A dangerous concoction of an unknown virus, a broken healthcare system, doublespeak, and lack of transparency is damaging India’s youngest state, Telangana.

The question here is: How far will a state go to protect its “image”, and does the impact of a global pandemic really mar this so-called image?

For the past few days, #WhereIsKCR has trended on social media platforms in Telangana. Why? A few days after news reports surfaced of staff members testing positive at Pragathi Bhavan, the office and residence of chief minister K Chandrashekhar Rao, rumours began doing the rounds, suggesting that Covid had not spared the chief minister. These speculations were fuelled by KCR’s conspicuous absence from the public eye ever since the birth centenary celebrations for former prime minister PV Narasimha Rao on June 28.

Despite opposition parties and citizens clamouring for an answer, the governing Telangana Rashtra Samithi has maintained a studied silence.

On March 15, KCR said, “Not Rs 1,000 crore, we will spend Rs 5,000 crore if required. We won’t allow coronavirus to enter Telangana.” A hundred days later, Telangana has the highest positivity rate in the country of 25 percent. That is, every fourth person tested carries the virus.

So, what went wrong? A glance at the state’s medical bulletin offers some clues. The bulletin’s format has been changed at least a dozen times since March 17,with the only clarity being that the government is hiding something.

The state’s health ministry included testing data in its bulletins only after at least three raps from the high court and pressure on social media. What this means is that Telangana’s people only learned the number of tests done two months after the lockdown was instituted in March to contain the spread of the virus.

There have also been discrepancies in the Covid numbers released in the daily health bulletins and the numbers recorded on the government’s live dashboard, which is used by private labs to upload data in real-time. The government has now blamed a private lab for its high positivity rate.

As of July 8, the state had conducted 1,28,438 tests and recorded 27,612 positive cases — 11,012 of them active — and 313 deaths.

Delays in permitting private testing

Globally, the only way that has proved effective to fight the virus is to test, trace and isolate. Telangana stumbled in this first step, with the high court intervening half a dozen times to pull up the government on issues ranging from lack of testing to missing bodies.

The state’s attitude towards testing was summed up by K Tarakarama Rao, minister and KCR’s son, who told the media on April 23 that he was against “indiscriminate” testing. “Will we get the first prize if we test more?” he asked.

Until June, Telangana refused to allow private diagnostic centres to conduct coronavirus tests. This despite a clearly worded directive from the high court on May 21 to let private labs approved by the Indian Medical Council of Research conduct coronavirus tests. The court, reacting to a public interest litigation, dismissed the government’s concern that allowing private labs to conduct tests would “lead to panic”, and that state labs had the capacity to conduct 2,000 tests a day.

Yet, the government only gave permission to private labs on June 14, after an uproar on social media. It also capped testing charges at Rs 2,200 — Rs 2,800 for home sample collection — and KCR said 50,000 samples must be tested over the following 10 days.

Before this target could be met, however, the government threw another spanner in the works. On June 25, it paused mass testing as samples piled up in labs. G Srinivasa Rao, the director of public health and family welfare, explained that delays in testing the collected samples might lead to “false results”.

At this point, Telangana was testing 2,500-3,000 samples a day, as against 250-300 tests before private labs were roped in. Importantly, the number of positive cases spiked once private labs entered the fray — 800-1,250 positive cases per day as opposed to less than 100.

This spike is obvious when you look at the number of cases between March and July. Telangana saw its first case on March 2. The state had 144 cases on April 2; 1,044 on May 2; 2,891 on June 2; and 18,570 on July 2 , about three weeks after private labs began testing.

These numbers made the government uncomfortable. Health minister Eatala Rajender said some private labs were conducting “pool testing”, which refers to combining several samples and testing them together, which risks receiving false negatives. Therefore, Rajender suggested, some of the results from private labs were not reliable.

Currently, 80 percent of Telangana’s testing data comes from private labs.

In the context of testing, another reality being dodged in Telangana is the testing of patients without symptoms. Even close contacts of those who succumb to Covid are not allowed to get tested. As recently as last week, Rajender said the state was following ICMR guidelines “which clearly state that the asymptomatic people should not be tested”.

Yet, members of the governing party have been tested, including the home minister, even though they were asymptomatic. Are the TRS’s leaders exempted from the guidelines?

Doctor woes

“Even if you are a millionaire, if you are Covid positive, you will be tested only at Gandhi Hospital,” KCR declared on April 7.

The government-run Gandhi Hospital in Hyderabad was the designated facility for Covid patients for the whole of Telangana. Exactly two months after KCR’s announcement, a journalist, Manoj Kumar, sent his brother a video message pointing out the lack of ventilators at the hospital and the apathy of medical staff.

Manoj was admitted to the hospital with Covid on June 4. On June 6, he sent his brother a message on WhatsApp: “The ICU is not good. Please, let’s go to a private hospital. No one is taking care here.” Manoj died 24 hours later.

