Sent home from quarantine early despite symptoms, Bihar migrant worker dies of coronavirus

Rajnath Prasad Yadav—a migrant worker who returned to Bihar—was released from the quarantine centre in eight days despite having symptoms. Akhilesh Pandey
11 June, 2020

Rajnath Prasad Yadav, a migrant worker who returned home to Fulwaria village in Bihar’s Saran district on 25 May, died on 4 June after complaining of severe breathing issues. Upon his arrival at the village—which comes under the Garkha block in Saran—he went to the Utkramit Madhya Vidyalaya, a nearby government school, which served as a COVID-19 quarantine centre. According to accounts of two others who were quarantined with him—his nephew Ranjit Kumar and friend Dinesh Rai—and his cousin Lal Saheb Rai, who was employed at the centre, Yadav started feeling sick within two or three days. As he complained of feeling feverish, cough and breathlessness, a team of health workers visited the centre for a check-up and gave him medicine. According to Lal, on 1 June, the quarantine centre was shut down and everyone who was housed there, including Yadav, was sent back home without any explanation. At home, Yadav said he was feeling breathlessness and his symptoms worsened. He died three days later. 

Yadav was tested for the virus only after his death. By all indications it was clear that he had contracted the coronavirus, Rinki, his 16-year-old daughter told me. On 10 June, Geeta Devi, Yadav’s wife, complained of breathlessness and had to be hospitalised as well. On 9 June and 11 June, respectively, Dr Madheveshwar Jha, the civil surgeon of Saran, and Subrat Kumar Sen, the district magistrate, confirmed to me that Yadav had COVID-19. But even till the morning of 11 June, his family did not have the test report, Ranjit said. 

In all, the administration and health system in Garkha appeared to be callous and grossly ill-prepared to combat the virus, even months after the first case of COVID-19 surfaced in India. Moreover, the events leading to Yadav’s death highlighted the perils of an ill-planned lockdown.  

I had met Yadav exactly a month before this story was published while visiting Khizrabad, a congested cluster of houses in Delhi which was occupied by thousands of workers from eastern Uttar Pradesh and Bihar, for a reporting assignment. Several residents, including Yadav, said that they have been unemployed and struggling for food due to the lockdown. Yadav told me the workers decided that “if there is no work, then it would be better if we could reach our native place.” In another report for The Caravan, I mentioned that on 23 May, Yadav began an arduous journey back home via the central government’s Shramik Special trains. Dinesh, who was with him during the journey, said, “We were without food, without water and in a route that was not known to us.” Yadav also told me he was distressed. “It was a painful experience,” he said. “We never thought that any train journey would be so difficult.”

Yadav, along with some other natives of the block who lived with him in Khizrabad, reached Garkha on 25 May. According to Dinesh, who was a part of the group, they were screened for COVID-19 at a local government hospital and were then asked which quarantine centre they would prefer. They chose the government school, as it was close to their homes, and moved there around 11 am that day. Dinesh said that social distancing and all precautions to prevent the spread of the novel coronavirus were being followed at the centre. 

According to accounts of three people who were present at the centre, Yadav showed symptoms of COVID-19 during his stay there. Yadav’s nephew Ranjit Rai, who had returned to the village from Bengaluru around the same time and was among the people who were quarantined, said, “Uncle was not well at all there. I saw him with fever and breathing problems.” Lal, a caretaker at the school who doubles as a cook, said that Yadav told him that he had a sore throat and felt feverish within two or three days of his arrival. He informed Manoj Kumar Singh, the headmaster, who was in charge of the centre, about his cousin’s health after which a doctor from the block-level government health centre visited the school. Lal and Dinesh could not identify the doctor. The doctor took Yadav’s temperature and gave him some medicine, specifying that he would be taken to the hospital if his condition did not improve. Yadav’s symptoms subsided briefly but the breathlessness persisted, Ranjit said. “He was trying to show that he was healthy,” he added. 

According to Lal, on 1 June, the authorities at the centre asked everyone who was quarantined there to leave and spend the remaining part of their 14-day quarantine period self-isolating at home. “They looked fit and fine,” Lal, who seemed hesitant about commenting on the centre, said. “It was a direction from the block [administration] to shut the quarantine centre and ask the people to go for home quarantine.” Referring to Yadav, Lal added, “We never expected his demise.” 

Manoj denied that there was any negligence on his part. “We were keeping a watch on him. Three days after the doctor came, he said he was okay. Others around him said he was okay too,” he said, referring to Yadav. He said as there were few arrangements at the facility—almost nothing apart from the provision of giving food—some people who were staying there opted to self-isolate and went back home themselves. Manoj said the quarantine facility was shut on 4 June, and not 1 June. There were 106 people in the centre on the last day. “The higher-ups asked us to shut it down and send them to another centre but no one was ready to go,” he said. 

According to Manoj, the people who were returning to the village were supposed to be quarantined at a block-level quarantine centre, and not at his school, but due to “local pressure” the school had to accommodate them. “There was less space in the centre but everyone wanted to come to this place itself. The people who were quarantined created chaos, did not follow the rules of the centre.” 

