As citizens rate their state Governments on COVID 2nd wave handling via LocalCircles, Tamil Nadu and Andhra Pradesh emerge at the top

June 30, 2021, New Delhi: The 2nd wave of SARS-CoV2 that caused havoc in the months of April and May has tested the pulse of every State Government of the country and their efficiency to handle the outbreak vis-à-vis Governance. Just when the country had started to recover from the 1st wave of the pandemic, the COVID-19 and its variants started taking a toll at an unprecedented pace, from the highest 97,400 daily spike (September 10th, 2020) to less than 10,000 cases (1st week, February 2021), which then increased close to 47,000 (3rd week, March) and reached its peak to more than 412,000 cases (1st week, May 2021). The wailing sound of ambulances ferrying COVID patients for days and nights had been a routine at the time. Most hospitals in cities crumbled to provide adequate treatment to those patients waiting in line for the treatment due to an increase in cases. Even crematoriums in major cities ran out of space as bodies were brought for final rites. Overall, the 2nd wave of the pandemic has caused a devastating effect on India and its citizens that will be etched for many years to come.

The increase in daily Covid cases caused utter chaos across states of India facing an acute shortage of oxygen cylinders & concentrators, ventilator & ICU beds, COVID management medicines & testing facilities, and related supplies & equipment. During the time of distress, while caregivers were running from pillar to post seeking aid and treatment for the patient, many became the victim of black-marketing and scamming. During such an emergency as patients were gasping for oxygen, some perpetrators were charging out-of-pocket rates to caregivers of the patient for an ambulance service, even auto drivers charged exorbitantly just for covering a few km towards the hospital. Hospitals ran out of ICU beds, oxygen cylinders, and medicines required to treat the COVID patient. An increasing number of patients laid in line for the treatment in almost every district hospital. Eventually, their unavailability became the major cause of most Covid-related deaths in India; some deaths did not even find a mention on the official record.

Both the Central and State Governments have faced their testing times to contain and mitigate the 2nd wave of COVID-19 in India that eventually forced states to observe lockdowns and restrictions on public movement. In states like West Bengal, Assam, Tamil Nadu, Kerala, the state elections were simultaneously held between March and May. As a result, these states experienced a sudden surge in the test positivity rate. The Indian Council of Medical Research (ICMR)-approved testing facilities were limited in various states where reports of RT-PCR tests took about 3-4 days to be produced, leaving many patients in the lurch without a hospital bed as they did not have the positive COVID test report.

In the aftermath of all the developments in the last 2 months since the outbreak of the 2nd wave of COVID-19 in India, LocalCircles has gone back to citizens residing in 17 biggest states of the country, asking them to rate their State Government’s performance on the overall handling of the 2nd wave of the COVID-19 outbreak. This allows both the broader citizenry and the Government to understand where things stand and what needs to be worked upon that is of pivotal importance in the fundamental control of the COVID-19 pandemic. This is vital to effectively handle the imminent threat of the 3rd wave, which is likely to hit India in 6-8 weeks, as suggested by medical experts. Medical experts have emphasised the importance of continuing to wear a double mask, follow proper hygiene, and maintain social distance. Taking cognizance of the early warning of the 3rd wave with children at high risk, the Central Government has issued guidelines for the care and protection of children affected by COVID-19 and has fixed responsibilities for the states, district magistrates, police, Panchayati Raj institutions, and urban local bodies. The states survey received 38,991 responses from citizens spread across 17 states and 383 districts of India.

59% Tamil Nadu residents rate Tamil Nadu Government’s handling of COVID 2nd wave as effective

The question in the survey asked residents of Tamil Nadu, “How do you rate your state (Tamil Nadu ) Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave?” In response, 32% of citizens said “very effective” and 27% said “effective”, while another 27% said “somewhat effective”. 11% of Tamil Nadu residents surveyed rated the Tamil Nadu Government’s handling of COVID 2nd wave as “ineffective”, while 3% did not have an opinion. On an aggregate basis, 59% of Tamil Nadu residents rated the Tamil Nadu Government’s handling of COVID 2nd wave as effective or higher. 3,120 responses were received on the survey.

While Tamil Nadu still has between 5000-8000 daily cases, the 2nd wave of COVID arrived a month later in the state as compared to the rest of the country. According to residents of Tamil Nadu, while there was some shortage of beds and oxygen cylinders during the peak in the 3rd and 4th week of May, the entire 2nd wave was managed effectively by the State Government. Of the 3120 respondents, not a single one rated the State Government’s handling as a “Total Failure”. Tamil Nadu received the highest approval rating pan India amongst the 17 states where the study was conducted.

