On 20 April, Rajesh Pandit, a 40-year-old owner of a meat shop, returned from Ludhiana to Patna by train. He was running a steep fever. He spent that night at the Patna station, for lack of transport, but was not screened for COVID-19 by the state’s authorities. The next day, he took a bus from Patna’s Mithapur bus stand and reached Baruna Rasalpur village, in Samastipur district. He was not swabbed for the virus there either. “All my neighbours knew that he had fever and breathing problems, but no health worker turned up or arranged for either testing or treatment,” Ram Udesh Pandit, Rajesh’s younger brother, told me. Rajesh’s family got him medicines from a local shop, but his condition did not improve. “On 24 April, we took him to Samastipur and got him tested at private test centre,” Ram Udesh said. “It was positive.” The next day, a CT scan at another private centre showed that 35-percent lung damage. By then, his fever had worsened and he was struggling to breathe. He was admitted to a private hospital in Samastipur town and transferred three days later to Darbhanga Medical College and Hospital. Rajesh died on 4 May.
“He was a healthy man,” Ram Udesh told me. “If he was tested earlier then he might not have died.” He told me that his brother was the first death in the village, once the second wave of COVID-19 began spreading into the vast rural hinterland of Bihar. “The entire village have socially isolated our whole family after that,” Ram Udesh said. Despite this, others in the village too had begun showing symptoms of COVID-19. The medicine shop owner, who the family had bought medicines from, had been suffering from a fever and severe cough for a week. Ram Udesh said that many others in the village were exhibiting similar symptoms. He told me that despite the visible spread of COVID-19 across the village, no testing or general screening was being done.
In the last few weeks, as the second wave of the COVID-19 pandemic overwhelmed Delhi, Mumbai and the other major urban centres of India, migrant workers from Bihar began returning to the state for a second time, in a panic. However, in comparison to the first exodus of migrant workers following the sudden nationwide lockdown in March 2020, this time, the Bihar government seems even more ill prepared to test and monitor returning residents. Despite the second wave being more infective and taking a larger death toll in Maharashtra, Gujarat, Uttar Pradesh and Delhi, the Bihar government has failed to prepare for the wave even to the levels they had in the first wave. Very few bus stands and railway stations in the state have the infrastructure to test returnees, and the few that do are not consistently testing them.
This has allowed the virus to spread to rural Bihar. Healthcare workers in villages have not been given any instructions to quarantine or test returnees—both panchayat leaders and rural health workers told me that despite them reporting the spread of COVID symptoms in their villages to senior government officials, the state government did not give them any resources or orders to deal with the situation. Simultaneously, major hospitals in cities are also facing severe shortages of beds and oxygen.
Despite many criticising the unpreparedness of the Bihar government to manage migrants returning in 2020, transport, testing and quarantining seem to be even less organised this year. Last year, when a country-wide lockdown was imposed and reverse migration started, thousands of workers thronged to their villages. The railway ministry had started Shramik Special trains to bring stranded workers back to Bihar. By 2 May 2020, the Bihar government had established quarantine centres in nearly every panchayat in the state. Two-week quarantines were declared mandatory for migrants who returned between May and late June. Health officials, such as the Accredited Social Health Activists, or ASHA, were also roped in to monitor incoming migrants in railway stations, bus stands and in each village.