Second wave: A dive into interior Telangana, Andhra Pradesh

Similar to the national situation, the case of Telugu states - AP and Telangana, it is observed that the lockdown during late March to May in 2020 had managed to keep the case count well under control. However, once the nation moved into the Unlock 1.0 phase, the cases started rising in both the states – steeply in AP and gradually in Telangana. The number of cases in AP rose from less than 2000 a month in May to almost 3 lakhs in August, which settled down to 5500 in January 2021.

Though we could see a similar pattern in Telangana, the peak came in September with over sixty-six thousand cases, and gradually came down to around four thousand mark in Feb 2021. The number of recovered cases also has a more or less similar path for both the states. What's interesting is that both the states are witnessing a steep rise in the number of cases, starting March 2021. AP has surpassed its monthly highest and clocked over 3.5 lakh cases in just first 17 days of May. Telangana on the other hand shows signs of improvement in May, with cases coming down marginally.

Could this be attributed to the lockdown imposed on May 12? It could be too early to decide on that. Deaths in AP follow the same pattern as confirmed and recovered cases; whereas in Telangana, though we see signs of recovery in terms of confirmed cases in May, the deaths have already surpassed the previous monthly record and are still going up with over 750 monthly deaths coming in just 17 days.

*Telangana reports ICU and ventilator beds together.

Majority of patients who were affected with COVID-19 in the first wave recovered fully with home isolation, whereas in the second wave a lot of people are requiring hospitalization with oxygen, ICU or even ventilator support. To keep up with the demand, both the states have relaxed regulations allowing private hospitals to treat COVID-19 patients, whose treatment was earlier limited to government-run COVID Care Centres. Telangana has ramped up health infrastructure from 20396 beds (12284 general, 5861 oxygen and 2251 ICU beds including 1117 ventilators) in late August to 54755 beds in all (for category-wise beds status, refer to the table above), currently.

A little deeper look into where the cases are coming from shows that not all districts are affected equally. Location Quotient (LQ) is drawn by calculating the concentration of the cases at the district level over the state average. The LQ is used to arrive at the order in which the districts rank in terms of COVID-19 cases.

For instance, in Andhra Pradesh, the concentration of cases is high in East Godavari, West Godavari, Nellore, Chittoor and Kadapa during both the waves. Visakhapatnam, Krishna, and Kurnool districts are able to contain the spread of the virus compared to the other districts during both waves. Guntur and Kadapa districts have been able to effectively contain the spread of Corona Virus and reduce the number of cases in the second wave compared to the first one.

A close look at the management of cases among various districts of Andhra Pradesh which require hospitalization of any kind (general, ICU, ventilator, oxygen) gives a clear picture of how well the district is prepared to treat COVID-19 patients. The following table shows the relation between COVID Index (calculated using infection rate, death rate, and the recovery rate) over Health Index (calculated using the availability of each type of bed in the district).

Chittoor district fares well in the health infrastructure and was able to effectively manage the cases. Despite having good health infrastructure, Guntur and Visakhapatnam districts were not able to effectively manage the situation. Regardless of having bad health infrastructure, the Srikakulam district is handling the COVID-19 cases well. East Godavari is doing a decent job in managing severe cases despite having a high caseload. Despite having low case concentration coupled with decent health infrastructure, Kurnool and Krishna districts have not been able to live up to the expectations.

District-wise data for recoveries and deaths are not officially declared by Telangana leaving us paralyzed to construct a district-wise quartile chart depicting which districts have performed better over others.

The trend clearly shows we haven't peaked yet, in the second wave. The pandemic is here to stay, how it goes further from here is all about how people, government, and civil society react to it. The lockdown imposed by both governments is doing little to contain the spread if not aggravate it. The window of 4/6 hours of relaxation is turning out to be super-spreading events forcing everyone to finish their business in the limited timeslot. We can only make the line flat, and bring it down by following social distancing, wearing face masks, and washing hands frequently.

References:

-Media Bulletins of AP and Telangana states

-www.COVID19india.org

-Websites of Health Departments of AP and Telangana states.

Disclaimer: This article is based on the analysis of secondary data collected from the official sources of both states. We empathize with the families of the deceased and those who had to face any kind of difficulties whatsoever because of COVID-19. We understand from several reports that there might be cases of under-reporting of cases & deaths but we cannot comment upon it at this point of time because of the lack of authentic secondary data.

Authors

Rajeev Agur: is an independent policy researcher and an alumnus of the School of Public Policy and Governance, Tata Institute of Social Sciences, Hyderabad. Apart from his full time job revolutionizing urban commute, he can be found reading, clicking pictures and discussing politics. Rajeev also loves teaching and conducts data analysis workshops at his alma mater. He can be reached on twitter @rajeevagur

Ganesh Maruvada: is an independent public policy researcher and an alumnus of the School of Public Policy and Governance, Tata Institute of Social Sciences. He has full-time experience as a policy, and political consultant. He loves to write about policy, politics, and governance with data-backed research. He volunteers for a developmental NGO based out of Hyderabad. He can be reached on twitter @maruganspeaks