54% Andhra Pradesh residents rate Andhra Pradesh Government’s handling of COVID 2nd wave as effective

27% of citizens rated the performance of the Andhra Pradesh Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 27% said “effective”, and another 27% said “somewhat effective”. 19% of Andhra Pradesh residents surveyed rated the Andhra Pradesh Government’s handling of COVID 2nd wave as “Ineffective”. On an aggregate basis, 54% of Andhra Pradesh residents rated the Andhra Pradesh Government’s handling of COVID 2nd wave as effective or higher. 869 responses were received on the survey.

An elaborate community-based tracking system was implemented in Andhra Pradesh, which was effective in putting anyone testing positive under the surveillance, followed by monitoring them closely at village or ward level, with either health or ASHA worker or an auxiliary nurse visiting the household every day.

51% Uttar Pradesh residents rate Uttar Pradesh Government’s handling of COVID 2nd wave as effective

32% of citizens rated the performance of the Uttar Pradesh Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective” and 19% said “effective”. Breaking down the poll, 13% said “somewhat effective,” 15% said “ineffective”, and 19% said “total failure”, while 2% did not have an opinion. On an aggregate basis, 51% of Uttar Pradesh residents rate Uttar Pradesh Government’s handling of COVID 2nd wave as effective. This question in the survey received 5,942 responses.

Only 47% Maharashtra residents rate Maharashtra Government’s handling of COVID 2nd wave as effective

16% of citizens rated the performance of the Maharashtra Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective” and 31% said “effective.” Breaking down the poll, 25% said “somewhat effective,” 13% said “ineffective”, and 11% said “total failure”, while 4% couldn’t say. On an aggregate basis, 47% of Maharashtra residents rated the Maharashtra Government’s handling of COVID 2nd wave as effective. This question in the survey received 4,162 responses. While the “Mumbai Model” was effective in handling the 2nd wave within the city, other districts continued to struggle. Caregiver of Covid patients in Maharashtra had to travel long distances to gain access to hospital, oxygen and COVID relief drugs.

48% Gujarat residents rate Gujarat Government’s handling of COVID 2nd wave as effective

21% of citizens rated the performance of the Gujarat Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 25% said “effective”, and 21% said “somewhat effective”. 8% of Gujarat residents surveyed rated Gujarat’s Government’s handling of COVID 2nd wave as “total failure”, 17% said “Ineffective”, while 8% did not have an opinion. On an aggregate basis, only 46% of Gujarat residents rated Gujarat Government’s handling of the COVID 2nd wave as effective or higher. This question received 1,982 responses from residents of Gujarat.

Only 43% Uttarakhand residents rate Uttarakhand Government’s handling of COVID 2nd wave as effective

14% of citizens rated the performance of the Uttarakhand Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 29% said “effective”, and 14% said “somewhat effective”. 14% of Uttrakhand residents surveyed rated the Uttarakhand Government’s handling of COVID 2nd wave as a “total failure”, and 29% said “ineffective”. On an aggregate basis, only 43% of Uttarakhand residents rated the Uttarakhand Government’s handling of COVID 2nd wave as effective or higher. 939 responses were received on the survey.

Only 43% Odisha residents rate Odisha Government’s handling of COVID 2nd wave as effective

43% of citizens rated the performance of the Odisha Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective” and 14% said “somewhat effective”. On the other hand, 29% of Odisha residents surveyed rated the Odisha Government’s handling of COVID 2nd wave as “Ineffective”, while 14% did not have an opinion. On an aggregate basis, only 43% of Odisha residents rated the Odisha Government’s handling of COVID 2nd wave as effective or higher. 736 responses were received on the survey.

Only 39% Kerala residents rate Kerala Government’s handling of COVID 2nd wave as effective

22% of citizens rated the performance of the Kerala Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 17% said “effective”, and 33% said “somewhat effective”. On the other hand, 28% of Kerala residents surveyed rated the Kerala Government’s handling of COVID 2nd wave as “ineffective”. On an aggregate basis, only 39% of Kerala residents rated the Kerala Government’s handling of the COVID 2nd wave as effective. 1,684 responses were received on the survey.

