MADURAI: Madurai, which crossed 100 deaths on Friday, has seen a 92 per cent rise in deaths and 85 per cent rise in cases since June 22. Despite this, it is only towards the end of June that testing was increased from an average of 250 samples a day to 1,500 a day. Despite the surge, experts said that the city is yet to see a peak and the rise in cases is set to continue. Meanwhile, Madurai, being the hub for southern districts, has affected surrounding districts, with 289 cases being reported for the first time on July 9 in Virudhunagar.
Loosening of lockdown
At the end of May, Madurai only had 269 cases and in the beginning of June, new cases were only trickling in. However, with the extension of lockdown till June 30 coming with certain relaxations, salons and other shops were allowed to open. The Madurai Corporation announced that the decentralised markets – action taken in the aftermath of the Koyambedu cluster – could be centralised again at Mattuthavani. Accordingly, 750 shops were shifted back to the market and a rotational basis 250 shops were set to open each day.
However, the markets were shut for disinfection as, between June 13 and 14, 13 persons connected to the Paravai market and three connected to the Mattuthavani fruit market tested positive. While officials claimed there were no Koyambedu-like clusters being formed, around 700 vendors from Paravai and 300 vendors from Mattuthavani were tested. Of them, 46 in Paravai and three in Mattuthavani were positive. Following this incident, the district administration collected a list of 1,500 vendors at the Mattuthavani vegetable market for monitoring.
Flood from Chennai
Many from Chennai had been coming to the district. Sources said at least 14,000 Chennai returnees, with authorised e-passes, reached Madurai via road, rail and airways by the end of the first week of June. Reports suggest there were not enough check posts installed to screen those entering the district via road allowing for more returnees to sneak in without e-pass. After several complaints of people entering the district through villages and with bogus e-passes, the administration stepped up checking by mid-June and constituted Village Vigilance Committees to monitor entries.
Strategies evolved
By mid-June the city started conducting medical camps adjacent to 31 Urban Primary Health Centres to assess symptomatic cases. Volunteers from various NGOs were also roped in for door to door surveillance. However, for weeks, testing lagged behind other districts. The State government released district-wise data of samples tested for the first time on June 7.
According to the data, 14,102 samples were tested in Madurai, placing the district 30th in the State and 4th among southern districts. While the data reported that 6,420 tests were performed per million population in the State, Madurai had performed only half that figure – 3,975 tests per million. Even as cases surged, testing was still averaging only 300 samples in the second week of June. It was only in the third week of June that samples tested each day increased to 1,500. Minister RB Udhayakumar on July 10 said that figure had since doubled to 3,000 samples each day.
Intense lockdown
On June 22, a day after Dr. B Chandra Mohan was appointed District Monitoring Officer, Madurai and its surroundings entered an intense lockdown. The situation was dire -- by the fourth week of June all 100 wards in the city had at least two active cases. As part of the containment plan, streets with more than three cases from different houses were demarcated as containment zones. From 57 streets so designated on June 26, more than 300 streets were under containment by the first week of July.
“Lockdown is not a cure. It only buys time to improve the health infrastructure and thereby handle the spiking cases,” said the Monitor Officer. In a bid to catch symptoms early, fever clinics initially established in June were increased from 95 to 155 in July. Around 1,400 frontline workers were deployed for door to door assessment. A contact tracing team and a disinfectant team was also constituted, he said. Ten strategies were being formulated to handle the surging cases, the officer said, adding that a behavioural communication strategy and community involvement programme were being designed. Collector TG Vinay had warned the residents of stringent action against those who failed to wear masks and violate lockdown restrictions. .
Treatment
While the moderately affected patients are now accomodated at covid care centres(CCCs), the severely affected patients are treated admitted at the Government Rajaji Hospital. “This will prioritise those in need of immediate medical attention,” added Chandra Mohan. While the district has increased the number of CCCs and beds, conditions at CCCs have come under fire. On June 29, a patient at Thiagarajar College of Engineering CCC succumbed to the injuries after he jumped off the building. It is alleged that 600 patients were accommodated in the building which had facilities only for 200. Mental health services were also lacking. Subsequently, an online counselling centre was established at Arignar Anna Maligai on June 28 and yoga classes have been conducted for patients at CCCs since.
Surging deaths
The quick rise in deaths has given cause for concern, with Madurai MP Su Venkatesan asking why the virus was killing so many people in Madurai. The MP urged the district to announce test results within 24 hours of drawing samples so that care could be provided to patients quickly. He suggested that fever clinics should be established in rural blocks as well even if the case load in such places was low.The monitoring officer said that the epidemiological studies revealed that the cases would increase in a pattern similar to a hockey stick curve. Once the caseload peaked, the number of new cases would fall, he explained.