The long-feared shift of COVID-19 cases from urban to rural India raises new challenges, as the medical and testing infrastructure in villages and towns is weaker. The New Indian Express begins this series on the explosion of infections primarily in rural areas by tracking the rising COVID-19 burden in six states between August 1 and 25.
79 per cent of infections outside Hyderabad
After the COVID-19 crisis hit Telangana in March, the capital city Hyderabad witnessed an exponential rise in number of cases in the following months. However, after movement restrictions were eased in June, the number of COVID-19 cases started drastically increasing in areas outside the Greater Hyderabad Municipal Corporation (GHMC) limits.
The share of COVID-19 cases in the districts (rural areas and small municipalities) out of the total cases reported in the state sharply increased from June to August, while the number of cases stabilised inside GHMC limits.
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In June, Telangana recorded 13,508 COVID-19 cases but a majority of them, 11,080 cases (82 per cent), were from inside GHMC limits. However, come August the scenario is completely different as of the 49,885 cases recorded in the state till August 26, only 10,508 cases (21 per cent) are from inside GHMC limits
Odisha bucks the trend
With COVID-19 at its peak in Odisha, seven districts — Khurda, Cuttack, Ganjam, Sundargarh, Sambalpur, Puri and Balasore — accounted for 56 per cent cases of the total tally of 90,986. Unlike in many other states, the trend on Odisha shows that most of the cases are confined to the urban localities.
Ganjam district has recorded 191 fatalities, the highest in the state, followed by 67 in Khurda.
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Even as the number of new patients falls in hard-hit Ganjam, cases continue to spike in other districts
In August, Bhubaneswar and Cuttack recorded 65.3 per cent and 75.2 per cent of the cases in Khurda and Cuttack districts, respectively.
Of the 8,261 cases in Bhubaneswar, 5,400 were registered till August 25 and of 3,653 cases in Cuttack city, 2747 cases reported
Villages in Kerala report sharp increases
The COVID-19 shift to rural areas is less noticeable in Kerala, but some of the smaller villages and towns have reported a surge in recent weeks.
| Taluk | Cases in August 1 | Cases in August 25 |
| Kottayam | 9 | 284 |
| Nellikuzhi (Ernakulam) | 0 | 90 |
| Cherthala (Alappuzha) | 29 | 70 |
| Mudhuthala (Palakkad) | 7 | 60 |
| Pandalam-Kadackad (Pathanamthitta) | 0 | 75 |
Reverse migration leads to spike
COVID-19 is spreading rapidly in Karnataka’s towns and villages. Reverse migration of people from big cities and increased testing may explain the spike in number of cases.
| Town | Cases in August 1 | Cases in August 25 |
| Shivamogga | ||
| Shikaripura | 308 | 1,191 |
| Bhadravathi | 200 | 826 |
| Sagar | 68 | 205 |
| Vijayapura | ||
| Muddebihal Town | 148 | 554 |
| Basavana Bagewadi | 187 | 555 |
| Sindagi Town | 165 | 481 |
| Udupi | ||
| Brahmavar village | 28 | 72 |