Only 36% Rajasthan residents rate Rajasthan Government’s handling of COVID 2nd wave as effective

36% of citizens rated the performance of the Rajasthan Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective”, and 45% said “somewhat effective”. On the other hand, 19% of Rajasthan residents surveyed rated the Rajasthan Government’s handling of COVID 2nd wave “Ineffective”. On an aggregate basis, only 36% of Rajashthan residents rated the Rajasthan Government’s handling of COVID 2nd wave as effective or higher. 877 responses were received on the survey.

Only 34% Haryana residents rate Haryana Government’s handling of COVID 2nd wave as effective

8% of residents rated the performance of the Haryana Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 26% said “effective”, and 27% said “somewhat effective”. Further, 8% of residents surveyed rated the Haryana Government’s handling of COVID 2nd wave as “total failure”, and 23% said “Ineffective”, while 8% did not have an opinion. On an aggregate basis, only 34% of Haryana residents rated the Haryana Government’s handling of COVID 2nd wave as effective or higher. 1571 responses were received on the survey.

Only 28% Punjab residents rate Punjab Government’s handling of COVID 2nd wave as effective

28% of citizens rated the performance of the Punjab Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective”, and 14% said “somewhat effective”. 19% of residents surveyed rated the Punjab Government’s handling of COVID 2nd wave as “total failure” and 29% said “Ineffective”. On an aggregate basis, only 28% of Punjab residents rated the Punjab Government’s handling of COVID 2nd wave as effective or higher. 878 responses were received on the survey.

Only 28% Madhya Pradesh residents rate Madhya Pradesh Government’s handling of COVID 2nd wave as effective

Only 28% of citizens rated the performance of the Madhya Pradesh Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective” and 29% said “somewhat effective.” 14% of residents surveyed rated the Madhya Pradesh Government’s handling of COVID 2nd wave as “total failure”, and 29% said “Ineffective”. On an aggregate basis, only 28% of Madhya Pradesh residents rated the Madhya Pradesh Government’s handling of COVID 2nd wave as effective or higher. 876 responses were received on the survey.

Only 25% Karnataka residents rate Karnataka’s Government’s handling of COVID 2nd wave as effective

5% of citizens rated the performance of the Karnataka Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 20% said “effective”, and 32% said “somewhat effective”. 15% of Karnataka residents surveyed rated the Karnataka’s Government’s handling of COVID 2nd wave as “total failure”, 20% said “Ineffective”, while 8% did not have an opinion. On an aggregate basis, only 25% of Karnatka residents rated the Karnataka Government’s handling of COVID 2nd wave as effective or higher. 3,685 responses were received on the survey.

Only 23% Telangana residents rate Telangana Government’s handling of COVID 2nd wave as effective

6% of citizens rated the performance of the Telangana Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 17% said “effective”, and 32% said “somewhat effective”. 28% of Telangana residents surveyed rated the Telangana’s Government’s handling of COVID 2nd wave as “total failure”, and 17% said “Ineffective”. On an aggregate basis, only 23% of residents of Telangana rated the Telangana Government’s handling of COVID 2nd wave as effective or higher. 2,430 responses were received on the survey.

Only 20% Delhi residents rate Delhi Government’s handling of COVID 2nd wave as effective

8% of citizens rated the performance of the Delhi Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “very effective”, 12% said “effective”, and 21% said “somewhat effective”. 31% of Delhi residents surveyed rated the Delhi Government’s handling of COVID 2nd wave as “total failure”, 21% said “ineffective”, while 7% did not have an opinion. On an aggregate basis, only 20% of Delhi residents rated the Delhi Government’s handling of COVID 2nd wave as effective or higher. 5,882 responses were received on the survey.

Only 20% Bihar residents rate Bihar Government’s handling of COVID 2nd wave as effective

Only 20% of citizens of Bihar rated the performance of the Bihar Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective”. 60% of Bihar residents surveyed rated the Bihar Government’s handling of COVID 2nd wave as “total failure”, and 20% said “Ineffective.” On an aggregate basis, only 20% of Bihar residents rated the Bihar Government’s handling of COVID 2nd wave as effective or higher. 1,625 responses were received on the survey.

Only 17% West Bengal residents rate West Bengal Government’s handling of COVID 2nd wave as effective

17% of residents rated the performance of the West Bengal Government’s handling (availability of testing, containment, hospital beds, oxygen, medicines, etc.) of the COVID 2nd wave as “effective”, and 41% said “somewhat effective”. 17% of residents surveyed rated the West Bengal Government’s handling of COVID 2nd wave as “total failure”, and 25% said “ineffective”. 1,733 responses were received.