But the family had emphasised that he was asked to leave. Speaking of his uncle, Ranjit said, “On the day when we were asked to leave the quarantine centre, I asked him about his condition but for some reason he tried to hide it.” Yadav went back home, where his family resided and complained of breathing problems. “He was kept separate from the rest of the family, but his problem suddenly started increasing,” Ranjit said. On 4 June, Yadav’s health significantly deteriorated. “Since morning that day he was not feeling well,” Ranjit said. They rushed to the hospital. “But on the way to the doctor he collapsed,” he said. 

Like everyone else, Ranjit said, the authorities should not have sent Yadav back home. “He was absolutely not well to come home. He should have been sent to hospital,” Ranjit said. “Here also, we couldn’t manage due to unawareness about COVID-19. We looked for some local doctor for help, when he should have been taken to Chapra town and maybe he would have survived.” Lal said, “Definitely, we took his breathing problem lightly and this became fatal for him.” He added, “He should have been sent to hospital but what could I do, I was just a caretaker there and not that aware.”

Ranjit said, “I am not sure about the time but he died around 12 pm.” The family informed the block’s administration. Medical staff and members of the administration, including the medical officer of Garkha Dr Sarabjit and the circle officer Mohammad Ismail, visited their home around 7 pm, Ranjit and Lal told me. “They took the sample from the body and suggested that we should perform the last rites,” Lal said. “The circle officer said that we should cremate him somewhere in agricultural lands not at the bank of any river as there could be a problem. We did the cremation at night around 11 pm in an barren agricultural land.” Reiterating this, Ranjit added, “In our village, cremation is traditionally carried out at Dori Ganj Ghat. But, as CO sahib had suggested, we did it on a barren land at night the same day.” 

The cremation was held that night  even though the test result was awaited, the family members said. This appeared to contravene a guideline issued by the ICMR, which states, “If the COVID-19 test report is awaited, the dead body must not be released from the mortuary until the final report is received.” The ICMR also mentions that “patients in incubation period may not meet the diagnostic criteria for suspected cases but if they have possible epidemiological history, all dead bodies without reliable clinical/ epidemiological history and all unidentified dead bodies should be treated as suspected COVID 19 deaths.” 

The officials were unclear about why Yadav’s body was cremated that night itself. Sarabjit said, “I was there after the death and medical team collected the sample for test. The circle officer was also there.” But when I asked Ismail, the circle officer, whether he nudged the family to perform the last rites, he replied, “I did not say that. When I reached they already disposed the body.” Two days later, when I again pressed him to respond, he said, “Why would we get it done? And it wasn’t as if he was a positive corona patient also.”

When asked if Yadav had the coronavirus, Sarabjit said, “I heard that it is positive.” Jha, the civil surgeon, kept evading answering questions on the test report. Reluctantly, he said on 9 June, “The test has come back positive.” 

Subrat Kumar Sen, the district magistrate of Saran, said, “According to our data, from what the family members have told us, he developed a high fever two or three days after he left the centre. The family tried to get him to a hospital, but he died on the way.” I said that I was told that he developed the symptoms within the centre itself. He denied this. “No, we cannot verify this. This is not accurate according to our records.” When I asked why he was asked to leave the centre in a week, the call got cut. I called him up again, twice, and dropped him a WhatsApp message but did not receive a response. 

But the administration had not informed Yadav’s family of the result till at least 2 pm on 11 June, Rinki said. Ranjit said that they had heard from somewhere that he had COVID-19. On 9 June, a team of doctors and medical staff visited the village and collected samples of about 45 people without giving a reason, Ranjit told me. “They came to us and took the samples of my entire family members and others who were close to my uncle,” he said. “They should have informed us about the result. When I asked about that, they said that from higher officials there was no permission,” he said. “At least his wife and the family members should have been informed.”

On the morning of 10 June, Ranjit called me. Referring to Geeta Devi, Yadav’s wife, he said,  “Chachi is unable to breath properly and has chest pain. What do I do?” I called up Sarabjit to get help for the family as soon as possible. A medical team and ambulance soon reached the house. Geeta and Rinki were then taken to a hospital at the nearby Chapra city. At around 4 pm, the daughter called me and said no one had attended to them. I informed Sarabjit of this and later, Yadav’s wife was admitted. 

Meanwhile, Yadav’s friends and associates are being stigmatised due to lack of awareness about the virus. “We are in trauma. They look at us like we have done some crime,” Kalika Rai, one of the villagers who were in quarantine with Yadav, said. They also sounded grim that they could not make the authorities to act in time. Dinesh, Yadav’s friend, said, “We are illiterate and unaware. We never imagined that we would lose him.” He, and others, said that the authorities could have prevented the death. “People here at the centre and also the doctors who were visiting here should have taken this subject seriously. He could have been saved if doctors had taken him to hospital.”