Health

As Bihar Finds 26% of Returning Delhi Migrants Infected, Doubts Cast on NCR's COVID Count

Delhi officials would like to believe the migrants picked up the coronavirus during their journey back to Bihar but if that were so then the prevalence of the disease in rural India is now higher than is officially assumed.

New Delhi: If random testing of returning migrants is any indication, one in four Bihari workers who made it back to their home state from Delhi were infected with the novel coronavirus.

The state government randomly tested 835 returnees from the national capital and found 218, or 26%, had COVID-19.

The statewise data on tests conducted on migrants in quarantine were tweeted by Manoj Kumar, head of the state’s health mission on Monday. “Most are asymptomatic so we took random samples,” he told The Wire.

In all, the Bihar authorities had until May 17 tested 8,337 migrant workers who returned from north Indian towns where they worked. Some 651 of them tested positive – an infection rate of 8% that is double the national average of 4%. Those who had returned from Delhi and adjoining areas were found to have the maximum positivity rate.

The Bihar government said those who had returned from other states had lower chances of contracting the infection. For example, 12% of the West Bengal returnees tested and a little under 11% of Maharashtra returnees tested were found to have the novel coronavirus.

An infection rate of 26% is quite high, but Delhi government officials have defended themselves saying the workers are likely to have been infected when they travelled, and not within the city itself. “It is not possible,” a Delhi health official told Scroll on condition of anonymity.

The national capital has reported 10,054 positive cases; according to the same official, the testing conducted on vulnerable groups in Delhi did not indicate such a high percentage of infections.

“We conducted tests on low-risk groups, such as pregnant women and other people coming into our hospitals who had no symptoms and were not contacts of confirmed cases, and did not find even a single positive case,” the official said.

Delhi has reported a positivity rate of 7% thus far.

Two possibilities arise at this juncture: either the workers got the virus in Delhi itself and the Delhi government didn’t know (e.g. because the workers skipped hospitals), or the official is right and the workers got the virus en route to their homes.

“A priori [it is] difficult to say,” Manoj Kumar told The Wire when asked about the possibility of the Delhi returnees getting infected along the way. “Many of them of hitchhiked,  and we don’t know whom they have traveled with. We are intently looking at migrants coming from Delhi, Surat, Ahmedabad, Mumbai, Pune and Kolkata.”

If the migrants picked up COVID-19 along the way, the prevalence of coronavirus infections in India may be much higher than has been reported because testing is currently restricted to urban centres, and hasn’t yet expanded into rural areas.

Most state governments and the Centre have continued to insist that India isn’t yet home to community transmission. However, the new data that Bihar has supplied seems to complement a study that researchers of the Indian Council of Medical Research published in April: indicating that community transmission has begun in some parts of India.

Even if the official was wrong and Delhi is in fact home to transmissions of the virus among groups the government has been unable to catch, it is yet another possibility that community transmission has taken root. Otherwise “low risk groups” such as migrant workers may have skipped hospital admission since they no longer had incomes, and therefore stayed in the government’s blindspot.

As Jayaprakash Muliyil, former principal of the Christian Medical College in Vellore, said, “Most of these migrants live in cramped quarters, so naturally they are [more] vulnerable than others living in more comfortable and larger spaces.”

Bihar and other states with large populations of migrant workers have their task cut out for now: the reverse migration has triggered a sudden spurt in the number of COVID-19 cases in the state. “More people have tested positive in the state in the past 10 days than in the previous two months,” Scroll reported.

Ever since the nationwide lockdown was imposed, lakhs of migrants have looked to make their home, either by walking or by arranging any transport facility they could get hold of. Over the last fortnight, Bihar has also flagged off 300 special trains to around 25,000 migrant workers into the state. Another 500 such trains are expected to come over the next week, Pratyaya Amrit, principal secretary of the state’s disaster management department, in charge of the repatriation, said.

A state official said that around 3000 migrants have been coming into the state daily through various means.

He said Bihar is now preparing to collaborate with other states to ensure “immaculate pre-boarding screening.”

Bihar state had a common quarantine facility in blocks and districts until now but is planning to quarantine migrants on the basis of where they have come from. Principal secretary Amrit said people will be separated into three categories. The first would pertain to those coming from hotspot cities like Mumbai, Pune, Surat, Delhi and Kolkata. “All of these people would be housed in block-level large isolation facilities. Each room in this facility would house two people,” Amrit said.

The second category of quarantine facility will house those from different parts Maharashtra, Gujarat, Delhi and West Bengal at the panchayat-level. The third will facilitate the quarantine of all others in their respective villages themselves.

Amrit said if those in the second and third categories developed more symptoms, they will be shifted to the first category. The period of quarantine for migrants is likely to be 28 days, but “any policy is contingent on capacity,” according to Kumar.

According to epidemiologists, a higher infection rate among migrants needn’t necessarily reflect a higher infection rate in their respective cities of origin, but only that when groups of people from different origins travel together, the number of infections could become amplified. T. Jacob John, a virologist, told Scroll, “If two percent were infected in Delhi, by the time they reached Bihar it would have shot up to 25%.”

Delhi has thus far tested 140,000 samples.

“The labs report the data to [Indian Council of Medical Research] and the format set by them is the number of samples tested,” said the Delhi health department’s official. “We need that data too [of the number of people tested as opposed to samples], but the system that the government of India has developed does not give us access to it.”