On January 16 this year two events took place in Goa. In the morning of that day the COVID-19 vaccination drive for health care workers was launched. It was meant to be the turning point in the battle against the virus. That same afternoon, in the midst of the pandemic, Goa hosted the inaugural of the International Film Festival of India.
Standing on that stage Chief Minister Dr Pramod Sawant had said, “Even as many countries are looking at another lockdown as the only option, our PM has taken up (this) massive vaccination drive.” There was reason for him to sound proud. The number of COVID-19 cases recorded in the State that day was 85, down from a daily high of 700 plus in September. But, was there reason for the government to turn complacent after that?
“In the entire country, not just Goa, people were complacent. That’s the reason for the increase,” a former top doctor of the Goa Medical College, now retired, told Herald on condition of anonymity.
D M Pal, a former Dean of the GMC speaking to Herald said, “There is general complacency. Other States are running from pillar to post for more beds, oxygen, etc and fortunately Goa has not faced such a situation so far. As a result they are not really feeling the pinch.”
Pal added, “I feel the government should impose all restrictions. They should think that a tsunami might come and Goa should not be overflowing (with cases of Covid-19). There has to be mass awareness and appeal to people for compliance.”
That tsunami has arrived, as Goa recorded 3000 plus cases for three consecutive days last week. Goa, should have been prepared to meet this second wave, but it just did not forsee it. On December 17, 2020, while addressing the ASSOCHAM meeting, Sawant referring to the pandemic had said, “We have survived the worst and now it’s time to work to achieve our best.”
The worst was yet to come only nobody knew it at that time, and when the worst began to manifest itself there was little the State that had relaxed its vigilance could do.
Look at the accompanying graphs. The line graph shows how, after cases’ having risen till September last year, the curve then slowly begins to flatten but never levels out, and then in April this year it takes a steep upward incline. From this we can infer that now, even when cases do start dropping in number, it will take time before the graph shows a visible flattening of the curve. Therefore, we are in for a few more weeks of cases, lower than the current, before the pandemic relents.
The bar graph depicts the number of cases per month that Goa has had and from it, we can see that after the maximum of September 2020, how there was a sharp dip in October, which then slowly fell till it came to a low in February. It took over four months for the State to get down to double figures of COVID per day from the maximum of 700-odd a day. Now from 3000 plus a day, how much longer will it take to fall to low double digits?
Worse is that the current strain, doctors say, could cause a lot more damage. “Mutant cases were found in Goa. Although four as per official records, the government should have begun contact tracing and put a stop to all the activities,” said a doctor running a private hospital.
Explaining further, Dr Jorson Fernandes, ENT surgeon who is interacting with around a 100 COVID patients said that the tracking down of the mutant virus patients was the most important. “They should have done the genotyping and isolated the patient. Now we get two types of patients – one who deteriorates very fast and they die and then the others who are with mild symptoms and they get better,” Fernandes said.
He added, “Now it has gone into the population and it is going to become very difficult to isolate the patients and their contacts and contain the spread. Once you test positive, you must isolate and do the genome typing. Once the genotyping is done, track down contacts and isolate everybody who has come in contact with the person.”
The mutant strains came from travellers. There is consensus among doctors that the decision not to demand COVID negative certificates from people entering Goa is one of the reasons for the spike in cases.
A doctor running a private hospital said, “Goa invited people without understanding that if cases are rising in other States, they could bring it to Goa. We ran behind tourism and in turn got COVID cases. Imported cases also attributed to rise in cases.”
“Goa is one of the tourist States. I think there was a bigger compulsion by which they permitted celebrations. So many labourers also work in Goa. The State does not have other revenue (other than tourism) and it means people (visitors) come and enjoy. There is no bar. It becomes difficult for the administration to cope with them. They (tourists) are complacent,” Pal said.
He added, “Outsiders come to Goa, pass the infection and go. Administration should note and buck up the facilities. Government is nevertheless improving facilities.”
Doctors also question why COVID negative certificates from tourists were not demanded. When other States sought these, even from travelers originating from Goa, the State never did.
“And also in Goa there have been no negative certificates or vaccination certificates sought from travellers, which also led to the increase in cases in Goa. Most of these are imported cases. Many people came to Goa,” the former GMC doctor said.
On that same day January 16 as Goa celebrated, the COVID-19 worldwide death toll crossed two million and Europe was in the grip of the second wave, which surely were portends of a possible recurrence in Goa. It was overlooked because India had the vaccine. Less than four months later, there is a shortage of the doses and the drive to vaccinate adults in the age group 18 to 44 has been postponed. The former GMC doctor reasons that the government can only prepare for more patients and for that infrastructure like oxygen, manpower and equipment have to be ready. “You require doctors, staff, sweepers and overall manpower. In the whole country they are talking of more hospital beds, oxygen, etc but nobody is talking about more manpower,” he said.
This is borne out by a resident doctor at GMC who said, “We are getting people with symptoms unlike in the previous one. Doctors, staff nurses, caretakers and everyone are working overtime.”
The government is now recruiting doctors and nurses for the COVID-19 cases that are piling up. But how much will this help? Simultaneously, the government has also converted the examination hall of the Goa Medical College to a COVID ward and will soon be opening the super specialty block for COVID patients. But, is there manpower to handle these extra facilities?
“With the number of patients’ increasing, there are harsh duty hours, nobody is talking about it. The working hours are taken for granted. This is the most important thing,” the former GMC doctor said.
“To reverse the trend, engage as many private doctors as you can for treating the mild cases and very vociferous immunisation,” suggested Fernanded.
But there is also a lot that the people can do. “People are not wearing masks. When you go to market for example, the masks on their chin,” said the former GMC doctor, adding, “There is no self discipline.”
Doctors are all in agreement that as cases dipped, people went back to a normal life.
“At the same time, when cases began to drop people began to take all safety measures lightly. If masks were worn, social distancing was maintained and all appropriate behaviour followed, cases would not rise,” the private doctor said.
Concurring with this view, the GMC resident added, “Precautions were thrown to the wind. People began crowding and thought everything was back to normal. Complacent attitudes by people led to rise in cases. Even in the present times, many people are still not following appropriate behavior.”
“In my personal opinion wearing masks in Goa is better than in other States like Delhi, Noida, and other places where I have visited. But the problem is inter-state migration. There is no restriction at the borders, railway stations and airport. This is where Covid starts,” Pal said.
The aim now has to be to end the pandemic. And would that mean restrictions at the arrival points to the State?
(With inputs from Vibha Verma)