As Bihar records 2,58,787 cases and carries out vaccination of healthcare workers, many in the state believe the coronavirus pandemic is over giving rise to conspiracy theories.
In Kankarbagh, Patna large crowds gather near shops, motorists zoom by, a traffic police personnel fines a driver for not wearing a seatbelt. All of them have one thing in common, none of them are wearing masks.
Vishal Kumar, a pet store owner in Patna says, "Yes, there were a few cases last summer but since then things have improved. I believe most of us have become immune to COVID-19 which is why no one in my family wears a mask. I don't ask my customers to wear it either but I do ask them to buy it from the store next door since it's part of my brother's business."
Vishal, like many, is not afraid of catching the virus. "Kya hoga agar Corona ho gaya (What would happen if I catch coronavirus)? It's just flu."
Saqib, a worker at a tyre repair shop in Patna says, "There are warnings everywhere that everyone should wear masks, wash their hands, and sanitise, but no one heeds to those warnings. Many of my customers get offended when I ask them to wear a mask, so I have stopped telling them."
As per the Bihar Health Department, the state currently has 2,491 active cases. The MyGov.in portal notes a total number of 2,58,787 recorded cases in Bihar with 1,479 recorded deaths.
But for locals, anxieties due to COVID seem to be over.
Nimrat, a resident of Patna city and a volunteer at Harmandir Sahib Gurdwara recalls large groups of people in the Gurdwara.
"I once asked people to stand six feet apart from each other with their nose and mouth covered. They looked at me as if I was crazy. Nobody cares about COVID-19 anymore," says Nimrat.
Sunil Ram Kumar, a dhaba (eatery) owner in Muzzafarpur says, "My dhaba is on the highway, there were no COVID-19 cases there, but yes there are several cases in the city. I don't worry about it too much since we're all immune to the virus now."
Shahnawaz Khan, a Patna-based contractor, who had tested positive for COVID-19 in November, says people won't take COVID-19 seriously unless it happens to them or someone close to them.
"I isolated myself immediately once I started showing the symptoms, but my test results came out nearly 10 days after the sample was collected," he informs.
After multiple unanswered calls and messages with government hospital authorities, Shahnawaz moved to a private clinic for treatment.
"It's been two months since I recovered from the disease. I had mild symptoms, but despite that, I still struggle with post-COVID-19 weakness. People will not take COVID-19 seriously until it happens to them or their loved ones."
COVID-19 conspiracy theories
Besides, a growing number of people flouting COVID-19 precautions, conspiracy theories such as the pandemic being "fictitious" have found a new footing in Bihar.
Aparajita Singh, a resident of Bhagalpur says, "From the last three-four months, the number of people not wearing masks has increased. A lot of people believe that COVID-19 is fictitious, a rumour spread by Westerners to ruin India's economy."
Dr Ankit Kumar, a resident doctor at Samay Hospital in Patna, points at "hidden cases" of COVID-19 in Bihar.
"More than the reported number of cases, our attention should shift to the hidden cases of COVID-19 in crowded areas. Locals have started dismissing COVID-19 as a temporary illness, similar to the flu," he says.
Many people from lower-income groups believe that COVID-19 will affect only the upper class and rich people since their immunity levels are low, he adds.
Ankit, who lost his father to COVID-19 in November, says that people need to know that the pandemic is not over.
"Our whole family was infected and despite being a doctor, I couldn't save my father's life. People need to know that the pandemic is far from over," he adds.
Dr Firoz, a doctor at Urban Primary Health Centre in Patna says that though the drop in COVID-19 cases has brought relief to healthcare workers like him, people should continue taking precautions.
"Earlier, eight out of every 10 samples we tested turned out to be positive, but now one out of every 10 samples tests positive. It's a big relief for healthcare workers like me. We used to work long and extended hours with very little rest. But the pandemic is not over. We must all proceed with caution," he says.
Ravinandan Kumar, a data operator at an Urban Primary Health Care in Digha says that the high cost of unavailability of masks and sanitisers led to a social divide in the adoption of COVID-19 precautions.
"There was no distribution of masks, sanitisers and soaps for people from the lower-income group. How can they afford to spend a section of their earnings on masks and sanitisers which need to be bought frequently?" he says.
