said. Around 1,500 tests were conducted daily on an average in the state right now, which has resulted in the detection of more cases, according to Sinha.

The state conducted a total 21,180 tests until April 29, according to a health department report.

The reason for the rise in number was because of intensive screening, Ragini Mishra, a surveillance officer with Bihar’s health department, told DTE on April 30.

“We have launched door-to-door campaigns — similar to polio drives — to identify suspects,” she said, while denying that community transmission had taken place and asserting that 98 per cent of the cases were the result of contact tracing.

Two traditional habits of villagers across Bihar — of sharing khaini or a type of tobacco and playing cards with several others — have also been pointed out as a health risk by several experts.

This habit resulted in the infection of 38 people — including 17 from a family — in Buxar district.

“Two villagers told a medical team that they may have received the infection as they used to share khaini and play cards with the son-in-law of a 67-year-old man who tested positive,” Aman Samit, the district magistrate, told local media.

The partaking of khaini in villages serves as an ice-breaker and is seen to be a way for strangers to become friends, as people don’t hesitate to ask for some, when they find someone rubbing the chewing tobacco on their palms.

Several villagers, however, have now stopped sharing it, out of the fear of infection.

Yet another problem has been migrants reportedly leaving temporary quarantine centres — sometimes at local schools or other buildings in villages and small towns — without completing a mandatory 14-day stay.

The migrants leave because of a lack of basic facilities, including power, potable water, beds and food.

Several migrants leave centres in the morning to work in fields and help harvest crops to return only in the evening, according to some village heads who spoke to DTE.

The state government has now ordered increasing checks on the border to prevent the influx of migrants returning to their villages.

Many districts free from COVID-19 have suddenly begun to report cases in the past few days, which means inter-district movements of villagers was still continuing, said Bihar Home Secretary Amir Subhani.

“There is an urgent need to intensify vigilance along the border to prevent movement of people,” he said.

Munger, Patna, Buxar, Nalanda, Rohtas, Siwan, Kaimur and Goganganj districts have emerged as hot spots in the state, with 75 per cent of the total cases reported from these districts.

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