Covid-19 Management In Odisha: A Recap
The Initial Hue and Cry
It all started on a Friday morning when a student returning from Italy caught a cold and started sneezing. He was admitted to a hospital the very next day as his condition wasn't easing. His family demanded some additional tests to be done, and they took him back home the next day. A few hours later, the hospital realised that they just sent the first Covid-19 patient of Odisha back home; this is the ingress of Covid-19 into Odisha, and so on 16th March 2020, Odisha got its first confirmed case of Covid-19.
It may be the prowess of the disaster management of Odisha or absolute happenstance that the entire State was locked down just a few days before its first case. Odisha was one of the very first states to announce the lockdown even before the national lockdown. It was at the very front in responding to the pandemic and in taking the appropriate measures. In hindsight, we can see the sheer experience of the Chief Minister and the proficiency of the Odisha State Disaster Management Association (OSDMA) here.
The Economy's Hit
One of the significant after-effects of the pandemic worldwide was the plummeting Economy, and Odisha was no exception. The small scale, semi large scale, and even some large scale businesses were hit, and families were left with nothing but their savings and hope. Various allowances given by the government were halted as well. But, the government did put all its money to good use. Odisha was one of the first states to start hospitals with 500 beds, especially as covid care centres. The State even reeled in private hospitals to contribute; it started many training programs for volunteers who wanted to chip in. The government started local covid care centres, helpline numbers for each district and its hospitals were issued and circulated. The State was successful in containing a spread and breaking the chain of passage up to an extent. Odisha recorded its first death on 6th April with the demise of a 72-year-old man. Even with extreme work and containment, the first wave hit, but people didn't know until it was too late.
One of the main reasons for this was the migrant exodus; it began as soon as the government announced a nationwide lockdown. People started pouring into the State and especially into districts like Ganjam, which migrant workers and their families entirely populate. The State struggled to control the influx, but the State established necessary quarantine centres, and arrangements were made so that people could follow the necessary quarantine protocols. The government even announced a 2000 rupee reward for every migrant worker who followed the quarantine protocols. As many as 16,824 Temporary Medical Camps (TMCs) were set up at 6,798 gram-panchayats to house the migrants 14 days before allowing them to mix with the families and communities.
However, as even the best-laid plans fall apart, this too had its pitfalls. Not willing to accept the 14-day quarantine at TMCs, many migrants evaded screening and escaped from the centres across districts, leading to the inevitable. They fuelled the virus transmission at the community level, and from May onwards, Odisha witnessed the steep spiral of Covid-19 cases across districts.
Rath Yarta and Remdesivir
The people were even more disheartened than before on the news that the Jagannath Rath Yatra, an iconic festival of the State, would not be commenced. The chariot, a symbol of truth and justice, was stopped for the first time in 284 years; this made people sulk.
The approval of the drug Remdesivir gave the people and the government some hope, but it was only approved as an extreme measure. The effectiveness of the drug made people wait for it to become completely available.
By 10th April, the number touched 50, with all infected persons travelling outside Odisha or abroad. The participants of the Tablighi Jamaat in Delhi, who had returned from the event, were in focus, with several of them testing positive. Then came the next surge fuelled by migrants returning from West Bengal to Balasore, Bhadrak, and Jajpur. Odisha recorded its 100th case on 24th April and touched 500 on 12th May, when the return of the migrants was in full flow.
Eye Of The Storm
There was no respite after that, and the graph began to shoot vertically, reaching 10,000 on 7th July and 50,000 a month after on 11th August. With community transmission setting in, the months from July to November saw the rampage of the virus, and Covid cases crossed three lakh. The highest single-day spike recorded in the State was 4,356 on 26th September when Odisha found its place among the top ten affected states in the country and clocked a test positivity rate of more than 10 per cent. While the case incidence has come down since the beginning of December, signalling the end of the first wave, the total number on date stood at 3.29 lakh.
Starting with only one laboratory for Covid tests at the Regional Medical Research Centre (RMRC) of ICMR, the State now has 54 labs, including 35 government facilities. The State has conducted 60 lakh tests by 1st December, with the highest being nearly 67,000 tests conducted on 22nd August. In August 2020, Odisha ranked 2nd in the number of tests performed per day, conducting 1,265 million tests a day.
