Testing, surveillance behind high number of cases in Ahmedabad: Municipal commissioner

With 1,854 Covid-19 cases and 103 deaths, Ahmedabad is the most affected district of Gujarat and has reported the second highest number of deaths. Jaykishan Sharma

With 1,854 Covid-19 cases and 103 deaths, Ahmedabad is the most affected district of Gujarat and has reported the second highest number of deaths. Jaykishan Sharma spoke to the city’s municipal commissioner, Vijay Nehra, about the reasons for the spurt in cases and the strategy to contain the virus.

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What are the reasons behind the high number of Covid-19 cases in Ahmedabad?

While we were aware that every effort must be made to contain the disease, we realize it will not be possible unless we do proactive discovery of cases and nip the infection spread in the bud. So, we adopted an intensive proactive discovery approach to find cases which we call the EPIC approach – enhanced testing, intensive surveillance, proactive detection and corona checkposts. As a corollary to this approach, it was all but natural that reported cases would go up. It must be appreciated it helped us in locating cases before they did large-scale damage through community spread. We have done 3,250-plus tests per million, more than double than the next highest figure in a city like Delhi, which has done around 1,500 tests per million. The doubling rate, which was three to four days, increased to seven to eight days. The recovery has improved. In the past, it was 5% and at present, the recovery rate is 10%.

Any other reasons behind such a high number of cases?

In the entire world, the problem has come to the cities first. In India also, Delhi, Mumbai, Indore, Jaipur, Ahmedabad and big cities with dense population were the first to be affected by Covid-19. As a quick early response, we effectively home quarantined almost 6,000 passengers who had come from Covid-19-prone nations. Of them, only 14 were found positive. But the cases increased after people in large numbers from Ahmedabad, who attended the [Tablighi Jamaat meet] in Delhi, came to Ahmedabad and were found positive.

Maximum cases have been reported from the Walled City. Is there any specific strategy to deal with this?

More than 800 medical teams are in the field for surveillance and as a result, we are able to catch super-spreaders like vegetable sellers, kirana owners and milk sellers on a daily basis through our intelligent sampling approach. On a scale never seen before in India, we sealed the old Walled City and in a single day, surveyed more than 100,000 people. We adopted a strategy of cluster containment early on and were able to moderate the growth of virus in hot spots like central Ahmedabad. Even at the cost of a rise in figures, we firmly believe aggressive testing and surveillance is the way forward. It might give an impression figures are rising in Ahmedabad, but it should be appreciated we are testing most aggressively. To complement our medicare efforts, we used the technology infrastructure that we had as part of Smart City Ahmedabad. We proactively monitor the lockdown in Ahmedabad through our 3,000-plus cameras in the city and in close coordination with police. Spitting fines and mask-wearing compliance is done through these cameras.

What was the initial response of the administration to Covid-19 cases in Ahmedabad?

Ahmedabad is a unique cosmopolitan city with a diverse multi-ethnic population. At the same time, it has diverse residential and habitation patterns which pose their own challenges regarding spread of the virus. Ahmedabad Municipal Corporation (AMC) was alive to the Covid-19 challenge even before the first case cropped up in India. We were among one of the first urban civic bodies to suspend mass transport to avoid infection spread. We were the first civic body to launch a massive disinfection campaigns with support of our fire department.

How are you tracking the people in home and institutional quarantine?

Everything, right from daily essentials to medicines to special requirements, were supplied to the 6,000 home quarantined passengers by AMC staff and there was real-time monitoring of these people. We used GPS app-based location tracing of quarantined people to monitor their real-time locations. For those who were not home quarantined, we established a world-class facility in the Sports Club of Ahmedabad with every modern amenity and passengers were kept there free of cost. We are happy that the quality of quarantine ensured there was hardly any spread of infection from these passengers and we were ahead of the curve when it came to dealing with the disease. We established quarantine facilities in every zone of AMC to deal with Covid-19 in a decentralised and effective manner. We now have more than 10 quarantine centres in Ahmedabad either operational or ready to be put into operation.

What were the steps taken to ensure uninterrupted supply of essential commodities after the lockdown?

Once the lockdown started, the biggest challenge was to ensure citizens don’t face any hassles and have uninterrupted access to basic requirements of life. Immediately, AMC rolled out new initiatives, including door to door supply of vegetables and other essentials, collection of garbage of Covid-19 suspects such as bio-medical waste, free food and medicine delivery to elderly on demand, surveillance and fumigation through drones and disinfection through a wide range of mechanical vehicles. Hyper-marts were taken on board and door to door supplies of groceries is being done by them. Our e-rickshaw-based Vegetable on Wheels initiative was recognised by the Union government as a model to be replicated by all.

How are you tackling the distribution of food in slums and areas having high concentration of workers?

We tripled our citizen helplines and now address citizen complaints, including Covid-19-related ones, almost on a real-time basis. To ensure the person at the bottom of the pyramid doesn’t suffer, AMC tied up with civil society members and we distributed around 50,000 food packets a day to the needy and no one in Ahmedabad slept hungry. Stranded migrant workers were provided with a roof and thousands were given a place to dwell. Similarly, to address the nutritional needs of people in slums, AMC supplied free vegetables and milk. We were one of the pioneers in social distancing and the ubiquitous circles outside shops were drawn very early on in Ahmedabad. AMC has enlisted more than 5,000 citizen volunteers through its online volunteer platform, who came forward to donate ration kits, food packets and sanitary material. Ahmedabadis came forward to sponsor tests for fellow citizens and hundreds of tests have been sponsored so far. With the support of Ahmedabadis, our strategy of aggressive testing is bearing fruit and we are hopeful that by May-end, we will be able to tide over this situation and this city will emerge victorious over Covid-19 sooner than later.