Struggling to cope

The rising number of COVID cases in Maharashtra, especially in Mumbai, is straining the manpower and infrastructure resources of the State.

Published : May 19, 2020 12:48 IST

Mumbai has added 1,000 more beds to its Dedicated Covid Healthcare Facilities on May 18.

Mumbai has added 1,000 more beds to its Dedicated Covid Healthcare Facilities on May 18.

Maharashtra is leading in India with some unenviable statistics. Nationwide it has the highest number of COVID-19 cases, with 33,000 positive cases and 1,198 deaths as of May 17. The day the fourth extension of the lockdown was announced, the State saw its highest spike in a day with 2,347 positive cases and 69 deaths. Mumbai, which is the worst hit within the State, reported a steep rise with 1,595 new cases that day. The city had been adding about a 1,000 cases a day until then. The increase has been attributed to the increase in the pace of testing. Mumbai’s tally is 19,967 positive cases and 734 deaths as of May 18.

In an order dated May 17, Chief Secretary Ajoy Mehta invoked the provisions of the Epidemic Diseases Act, 1897, and the Disaster Management Act, 2005, to extend the lockdown in the State until May 31 midnight.

A helping hand

However, there are moves to give people some more breathing space, except in the red zones, and to revive the economy. It is understood that there is some disagreement within the ruling Maha Vikas Aghadi comprising the Shiv Sena, the Nationalist Congress Party and the Congress about how to do this. The NCP feels that economic revival needs to be the priority whereas Chief Minister Uddhav Thackeray of the Shiv Sena is keen on continuing with a strict lockdown for some more time.

The government has finally reached out to a severely overworked police force, especially that of the Mumbai Police. On May 18, the Maharashtra Police said 1,273 personnel had tested positive for the virus and five had died. On May 13, the State asked the Centre for 20 companies of the Central Armed Police Forces (CAPF) to assist the State police. Home Minister Anil Deshmukh on Twitter video said that as the police needed rest before the Eid festival when “law and order has to be maintained” the State government had requested the Centre to deploy 20 companies (2,000 personnel) of the (CAPF).

The Bombay Electric Supply and Transport Company, better known as BEST, has been running skeleton services for those who have to travel to maintain essential services. But as in the case of the police force, there is a huge shortage of masks, gloves, sanitisers and personal protective equipment (PPE) for conductors and drivers. Eight on-duty staffers have died and one of the BEST unions has announced a strike.

The striking union had been in talks with the management, but when nothing was done they called a strike. Another union, controlled by the Shiv Sena, is unlikely to go on strike.

Migrant workers

The city is feeling the backlash of migrant workers returning to their home States. Many who manned provision stores, bakeries and other essential services have left, resulting in the temporary closure of these establishments. The State government scrambled to try and stop them from leaving by giving permission to 65,000 industries in green and orange zones to resume operations.

Decentralising responsibility seems to be the new mantra. After Iqbal Singh Chahal, the new Commissioner of the Brihanmumbai Municipal Corporation (BMC), took over, one of his first acts was to assign eight senior Indian Administrative Service (IAS) officers to key posts and responsibilities. Decentralising is also seen in a new rule in which chairmen and secretaries of housing societies will be held responsible if any resident violates the containment period. They can be booked under Section 188 of the Indian Penal Code (causing danger to human life, health or safety) and be jailed for a month or fined. The move is to try and take the burden off the police.

Institutional care

A dark cloud that hangs over the city’s authorities is with regard to the inadequacy of medical institutional care for patients. The BMC has created three types of care facilities. Covid Care Centres, or CCC, are divided into CCC-1 and CCC-2. The former is for high-risk suspects, that is, people who may have been traced via contact tracing, and those who live in infected, crowded areas with no chance of physical distancing. They have access to 22,941 beds. The latter is for asymptomatic positive cases or those with typical symptoms but no sign of coronavirus; there are 34,329 beds for this section.

The second category is Dedicated Covid Health Centres, or DCHC, for moderately affected cases; they have about 10,000 beds. They will be observed so that they do not slip into the severely ill category. The severely ill have to go to a Dedicated Covid Hospital, or DCH, which is equipped with ventilators in ICUs. There are only 4,800 beds for this severe category.

While the BMC says there are adequate beds for the first two categories it is the third category that is failing critical care patients. With more aggressive testing the numbers are bound to leap.

Recognising that critical care patients are its next immediate challenge, the BMC is working to increase the capacity in the DCH category. By the end of the month the corporation hopes to have about 3,000 more beds, though that too may be sparse. A BMC source said private hospitals need to participate more. Health Minister Rajesh Tope has asked private hospitals to reserve 60 per cent of their beds for coronavirus cases.

Tope also addressed the long-pending matter of vacant posts in the Public Health and Medical Education departments. Sixty six per cent of the posts in the Public Health Department and 41 per cent in the Medical Education Department were vacant. Tope said both would be filled within the month.

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