200K cases in Mumbai; trains, eateries unlock on cards
More coronavirus disease (Covid-19) locks look set to be removed with restaurants across Maharashtra likely to reopen in the first week of October, although with a host of safeguards. The government is also considering resuming suburban train services for all by the middle of next month. The developments, ironically, happened on a day when Mumbai crossed the 200,000 Covid-19 cases mark, with the addition of 2,055 infections taking the count to 200,901.
The state government on Monday assured hoteliers of granting requisite permissions, during a meeting with chief minister Uddhav Thackeray. A standard operation procedure (SOP) is expected to be finalised in the next few days. Valsa R Nair Singh, principal secretary, tourism department, said they have been allowed to reopen restaurants from the first week of October. “The SOP is yet to be finalised,” she said.
Mumbai suburban guardian minister Aaditya Thackeray on Monday told HT the state government was looking at resuming suburban train services by mid-October, a demand made by commuters for a while. Thackeray also said the government was talking to associations of the business community to stagger office timings to ease congestion in public transport and was thinking about allowing 24x7 offices in commercial establishments.
All this comes after September witnessed a dramatic surge in the number of Covid-19 cases in the city, with 2,000-2,300 cases being reported daily through the month, against the earlier 1,200 to 1,500 cases.
The state, meanwhile, reported 11,921 cases on Monday, taking the count to 1,351,153, and 180 deaths, pushing the toll to 35,751.
There were 26,784 active cases in Mumbai, as of Monday. According to figures up till Sunday, September saw a 105% increase in Covid-19 cases, from the corresponding period in August, and a 98% increase in comparison to the same number of days in May. A total of 51,899 Covid-19 cases have been reported in the city between September 1 and September 27.
Civic health officials said that the high daily caseload would continue in the coming days, owing to the upcoming season of festivals.
Experts believe the number of Covid-19 cases will drastically drop by December or January, especially if Mumbai continues to increase its testing capacity, and timely isolate more patients and high-risk contacts.
Until Saturday, Mumbai had conducted 10.82 lakh Covid-19 tests, at a positivity rate of 18.15%.
Positivity rate is calculated as the per cent of people who have tested positive in comparison to the total number of tests done. Mumbai has been conducting up to 15,000 tests a day. This figure is lower on some days and ranges between 9,000 and 13,000 tests. Dr Rahul Pandit, director-critical care, Fortis Hospital, Mulund, said, “There is no one reason why September has been the worst month. But the more we test now, and if we continue with this aggressive testing even in October, then come December and January, the numbers will drop, because we will be able to isolate patients and curb the spread.”
Civic health officials and experts have also attributed the increase in the number of cases in September to reverse migration, as labourers are now returning to the city for work; to ‘herd’ testing, which means as businesses, shops, offices, or eateries are opening up, employers and owners are opting to get their employees tested periodically before returning to work; increased interaction of the unorganised workforce such as house helps, drivers, street vendors, or hawkers, with the community, and instances of local transmission arising from such interaction, as well as from the festival season. The increase in cases has also been attributed to scaled-up testing in Mumbai.
According to experts, the surge is also partly due to lack of Covid-19 etiquette among Mumbaiites; failure to maintain social distancing, to wear masks, to wash hands frequently, to avoid crowds or poorly ventilated spaces; and an overall complacency about taking precautions.
Suresh Kakani, additional municipal commissioner in-charge of the public health department in the civic body, said last week, “With unlock plans and the city opening up, this trend is expected. We are testing more. But this is not only attributed to increase in testing, but also to increased interaction in the community in general, such as house helps returning to work, people beginning to buy groceries and vegetables on a daily basis, as opposed to the behaviour in March and April.”
Kiran Dighavkar, assistant commissioner of the G/North ward, comprising areas of Dadar, Shivaji Park, Mahim and Dharavi, said. “A trend is very evident where employers of businesses want to test their employees before they return to work. So at a time, one business, or shop, or organisation gets anywhere between 10 to 50 people tested. Moreover, as house helps and drivers are returning to work, their employers, too, test them regularly.”
Dr Shashank Joshi, who is a member of Maharashtra government’s Covid-19 task force, said, “This trend was expected, as transport opens up, and people commute within the city and to satellite cities. With unlocking plans, interaction is going to increase.”
Dr Pandit said, “Just at the onset of September, we had one festival, that gave scope for more interaction and for people to meet each other, venture out for shopping. Around the same time, BMC increased their testing capacity, and now they are testing almost 15,000 daily. In a way, they cast a wider net to catch more cases, and that is a good thing.”
However, experts have pointed out that the way forward is for Mumbaiites to show greater responsibility. Pointing out that for every tested person, there are 20 people who are also positive, but who have not tested and who do not have symptoms, Dr Joshi said, “In terms of lack of cooperation from citizens, the month of September has been very disappointing. Mumbaiiites have not shown any discipline in terms of maintaining social distancing, wearing masks, avoiding crowds and avoiding poorly ventilated spaces and Covid hygiene. Mumbaiites need to wake up and observer stricter discipline.”
As Mumbaiites are allowed to venture out for work, shopping is allowed, visiting public places such as beaches or promenades is allowed, a sense of normalcy is settling in. According to Dr Pandit, this lack of discipline is also attributed to some amount of complacency setting in due to unlock plans. “The pandemic has reached a stage where it is no longer the government, which is responsible for absolutely everything. It is the people’s responsibility that is more than that. We must observe appropriate behaviour and habits. Wear masks, maintain social distancing, plan travel so as to avoid crowds, test on time and isolate on time. On the contrary, in March, April and May, lockdown mandated stricter discipline.”
The civic body has until Saturday fined 14,207 citizens for not wearing masks and collected ₹52.76 lakh from them. Of this, fines worth ₹19 lakh were collected from 9,218 defaulters between September 13 and 26 alone.
“If you do not maintain social distancing, and do not wear masks, the chances of your proximity to an asymptomatic carrier are going to increase. Social distancing works, we have seen that, even in other countries. This is the only thing that can be applied in the long term”, said Dr Om Shrivastav, who is a city-based consultant for infectious diseases. As per BMC’s Covid war room data, 68% of detected Covid patients are asymptomatic, 27% are symptomatic and 5% are critical.
Experts also believeD that the government needs to further scale up Mumbai’s testing capacity to at least double the number of daily tests being done at present. While Dr Joshi said, considering Mumbai’s population, the city needs to conduct at least 30,000 to 50,000 tests a day. Dr Om Shrivastav said, “Mumbai should be doing over 1.5 lakh tests per day.”
According to Dr Pandit, it is also important to stick to the basics from the administrative point of view, testing in high number, isolating positive patients, contact tracing, and quarantining high risk contacts.
Dr Joshi said, “We are aiming to bring down case fatality rate (CFR) to less than 1%, going forward. In many parts of Maharashtra we have been successful in doing so.” In Mumbai too, CFR has dropped from 5.7% to 4.5%. HT reported on September 21 that in the past 31 days, the city has recorded CFR of 2.2% (1,115 deaths and 51,617 cases), which has helped bring down Mumbai’s overall CFR.”