Surprise surge

In Maharashtra, Mumbai is emerging a hotspot, but the people are generally happy with the government’s efforts to contain the virus and ensure that people’s needs are met during the lockdown.

Migrants sleep under a flyover next to rail tracks near the Lokmanya Tilak Terminus in Kurla on March 31.

O n April 14, Maharashtra’s tally of coronavirus cases more than doubled in a matter of six days. With 352 new cases detected the previous day, the State’s tally reached 2,690. As many as 178 deaths were recorded until April 15. By April 17, the number of cases had soared to 3,202 with and 194 deaths.

Mumbai still leads in the number of coronavirus positive cases with 2,073 cases and 117 deaths. Apart from Mumbai, there were 350 cases in the Mumbai Metropolitan regions. Pune had 473 cases; Malegaon had 40; Nagpur had 56, Aurangabad and Ahmednagar had 28; and Sangli had 26.

Malegaon in Nashik district has seen a surge in the number of coronavirus cases. On October 13, 14 cases were reported from the area, taking the tally to 29, and by October 17 it was 40. It is being looked at as another cluster where the spread has spiked. The district authorities, in conjunction with the municipal council, are looking at demarcating containment areas in the city. Government officials are not ruling out the possibility of the presence of Delh-returned Tablighi Jamaat members in the area.

Mapping the virus shows an interesting progression. The State took 30 days to cross the 1,000-case mark on April 7, while it crossed the 2,000 mark in just six days. However, the State Health Department is not unduly worried about the increase in cases. A ward-level doctor, requesting anonymity, said: “The spread of the virus is still at stage 2. This means [it is restricted to] people who have had a history of travel or those who have come in contact with an infected person. It is easier to detect these cases and those around them through contact tracing.”

Government spokespersons have said the spread of the virus is not exponential and is under control. Cluster containment plans of the government, such as the one applied at Mumbai’s Worli-Koliwada, where the entire locality was sealed, seem to be getting results. The government is confident that the current growth is a natural one and that it is not out of control. About 3,000 tests are being done on a daily basis to try and monitor the progression. Until April 17, 56,673 tests have been carried out and more than 20.50 lakh people have been screened. As many as 71,076 people are in home quarantine and 6,108 in institutional quarantine. State Health Minister Rajesh Tope attributed a large number of the deaths to comorbidity issues—underlying ailments like diabetes and poor kidney and heart health.

Conducting 3,000 tests every day is indeed a valiant operation, but daunting when compared to the untested population. The Public Health Department says government and private labs have, until April 15, tested 45,142 samples. Of these, 44,808 (98.83 per cent) have been negative and 2,334 (5.17 per cent) were positive.

Shortage of testing equipment, personal protective equipment (PPE) and manpower remain the main hurdles. “Sealing off and quarantining entire localities where cases have been detected is actually the only way forward,” said a ward-level medical officer. He said the administration was hesitant to take that route because it would be politically unpopular. However, another official in the State government said, “The BMC [Brihanmumbai Municipal Corporation] is overthinking things. The Chief Minister is in no mood to think of politics. He is genuinely working to contain the virus.”

Dharavi is the other hotspot in the city where the first case was found on April 1. Again, lack of testing kits was a problem but a system had been put in place. There were 71 positive cases from the area on April 16 and eight deaths while 215 residents are in institutional quarantine. The addresses of the affected have been mapped and five pockets within Dharavi have been marked as red zones, their residents segregated as far as possible and door-to-door screening carried out. These zones have a population of about 50,000 people. Dharavi’s total population is 8.5 lakh. Until April 15, of the 13,250 people thermally screened, 113 were sent for testing to a private lab that the BMC has tied up with; 1,381 residents have been found to be high risk contacts and 3,450 as low risk. People with high-risk display typical positive symptoms and they are institutionally quarantined. People with low risk are asymptomatic cases and are permitted to stay home.

When the BMC appealed to private doctors for help, 24 local doctors came forward. They were provided with basic equipment and have been working with residents who are more amenable to local doctors being involved. A sports complex, a municipal school and a local hospital have been taken over as quarantine centres. Clearly, the administration expects the numbers to rise rapidly.

People were hoping that the lockdown will be lifted on April 14, but with the number of cases still on the rise, Chief Minister Uddhav Thackeray had no option but to extend the date. But the government will have to make special provisions for certain sectors and in certain areas. While the specifics are not yet announced, it is known that there will be no relaxing of rules in the Mumbai metropolitan area or in Pune. Some industries will be allowed to start on the condition that they accommodate the workforce in or near the factory.

District officials have been asked to send reports on the economic activities that can be allowed in their areas which will not assist the spread of the virus. It is understood that all the districts will be colour-coded to indicate the infection levels, starting with red (high) to orange (cases less than 15) to green (zero cases). Small and medium enterprises will be allowed to function with basic hygiene and physical distancing norms. While this is viewed with anticipation, the real challenge lies in arresting the spread of the virus so that the main industrial areas, currently in the red zone, can start functioning.

Agriculture is expected to get urgent assistance. Horticultural harvests are already being drastically affected and farmers are tense because there is no way to get the produce to the market. In Sangli, which is famous for sonaka grapes, farmers are literally dumping entire harvests by the roadside. Attempts to dry them and sell as raisins also do not seem to be working because of the huge quantities involved.

The general perception of the State government’s efforts continues to be favourable. Public support flagged a bit when the April 30 and May 3 extensions were announced. The government needs to ensure a continuous supply of provisions, for which the factories need to work and the farmers’ produce need to be picked up. There have been brief phases when, for instance, the Agricultural Produce Market Committee’s (APMC) yards were shut with no warning and no explanation, causing panic-buying. Things levelled out when it was known that the reason was that a trader had tested positive. Loaded trucks, meanwhile, were directed to another location, where the temporary market continued. The APMC and grain and spice markets are expected to begin operations on April 16.

If the government has been found wanting it is in the logistics of getting food from the farms to people’s homes. A bureaucrat agreed, saying: “That chain of farmer-trader-retailer-buyer, that’s what we’re working on…. That needs sorting out. All we ask is that the public do their bit: stay home and keep physical distance.”

Physical distancing, masks, working from home, no public transport, it is all being mostly applied, but the virus is still spreading. The final word on this goes to Dr. Zarir Udwadia, the eminent pulmonologist: “There is little option. Quarantine and lockdown as a containment strategy against the coronavirus is all we have.”