Gram Panchayats To The Rescue
Something that played a significant role in flattening the curve was the decentralisation approach of the government in containing the spread. The gram panchayats of the State were given autonomy over their jurisdiction in containment and prevention of the virus and some financial support from the government. Each gram panchayat was given Rs 5,00,000 to set up and operate quarantine centres with governmental bodies. Along with the decentralisation, the State even recruited Self Help Groups (SHGs) and other women groups like Mahila Arogya Samithi’s and Gaon Kalyan Samithi’s for helping them in making the State safe. On 22nd April 2020, nearly 67,000 sarpanches were asked to take an oath to protect the migrants on their return, thus projecting the state government's intention.
The Unlock Conundrum
While the Ministry of Home Affairs announced guidelines for “Unlocking,” or easing restrictions, starting from June 8, 2020, Odisha’s strategic restriction lifting was far more cautious than most states. The Unlock 1.0 was heavily restricted in states like Maharashtra, Tamil Nadu due to many prevalent covid cases.
However, Odisha saw the restrictions to be sufficiently moderate. Odisha decided to go strict on movements and ensure people venture out only for necessary economic activities five days a week by enforcing weekend lockdown until June 30. Odisha also decided to continue with the 10-hour curfew (7 am to 5 pm) instead of the Centre’s 9 pm to 5 am. Despite a controlled effort to curb the infections while allowing certain degrees of freedom, the state saw an increase in cases, prompting a revamped Unlock strategy. The new guidelines, which took control in July, divided the state into two zones based on the number of active cases, and the authorities placed restrictions accordingly. This move was necessary to revive the economy, but it came at the price of the cases per day.
Unlock three, too, carried similar sentiments because this was also focused on restoring the tertiary sector, and the government opened certain tourist spots. The month of September brought in major reopenings of malls and restaurants. Puri did away with the weekend shutdown in August while Konark Temple opened itself to visitors amid tight security and a ceiling of 1500 people in two shifts. Consideration for JEE and NEET exams was kept in mind as there was no complete shutdown in the entire state, and exams were evaluated. However, due to the relaxing of restrictions, September saw a surge in cases.
The peak in September cautioned the authorities, and Unlock five was initiated. October calls in for Durga Puja, a significant festival in Odisha, the state of affairs returned to the way it was during Unlock 1. Following this was a phased unlocking process, with selective and specific unlocking. Districts began to implement the restrictions according to the caseload. Now that the health system had stabilised to a certain extent and the number of cases decreased, the situation became more accommodating for economic activities to resume at an average pace. The restrictions became lax, and meanwhile, the state government began to ramp the systems for the vaccination drives.
During the early briefing sessions, Odisha had indicated that they had a tentative modus operandi ready for the vaccination drive. In the meeting with the Prime Minister on 1st December, there were indications about a multi-sectoral response system at different levels. The state had dry drills, initiation of block-level and district-level task force committees, and necessary logistics arrangements.
A primary task that the health ministry completed between the two waves was to create databases for health workers and infrastructure that could be used for logistics for vaccination. This included enlisting vaccinators, vaccination sites, assessing the requirements for cold chain, safe storage, and transportation. There were also talks about enlisting the community leaders for grass root campaigns for vaccine promotions.
Phase 1 of the vaccination drive officially began on 16 January, when a sanitation worker was given the dose. The first phase was aimed at healthcare and frontline workers, and the centres provided either Covaxin or Covishield. During the initial days, like other parts of the country, there were low turnouts, technical problems, and misinformation, which were cleared in due course. Despite better turnouts than other states, the rates were still lesser than expected.
The second phase of vaccination was aimed at residents over the age of 60 and began from 1st March, and the third phase started from April 19. The vaccination drive for the age group 45-60 years began on July 7.
There were frequent slumps in the vaccination drive owing to a shortage in stocks. The government raised SOS during April, citing that vaccination centres were on the verge of being shut down. What followed next were global tenders for procuring the vaccines, which eventually didn’t work due to inadequate response. Along with Tamil Nadu, Odisha suggested the centre buy vaccines and distribute them amongst the states, with the costs allocated proportionally.
