Why Andhra’s border districts of Kurnool and Krishna have higher COVID-19 death toll

While Kurnool has the highest death toll in the state at 164 from 12,235 cases, Krishna district has reported 149 deaths out of 5,707 cases.
Frontline workers amid the coronavirus pandemic
Frontline workers amid the coronavirus pandemic
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As the COVID-19 pandemic continues to take a toll in many states in India, the districts of Kurnool and Krishna in Andhra Pradesh have seen a steady rise in the number of cases and deaths. Officials attribute this to a large movement of people from the neighbouring states of Telangana and Karnataka to hospitals in these districts.

While Kurnool has the second highest number of cases in the state at 12,235 (5,645 active), it has the highest death toll in the state at 164. Krishna district has reported only 5,707 cases, of which 1,362 are active. Despite this, it has a high death toll of 149.

Officials told TNM that the reason for the high death toll in these districts is because they reflect the entire region’s case load. Andhra has five major COVID-19 hospitals – at Vijayawada, which is located in Krishna district, Kurnool, Visakhapatnam, Nellore and Tirupati.

Many of the cases that Kurnool and Vijayawada receive are also more serious cases, which has led to a higher death toll, authorities claimed. According to them, patients, especially in remote rural areas, were failing to recognise coronavirus symptoms and dismissing it as the normal flu.

Kurnool an ‘epicentre’

The reason for Kurnool’s high case load, according to authorities, is its geographical location. The town is located close to the borders of Telangana and Karnataka. With interstate movement allowed for medical emergencies, many prefer travelling to Kurnool for the medical facilities available there, rather than their state capitals, which is far away.

Speaking to TNM, Dr PV Ramesh Kumar, Additional Chief Secretary to Chief Minister Jagan Mohan Reddy said, “Kurnool has been supporting people from the southern parts of Telangana like the southern part of old Mahbubnagar district, which are now the districts of Gadwal and Wanaparthy, besides Kadapa and Anantapur. There are also people coming in from neighbouring Karnataka. There is generally a lot of movement along the border areas even before the pandemic, so that continues now for medical emergencies.”

“So in the case of Kurnool, you have an epicentre where serious cases come in. The numbers thus reflect cases from all the surrounding districts,” he added.

Officials on the ground also agree.

“The cases from other states are also being added to our tally in Andhra Pradesh if they get admitted here, especially to the Government General Hospital (GGH) in Kurnool. There are many people from outside the district who are availing treatment here,” Dr Ram Giddaiah, the Kurnool District Medical Health Officer (DMHO), told TNM.

According to him, the high case load is a result of the district administration designating three government medical colleges and six private hospitals for COVID-19 treatment along with COVID Care Centres (CCC).

When asked about how the patients are being brought to the hospitals, Dr Giddaiah said, “If the cases are from within the district, we have adequate ambulances to shift them to hospitals. If the patient is referred from another state, the family makes arrangements for an ambulance.”

Another issue that authorities are facing, according to the Kurnool DMHO, is a “mental burden” on frontline workers. Recruitments are underway to address this. So far, 15 medical professionals who were treating COVID-19 patients have caught the virus and almost recovered.

Krishna sees more local cases

In the case of Krishna district, which borders Telangana, the cause for the rise in cases has been slightly different. Here, the number of local cases are more when compared to Kurnool. Officials attribute it to the dense population in Krishna and surrounding districts.

“You have hospitals at Vijayawada pertaining to the districts of Krishna, East and West Godavari, and Guntur. The Vijayawada GGH is a major referral hospital. So it services four districts that are densely populated and harbour almost one-third of the state’s population,” Dr PV Ramesh said.

“Especially the two Godavari districts, where cases have been increasing of late, the urban and rural areas are a continuum except for tribal areas. So on the ground, rural areas are also densely populated like urban areas, so the transmission occurs faster,” he added.

Krishna DMHO Dr Ramesh said that the possible reason for the surge in numbers is the dense population in the district, especially in Vijayawada city, which has a population of around 12 lakh.

Speaking to TNM, he said, “The movement of patients alone is not the reason for a surge in cases and fatalities here. Dense population is a major concern within Vijayawada city, which has many narrow and congested residential areas. Physical distancing is not being followed and neither are masks worn properly in certain places.”

Warning about potential community spread in Vijayawada, Dr Ramesh said, “In the initial stage, many are ignoring the symptoms but when it aggravates, they’re rushing to hospitals. By then, the entire family might have got infected. Late recognition of the infection and comorbidities are certainly causing a surge in the number of deaths.”

Noting that the recovery rate was good, the Krishna DMHO added that they were using all the infrastructure and equipment available to contain COVID-19, adding that self restraint on the part of the public was also necessary.

The official also said that they have observed a trend of a slow increase in herd immunity. In both districts, authorities say that while deaths are unfortunate and have to be prevented, it is not a reflection on the state of healthcare in the region.

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