To ensure adequate supply of vaccines, Uttar Pradesh has become the first state to float a global tender to procure Covid-19 vaccines, specifying it wants 40 million doses within six months.
The state of Uttar Pradesh, which faced a ruthless second wave surge of COVID-19 cases is now regaining control of the situation and ensuring last mile reach within the state through ‘Tracing, Testing, Tracking and Treatment’. So far, the state has undertaken the highest number of tests in the country, a total of 4.61 crore, out of which 2.34 crore tests were conducted in the rural areas. The total number of cases has gone down by 68% from the peak of 2 lakh 10 thousand on 23rd April. The state’s positivity rate has also reduced to 2.45% from 22% in April, which is one of the lowest in the country. The recovery rate for the state now stands at a good 92.5% while the Case Fatality Rate is 1.1%. Every day around 3 lakh samples are being tested in the state.
With 240 million people, Uttar Pradesh is India’s most populous state. Home to every sixth Indian, if it was a separate country, it would be the fifth largest by population in the world, just behind China, India, US and Indonesia – and bigger than Pakistan and Brazil. The state already proved its mettle last year with the deft handling of the pandemic and mitigating the adverse economic effects.
After the second wave hit India in March, Uttar Pradeshbecame one of the worst-affected states in the countryaround mid-April, after Maharashtra and Delhi. This can be attributed to the reverse migration from Mumbai and Delhi into UP, as these states employ a significant proportion of UP’s working population. It should be noted that even though both Mumbai and Delhi aremuch smaller in size and population than Uttar Pradesh, they recorded great surges in COVID-19 cases.
According to World Health Organisation Chief Scientist Soumya Swaminathan, the current coronavirus variant in India is more contagious than the first, which explains the massive outbreak of the infection during the second wave. Cities closer to Delhi like Noida, Meerut and Ghaziabad bore the brunt of the virus before it struckLucknow with full force. The virus’s unpredictable ebbs and flows caught the country off-guard and worse, several health workers, including doctors, nurses, ward boys and lab technicians fell sick, further aggravatingthe healthcare emergency.
It was time for Uttar Pradesh to let go of its previous glory of handling the first wave and spring into action. Despite being overwhelmed by the magnanimity and deceptive nature of the virus, the state government was ready with its “go hard, go far” strategy to combat thefurther spread of the virus.
Chief Minister Yogi Adityanath and his administration were faced with a herculean storm and the only way to survive the storm for him and his administration was to face it head front. This is exactly what they did. Yogi Adityanath’s prior knowledge of handling the Encephalitis during his term as a five-time Member of Parliament from Gorakhpur proved useful.
Uttar Pradesh’s efforts to combat the spread of the second wave are being orchestrated using an all-of-government approach and the following outlines Uttar Pradesh’s second wave pandemic response:
TEAM – 9
Team 11 ( which was at the center of all decision-making last year) was reconstituted into Team-9 comprising of senior ministers and senior bureaucrats to implement the state’s quick response strategy. Led by the Chief Minister, Team-9 is leading a coordinated governmental effort which includes all ministries and government agencies and is focusing on the immediate requirements for arrangement of beds, oxygen, medical equipments, integrated control room, vaccine availability and other logistics arrangement. As soon as first few cases were recorded, the task force had immediately initiatedsurveillance measures in around 40 districts.
Furthermore, the District Magistrates of all the 72 districts have been asked to constitute their own ‘Team 9’ for a faster dissemination of government schemes among citizens. More than 73,000 monitoring committees have carried out the herculean task of door-to-door screening in around 97,000 villages. The state is conducting more than 1 lakh Covid tests daily in villages through 8000 Rapid Response Teams (RRT). Around 68% of the villages haven’t registered any cases in the past few days.
LEADERSHIP AND DECENTRALISED STRATEGY
It is a saying that wars are won only when they are led correctly. One aspect of Yogi’s personality is the ability to articulate a form of leadership that embodies strength and boldness. Yogi, who himself tested positive at the outset of the second wave, realised that handling this second wave might be the capstone of his decades in public life. Covid-19 became the most dangerous criminal for him to crack down upon and he put his bestfoot forward to tackle the situation.