Kumar says that people from the lower-income group are often hesitant to get themselves tested for COVID-19, but "everyone needs to understand COVID-19 will impact people regardless of social status".
COVID-19 spurt and exodus of migrant workers
In rural Bihar, COVID-19 seems like a nightmare that is over. Several locals believe that COVID-19 spread in rural Bihar during the first migrant worker exodus after the national lockdown in March 2020, but not anymore.
Firoz agrees. "When migrant workers returned from big cities like Delhi and Mumbai, cases in rural Bihar went up, but now things seem to be looking better," he informs.
Santosh Kumar, a nursing home worker in Mohabbatpur Village, Bihar Sharif, expresses his relief at the lack of cases in his village.
"Earlier, we found at least 40-50 cases per day, but now everyone wears a mask and follows strict social distancing, this has helped eliminate COVID-19 completely from our area."
Rekha Kumari, an ASHA worker who works across villages and towns in the Gaya district points out that there are no COVID cases in her area either.
"My village is cut-off from the bustling sides of the district, so we haven't seen any COVID-19 cases. Yes, there were cases last summer, but not anymore." Rekha was given the Covaxin on 19 January.
Manisha Mehta, a resident of Mansapur village in the Supaul district travelled to the neighbouring city of Purnea with her father for his surgery.
"The only people wearing masks were the hospital staff. No one else," she says.
There are no COVID cases in her village at present, but she is worried that she may accidentally carry the virus due to frequent travelling. "I have to make more trips to Purnea and Patna in the upcoming weeks for medical checkups. I'm scared that I will catch something and spread it," she says.
Waiting for the vaccine and salary
In the first phase of the vaccine rollouts, healthcare workers and frontline workers are being given the vaccine. However, Anita, an ASHA worker based in Muzaffarpur, is yet to receive any formal notice for immunisation.
"I read in a local paper that ASHA workers will be getting the vaccine soon, but we are yet to receive any information on this," she says.
For Anita, being the sole breadwinner of the house and being an ASHA worker is an exhaustive task. The medical store her husband used to work at closed down a few months ago, leaving him jobless.
"I have two children to feed and I am yet to receive my salary for months. The government calls us 'corona warriors' in public, but fails to pay our salaries on time. What do we do? Kill ourselves?"
ASHA workers are paid between Rs 1,500 to Rs 2,000 for their work per month.
What's actually behind low numbers?
Dr Dipali Singh, a second-year MD student at Patna Medical College and Hospital points out that the varied immunity levels in rural and suburban regions could be behind the lack of COVID-19 cases in Bihar, but the role of lower testing can't be ruled out either.
"People from rural regions have better immunity which possibly led to them fighting off COVID-19 much quicker than the city folks," she claims.
However, the lack of centralised, vigorous testing could also point towards low numbers in Bihar.
"There is a lack of testing due to which we are seeing lower numbers, even if the infection rate is low, we all need to stay alert," she adds.
At the peak of the pandemic, healthcare workers were burdened by long shifts and little rest. Dipali has been on COVID-19 duty since late March. She was called for duty just eight days after giving birth to her son.
"It was scary to go back home to my newborn while dealing with COVID-19 patients all day long, but I'm glad we've made it this far," she says.
Dipali, however, has not been cleared for the Covaxin vaccine provided by her hospital since she is still breastfeeding.
Sanjeev Kumar, Head of Department of Cardio-Thoracic and Vascular Surgery at the All India Institute of Medical Sciences (AIIMS), Patna, and Nodal Officer COVID-19, was a volunteer for Bharat BioTech's Covaxin.
"With continued immunisation, we will see the growth of herd immunity. Yes, several cases have gone underreported and there are hidden cases too, but we have won half the battle with COVID-19 already. I would urge people to continue following safety protocols," he adds.
The socioeconomic gap which leads to better access to healthcare in urban regions could also be the reason behind lower COVID-19 numbers in rural Bihar.
"The socioeconomic gap is definitely at play here, for many regions there is very little data on COVID-19 cases, recovery rates, and deaths," adds Sanjeev.