COVID-19 Containment: Lessons From Bengaluru and Mumbai Cities in India
5 Pages Posted: 5 Aug 2020
Date Written: July 27, 2020
The Indian subcontinent reported its first case of COVID-19 on 30 January 2020 and has been taking active steps to mitigate the effects of this biological disaster. India with a population of 1.3 billion people, across diverse states, health inequalities, widening economic and social disparities, and distinct cultural values has differed in its preparedness and response to COVID-19 at the level of the various constituent states and districts of India.
The eight designated metro cities of India- Delhi, Mumbai, Chennai, Bangalore, Hyderabad, Kolkata, Ahmedabad and Pune, due to the high population density, and as being hubs of industrial and economic activity in the country, have been affected to a large extent. They have been identified as hot spots and COVID-19 cases in these cities are seen to be on the rise. From the above metros, an active response, starting mid-March at war-footing, was seen in certain areas of Bangalore, under its administrative unit- Bruhat Bengaluru Mahanagara Palike (BBMP) which is responsible for civic amenities and infrastructural assets of the Greater Bangalore metropolitan area with a population of over 8 million. In contrast to this, as on 20 June 2020, the Dharavi slums in Mumbai, which were once a COVID-19 hotspot recorded only seven new cases- the lowest such rise in a single day. This was preceded by a steady decline in the number of cases in Dharavi in the four weeks before and followed by reporting just one new case on 7 July 2020. It is necessary to understand the positive and negative features of thr strategies adopted in the two cities to evolve lessons for future.
Acting under the guidelines issued by the centre and exercising its federal powers, the Government of Karnataka took strict containment initiatives and created a crisis management team to execute them. First and foremost, the ‘Crisis Management Team’ established a ‘BBMP War Room’ with support from other disaster management teams. An ‘Incident Command System’ was triggered in the BBMP to work exclusively on the management of the COVID crisis. Secondly, a ‘Special Health Team’, was put in place to address the needs of the population requiring uninterrupted or emergency care, like pregnant women and cardiac patients. These patients had to be identified and segregated from containment area, a task that was efficiently carried out by this team. ‘Perimeter control’ was one of the major and challenging issue to be dealt with for effective containment of the virus spread. A national guideline was issued for the same. Execution of this task was tricky and required the containment areas to be marked and curfewed properly. This was taken up by Department of Police and people from these areas (Padarayanapura, Tilak Nagar, to name a few) were not permitted to enter other areas. Major emphasis was laid on ‘surveillance and preventive measures in BBMP.
Dharavi, Asia’s largest and densely packed slums in Mumbai, with a high population density, faced various challenges in containment. Difficulty in execution of social distancing and ‘home quarantine’, presence of narrow lanes, dependency on community toilets and outside food and inhabitation of many people in each household were some of the major ones. The Brihanmumbai Municipal Cooperation (BMC) acted fast and implemented 4Ts- Tracing,Tracking, Testing and Treating. As of 11 July 2020, doctors and private clinics covered 47,500 households and mobile vans screened 14,970 people. More than 3.6 lakh people were screened, and 13,500 tests were done. Infrastructure was put in place for treatment and 24*7 food provision. Only critical patients were moved outside Dharavi for admission to hospitals while 90% patients were treated inside the area. BMC followed a “Chase the Virus” approach through strategic public-private partnerships. Proactive screening was conducted in high-risk zones and fever camps were organised to identify the suspects. Available ‘private’ practitioners were mobilized through the drive conducted in ‘mission-mode’ and provided with PPE Kits, thermal scanners, pulse oxy-meters, masks and gloves to do door-to-door screening. All private practitioners were asked to open their clinics which were sanitized by the BMC and the practitioners were provided PPE to attend patients and communicate to BMC about all the suspected cases. A 200-bed hospital was also set up in record 14 days. Since home quarantine was not an option in Dharavi, focus was put on setting up of maximum institutional quarantine facilities at all available schools, marriage halls, sports complexes etc. These quarantine facilities provided a community kitchen, 24*7 doctors, nurses and medical staff, medicines and multivitamins and all medical equipment.
WHO Director General Tedros Adhanom Ghebreyesus praised the efforts taken to control the spread of Corona-virus in these densely packed slums as Dharavi reported only one corona-virus case on 7 July 2020 after the successful containment. Taking seriously all the guidelines provided by the nodal agencies, BMC went on a real war footing and also took care of sustaining the measures adopted to contain the pandemic with public health approaches like public-private partnership, 4’T’s strategy, reinforcement of individual information for effective control. These strategies can be adopted as a model by BBMP to sustain the efforts of the Govt of Karnataka in Bangalore to conquer Corona. Such sustained approach is also needed in other metros and urban areas of the country which may witness a further surge in the number of COVID-19 cases.
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