Manoj’s story went viral, strengthening the narrative that the government was being lax in dealing with the pandemic. In this story, Gandhi Hospital is a central character.

On June 10, junior doctors at the hospital went on strike after one of them was assaulted by family members of a Covid patient. The doctors — vexed by negative publicity and the lack of rest and manpower — demanded the decentralisation of Covid treatment to prevent the hospital’s “pathetic” infrastructure from crumbling completely.

At around the same time, news reports emerged on how politicians were being treated for Covid in private hospitals while the public was forced to rely on Gandhi Hospital alone. The government was forced to withdraw from its stance, and allowed private hospitals to start treating Covid patients.

Many junior doctors, including house surgeons, MBBS interns, postgraduate medical students, also said they were upset with how the state’s media was portraying them.

“We all know that the governing TRS party and their families own and direct most mainstream media houses,” said one of the doctors on the condition of anonymity. “Instead of being appreciative of our efforts, they spread false narratives. Not a single mainstream media house [controlled by the TRS] portrayed the junior doctors’ protests properly. Knowing that we are the face of a hospital, all problems are projected as the inefficiency of doctors.”

The TRS owns T News, Namasthe Telangana and Telangana Today. KCR’s close associates, PV “Megha” Krishna Reddy and Rameshwar Rao, also have stakes in several news channels, including TV9, 10TV, TV1 and NTV.

‘We are working 18-hour shifts’

Dr K Mahesh Kumar, president of the Health Care Reforms Doctors’ Association, told Newslaundry that KCR’s claim that Telangana would be Covid-free by April 7 was “the biggest joke”.

“The government wasted the entire lockdown period without any plan,” he said. “God only knows who is advising the government.”

Mahesh added that the government did not care about medical staff in the state. “We are working nonstop, putting in more than 18-hour shifts for months together,” he said. “Even if we want accommodation, we need to go through a lengthy bureaucratic approval process. If we contract the virus, there is no specific set of directives for treatments.”

While healthcare workers have been orally informed to get treatment at Hyderabad’s Nizam's Institute Of Medical Sciences if they test positive, they are awaiting written orders.

In June, a video of a patient at the Government Chest Hospital, Hyderabad, went viral. Ravi Kumar, 35, was admitted in the hospital after testing positive. He shot a video of himself which he sent to his father, and died soon after.

In the video, Ravi said, “I can’t breathe. They removed my ventilator. I feel my heart stopped beating. Bye daddy, bye everyone.”

Instead of extending his condolences to Ravi’s family, the health minister chided him. “We allowed phones for patients to talk to families, not to roam around the hospital and shoot videos,” the angry minister said. “Because of people like him, real patients are getting affected.”

Ravi’s family was distraught at Rajender’s pronouncement that Ravi was not a “real patient”. “There is no empathy for people in this government,” said Shiva Kumar, a reporter and an acquaintance of Ravi’s.

Dr Mahesh Kumar said Ravi’s case stemmed from a lack of resources, not medical negligence. “I came to know that there was not enough pressure in the oxygen pipeline, and there were no anaesthetists present at the time,” he told Newslaundry.

The curious case of a ‘state-of-the-art’ Covid centre

In April, in a bid to augment its healthcare infrastructure, the government converted the Gachibowli sports complex into a state-of-the-art Covid speciality centre called the Telangana Institute of Medical Sciences. The video of the new hospital was promoted as a positive piece of news, similar to how China converted stadiums into hospitals at lightning speed.

However, TIMS, touted as the brainchild of KCR’s son K Tarakarama Rao, is yet to admit a single in-patient, even though it was announced on April 20.

“The world-class facility has four security guards and a dog,” declared Revanth Reddy, a member of parliament and the working president of the Telangana Pradesh Congress Committee, during a surprise visit to the centre on June 15. Recruitment for TIMS is still underway, though the government claimed the hospital would begin accepting patients from July 8 — after multiple postponements through April, May and June.

Speaking about the acute shortage of manpower in the state, Dr T Uday, a final-year postgraduate student at Gandhi Medical College, told Newslaundry: “Our neighbouring state of Andhra Pradesh canceled final-year exams, gave provisional certificates to the students, and hired them immediately. Here, the government was totally unwilling.”

Uday, like scores of other frontline healthcare workers, tested positive for Covid on June 1. However, he was still forced to take his final-year exams. The Telangana government plans to hire these students on a contractual basis only, he added.

“The compensation they are offering is not even one-third of the market rates. Who will take the risk?” he said. Uday, like many other healthcare workers in the state, had to collect donations to buy his own PPE kit.

‘This is not the Telangana we fought for’

“Every press conference in Telangana is a rejoinder to the media.”

This statement by Ankam Ravi, chief editor of Velugu newspaper and V6 News, summed up the Covid situation and the information war that takes place on a daily basis in Telangana.

