Rural India is in a catch-22 situation. RT-PCR testing for COVID19 is sluggish. Those showing symptoms of the virus are being refused admission unless they produce an RT-PCR test report. Many who manage an RT-PCR test have to wait for days, even weeks, to receive the test report.
A large chunk of the rural population is unable to access COVID tests. All photos: By arrangement
Arvind Kumar has been unwell since April 15. A resident of village Kajri Mulpur in Shahjahanpur district of Uttar Pradesh, the 27-year-old has been running a fever and cough. On April 17, he got his RT-PCR (reverse transcription-polymerase chain reaction) test done at the district government hospital to rule out the possibility of COVID-19.
Eighteen days later, Kumar is yet to receive his test result. Online status (checked today) shows his sample has not even been sent to the lab for the testing. “The testing centre is about twenty kilometres away from my village,” Arvind Kumar told Gaon Connection. “When I went there they had run out of antigen test kits [immediate test result] and I had to do the RT-PCR test. It is nearly eighteen days now and I am yet to get my test results,” he said, but added that he was better now.
Over 800 kilometres away, distance is what is keeping villagers from getting tested for the coronavirus. “Nearly ten people have died in my village since April 15,” Shivam Baghel, a farmer from village Paraspani, in Seoni district of Madhya Pradesh, informed Gaon Connection. The villagers in the area are wholly dependent on the district hospital for COVID 19 testing, he said.
“The hospital is nearly sixty kilometres from my village. No one visits the village to conduct the RT-PCR tests. All those who lost their lives were ill, but because of the distance, they did not care to go to the district hospital to get tested for corona,” he said.
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As against the antigen test kit, which provides COVID test report within five to ten minutes (like a home-based pregnancy test kit), RT-PCR is considered a more reliable method of testing for the coronavirus. However, a large chunk of the rural population is unable to access these tests. Those who are able to get themselves tested through RT-PCR, their reports come after several days, sometimes after the patient has died.
Village after village is reporting a wave of fever, cold and cough, but in the absence of timely testing, it is hard to figure out the extent of corona spread in rural India.
But the second wave of the coronavirus in the country has led to untold grief. On May 3 alone there were 368,000 fresh cases reported in India and 3,417 deaths due to the virus. The virus has found its foothold in rural India that was relatively less affected last year when compared to urban areas. And the inadequacy of rural medical health infrastructure is becoming glaringly obvious.
When Ayushi Bagriya’s 62-year-old father developed fever, cold and a cough, she took him to the Kushinagar district hospital in Uttar Pradesh on April 30. But they were turned away as there were no beds available. Then, they travelled more than 50 kilometres to Gorakhpur where again they were refused admission. None of the hospitals they visited would take them in, first because there was a shortage of beds, and secondly, because they did not have the RT-PCR test results, Ayushi alleged.
It isn’t that the 34-year-old did not get her father, Anjani Bagriya, tested for COVID-19. On April 24, she had got her father’s RT-PCR test done at the government hospital Kushinagar, but did not get the result for two whole days.
“My father’s condition was deteriorating, so we decided to get him tested at a private lab,” Ayushi, who lives in Patti Padrauna village in Kushinagar district, about 350 kms from Lucknow, told Gaon Connection. The private lab report (based on the antigen test) confirmed he was positive. Thereafter, he was treated at home and is safe now.
Meanwhile, the result of the RT-PCR test done on April 24 came an entire week later on May 1. “And to our surprise, the results were negative,” said a perplexed Ayushi.
Somewhat similar is the story of Asha Pandey, a resident of Vidapur village in Sikhad block of Mirzapur, who fell ill on April 25. Her son Abhishek Pandey took her to the nearby Community Health Centre where an antigen test was done, and she tested negative. Just to be certain the 55-year-old also underwent an RT-PCR test the following day.
But within two days, by April 28, Asha’s condition worsened. “She developed difficulty in breathing and we rushed her to the district hospital, but she was refused admission,” Abhishek told Gaon Connection. The family then took her to Varanasi 14 kms away. But she was refused admission in the hospital as she did not have the RT-PCR test results. After much running around, the family finally found a hospital Bhadohi that took her in, but they had to arrange for the oxygen she needed.
“The antigen test is not dependable and the government must step up the RT-PCR tests in rural areas,” Amulya Nidhi, who works with the Jan Swasthya Abhiyan in Madhya Pradesh, told Gaon Connection. “If the villages are to be saved then the testing has to be increased and arrangements must be made for the people there to be tested,” he emphasised.
For people in rural India, it is a catch-22 situation. Hospitals do not admit patients unless they carry their RT-PCR test results. But the test results are handed over to the patients who are showing symptoms of fever, cold and cough, after an inordinate delay. Meanwhile, the person, who could be COVID-19 positive, moves around with others increasing the risk of the spread of the virus in villages.
The RT-PCR tests are considered to be more dependable, though the rapid antigen test results are almost immediate. On paper, RT-PCR test results take anything between 70 and 72 hours. But the ground situation is far different.
“I always thought the testing and the diagnosis would be better and quicker at a government facility,” Ayushi said. But, it is only when her father fell sick that she learnt to her dismay that the samples collected for corona testing were sent 90 kilometres away to another government lab at Gorakhpur to be processed.
“Thank god we did not wait for the reports to come from the government hospital and got our father tested privately. He could have lost his life in the delay,” she said. But, most people in the villages depend solely on government health centres, she pointed out.
Gaon Connection tried to get in touch with NP Gupta, Chief Medical Officer (CMO) of Kushinagar, but despite repeated calls and messages, was unable to get any response from him. Meanwhile, according to a press release on May 3 by the government of Uttar Pradesh, on May 2, over 129,000 RT-PCR tests were done across the state.
In the far north western end of the country, similar stories of delay in testing and test results are being reported in the villages of Rajasthan. “The testing centre is nearly thirty kilometres from my village,” Ram Chaudhry from Sindhari tehsil, Barmer district, told Gaon Connection. “There is no testing being carried out in the village, and people despite being ill do not want to undertake that long journey,” he said. “Unless they get tested, how will anyone know if they have COVID or not,” he wondered.
In Bairiya village in Gopalganj district of Bihar, Triyambak Srivastav is awaiting RT-PCR test results since April 17. “My brother, sister, father and my aunt are down with COVID 19. Their samples were taken on April 17 and we are still awaiting the results,” he told Gaon Connection.
Meanwhile, when his brother’s condition deteriorated, Srivastav got him admitted to BRD Medical College in Gorakhpur (UP) nearly 90 kms away.
While the patients and their families suffer, officials claim they are helpless. “The truth is that we are not getting sufficient testing kits. We get about twenty to twenty five kits every day while the number of people showing up for testing is many times more,” a health official at a test centre at Bhadohi, on conditions of anonymity, told Gaon Connection.
“Many of our staff are COVID positive because of which it has become difficult to carry out the RT-PCR tests,” Vidhu Gupta, CMO, Mirzapur district, told Gaon Connection. He added that the results for the testing should not normally take more than 10-12 hours, but because of shortage of staff, it is taking three to four days.
Rural medical centres are staggering under the load even though the number of people getting tested in rural India is abysmally low. For instance, on May 2, only 1,123 samples were collected in Mirzapur district in Uttar Pradesh, which has a population of approximately 2.5 million. Of this, only 363 were RT-PCR tests. At Bhadohi district that has a population of approximately two million, only 660 samples were collected the same day for testing.
It is difficult times for rural India as the coronavirus makes its presence felt there. The worst is yet to come and this is but just the tip of the iceberg.