Back to reporting after ~4 weeks of battling the virus, being a caregiver to 3 in family, finding hospital beds, labs, struggling to seek info about hospitalised parents. All this in a small town. Was lucky though to have eventually found resources & recover. Many are not #Thread

The chaos, health infra in JSR, my hometown & a fairly developed city, has given a 1st hand experience of healthcare in small towns. Doesn't end at lack of infra. Sheer negligence & under-preparedness both by govt & ppl is beyond belief. Story same across tier 2&3 towns in India

#Covidcrisis has fiercely moved from big cities to small towns - those having limited experience of 1st wave, were complacent & poorly educated about the outbreak. Health infra broken, unable to take the load, processes are slowing. 2020 was just taken as a one-off historic event

With what I've seen & experienced in last month here in JSR & with relatives & friends in UP, Bihar, WB, there is massive under-reporting of cases & deaths. 3 major reasons - lack of testing & hospital infra, absolutely no contact tracing & a deeply entrenched #Covid #stigma .

Covid #stigma! Yes, it's still a thing. Ppl say "Covid+ve people 'caught' in xyz's family." Even whr entire families are down, tests are resisted. "Labs giving false +ve rpts", "Don't get tested, its a flu. Take Calpol & drink hot water" was the most common advice we got. #thread

Maha, Delhi, TN have huge case surge, but that's also bcoz they ve proactive sys to detect cases, esp Maha. I have seen the build, up & close in states that are now exploding. Massive under-reporting, under-testing & mis-diagnosis. #CovidTesting #UP #Bihar #Jharkhand

Most GPs in small towns don't advice #CovidTesting even on classic symptoms (may be they know patient may not come back to them). Start with typhoid, dengue, malaria. If they at all prescribe, it is a rapid antigen test. #Covidcrisis

Few govt #CovidTesting centres - reports come 3-4 days later. Pvt centres overwhelmed. Home testing rpts in over 5 days. UP is doing majority tests (~90%) RAT, testing rackets ve been busted in these states where RAT performed illegally, reports given as per choice. #CovidInIndia

No contact tracing! Been 3 wks my parents tested +ve, were hospitalised, but not a single call from anyone sarkari/ health worker- so no contact tracing, no mandatory isolation or testing of symptomatic contacts, if u don't do it voluntarily! #diseasespread #diseasecontrol

Most want to treat patients at home, even comorbids - stigma of testing, fear of hospital leading to disease worsening. #Covid fatalities rising. In UP, Bihar, JH, people with money hoarding O2 cylinders, drugs - try treating at home, then run to hosp when O2 level falls to 45/35

Seen mny complicatns, deaths of 4 acquaintances, not coz of virus but negligence. Last wk 2 pts reached JSR district hosp: 1 died in the auto itself, other on casualty table. Both had classic covid sympts, breathlessness. Many of these won't count as #COVIDdeaths as no test rprt!

Those who seek medical care, oxygen find none. A friend lost 18 relatives in just last 4 days in Basti, #Gorakhpur & #Lucknow in UP -struggling to find oxygen or a hospital bed! Remember govt complacency, no prep, whatever available is hoarded #Covidcrisis #India #COVIDdeaths

Absolutely no #Triage at #hospitals! Casualty in TMH JSR, was chaotic, over-crowded & common, receiving all sorts of pts, covid suspects & non-covid. My dad, a suspect with full blown sympts, had to wait for his TrueNat rpt for 8 hrs, given an obsvn bed along with non-covid pts.

#healthcare workers are at breaking point. Govt hospitals ve few docs/ #nurses/cleaners. Pvt hosp overwhelmed. Many GPs, hosp staff ve tested +ve . Rest are struggling. 3 docs I know of in JSR passed on due to #Covid in last 1 wk, 25 seniors #doctors under treatment, few critical

Early April when JSR was reporting 200 daily cases, finding a covid bed was a task. Today JSR is reporting ~850 daily cases. People with funds run to corporate #hospitals in Ranchi (150kms) /Kolkata (300kms) but now even they r over-burdened. Ranchi ~1800 daily cases #Covidcrisis

#India Most district admins waking up now, to setup triage, wards, O2, ICU beds, but unable to find #manpower to run them. It's been the citizens helping each other, arranging drugs, oxygen, beds, cremations! Hoping the #Covidcrisis eases soon. Thanks for reading thr long #thread

Finally, no words of gratitude is enough for @drmandark & @docvked for their unconditional support, 24x7 help & guidance in tiding over the crisis that suddenly hit my family. We owe a lot to docs, nurses who are doing everything in their capacity to help patients & families!