Districts in rural India are seeing a surge in cases of COVID-19 cases as the country continues its economic reopening.
IndiaSpend reports “on June 1, 2020, 41 percent of Maharashtra’s COVID-19 cases were outside of Mumbai. As the lockdown has opened and testing has increased, COVID-19 cases in the rest of the state have grown. By September 23, 85.7 percent of Maharashtra’s cases were outside of Mumbai.
“As the fourth phase of opening the lockdown proceeds apace, some districts that currently have few cases of COVID-19 should brace for a surge, experts warn. An analysis of data from the three states [Andhra Pradesh, Karnataka, and Maharashtra] with the most active COVID-19 cases shows that almost all of their districts are at risk of a surge, based on test positivity rate and doubling time.”
This is not unprecedented. In early June, my colleague Nicholas Parry wrote of COVID-19 cases permeating communities in rural India. “As migrant workers have left the cities, gradually reaching their home villages,” he wrote, “the disease could permeate rural areas, making the disease far more difficult to eradicate. Of particular concern is that any severe symptoms — often requiring that the individual be ventilated for weeks at a time — would be all but impossible to address in a rural setting.
“As of yet COVID-19 – the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly referred to just as the coronavirus – is largely contained to a number of concentrated areas and regions. This presents a prime opportunity for containment efforts. If the virus can be contained within these areas, the chances of spread may be significantly reduced. Should the virus spread to more areas, (in particular — and in stark contrast to each other — densely populated urban areas and remote, rural locations) the disease may become endemic.”
Subsequently, he reported of villages in rural India entering self-imposed lockdowns in the state of Goa. Later in June, Health Issues India reported of the pandemic hitting communities in rural India. This phenomenon flew in the face of the notion that COVID-19 and its manifold effects being restricted to an urban issue.
We cited data from the World Bank, outlining that 66 percent of India’s 1.3+ billion people reside in rural communities as of 2018. Despite this, we noted, “it is urban India that continues to enjoy the bulk of the country’s healthcare infrastructure.”
The IndiaSpend report highlights this grim reality, noting that – in the three high-burden states it identifies – it is rural India that goes overlooked. It quotes Giridhar Babu, head of Life Course Epidemiology at the Public Health Foundation of India (PHFI), who says “many are worried only about the rise [of COVID-19 cases] in certain cities but are not paying attention to the silent areas that are high in population. These areas are more dangerous and are likely to become future hotspots. It is only a matter of time.”