As much of India began relaxing restrictions allowing people to move freely and businesses to operate, Udupi, a coastal district in Karnataka is experiencing a spike in hospitalisations driven by the rising number of people returning from Mumbai, a city overwhelmed by coronavirus cases.
In the past week, Udupi has recorded 352 coronavirus cases, a number that steadily rose through the week before peaking on Tuesday when 150 new cases were recorded, all of whom are people who returned from Mumbai.
The cases recorded on Tuesday and the 62 cases reported on Wednesday took the total number of cases reported in Udupi to 472, making it one of the worst-affected districts in the state.
But despite the rising cases, little seems to have changed regarding the lockdown rules in effect in the district. On Wednesday morning, close to usual traffic was seen on the main road linking Udupi and Manipal in the district despite overcast conditions due to the onset of the monsoon.
The reason for the spike in the district was attributed to the thousands of migrants who returned from Mumbai in the past two weeks. In fact, on May 15, the district had recorded just 3 COVID-19 cases, all of whom tested positive in March.
Among the 407 active cases currently in the district, 98% of the patients returned from Mumbai. In the past two weeks, over 8,500 people returned to the district from Maharashtra and the results of 2,366 patients are still pending.
"The spike is not due to cases which were started in Udupi. Mumbai residents who are mostly working as coolie workers in hotels returned home, leading to a spike here. It is our dharma to allow them to come home since they are the people of this state and this government will provide treatment for them," Dr Sudhakar K, Medical Education Minister of Karnataka told reporters in a press conference in Udupi.
The minister was on his first visit to the district since the lockdown was imposed in the country amid the coronavirus pandemic, and his first stop was the Kasturba Hospital in Manipal, which is testing COVID-19 samples in its laboratory.
The lab, which is currently testing 500 samples every day, is set to expand its testing capacity by installing three additional RT-PCR machines in the laboratory. "We will be able to test more than 1,000 samples in a day going forward," says Dr Avinash Shetty, Medical Superintendent of Kasturba Hospital in Manipal.
Health officials in Udupi are also testing samples at the laboratories in Wenlock Hospital in Mangaluru, KS Hegde Medical Academy in Mangaluru, Yenepoya Medical College in Mangaluru and the Virus Diagnostic Laboratory in Shivamogga.
In addition to increasing its testing capacity, officials in Udupi will alo turn two more government hospitals in Kundapur and Karkala in the district into dedicated COVID-19 hospitals. Until now, patients who tested positive for the virus were admitted in the TMA Pai Hospital in Udupi. This hospital will now concentrate on treating critical cases including pregnant women, elderly persons and people with comorbidities.
"We will be shifting the patients in the hospitals in Kundapur and Karkala to nearby health centres and turning them into dedicated COVID-19 hospitals. The hospital in Kundapur will be for people who test positive from Kundapur and Byndoor regions while the hospital in Karkala will be for patients from in and around Karkala," Sadashiva Prabhu, Udupi Additional District Commissioner told TNM.
Another COVID-19 healthcare centre will be established at the Lalitambika Guest House in Kollur to treat asymptomatic patients while the SDM Ayurveda Hospital in Udyavara in the district has also been converted into a dedicated COVID-19 hospital. Dr Sudhakar further announced that 2,000 Personal Protective Equipment (PPE) kits will be sent to Udupi district due to the spike in cases.
But despite the measures taken to fight the spread of the virus, Dr Sudhakar stated that there would be no change in the quarantine protocol in place in the district. Currently, people returning to the state from Maharashtra are placed in institutional quarantine while those returning from other states are placed in home quarantine.
Some of the patients from Udupi who tested positive over the last few days had completed their institutional quarantine period and returned to their residence. The worry is exacerbated by the fact that a majority of coronavirus patients in the state are asymptomatic.
But when asked about the fact that returning migrants were going home to their villages, possibly carrying the virus, Dr Sudhakar responded, "Those who leave institutional quarantine will remain in home quarantine. We will identify those in the district who are at risk and ensure that they are tested." Residents of Udupi with a history of Severe Acute Respiratory Infection (SARI) and Influenza-like-Illnesses (ILI) will be identified in a census-like exercise by the district administration. They will also be tested for the virus.
But the district administration is reluctant to keep people in institutional quarantine till their test results come back due to concerns over the spaces available to quarantine all those who return to the district. The MLAs in Udupi led by Halady Srinivas Shetty, the legislator from Kundapur constituency, are keen on sealing off homes of the people who return to the district from Maharashtra as opposed to quarantining them in government-designated facilities.
"We have limited facilities to quarantine people returning to the district. There are practical difficulties because around 12,000 people can be quarantined at a time but if more people come in, we don't have the facilities," Dr Sudhakar admitted. A total of 1,120 beds are available in the district, officials say.
Along with the onset of the south-west monsoon in Udupi, the rising coronavirus cases has led to concern among the residents of the district. "If people experience cough and cold, they will immediately worry whether they have contracted the virus," said Abhijit, a resident of the district.
The district administration and the state health department conceded that the active participation of the citizens is required in the fight to contain COVID-19 cases in Udupi, urging people who develop symptoms to isolate themselves and immediately report to fever clinics.
"The role of the public is important in fighting the virus and hopefully, in the coming weeks, all those who tested positive in Udupi recover from the virus and this can once again be a green zone," Dr Sudhakar said. "Our work may not be foolproof, but we are watching this dynamic situation and we will remain flexible over changing guidelines whenever necessary," he added.