How Plasma Therapy can change our view of migrant workers?

How Plasma Therapy can change our view of migrant workers

Covid-19 has been one of the scariest diseases. It has forced us to do long successive lockdowns and has locked people indoors. For some of us staying at home has been more of a life of seclusion without any attendant difficulties of hunger or immediate economic hardship.

But for a large number of people, it has meant untold physical and mental hardship. The worst affected people have been those who were stranded far from their villages and towns at their place of work where there was no more work, no income and little or no access to support from the local administration.

The tragedy of these migrants who faced enormous hardships while trying to return to their villages and towns was further aggravated by the anger and hatred they faced on their return from the people of their own state who accused them of bringing Covid-19 with them.

The beginning of Plasma Therapy can probably change the entire perspective of the middle class who saw the returning migrants as unruly and as carriers of Covid. They are no more carriers of Covid but potential lifesavers who can donate their plasma to cure people in acute Covid conditions.

As on 21st July 2020, Odisha had 18,757 cases which are 1.6% of the all India figure of 11.9 lakh cases. Odisha’s population being about 3.4% of India’s population, the state can still claim to have contained Covid-19 better than the average performance across the country.

However, the share of Odisha was far lower at 0.4% until the first week of May. In July so far, new cases in Odisha have amounted to about 2% of new cases across the country. Available data clearly points to the fact that the spurt in number of Covid cases in Odisha happened on account of the return of migrants who were stranded in other states.

In the initial days of March and April people stranded in neighboring states returned surreptitiously. While there is no accurate figure for how many people returned this way, the number of such people getting tested positive remained low.

The first major formal return of migrants to Odisha started with the buses coming from Surat to Ganjam with the first bus arriving on 29th April. In the first two weeks of May, Ganjam which had zero cases till 30th of April zoomed to the top position in the state and has stayed there ever since.

That the large increase in the number of positive cases in Odisha has been on account of returning migrants is a no-brainer and this has been apparent to the public.

However, what has not been well understood is that the formal return of the migrants was actually good for the people of the state. A very large proportion of the returning migrants came through formal means of Shramik Express Trains and through hired buses.

All these people directly went to Temporary Medical Centres (TMCs) established by the Government of Odisha, predominantly under the leadership of the Sarpanch of Village Panchayats across the state. The very large number who walked or cycled or hitchhiked back to Odisha were also registered and put into the TMCs.

In the initial days of returning migrants, most new cases were identified from the TMCs. This meant that there was very little new spread of Covid in the state.

For instance, in the entire month of May, a little over 95% of all new cases were identified from the TMCs. Another way to look at this would be to compare the cases outside the TMCs in the month of April (when there were hardly any TMCs) to the same figure in the month of May.

While in April there were 142 new cases in the state, in May there was less than half that number outside the TMCs. On the other hand, about one-third of all cases in July so far are from local transmission outside quarantine.

In fact out of the cases that are labeled as being in quarantine, many would be from the rather inefficient system of home quarantine that was allowed to the middle class returnees who came by car, trains or increasingly, by air.

To a certain extent, it can be said that the returning migrant workers who came through organized transport and stayed in TMCs contributed less to Odisha’s Covid crisis compared to those who came by higher-end transport and opted for home quarantine.

Unfortunately, the government of Odisha which is among the most transparent in the country in terms of sharing data with the general public has over the last few weeks increasingly opaque. So the extent of spreading of Covid through home quarantine remains a matter of conjecture.

The Migrants who returned and stayed in the TMCs, therefore, gave the Government of Odisha an opportunity to save valuable lives of returning Odias without putting other Odias at risk.

However, the anger against the returning of the migrants has remained more or less ingrained in the psyche of Odia people, especially urban middle-class people who had very little idea about what was happening in the TMCs in far-flung rural areas.

Sadly, even Government officials who were directly in charge of facilitating the return of the migrants and their accommodation in the TMCs often misbehaved with them.

The case of a BDO who had to be suspended due to misbehaving with the returning migrants is a sad example of what the urban elite thinks about the returning migrants.

Under these circumstances, we can hope that the beginning of Plasma Therapy might make the middle class look at the migrants with a different perspective. Most of the migrants who returned from other states are young, male and have shown robust recovery from Covid-19.

Compared to states which have more domestic transmission, Odisha has a far higher proportion of Covid patients in the age group eligible to donate plasma.

Odisha’s Case Fatality ratio of just 0.55% (India average is 2.4% and worst performing Gujarat is 4.4%) is principally on account of the high recovery rate of these young people.

They are just what the ICMR looks for in a prospective Plasma donor, young and brave. But what does the Government need to do to ensure that these people come out in large numbers to donate plasma?

The most important act of the Government should be to recognize and incentivize such donors. Not so much in terms of money, but in terms of being celebrated as heroes.

But it also needs to ensure that in future when recovered patients are discharged, they are discharged after proper testing. Every discharge without a negative Covid test is not only a risk, but it is also one less potential donor for Plasma Donation. The third point is to ensure that in the first month after getting discharged.

Article Written by MR Mishra

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