Figures in dispute

The Maharashtra government claims an impressive recovery rate, but the opposition says confusion prevails even over the number of deaths.

A new isolation centre at St. Xavier’s College in Mumbai on June 17.

“I t is time to understand and acceptthat COVID is here to stay for some time. We cannot say how long, but we will have to learn new ways to live with it.” This is what a Mumbai municipal official said on condition of anonymity. “Numbers will increase especially after the lockdown is called off because people will mingle more. And we have increased testing so more cases will be discovered,” he said.

The city was doing relatively well, he said, pointing out that the March and April predictions for COVID cases were higher than the actual numbers. He drew attention to a comparison between the numbers of positive cases, recoveries and deaths. Until June 13, Maharashtra had 1,01,141 positive cases. Of this, 47,796 persons have recovered and 3,717 died.

It took 95 days for the number of cases to touch one lakh after the first case in the State was discovered on March 9. Officials say that Maharashtra’s corona curve going up slowly can be attributed to the precautions taken by the government. They compare it with New York where cases shot up to one lakh in 22 days, the United Kingdom where it went up in 60 days, and Italy and Spain where it crossed the one-lakh mark in 63 days.

Maharashtra’s recovery rate is 47.03 per cent and the mortality rate is 3.07 per cent. This high recovery rate has encouraged the thinking that there must be many people who have (or had) the virus and recover without even knowing they had it. So, logic points to a new direction for action—focus on reducing the fatalities by caring for the severely infected and thereby bringing the situation under control.

“Our practice has been to trace, test and isolate and we still continue to do that, but there’s a change now. We will be focussing on preventing deaths of those who have been severely affected by the virus. So, those with breathing difficulties should be the ones that get into hospitals. Those with symptoms need to self-quarantine and be educated on when and if to move to hospital. This will free up beds. And make the best use of medical personnel. We’ll control it through good, accessible hospital care,” says the same official.

Accessible medical care has been the stumbling block so far. On the one hand, private hospitals have been brought into the COVID treatment system, thereby enhancing medical facilities. The Brihanmumbai Municipal Corporation (BMC) has said that if private hospitals do not fully turn into COVID care facilities, they need to reserve 80 per cent of their beds for COVID patients. However, according to BMC sources many are yet to act on this. There is also a ceiling on charges for these beds.

On the other hand, there is a shortage of beds, patients dying because a doctor could not see them or because they were denied entry into hospitals, or because of a lack of oxygen support systems and of ventilators. There is also a shortage of ward boys, kitchen staff, cleaners and even nurses. Many hospitals are working with only 40 per cent of their normal staff complement.

Coordination issues

There seem to be coordination issues between private hospitals and the BMC. The State is totally focussed on setting up jumbo facilities over which it has complete control. As many as 8,000 new beds in these facilities will add to the 7,000 beds in public hospitals and 23,000 in private ones currently in use for COVID cases.

The Bharatiya Janata Party (BJP) has been carrying out its own independent research and says that an additional 15,000 beds can be requisitioned from private hospitals and there is no need to build jumbo isolation centres.

Another complication confounds this forest of numbers. The BMC has been accused of fudging the number of COVID deaths. Former Chief Minister Devendra Fadnavis of the BJP wrote to Chief Minister Uddhav Thackeray saying 950 deaths had been covered up and not shown as COVID deaths. An investigation is on.

Meanwhile, from the point of view of the average citizen, there is a need to know when things will return to normal. While the municipal source reiterates the problem of unpredictability of the virus, Chief Secretary Ajoy Mehta says that infection rate has plateaued in the city.

But with the country opening up and travel being allowed it is possible that Mumbai’s plateau may become a rising arc again. This has already been proved in reverse. Those that left Mumbai for their home States took the virus back with them. Dadra and Nagar Haveli, Mizoram, Nagaland, Arunachal Pradesh and Sikkim were COVID-free until their residents returned home.

Debate on lockdown

This has revived the lockdown debate again. Said a bureaucrat in Mantralaya: “There are two views on the lockdown. One is that we created a false sense of hope and people expected that at the end of the lockdown the virus would have vanished. Frankly I doubt that anyone was so foolish to think the virus would disappear. The second view is that when it opened up the virus would get us anyway so what was the point of the restrictions. Critics quote the Swedish government’s chosen path, but that is not relevant to the Indian situation.”

“The lockdown gave people an understanding of the gravity of the situation. It also slowed down the spread of the virus. There are models that prove this. A group of scientists [Indian Scientists’ Response to COVID-19] has estimated that the lockdown has prevented 8,000 to 32,000 fatalities . NITI Aayog estimates that 37,000 to 2,10,000 deaths were prevented,” the official said. Indian Scientists’ Response to COVID-19 is a voluntary group of concerned scientist citizens who have come together to discuss the rapidly evolving situation and the need for science communication.

The lifting of restrictions in Mumbai has highlighted the city’s dependence on workers from the rest of India. The very people the city was eager to transport back are the ones who are desperately required now.

Taxis which are allowed to ply are scarce because most of the drivers have gone back. Shops can stay open longer but do not because of a shortage of staff. The same goes for house help, vegetable and newspaper vendors, and so on.

With no earnings and no way to pay their rents during the lockdown the daily wagers had to leave. The bureaucrat says that if States had been given some warning of the lockdown “lives of people would not have been impacted in the way they were. It was cruel to declare a lockdown within hours.”