By and large, the 2nd COVID wave caught most Indian states by surprise and most State Governments struggled to provide adequate testing, access to hospital, oxygen, ICU beds, ventilators, oxygen supplies, medicines, and share related information, along with host of several other issues. Tamil Nadu, the highest-rated state had the benefit of the late arrival of the 2nd wave and a relatively better hospital infrastructure than many other states. The hospital bed information system put in place by the Tamil Nadu Government seemed to have worked as per the state residents. Despite having its state elections, the state did a reasonably good job of handling its 2nd wave of COVID with 59% of its residents rating it as effective. Andhra Pradesh was commended for its community engagement and creating awareness about testing and surveillance of COVID positive individuals at the ward level with the effective deployment of health and ASHA workers as well as auxiliary nurses.

Uttar Pradesh with its high population and poor health infrastructure got severely impacted by COVID 2nd wave, and many people succumbed due to infection. Images of dead bodies on the shores of Ganga made headlines around the world. Nonetheless, it is noteworthy that despite the gap between demand and supply for healthcare at the peak of the COVID 2nd wave, Uttar Pradesh was able to reduce 95% of active cases within a month, crediting the Test-Trace-Treat (T3) model. Though a lot still needs to be done in Uttar Pradesh in preparation for the 3rd COVID wave, 51% residents of the state participating in the survey have rated the Government’s handling as effective. Similarly, the “Mumbai Model” implemented to handle the 2nd wave of COVID earned rave reviews on how large cities must manage COVID. Though many districts in Maharashtra struggled with COVID 2nd wave for the longest duration, 47% of the residents of Maharashtra surveyed rated their State Government’s handling of COVID 2nd wave as effective.

On the other hand, for most of the period during the 2nd wave of the outbreak, West Bengal did not update its Government COVID relief website in a timely manner. It showed availability of beds in their website whereas the ground reality was different. Residents of Bihar experienced difficulty in finding RT-PCR tests as well as delays in test results and getting hospital beds. There just weren’t enough beds for all who needed them, while many who could afford travelled to neighbouring cities in Uttar Pradesh or Delhi for the treatment. While most states were experiencing shortage of oxygen supplies, residents of Delhi witnessed many deaths due to lack of oxygen. Delhi struggled on all counts, from lack of testing, access to hospitals beds to adequate supply of oxygen, and even black marketing of COVID management medicines, oxygen cylinders and concentrators were rampant across the city. The lakh of clarity on oxygen cylinder refilling process as well as the flourishing black market were the main reasons behind the same.

As State Governments work on preparing to handle the 3rd wave of the outbreak, it is critical that all aspects starting from testing, containment, hospital beds availability, readiness to handle child cases of COVID, doctors and medical staff; equipment like ventilators, BIPAP machines, concentrators, medicines and all things COVID are available in sufficient quantities. Also, it is critical that information flow is significantly improved and centralised such that citizens can call a single toll-free number and based on their condition, location and preferences, budgets are assigned to the right hospital. Similarly, it is key that the patient information dissemination is streamlined, and hospitals can communicate with the family on the patient’s current health condition in a timely manner.

A major obstacle for all states has been to create awareness about testing and isolation. Many states reported that people did not want to get tested despite having symptoms due to social stigma attached to it. Like Andhra Pradesh, State Governments can launch awareness programmes in rural districts. While some districts have performed relatively better, it is important to empower local administrators to effectively handle the 3rd wave in their district. This will also help drive accountability on the ground.

The Ministry of Health and Family Welfare has issued Guidelines on Operationalization of COVID care centres for children and adolescents, which provides States with instructions about additional requirements for infrastructure, equipment and manpower. It also lays out a plan to handle COVID at a community level, encouraging local leaders and medical colleges in the area to step up. It instructs States to launch IEC (Information Education and Communication) campaign for communication of correct information and dealing with the mis-information on media and social media. Each State should focus on taking action and perform better in the imminent 3rd wave, which per experts is likely to hit India in 6-8 weeks if COVID protocol is not followed.

Survey Demographics

The survey received 38,991 responses from citizens in 17 states and located across 383 districts of India. 67% of the participants were men, while 33% were women. Respondents were only permitted to evaluate the performance of their State Government based on their registered address.

State-wise Reports

1. Tamil Nadu
2. Andhra Pradesh
3. Uttar Pradesh
4. Maharashtra
5. Gujarat
6. Uttarakhand
7. Odisha
8. Kerala
9. Rajasthan
10. Haryana
11. Punjab
12. Madhya Pradesh
13. Karnataka
14. Telangana
15. Delhi
16. Bihar
17. West Bengal