Some thoughts from the Pune — the Covid Hotspot
I am not very inclined to writing personal experiences on blogs read by strangers, but here i am making an exception as i have felt the urge to share this experience for over a month.
Like everyone in the world, Covid has had terrible impact on life in Pune (and Maharashtra on whole) especially these last 2–3 months. India went into a harsh lock-down around March end and the lock-down continued in some form into the month of May. Things started getting loosened up by May end when Mumbai and Ahmedabad were the Covid hotspots in the country shortly followed by Delhi and Thane. But since July, its Pune that had held the pole position. We are yet to see 3 digit new cases per day since start of July with the average daily increase of cases being around 3000.
As seen since July end the case load in Pune Municipal corporation (Pune city) has plateaued at saturation level with no signs of going down. A mega facility to treat the rising Covid patients was opened in the city, but it has gotten very bad reviews with many citing negligence and lack of medical staff at the facility. Link
A Pune based journalist died a few weeks ago after not medical treatment on time. This incidence sent panics waves across the city as a well connected person (journalist and lot of noise of social media) couldn’t get treatment on time, the condition of normal patients is much worse (viz getting treatment). Out of habit i keep checking the CSS board of available beds daily and on most instances the picture is similar to seen below. A daily small time spike in ventilator means generally means there have been more fatalities than admissions into ICU with ventilators.
Even though the Oxygen-less beds are 3005, there is extremely acute shortage of staff, hence the number is largely immaterial. The vacant oxygen enabled bed is 133, but even they are not well staffed and getting admission is anything but easy.
The test positivity rate has been consistently over 20% since July and at times has also touched 30% inspite of testing being scaled up significantly. Pune district has a population of 7 million and 250000 positive cases. But no one believes these numbers to be accurate as there is massive under-counting as found in the sero surveys. Even if one assumes a moderate 5,6 times more cases, Pune has almost 15–20% population infected (with the number being higher in core city). Why the quieter non Metro city of Pune has overtaken busier Mumbai and Delhi hasn’t been properly explored yet.
Every-time i have gone out to buy something or just for a bike/car ride, i have atleast seen 2 or 3 ambulances (at times even more). As of now I personally know atleast 50–100 people who have contracted Covid — including many close relatives and friends. A reasonably healthy 50 year old woman family friend of ours, was in ICU for 2 weeks including on ventilator for 2–3 days before getting out of hospital. She also suffered a stroke and it might take her months to make a recovery. A close friend of mine aged 30 and in reasonable health had a high fever for 15 days before getting admitted for low oxygen. This friend got Remdesivir and apparently that worked well for him. His fever subsided the next day and oxygen level was back up in a couple of days. His experience in hospital was harrowing, as the hospitals are extremely overworked. Over 20 people from my old society (where ~40 people live) have been infected including one fatality. Currently 2,3 people i know well are in ICU with news of their health coming infrequently. Even in the people who have recovered (including my in-laws), the recovery isn’t 100% even 2 months after the negative test. There are many instances of people getting admitted for some other issue and getting infected in hospitals with Covid and finally succumbing to Covid (not the original ailment). My wife tested positive a day after she delivered in early August with CT value 37.5 (not infectious according to experts), I tested 2 days later and was negative. Thankfully my wife had no symptoms whatsoever, but still the experience was extremely stressful. Adding to the misery, the hospital was seriously understaffed, leading to lot of chaos and bad health care inversely proportional to current health care costs.
I had personally guessed that cases will start falling around end of August given the high % infection in Pune, but they haven’t fallen yet. The Ganesh festival wasn’t celebrated publicly for the first time in 100+ years — yet people did visit each others houses for the festival. The resultant infections , with entire extended families getting infected in a matter of days resulted in a tall spike around start of September. For last two weeks not a day has passed by when i haven’t heard of some new cases in people i know on first name basis. All this while i continue to lead a very safe life with working from home & incomes unaffected.
From my own anecdotes in my experience, I can say see reasonable correlation between quantity of exposure and severity as suggested by Siddhartha Mukherjee. The thirty year old friend of mine spent half an hour talking to a man who was coughing intermittently (without masks & indoors). Typically the person from the family who gets the disease first (who typically catches it outside home) has had milder symptoms versus his/her family members who must be exposed to more viral load in Indian homes. Most other younger folks who have had moderate/severe disease in my experience had more exposure to viral loads. Masks seem to work very well in so far as they atleast seem to reduce the severity of disease. Personally i have tried researching on evidences of fomite transmission (as a significant mode)of any respiratory disease but evidence i saw is extremely tenuous. I cannot overstate the harm the whole Fomite transmission theory as the primary spread of disease has done. People have been fixated on cleaning surfaces and items, yet removing masks while talking to strangers. My current apartment has had EXTREMELY STUPID rules — like cleaning the entire premises every time we get a new patient (we have had over 20) while people continue visiting each others homes without masks.
Take everything i wrote in this paragraph with a grains of salt — as these are conjectures of a non biology/ scientific background layman.
Experts and laymen have been saying the peak (or is it the plateau) is truly in Pune for two months, but there has been neither a drop in number of deaths, cases nor in the Test Positivity rate. There is no attention in the media to suicides and other economy induced tragedies, here is a small statistic — 7 barbers had committed suicide in the Pune district in the month of June (i cant find a newspaper link to corroborate but am pretty sure about its veracity). From where I stand, there is some light at the end of the tunnel, I am just unable to gauge how far it is. Eventually the cases will fall before the vaccine is out and most cities in India should attain some level of herd immunity by Diwali, but the cost — both lives lost, lives affected and incomes crushed will be very high. What lies ahead life wise and livelihood wise, is anyone’s guess, but i fear social life as we knew it will no longer exist (atleast for a few years). Personally I dont know when i can comfortably stand close to another unknown human being without wearing a mask 🙁 .