“Tell me one press conference where the health minister or the chief minister has been rational and answered the media,” Ravi said. “Not an iota of information that comes from the government is true.”

KCR’s press conferences are notorious for reprimanding journalists and media houses. In April, when Andhra Jyothi published an article about the shortage of PPEs in the state, KCR, without naming the newspaper, cursed them in a press conference. “I am cursing you, you should get coronavirus,” he said. Some of his favourite phrases while addressing the media include “are you stupid” and “this is an idiotic question”.

Ravi was part of the Telangana statehood movement, working closely with KCR at the time. Today, he is disappointed with how terrible the governance is. “This is not the Telangana we fought for,” he said.

Since the end of March, Ravi has been running a campaign on his media platforms, questioning the discrepancies in the government’s health bulletins, the state’s low testing rate, and the government’s lack of transparency. In response, he said, the government stopped giving advertisements to his newspaper and TV channel, apart from personally warning him.

“I got calls, right down from the chief minister’s office to the information and public relations department. The gist was simple: ‘Why are you getting overly involved? Let things be...tomorrow, no one will protect you,’” Ravi said, listing the “friendly advice” he was given.

V6 News and Velugu are backed by G Vivek, a former MP who is now with the Bharatiya Janata Party. But Ravi said this association did not influence his journalism. “I fought for Telangana and I will fight for the state we dreamt of, for as long as it is required,” he said. He also published a strongly-worded editorial on the front page of his paper.

Coreena Suares is a senior journalist with NewsMeter, an independent news website based in Hyderabad. Unlike the mainstream media, news websites aren’t dependent on government ad revenue, but they have to work with the government for information.

“People are not irrational to blame the government for a virus. But lack of transparency will be questioned,” Suares pointed out. After being stonewalled every time the website approached an official for information, Suares decided to do away with them.

“I stopped wasting time waiting for them to share information,” she said. “I use my own sources in the Greater Hyderabad Municipal Corporation, ward corporators, police department, even resident welfare associations. I have nothing to lose.”

While Suares wasn’t on the receiving end of “friendly advice” from the government, she knew of journalists who were telephoned for expressing their opinions on social media. Every tweet is monitored and questioned, she said.

“Even the health bulletin goes to Pragathi Bhavan first and it’s released only after the chief minister’s office finalises the template,” she said. “They only care about the ‘image’ of Hyderabad. In Telangana, it is bureaucracy all through.”

Journalists targeted for asking questions

Independent journalist Teenmaar Mallanna, formerly known as Naveen Kumar, runs a YouTube channel called Q News, which is known for being vocal about public issues. In one of his videos, Mallanna advised people to “leave Hyderabad and move to their native places to protect themselves”. In response, a case was filed against Mallanna under various sections of the Indian Penal Code and the Disaster Management Act.

“The FIR was filed by TRS party workers saying I was terrorising the public and creating a panic situation,” Mallana said. “What cases should be filed against the government for lying continuously and risking people’s health?”

He added: “What else do you expect in a dictatorship? This is worse than Nizami rule. I did the government’s job of educating people about the pandemic situation and today, they are trying to hound me with cases.”

In Telangana, Mallanna said, there are four stages for a journalist who wants to speak the truth.

“First, they will try to buy you out. Then they try to get friendly. Then they try to threaten you. Stage 4 is police cases,” he said. “I am currently in the fourth stage. During this Covid season alone, they filed six different cases against me.”

It should be noted that KCR has a history of going after “anti-establishment” journalists, this reporter included.

Mallanna said he hoped the central government would take over healthcare in Telangana. “This is a serious issue. This government is unfit to rule,” he said. “Despite such a massive danger to public health, they are least bothered. We are neck-deep in the Covid crisis. Even a blade of grass thrown at us will give us some hope.”

In the last few days, Telangana governor Tamilisai Soundararajan finally stepped into a more proactive role to contain the outbreak. After much persuasion, the chief secretary Somesh Kumar and principal health secretary Shanthi Kumar met with her for a briefing on the Covid situation in the state. Prior to this meeting, Soundararajan also held a video conference with the heads of various private hospitals, instructing them not to deny treatment to anyone during the pandemic.

After Soundararajan’s involvement, the Telangana health bulletin for the first time included details like the availability of beds and ventilators, and which hospitals to approach at various stages of the infection.

Meanwhile, the rest of the government has been busy demolishing the current secretariat complex to construct a swanky new one at an estimated cost of Rs 400 crore — a decision that has irked many.

“We don’t know where the chief minister is. None of his ministers are able to handle the pandemic,” Congress MP Revanth Reddy told Newslaundry. “Healthcare staff and resources are being stretched to their limits. No one knows when TIMS will start. All this government is focusing on is building a new secretariat. This government is blind to the suffering of the people, just like Emperor Nero.”

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