The state has engaged experts from the Indian Institute of Technology (IIT) Kanpur to prepare the district-wise trajectory of the Covid curve using mathematical modelling to fine-tune its Covid-19 response. The state has also built engagement with various groups of doctors, farmers, Nigrani samitis, sportspersons andreligious leaders among others. UP has also constituted an expert committee of prominent doctors and has held meetings for strategizing containment of Covid-19.
UP has effectively managed to boost its oxygen supply from various sources (almost three times) from 350 MT to 1050 MT. In a first, Uttar Pradesh has set up “Oxygen Monitoring System” for ‘real-time’ tracking of oxygendemand of hospitals and the distribution of oxygen supply. The state has also floated a global tender for urgent procurement of cryogenic tankers.
The pandemic has posed significant public health and economic challenges to not just the state and country,but the entire world. With a large population dependent on daily wages, these challenges have been met with decisive government leadership, strongly informed by experts from the healthcare sector.
A partial curfew in the state was implemented on April 29 and remains operative till 7 am on May 24th. A full lockdown was a no-go as Yogi understands the needs of average working people, many of who are dependent on daily wages. This has helped the industry to function and retain the employment of millions of our population.
A week after testing negative, Yogi Adityanath is on his toes and travelling within the state to oversee facilities in hospital, talking with experts in the healthcare sector and checking on citizens. He has travelled to almost 8 divisional headquarters and has personally reviewed 45 districts during his visit. – something which no other Chief Minister has done.
HEALTHCARE TO ALL
On April 29th, Yogi Adityanath announced that the government will provide Remdesivir injections free of cost to critically ill patients. However, the private hospitals will have to procure this drug from the manufacturing companies and the market itself.
To curb the illegal sale of essential drugs amid the rising corona virus infections in the state, National Security Act (NSA) is to be invoked against people who are involved in black-marketing of Covid-19 medicines.
UP had a total of 23,000 level 2 and level 3 beds in the first wave, apart from almost 1.16 lakh level 1 facility beds. But with the L1 beds not in much use, for the second wave, the state has prepared 80,000 L2 and L3 beds, which are in use, besides the facilities provided by the Defence Research and Development Organisation.
WELFARE OF EVERY CITIZEN
Yogi provided the much-needed empathic leadership and effectively communicated key messages to the public, calling the tackling the pandemic as the work of a unified “team of 24 crore”, which resulted in high public confidence and adherence to pandemic-control measures.
The state government further announced that all the health workers, including doctors, paramedical staff, housekeeping staff, sanitation workers, accredited social health activists (Asha) and Anganwadi workers will be given an additional 25% of their salary or honorarium for their Covid duty days. Also, kin to any deceased Covid worker will be given Rs. 50 lakh ex gratia.
More than 450 community eateries have been started in the state and the number is set to further increase. Free ration is also being provided to the needy from the PM Scheme for the next 3 months and a monthly subsistence allowance is being paid to all daily wage earners, street vendors etc. Dr. Gautam Sen, Former LSE professor said: “Uttar Pradesh government is making every effort to balance the terrible impact of the Covid second wave to avoid the people from suffering worse than they are already. We will survive and emerge stronger as an economy and people from the pandemic.”
AGGRESSIVE TESTING
The state government is aggressively following the ‘Trace, Test and Treat’ mantra and is reaching the last mile. Antigen kit testing is being carried out by the Rapid Response Team.
The state government has further initiated world’s largest house-to-house surveillance of COVID-19 in rural areas to contain transmission by testing people with symptoms for rapid isolation, disease management and contact tracing. Government teams are moving across 97,941 villages in 75 districts for this activity, which began on 5 May, and has been extended to cover 100% rural households.
A recent WHO article details: “The state government has deployed 141,610 teams and 21,242 supervisors from the state health department for this activity to ensure all rural areas are covered.”
Meanwhile, a massive vaccination drive has beeninitiated for 18-44 years age group in the state from May 10. The drive will be conducted in 22 municipal corporations and Gautam Buddh Nagar districts which have a greater number of cases.
The state’s rural-control strategies, as well as both community-based and individual case-based control measures, so far seem overall effective in identifying and treating patients. The WHO article has acknowledged the efforts being put in by the state government.