Apart from vaccine shortage, vaccine hesitancy and distribution in remote areas was a significant issue. While the vaccine’s registration was online, there is a lot of confusion regarding the process of registration. Ignorance about slot booking systems, enrollment in the CoWin platform has restricted many people from getting vaccinated due to the lack of offline modes for registration. The government has been exploring ways to help such people. The Economic Survey reported that there are 28.22 internet subscribers for a population of 100 in the state.
Odisha Braced For The Impact
Odisha was wary of the second wave as it began implementing the necessary changes starting from December itself. The state-organized committees to oversee possible scenarios and, in turn, prepared its hospitals and health centres by equipping them with essential equipment. The testing was increased, and the authorities reinforced the rules for social distancing.
Western Odisha Encountered The Burnt First, Followed By The Coastal Regions
The caseload across the state was showing a gradual increase since March 2021. Chhattisgarh was among the first states in India which witnessed the wrath of the second wave. Districts such as Sundargarh, Bargarh, Sambalpur, Balangir, and Nuapada near Chhattisgarh were found to be in the Red zone. They were contributing a high number of positive cases, with Sundergarh topping the list. In a few days, Khorda’s caseload also increased drastically. By May 1st,2021, Odisha’s cases escalated to 10k.
The State Government Swings Into Action
The state government adopted strict measures to combat the second wave. Naveen Pattnaik’s government always aced the race in disaster management and imposed a strict lockdown across the state. Thus, from May 5 began the trail of lockdowns again. History repeated, but the first wave had transformed into a tsunami this time. It engulfed businesses, toppled economies. People stifled as the noose of lockdown tightened further.
Test and Vaccinate
This became a clarion call by all the eminent medical professionals in the state. Dr Binod Patro, professor of community medicine at AIIMS Bhubaneswar and a leading epidemiologist, disseminated, “Currently, the testing is inadequate, so Rapid Antigen Tests need to be ramped up in villages as they will give results in 15 minutes.
Once tested positive, they should be admitted to the block-level Covid hospitals.” In response to the demands, the government established RT-PCR laboratories for Covid-19 testing in 16 district headquarters. But, most of the rural population was still not able to grasp the gravity of the situation. There were reports of mass feasting and celebration in the rural hinterlands of Odisha.
But when the shroud of death encompassed villages after villages, people woke up from their deep slumber. Crematoriums in the state capital were running out of space to bury the dead. The virus strain behind the second wave was much more contagious than the first one. Thus, it spread across the country like wildfire.
Vaccination was the only solution to combat the lethal coronavirus that had wreaked havoc in everybody’s life. Naveen Pattnaik, like a pillar of strength, assured that “ People will not have to spend a penny for vaccines. This is the responsibility of the state government.” Covaxin was administered to people in the Bhubaneswar Municipal Corporation, while the rest of the state was issued Covishield. People of Odisha slowly shed their inhibitions and took their jabs. Though there were instances of vaccine shortages, by the end of June, Odisha successfully administered two doses of vaccines to about 1.8 million people.
The Lungs Of The Nation
When several states of India grappled for life-saving oxygen, Odisha came to rescue. Indian Air Force’s transport aircraft, C-17 Globemaster, made several sorties to and fro Odisha to supply 300 tonnes of oxygen to several parts of India. Rourkela, Jajpur, Dhenkanal, and Angul districts were significant contributors. The administration took charge of maintaining a smooth supply of oxygen to other states through an entire corridor. The chief ministers of several states were full of gratitude for this gesture. In an interview, Dr Niranjan Mishra, Director of Public Health, said,
The current oxygen manufacturing capacity of Odisha is three times that of oxygen consumed during the peak first wave of COVID-19. We also use oxygen concentrator machines, which draw oxygen from the atmosphere, and the government is in the process of acquiring more such machines.
And The Hustle Continues…
As of July 18, 2021, the cases in Odisha have been hovering around 2k. The caseload is decreasing gradually. The Test positivity rate(TPR) is currently 2.8 pc. Most of the restrictions have been eased down across the state. The coastal districts still have a long road to recovery from the blow of COVID 2.0. But, there is hope if each person across the state follows COVID appropriate behaviour.
Designs by – Piyush Sahoo