[Editorial Analysis] Covid in Mumbai: The municipality led a decentralised effort to increase testing, tracing, hospital beds

Mains Paper 2: Governance
Prelims level: Coronavirus disease
Mains level: Government policies and interventions

Context:

• Four pillars on which the fight against COVID-19 would stand — testing, ambulances, COVID beds and abundant trained doctors/ paramedics.

• Testing, tracing, tracking, quarantine and treatment – Mumbai’s fight against the COVID contagion.

About Covid-19:

• Coronavirus disease (COVID-19) is an infectious disease caused by the coronavirus which has become one of the deadliest pandemics in the history of human civilization.

• It may cause death in patients with lower immunity and other pre-existing diseases. So, older people are prone to contract the disease.

• The best way to prevent/slow down transmission is to practice sanitary habits, maintain social-distancing and wear a mask at all times when in public spaces.

• Also, it is imperative that one must be informed about the current spread in and around the locality, check the news regarding any new updates, etc.

• The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. So, wearing a mask is a must to limit the spread.

The spread:

• The well-known slums, Dharavi, Deonar Bainganwadi, Govandi, Ghatkopar and Worli Koliwada, were teeming with the infection.

• The death rate touched 8 percent and there were rumours of innumerable deaths in Mumbai.

• Soon, dead bodies were found on the city’s streets and road dividers. Social media was flooded with such videos and hospitals filled with Covid infected patients.

Measures taken:

• A 4-km long march to the containment zones of Dharavi to understand the situation in the slums. Four pillars were identified on which the fight against COVID-19 would stand – testing, ambulances, COVID beds and abundant trained doctors/ paramedics.

• The Municipal Corporation of Greater Mumbai (MCGM) ensured a massive increase in health infrastructure.

• The number of COVID-19 beds were increased from 3,700 on May 8 to 22,300, with ICU beds increasing from 480 to 1,957

• There was a manifold increase in ventilator beds.

• The availability of COVID-19 test results in 24 hours was made mandatory.

• Thousands of health workers visited slums and containment zones for door-to-door surveillance and focused testing.

• More than a million RT-PCR tests were conducted in the city.

• There was a 10-fold increase in the number of ambulances, from 80 to 826. They were available on the Uber platform, free of cost.

• More than a thousand doctors and paramedics were roped in, including retired government doctors.

• Around 900 MBBS interns were deployed to manage the war rooms in the city’s wards.

• An innovative and extremely aggressive “Chase the Virus Policy” was implemented and lakhs of high-risk contacts were shifted from the slums and placed in institutional quarantines to shield them from the contagion; 48,000 institutional quarantine beds were created.
• Decentralised hospital bed management along with the Chase the Patient policy proved a game changer.

• Senior IAS officers were deputed to hospitals to supervise operations.

Landmarks in Mumbai’s approach:

• Mumbai became the first city in India to fully regulate COVID-19 beds in 35 major and 73 other private hospitals at government rates through a single online dashboard.

• A world-class online platform for dialysis management for COVID-19 patients was operationalised.

• Nine centrally air-conditioned jumbo field hospitals with ICU and dialysis beds were established and Mumbai became the first city in India to successfully build and operate them.

• Walk-in facilities of beds for suspected COVID-19 patients were created all over the city to treat suspected patients without test reports.

• Dashboards were created in hospitals to provide information on crematoriums.

• Mission Save Lives for hospitalised patients led to a reduction of mortality rate from 8 per cent to under 2 per cent.

• Compensation of Rs 50 lakh was given to MCGM/BEST staff who had succumbed to the disease and were not covered under the Government of India’s insurance scheme for frontline COVID workers.

• The My Family My Responsibility campaign was implemented for two months – 12,000 health workers reached out to 3.5 million families twice for surveillance and health checkups.

• The No Mask no Entry campaign was launched.

• iPads with Wifi facilities were distributed to COVID-19 positive patients admitted to hospitals to facilitate interaction between them and their relatives – The psychological aspect of the patient’s revival was paid equal attention.

• Plasma banks were created in major BMC hospitals and the drug protocol was standardised.

Outcomes:

• In November, the city had less than 10,000 active cases, the doubling rate had increased to 218 days,

• The rate of infection had fallen to 0.3 percent, the positivity rate was down to 6 percent and the monthly mortality rate was below 2 percent.

• More than 90 percent patients are now discharged from hospitals.

• The situation did not deteriorate in Mumbai during the festive season.

Conclusion:

• The virus is an unpredictable adversary and unless a vaccine becomes a reality for all, the infection cannot be ruled out.

• Other cities can walk on the path laid out by the MCGM team since it has proven to have controlled the devastation to some extent. Cities still under the deathly grip of this virus should consider employing what Mumbai did.

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Prelims Questions:

Q.1) With reference to the desalination plants, consider the following statements:

1. Maharashtra announced the setting up of a desalination plant in Mumbai, becoming the fourth state in the country to experiment with the idea.

2. Desalination is an expensive way of generating drinking water as it requires a high amount of energy.

Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2
Answer: C

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