Mumbai remains the worst affected city in India with the highest number COVID-19 positive cases and deaths has become a cliché since March 2020. In an interview with Dipti Singh, Brihanmumbai Municipal Corporation (BMC) commissioner Iqbal Singh Chahal talks about how BMC has managed to grip the virus and bring the number of cases in majority of the wards to just single-digit.
However, talking about the steps being taken by the civic body to contain the spread of COVID-19, Chahal, also cautions Mumbaikars to adopt the new normal and take precautions until a vaccine is found.
Excerpts:
How would you as the chief of BMC evaluate the situation of COVID-19 outbreak in Mumbai?
Let me tell you, as on today we have managed to get perfect grip on the virus in Mumbai.
From Colaba-Nariman Point to Bandra and from Vashi bridge to Chembur number of cases reported on a daily basis have come down to just 5 to 7. On, Saturday, Dharavi, which is the worst affected area too have reported just 7 cases. Our focus here is to maintain this and then bring it down even further.
If you look at the average growth rate of outbreak in Mumbai it has come down to 2.17 % from 9.5%. Health experts across the globe have said, that once the doubling rate of the cases increases and stays at 30 days, the situation can be considered under control. The average doubling rate in Mumbai as on June 20 is 34 days. Furthermore, wards like H (East) (Bandra East, Khar) have a doubling rate of 72 days.
G North (Dharavi, Dadar), which earlier had a big spike has registered a doubling rate of 45 days.
The national average doubling rate stands at 17 days currently. No other city in the country has achieved a doubling rate of 30 days. This shows that the situation in Mumbai is getting under control and we are working harder to make it even better.
How prepared was BMC to handle the situation, especially after the ease of restrictions under 'Mission Begin Again?
We were prepared to face the worst. We had even expected cases to double after relaxations of restrictions. After watching people crowding in several areas in the city, I believed that cases might surge from 1,500 to 2,500 and more on a daily basis. But that did not happen, and the number of cases reported on a daily basis started sliding despite all the relaxation to lockdown restrictions.
People across Mumbai have been complaining of non-availability of beds, how is BMC dealing with this issue?
What non-availability of beds? As on today, the issue of non-availability of beds has become irrelevant. The question of 1916 not operational and shortage of beds and people roaming in multiple hospitals looking for beds has become redundant in Mumbai. We have formed a strategy called "Chase the patient", under which proper protocols are followed, which ensures, no patients will be left out and will get a bed if he/she needs one. Our online dashboards and ward level war rooms are operational 24x7.
Once a person calls us for help, complains of COVID like symptoms, our ward level teams reach them in 20 to 30 minutes. They are checked for symptoms, oxygen levels and other symptoms. If they the person has strong COVID like symptoms we allot them a bed either in the nearby institutional isolation centres or a hospital. The team does not leave until a bed is allotted. We have clearly instructed them.
How many beds are currently occupied for COVID patients, and how many more ICU beds is BMC arranging for?
Off the total 28,839 active patients in Mumbai, only 9,200 are actually occupying beds in hospitals. Remaining patients are either at home quarantine or at common/ institutional isolation centres. We are, arranging for more beds. In the next 10 days, we will have 300 to 500 more ICUs (intensive care units) by next week. We are now preparing to ensure that even if we have a lakh more patients, we have the infrastructure to handle it. For the last several days, I have not got any messages on my phone from people seeking beds because the situation has improved so much that people are getting beds easily.
Which are the areas that the BMC is focused on currently?
There are only six to seven wards where we are seeing rise in the number of cases and we are now focusing aggressively in these areas. Once we control cases here, we will be able to win this battle.
These wards include P North(Malad), P South (Goregaon), R South (Kandivali), R North (Dahisar), K East (Andheri east) and S (Bhandup)and T (Mulund) wards. We have set targets on chasing the close contacts. We have appointed community leaders in these areas.
These are people who have lived in the area for many years and know the locality well. These community leaders keep us updated with ward level work done including community toilets being cleaned and sanitised regularly.
Quality of food packets they are receiving. NGOs we have appointed are working as directed by us. Has any co-morbid person been left unchecked? We will have stringent containment measures in place in these areas. We will monitor this for next three weeks.
How has the campaign "Chase the Virus' helped?
The campaign has helped us to a great extent until now. However, from Monday onwards we are intensifying the campaign even further. With the help of a few NGOs we are planning to launch 50 mobile dispensaries/ labs with 50 doctors and 100 lab technicians collect swab samples. We will start rapid testing with the help of these mobile dispensaries/ labs. Besides this, 150 private doctors have joined our campaign and have agreed to work with us free of cost.
The reconciliation of death cases led to a controversy; BMC was accused of hiding the number of deaths. Tell us about that.
On June 6, when I was going through the data, I saw one well-known private hospital has listed 17 deaths in a day. I was shocked discussed this with other officials. We found out there was just one death on that day, remaining deaths occurred between April and May 2020, but were reported on that day.
We decided to dig further. After carrying out a reconciliation exercise the total number of cases turned out to be 862. I informed the chief secretary and asked if we could put this in public domain. We decided to be transparent, when we could have kept it covered. We are not hiding anything, people must understand that.
There has been some controversy over the new BMC rules to not give the report to patients but to the civic body directly. Can you tell us about that?
The idea was to discourage people to get the report and look for the hospitals themselves. However, following our new protocol, we have put a team of doctors contacting the patient, informing them and assuring them that they will be taken care of and things would be fine. People who have symptoms need hospitalisation, those symptomatic can be quarantined at home if they have facilities. The shortage of beds in Mumbai happened because 95% of the beds in private hospitals had people with asymptomatic cases.
The hospitals wanted money and these asymptomatic people felt psychological security. We are doing what is best of the Mumbaikars. Once beds are allotted to the patient, ambulances reach at the residences for those who need hospitalisation.
What lessons have been learnt from the pandemic, how can we improve our health infrastructure?
We have to boost our health infrastructure and invest more on health sector. We need to build more public hospitals. This year we have increased the highest number of ICU beds. For example, Mumbai had only 371 ICU beds, until now. Now as on June 20, we have 1160 ICU beds, the number will further increase to 1660 by the end of this month. This has not happened in last 10 years. Pandemic has come after a century. It is new to us, and we are learning on job while dealing with it.
What message would you like to give Mumbaikars?
I would just like to say that its time that Mumbaikar need to adopt the new normal. Need to wear a mask every time they have to go out, wash your hands regularly or used sanitisers frequently. Maintaining physical distancing is something we need to follow religiously. All this until the vaccine comes out.