VACCINATION AS EXIT STRATEGY
Uttar Pradesh is pursuing a strategy focused on local outreach and expanded accessibility for vaccine.
The fastest way out of the second wave is to vaccinate as many people as possible and the state government is faced with a herculean task to vaccinate its entire 24 crore population within months.
The state claims to be by far the most vaccinated state with 1.56 crore doses being already administered. As of 20th May, 1,58,41,256 people have been inoculated within the age group of 18-44 in 18 districts. Vaccine waste has been minimised as well to a 0.6%.
To ensure adequate supply of vaccines, Uttar Pradesh has become the first state to float a global tender to procure Covid-19 vaccines, specifying it wants 40 million doses within six months. The state government is rapidly working on expanding medical facilities in the state in collaboration with various corporate and multi-national companies while using all available government resources. While the immunization drive is getting stalled in other states of the country including Maharashtra and Delhi, the process of Covid-19 vaccination in Uttar Pradesh is getting faster every day. The Yogi government is running a vaccination campaign for the youth in a phased manner and so far, 8 lakh youths have been inoculated in 23 districts.
To increase the pace of vaccination in rural areas, the government has decided that common service centres will be roped in to help people register on the CoWinapp. Each centre will provide this facility and also that of vaccination in the near future. The work will be done for free and nobody is to charge for helping someone with the work.
THIRD WAVE PREPARATION
Yogi Government has buckled up to further be ready for the third wave which is said to be harmful to children. To fight the ‘Black Fungus’, an expert committee has been set up consisting of prominent doctors.
The Bombay High Court has further praised the Yogi government’s model for protecting people and children from infection and curb the spread of the second wave. A division bench of the Bombay High Court comprising of Chief Justice Dipankar Dutta and Justice Girish Kulkarni took cognizance the preparation of the UP government of increasing the number of paediatric ICU beds to tackle the third wave in which children are said to be affected. The bench requested the Maharashtra government to replicate the same.
UP government has decided to set up a 50 to 100 paediatric beds (PICUs) in major cities of Uttar Pradesh to protect children from COVID-19 infection. Meanwhile, all districts have been directed to remain alert and the authorities have been asked to ensure that the children receive prompt treatment. PICU (Paediatric Intensive Care Unit) is for children above one month, NICU (Neonatal Intensive Care Unit) is for treatment of children below one month, and SNCU is for children born in women’s hospital.
Severely infected children will be provided with treatment and oxygen facilities on these beds. Significantly, this is not the first time Chief Minister Yogi Adityanath’s compassion towards children has come to the fore. The entire nation remembers the campaign he undertook to save them from the deadly disease like Encephalitis occurring in the children of Purvanchal. Presently, mortality from encephalitis has been controlled up to 95%.
CONCLUSION
Brazil’s population is 21.27 crore and England, Spain, Italy, France together is 25.6 crore which is equivalent to Uttar Pradesh population and yet these four countries of Europe recorded total positive cases of 173.32 lakh while Uttar Pradesh recorded 10.3 lakh. Manindra Agrawal, Professor, IIT-K said: “This pandemic has caused a lot of damage everywhere. The state of Uttar Pradesh is no exception. However, given its size, I believe that the state has done well to avoid a much bigger calamity. The lockdown was imposed at the right time which slowed down the spread of pandemic just when it was spreading to the villages. It helped reduce the peak infections by a factor of two as per our SUTRA model. Also, proactive steps were taken to rationalize the demand of oxygen through an audit resulting in 10% + savings.”
The dominant theme of Uttar Pradesh’s response to the second wave has been resourcefulness and astute response. At a moment of extraordinary tragedies and pain, Yogi’s seemingly boundless capacity for resilience and not leaving any stone unturned to salvage the situation projected hope. Faced with multiple crises including the coronavirus pandemic, Yogi has sought to rebuild trust in the government with an audacious Rs. 12, 242 crore spending on healthcare infrastructure announced during the budget earlier this year.
While the second wave is far from over and Uttar Pradesh may not be an emblematic champion of proper prevention, it has stepped up with an adequate response to the deadly second wave coronavirus 2019 (COVID-19) pandemic.