On March 9, the fisherfolk of Koliwada, Worli, set fire to a coronavirus-themed effigy in a symbolic gesture to root out the deadly virus. An otherwise vibrant locality in central Mumbai, Koliwada now stands deserted and morose. One of the most impacted areas in the city, the neighbourhood has been identified as a COVID-19 hotspot. The police have sealed the area with a blanket ban on the residents’ movements with no outsiders allowed. Almost 400 residents were quarantined till April 5 after 42 people in the area tested positive for the virus, the highest in any locality in the city. The Brihanmumbai Municipal Corporation (BMC) has demarcated 202 localities in the city in suburbs, like Worli, Dharavi, Malad, Chembur, Ghatkopar and Andheri, as containment zones. With 714 positive cases and 45 deaths recorded till April 8, Mumbai makes up almost 60 per cent of the total number of positive COVID-19 cases (1,135) and deaths (72) in Maharashtra.
Dharavi, one of Asia’s largest slums and a mere 10 km from Worli, is another area where life has been paralysed because of COVID-19. Fear descended in the area after one person died and another one, a surgeon, tested positive. Kumar Ranjan, a resident of the building where the surgeon lives, and a diabetic with heart problems, says he cannot even think of venturing outside right now. “I am worried about the future. There is no end in sight,” he says.
The BMC has taken several measures to prevent the spread of virus–from sanitisation and forced restrictions on residents’ movements, to putting up banners in containment zones to enforce social distancing. On April 3, it started ‘fever clinics’ in the containment zones. An area with more than 15 patients will have three clinics, while the rest will have two each. The BMC administration has tasked every medical officer in each ward with arranging for a doctor and nurse in each clinic and authorised assistant commissioners of all 24 wards to rent empty residential buildings, hotels, dharamshalas, clubs, exhibition centres, colleges, hostels, dormitories, gymkhanas and banquet halls to be used as isolation centres. The BMC is also arranging for food and basic facilities in these centres. On April 5, they acquired Sai Hospital, which has a bed capacity of 300, for the Dharavi residents.
A note released by the BMC says that the civic body has formed 214 teams comprising 3,100 staff members for door-to-door checks. Over 9,500 people had been tested in the city till April 5. Additional Municipal commissioner (Western Suburbs), Suresh Kakani says the city has 5,000 isolations beds at present which could be increased to up to 20,000 at short notice.
In Mumbai, the BMC and the state government have jointly designated five hospitals–Kasturba, Saifee, St. George, Seven Hills and Nanavat—for symptomatic positive patients. There are seven other hospitals for non-symptomatic positive patients. Schools, halls and civic-owned buildings are also being used to isolate low risk cases. Director of medical education Dr. T.P. Lahane says standalone facilities have been created keeping in mind all precautions. On April 5, the isolation beds occupancy was at 28 per cent, while quarantine beds occupancy was at 18 per cent.
The state government and the BMC has also launched a 24x7toll-free helpline number to put citizens in touch with trained mental health counsellors, clinical psychologists and psychiatrists. The helpline had received 4,239 calls till April 3. Of these, 230 callers were advised tests.
The BMC, however, is facing flak for its slow pace. The pandemic has spread to several leading hospitals in the city, such as KEM, Nair, Hiranandani and Wockhardt, which are now facing shortage in manpower with their staff under home quarantine. The doctors and nurses have complained about the lack of personal protective equipment (PPE).
BMC commissioner Praveen Pardeshi has refuted the allegation of being slow and claimed that the BMC has traced four lakh people who might have come in contact with COVID-19 positive patients. He also hinted that they might take over small hospitals and nursing homes to create quarantine facilities. “We intend to quarantine 5,000 people in BMC facilities,” he says. “Almost 10,000 rooms with clean washrooms are ready for families from slums.”
At 4 per cent, Mumbai’s COVID-19 fatality rate is above the national average of 2.5 per cent. Maharashtra’s overall fatality rate is 5 per cent, which is close to the global rate of 5.17 per cent. The availability of only 2,500 intensive care unit (ICU) beds and ventilators in Mumbai has left the administration worried in case there is a surge of critical patients. The BMC, says Pardeshi, has ordered for another 500 ventilators. In the rest of Maharashtra, 50,000 quarantine beds, 10,000 isolation and 1,000 ventilators have been kept ready to face the situation.
Currently those with travel history and symptoms; asymptomatic senior citizens with travel history and co-morbidities and health workers and patients with acute respiratory distress syndrome are being tested in government laboratories. The rest are being tested at private laboratories. The data available with these laboratories show that there is no community spread in the state so far. Till April 4, government laboratories had tested 8,956 high risk category samples. Of these, 414 samples (4.6 per cent) were positive. The private laboratories tested 3,896 people and found nine (0.24 per cent) positive. However, the fact that almost 69 per cent of the positive patients are asymptomatic and are capable of transmitting the infection to others unknowingly has remained a cause for worry.
Maharashtra health minister Rajesh Tope says the state is prepared to face the worse situation and has plans to make use of 1,096 hospitals empanelled under its health scheme, Mahatma Jyotiba Phule Jan Arogya Yojana (MJHJAY), apart from the existing isolation beds. These empanelled hospitals, however, are hesitant in treating the COVID-19 patients as they do not have access to PPE, a concern that Dr. Sudhakar Shinde, head of MJHJAY, acknowledges as genuine. According to Tope, the shortage of PPE will be sorted out soon. The state received 15,000 PPE from Chennai on April 5 in addition to the existing 25,000 PPEs in its stores. “We have roped in all non-Allopathic doctors to join the COVID-19 battle. Ayurveda, unani and homeopathy doctors are being trained,” says Tope.
Meanwhile, private players have offered their services to combat the pandemic. Mumbai Port Trust Sanjay Bhatia is in talks with Jalesh Cruises which runs a cruise liner Karnika for the setting up of 1,000 isolation beds on the ship. Another 500 rooms are being readied in the seafarer’s hostel and 500 more in other buildings of the port trust including its training institute and college. On the other hand, Tata Trust has offered the use of the renovated Mahatma Gandhi Hospital in Parel, which has 350 beds. The Western Railway has vacated Jagjivan Ram hospital in Mumbai Central and has plans to convert 460 train coaches into quarantine facilities, while Central Railway will convert 482 coaches into isolation wards. Each coach will have 16 isolation beds.
The science and Technology department of IIT Bombay, too, has created a team to take immediate actions and scale up responses to detect, treat and reduce transmission of COVID-19.
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