Spiralling irresponsibility behind rising number of new COVID cases in Maharashtra

Non-compliance with safety measures is causing numbers to rise in Maharashtra.

A health worker takes swab sample for COVID-19 tests from a visitor at a mall in Mumbai on March 30.

PASSING through the Null Bazar area of south Mumbai, this correspondent was witness to a crowd of about 25 people who had gathered in a circle and were shouting at someone in the middle. People had their mobile phones raised and were taking videos of the fight. In the centre were two Brihanmumbai Municipal Corporation (BMC) employees deputed to fine those not wearing masks. The irate crowd had gheraoed (surrounded) them. The mood was one of ugly aggression, and while one of the municipal men was trying to reason with the people saying they were just doing their duty, the other was trying to connect with someone on his phone.

While both the BMC men wore masks and one even had on a visor, not a single person in the crowd had a mask on. Neither did the majority of the people on that extremely crowded street. Further down the same road, a similar fight was in progress, but this one was more aggressive and the officials were being shoved around by the crowd. Here, too, the crowd was without masks. The objection was to the Rs.500 fine that is mandatory for not wearing masks and Rs.1,000 for spitting in public. The exhausted and slightly bewildered municipal officials were perplexed at the attitude of the crowd. “This is for everyone’s good. Why can’t you understand that?” one of them kept saying as he was jostled.

Such scenarios, increasingly common, are responsible for the rising numbers of COVID-19 cases in Mumbai. Ever since the city opened up late last year, there has been spiralling irresponsibility by the public about violating restrictions meant to contain the pandemic. From March last year, the BMC, Mumbai Police and the Railways have fined more than 23 lakh people and collected Rs.46.87 crore in fines.

There is violent objection to the restrictions, but at the same time there is a refusal to comply with mitigation measures such as wearing masks. The government is caught in a bind. There is a desperate need for restrictions, but there is also the economy to consider and, in many cases, it is the small businesses that are going to be hit. Chief Minister Uddhav Thackeray is well aware of this and has resorted to the new restrictions only after much deliberation. A night curfew has been reimposed in Mumbai and Pune and is operational from 8 p.m. to 7 a.m. and permits no more than five people to gather.

Uddhav Thackeray is baulking at a full lockdown, saying it will hurt earnings. But a standard operating procedure (SOP) with restrictions on public movement is expected in April. Despite this reasonable attitude of the State government, there continues to be resistance to restrictions. In the third week of March, the BMC said that rapid antigen-testing should be carried out at random public places, including malls and railway stations. The Shopping Centres Association of India has asked the BMC to lower the number of tests required to be carried out at malls in Mumbai. It says: “The move to carry out random testing is likely to spread fear among the public, dissuade genuine shoppers who have slowly returned to shopping centres and put into motion a spiralling effect on modern retail that could derail the recovery of the segment.” Hawkers will feel the pinch even more with no option to store perishables. The main contention from the hospitality industry is that they were among the last to start after the lockdown and most of their business is conducted in what are now curfew hours.

The Bharatiya Janata Party (BJP) is trying to take advantage of the situation by saying a total lockdown would be the worst thing for the State. This, from a party whose leader gave four hours to the country to prepare itself for what is now seen as the world’s most stringent lockdown. The suffering caused by that has been well documented.

On March 28, the option to reinstate a lockdown was discussed at a meeting Uddhav Thackeray held with Health Minister Rajesh Tope, Health Secretary Dr Pradeep Vyas, and the Covid Task Force. The Health Department advised a lockdown, but Uddhav Thackeray was averse to it. However, instructions were issued to the Relief and Rehabilitation Department to formulate an SOP in case a full lockdown had to be imposed. Chief Secretary Sitaram Kunte was put on alert to ensure uninterrupted supplies of medicines and food stuffs and to see that essential services and medical facilities function unhindered.

The State has registered close to six lakh cases in March with more than 2,100 deaths. In the last two weeks of March, the State saw a 32.21 per cent rise in COVID-19 cases. On March 29, Maharashtra had 31,643 new cases and 102 deaths, thus taking the active case load to 3.36 lakh. Mumbai recorded 5,890 new cases, Pune 4,972 and Nagpur, which has come out of a second lockdown, had 3,243 cases. The numbers have been rising since February with the deaths doubling.

The State’s first COVID-19 case was recorded on March 9, 2020. By March 31, 2020, the doubling rate in the city was three and a half days. In October last year it dropped to 100 days and in January-February this year the average doubling rate was 393. The latest figure, however, shows that the infection is rising and the doubling rate is 63 days. The rapidity with which this has occurred is a matter of concern, and the old fear of inadequate health facilities is haunting medical personnel again.

At the current rate of increase, the 60,349 oxygen beds will be occupied within a week. Until March 28, 12,701 oxygen beds were in use. Likewise, the ventilators, of which 1,881 of the 9,030 are in use. The State has 3.57 lakh isolation beds and 1.07 lakh are already occupied. Pune and Nagpur, which have been deemed to have a mutant variety of the virus, have run short of isolation beds. Hospital infrastructure all over the State is falling short. In Mumbai, the BMC has asked private hospitals to increase bed capacity to 4,800 and the inclusion of 63 private nursing homes for COVID-19 treatment has upped the bed capacity by a further 2,000. This, too, will be severely inadequate if BMC Commissioner Iqbal Chahal’s projection of cases touching 10,000 per day in Mumbai turns out to be correct.

At the March 28 meeting, Uddhav Thackeray directed that 80 per cent of the oxygen produced in the State be reserved for medical facilities and the remaining 20 for industrial use. This order is similar to the one issued in August 2020—another indicator of the severity of the situation.

One of the reasons for fatalities is that patients are being brought to hospitals too late. Speaking on condition of anonymity, a doctor at a public hospital said: “When they come here they are in such a bad shape that we have to put them in the ICU [intensive care unit] on a ventilator. Sadly, many are terminal purely because of delay in treatment. We do not grudge these patients the special facilities, but if they had been brought in earlier they would either have not needed them or they would have needed them briefly which means the facilities could have been used by more patients.” The doctor said that the refusal of the public to cooperate in basic precautions was “frustrating” and was “bringing about this surge”. He said he understood the phenomenon of ‘COVID fatigue’ but a price is being paid for it.

To intensify the fight against the virus, the age bar for the vaccine has been dropped to 45. Incredibly, there is actually the concern of vaccines going to waste, so the State is prompting people to just walk into any of Mumbai’s 97 vaccine centres and get inoculated. In the last week of March, about 75,000 people were vaccinated every day. The BMC plans to increase this figure to one lakh. State-wide, more than 35 lakh people of the priority population of about three crore have been vaccinated. The total number of people administered the vaccine has crossed 50 lakh in Maharashtra.