Gurugram’s battle against Covid-19 is a year old today

A year ago on March 13, around 8

A year ago on March 13, around 8.45pm, district epidemiologist Dr Ram Prakash was on his way home to Delhi’s Najafgarh when he got a confidential call from an employee of the state health department, confirming the first case of Covid-19 in Gurugram, and also in Haryana -- that of a 27-year-old woman resident of  Sector 9. Prakash immediately called the chief medical officer, returned to his office, and headed straight to Patient Zero’s home along with his team.

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Thus began the battle against a pandemic -- the World Health Organization had declared Covid-19 a pandemic on March 11, 2020 -- the likes of which the district had never seen before.

Since then, 59, 698 cases of Covid-19 have been reported in Gurugram and 359 people have died of the disease. Data shows that Gurugram, which experienced two severe waves of the infection until now, was among the worst-hit districts in Haryana.

The district had to grapple with its own share of challenges — it had no prior exposure in handling a public health crisis of this magnitude; there were several delays in interdepartmental coordination; manpower and resources fell woefully short; and fear was spreading rapidly among the people in the absence of awareness about the disease.

Still a workforce of just over 30,000 managed to best the dreaded infection -- from a peak of almost 1,000 cases a day in November , Gurugram managed to reduce the daily caseload to 16 (as on February 15). The test positivity rate, which had at one time climbed to 23% (last June) is currently 1.7%. To achieve this reduction, Gurugram stepped up testing; at one point conducting more than 3,000 tests daily.

With several Fortune 500 companies having offices in the city, corporates, too, came to the aid of the district administration and cumulatively contributed nearly ₹30 crore for various Covid-related work.

Interdepartmental coordination

“Over 30,000 government officials and employees were part of an extensive exercise to curb transmission of infection in Gurugram. Coordination between various departments such as health, revenue, municipal corporation, agriculture, education and others was crucial,” said Prashant Panwar, additional deputy commissioner.

In June, during the peak period of infection, the administration allocated tasks among different departments to curb the infection -- if health department did the sample collection, MCG maintained the records on test reports. Based on the test results, Haryana Shahri Vikas Pradhikaran(HSVP) employees worked on contact tracing, while co-ordinating with the health department, police and the district administration’s mobile wellness unit simultaneously.

Panwar said, “Although Covid-19 comes under disaster management, there is only a flood control unit to handle a disaster. Covid -19 was new to everyone. Everything had to be done within short deadlines — from manufacturing masks and sanitisers to making personal protective equipment (PPE) kits for which we had to take permission from a government body in Coimbatore. Companies in the auto sector helped to manufacture these items.”

Even for those involved in activities such as food and ration distribution, the challenges were similar. Mohit Sharma, chief warden, civil defence — he was recently felicitated with the Utkrisht Seva Medal by the Union ministry of home affairs for his contribution in handling the migrant labour crisis and ration distribution during the Covid-19 lockdown — felt that resource management could have been better.

“Volunteers, small groups, residents’ welfare associations, which were involved in food and dry ration distribution, had scant idea how to handle a crisis like Covid-19,” Sharma said.

Preet Pal Sangwan, assistant commissioner of police (ACP), crime branch, agreed that coordination problems existed. “Co-ordination between departments has always been difficult. The impact of the lack of coordination was felt throughout the course of the pandemic.”

For better co-ordination, nodal officers, along with deputy commissioner and divisional commissioner, held meetings daily to discuss and clear all roadblocks. They came up with an internal application to access records related to Covid-19, from testing to contact tracing and identifying hot spot areas where containment needed to be strictly imposed.

Making the most of resources

In the beginning, there were no arrangements or machinery to conduct large-scale testing or deliver timely results, recalled Dr Virender Yadav, who joined as Gurugram’s chief medical officer last June, when cases were at its peak in the district. “The reporting schedule, arrangements for hospital admission of severe patients and contact tracing were all in a disarray,” said Yadav, adding that department had only two RT-PCR testing machines at that time.

“Handling a pandemic is challenging. It is once-in-a-lifetime kind of crisis, where it is difficult to predict how people will behave. The situations are dynamic and keep changing every now and then,” he said.

The staff too lacked exposure to handle a pandemic. “After swine flu, none of us has experienced a major health crisis like Covid-19. Extensive training had to be given to the staff to handle the situation effectively. Even now, some of them are still hesitant about dealing with Covid cases,” Prakash said.

Through a series of training sessions for health workers, installation of two RT-PCR machines at Civil Hospital to speed up testing, and by holding several testing camps daily, Gurugram made the most of the resources available at its disposal. The district also hired additional lab technicians to step up testing.

Tackling fear

ADC Panwar says fear in the initial months was so rife that relatives refused to perform the last rites of deceased Covid-19 patients. “Our people had to bury or burn the bodies. Families refused to collect the bodies and perform last rites,” he said.

Those who directly dealt with positive persons and their families, like accredited social health activists (ASHAs), auxiliary nurse midwives (ANMs) and lab technicians, were equally wary. “When people within the system are so wary, it becomes important to have leadership and motivational skills to keep your team going,” Yadav said.

But creating awareness among the general population is still difficult, said ACP Sangwan. “People simply stopped wearing masks due to their lack of awareness. How many fines can the police issue? if people are not willing to take a contagious disease like Covid-19 seriously, even after a year, then there is little that police can do,” he said.