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Shifting Corona Pattern from Cities to Rural Areas an Ominous Sign: Health Experts

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Manas Dasgupta

NEW DELHI, Sep 21: Even as the hunt is on for an effective vaccine for Corona, experts see some ominous signs in the shifting pattern of the pandemic in India from the urban-centric to semi-urban and rural areas that could cost loss of more precious lives because of poorer health network.

One of the major reasons for the comparatively lower Corona fatality rate in the country, being trumped by the union health ministry as a major success of its COVID-19 management, was believed to be so far it essentially remained an urban phenomenon having better health infrastructure facilities. The metropolitan towns and other big cities and state capitals accounted for most of the cases in the country while a very minuscule percentage was attributed to the rural and semi-rural districts. However, in a worrying trend, this appeared to be changing in the recent weeks.

According to data collected from the official sources, ten big cities/districts of India contributed 57.77% of the total caseload when the lockdown ended on May 31 and unlock-1 started from the next day. That percentage reduced to 40.11% in a couple of months and further declined to 25.31% on September 18, which meant that from accounting for almost three-fifths of the caseload in May end, the 10 big cities now contribute to one-fourth of the total number of cases in the country.

Only the three major metros, Mumbai-Chennai-Delhi recorded a huge fall in their caseload contribution over the last few months. The three megacities accounted for almost two-fifths of the total number of cases in May end. By end July, the share dropped to one-fifth. It has further gone down to one-tenth of the total caseload on September 18.

On a larger canvass, the share of the 52 metro/big city/state capital/ major town districts from the total 740 districts in the country including the metro cities and other major urban centres has dropped to 40.03 per cent of the total caseload in the country by September 18. It was a significant drop from June 30, when these 52 districts accounted for 67.46%, i.e., more than two-thirds of the number of cases in the country

Ahmedabad, Mumbai, Chennai, Delhi, Gurugram, Agra, Indore, Thane, Udaipur, Hyderabad, Faridabad, Vadodara, Gautam Buddha Nagar and Jaipur also saw a rate of growth of cases which was less than five times from June 30 to September 18. This in turn meant that there had been an increase in share in the caseload from the rural/semi-rural districts of the country.

The Urban-percentage of Covid-19 fatalities had also reduced significantly in the last two-and-a-half months. The 52 Urban districts accounted for 13,886 of the total 17,409 deaths till June 30. That percentage of almost 80% has gone down to approximately 54% — 45,051 deaths of the total 84,238 deaths — as on September 18.

Palghar, Chengalpattu, Raigad and Thiruvallur were the only four non-Urban/ non-Big City districts in the top 20 affected according to caseload on the June 30. The number has increased to eight by September 18 – Raigad, SPS Nellore, Guntur, Anantapur, Chittoor, Kurnool, West Godavari and East Godavari. Along with these, other non-Urban districts like North 24 Parganas, Jalgaon and Prakasam – all have more than 40,000 Covid-19 cases in India.

In fact, a majority of 16 districts which can be classified as non-Urban are among the top 30 in terms of the caseload in the country. “There are many reasons for the rise in the number of cases in rural districts – easing of lockdown restrictions, the opening of the economy, return of migrant workers to their villages and now back to their work places by many of them, lack of awareness and breach of social distancing norms and protocols were among the factors contributing for the shift in the pattern,” the official sources said.

The experts believed that the “signs are ominous.” Even big cities and metros haven’t been able to cope with the alarming rise in cases. “With inadequate health infrastructure and medical facilities, these districts, with a large population, have their task cut out,” the experts expressed the apprehension.

Meanwhile, the official sources quoting western media reports said at least ten countries in Asia, South America and the West Asia had entered into agreements to access the Russian coronavirus vaccine Sputnik V.

The list of countries includes India where Hyderabad-based Dr Reddy’s Laboratories has partnered with the vaccine developers for carrying out late stage trials and then distribute 100 million doses of the vaccine. The Russian developers are also looking for an Indian partner to manufacture the vaccine in India.

Brazil, South Africa, Mexico and Saudi Arabia were among other countries that have struck deals to bring the Russian vaccine for their people, the report said. Besides, Russia has claimed that about ten more countries were negotiating to buy the vaccine from it. It has said it had received requests, or expressions of interest, for about 1.2 billion doses of the vaccine so far, according to the report.

Sputnik V was the first coronavirus vaccine to get the regulatory approval for public use in the second week of August, though China had allowed limited use of at least one vaccine before that.

AstraZeneca, which had been contracted for manufacturing vaccine developed by the Oxford University, has also come out with detailed disclosures about its ongoing coronavirus vaccine trials. This along with the vaccines of  two other major drug manufacturing companies are the only ones to have entered phase-3 clinical trials in the United States. They are also expected to be the first ones to come out with a coronavirus vaccine.

AstraZeneca’s  clinical trials across the world which had to be paused earlier this month after one of the volunteers in England developed some serious illness, have resumed in the UK following a review by an independent team of experts as well as the country’s drug regulatory. Though the trials  in India, South Africa and Brazil have also resumed, those are still to restart in the United States where the Centres for Disease Control and Prevention (CDC) has ordered its own investigation.

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