BMC’s focus areas to battle Covid-19: Test, distance, front-liners

BMC chief Praveen Pardeshi says they might allow more labs to ensure aggressive testing; looking at ways to bring down mortality rate, ensure social distancing

While the spiraling number of Covid-19 cases and deaths is the biggest challenge for the Brihanmumbai Municipal Corporation (BMC), civic chief Praveen Pardeshi said they are looking at the way forward to bring down the numbers through aggressive testing, stricter compliance of social distancing, and safeguarding front-liners – doctors, nurses, hospitals’ other employees, municipal and law enforcement staff.

HT Image

Mumbai has recorded (642) over 60% of Maharashtra’s 1,018 Covid-19 cases. “We are aggressively testing and need to continue to do so for early detection of Covid-19 cases. Testing is being carried out even in fever clinics on a war footing. I have now authorised ward officers to engage private laboratories to conduct tests, because government laboratories are going to be overburdened. If a ward officer feels testing on a large scale is needed in any area in his ward, say for example where a Covid-19 positive patient has been found, the BMC will subsidise private lab tests the ward suggests,” said Pardeshi.

Currently, 13 laboratories in the city conduct Covid-19 tests, eight of which are private. More than 11,500 tests have been conducted in Mumbai so far, and roughly 4.2% of these cases threw up Covid-19 positive results, according to BMC. More than 5,000 home visits have been conducted so far to screen persons.

For stricter compliance of social distancing, the BMC has barred selling of fruits and vegetables on footpaths and in open markets in containment zones. Pardeshi said, “This will cause discomfort. People may have to eat grains for the next 10 to 12 days, but if we want to break the chain in the outbreak, we have to strictly follow this. The BMC noticed purchase of fruits and vegetables on footpaths led to crowding, and became a form of transmission of Covid-19 in high-risk areas.”

There are presently 241 containment zones in the city. Sale of vegetables in Dharavi, and Worli was stopped on Tuesday.

To reduce the mortality rate, early detection of the infection is crucial. About 70% to 75% of the 40 persons who died in the city due to Covid-19 came to the hospital for medical aid in the advanced stage. They died within a day or less than a day of being admitted. “If the infection was detected earlier, there would have been a better chance of medical assistance for these patients. With more testing, the BMC will be able to detect the infection early, save more lives, and reduce chances of transmission,” the commissioner said.

As of April 6, when 490 positive cases were reported in Mumbai, 361 were reported stable, 36 were critical, 59 were discharged, and 34 deaths were recorded.

Special care is also needed for patients who have an additional health condition such as heart ailments, diabetes, hypertension, leukemia, among others. “We need to fight the infection in these patients much in advance,” Pardeshi said. The BMC’s one strategy is testing and early detection, the other is caring for these cases in advanced hospitals. There are dedicated Covid-19 hospitals, like Seven Hills, Kasturba, Saifee, Nanavati, Sushrusha and Sai hospital. However, a Covid-19 patient without co-morbidity is not at high risk. “I cannot mix high-risk patients who also have co-morbidity, with other Covid-19 patients who do not have other health issues. When that is happening, I am not able to pay proper attention to these critical patients. So I need to separate them from the other patients and pay better attention to them,” Pardeshi said.

Patients with co-morbidity and elderly patients will be moved to sophisticated hospitals with specialised wards only by reference of the doctor treating them.

Moreover, high-risk and low-risk persons who have come in contact with Covid-19 positive persons from densely populated areas in the city will be forcefully moved to institutional quarantine facilities. The BMC has up till now traced over 18,305 persons who came in contact with Covid-19 positive persons, and over 1,500 of them were shifted to institutional facilities for quarantine.

To safeguard front-liners, the BMC has started administering hydroxycloroquine tablets (HCQ). Mumbai has a stock of over 1 crore tablets for front-liners and patients. The BMC is also procuring rapid testing kits, to determine who is safe to go on field, and who is not, and also determine a person’s susceptibility to the coronavirus. A senior civic officer said, “These can be used in containment zones, and preliminary detection, before a laboratory test is done. The BMC aims to get 50,000 such kits.”

It has also begun airlifting of personal protective equipment (PPEs) for all medical staff, from a manufacturing unit in Coimbatore in Tamil Nadu. While 12,000 PPEs have already been airlifted, 30,000 more will be brought on Thursday. The BMC aims to target getting 35,000 PPEs per week for its doctors and nurses. A senior civic officer said, “It is important to equip all doctors working everywhere in the city with PPEs, because a person with mild symptoms of flu, visiting a nearby dispensary can turn out to be a Covid-19 patient. So not just doctors in dedicated Covid-19 hospitals, but all medical professionals should get PPEs.”