Real situation is 22K active cases: BMC chief IS Chahal
Municipal chief says of the 22K, 7,500 are in hospitals, rest in home quarantine, Mumbai need not fearUpdated: Jul 15, 2020 01:31 IST
Brihanmumbai Municipal Corporation (BMC) commissioner IS Chahal elaborates on the Covid-19 situation in Mumbai. Excerpts from an interview:
Is the Covid-19 outbreak under control in Mumbai?
Today [Tuesday] morning, Mumbai recorded 950 new cases. The last time Mumbai had 900 cases, the number of tests for that day was 3,700. As of today morning, we have done 6,000 tests in the past 24 hours, but we still have 950 cases. I was expecting the number to increase as our testing increases. Although testing has gone up by 2,000 to 3,000 every day, cases are coming down. This is a good sign. Of the 950 cases too, less than 150 are symptomatic. On Monday, of the 1,158 cases, only 190 patients were symptomatic. The past week’s trend shows the actual bed requirement per day is not more than 200. Whereas every night, we have 7,000 beds vacant.
The sign to watch out for to decide whether we are in control is not the cases becoming zero. Nobody can do that until we get a vaccine.
If we ensure that every person who is infected has a bed and a doctor waiting for him, and if there is 0% waiting queue for a bed, the battle is won.
Mumbai has 94,000 cases, but our discharge rate is 70%. We have 22,000 active Covid-19 patients. It is important to highlight that Mumbai has 22,000 active cases to remove the fear from the minds of the citizens. The real situation is not 94,000 cases.
We have 22,000 positive cases, of which 7,500 people are on hospital beds and the remaining are in home quarantine. They are asymptomatic and leading a normal life.
According to you, what will Covid numbers in Mumbai look like for the rest of July and August?
On June 7, Mumbai had 48,000 cumulative cases and 30,000 active cases. Today, Mumbai has double the number of cases at 95,000, but active cases have come down to 22,000. By general progression, 30,000 active cases should have become 60,000 active cases. But 30,000 active cases have become 22,000 now. If this rate continues, I am very hopeful of even better results in July and August. In another 15 days, I am expecting the ICUs of KEM, Sion and Nair hospitals to be empty. I have already passed an order that 612 ICUs in our jumbo facilities will be outsourced to private doctors.
When will local trains, malls and gymnasiums open?
It depends on the situation in the Mumbai Metropolitan Region (MMR). When the situation in MMR becomes similar to the situation in Mumbai today, I would immediately recommend opening of malls and gyms.
How long will the lockdown last?
Mumbai does not have a lockdown in the real sense anymore. Every two-wheeler and four-wheeler is virtually allowed to come on the road, because there is no way to distinguish who is allowed and who is not. Mumbai has allowed 100% shops to remain open in a 48-hour cycle [shops on alternate side of the road can remain open on alternate days]. Every shopkeeper can get his vehicle out. If you leave aside malls, every shop in Mumbai is opening. On an average, we have one crore people on the road every day, so it cannot be called a lockdown.
BMC is saying until we have a no-pandemic situation, elderly, children and people who are co-morbid should not come out. These are preventive measures. It is more of an advisory. If a senior citizen is spotted walking on the road, no one can arrest him. This is for the benefit of people. They should co-operate.
Mission Save Lives – to reduce fatalities – started 15 days ago, but the fatality rate in Mumbai is still around 5.6%-5.7%. How effective is the mission?
The overall fatality rate is 5.7%, for over 100 days, but in the past one week, the average fatality has been around 4%. Take for example yesterday (Monday). Mumbai had 1,158 cases and 47 deaths. Mumbai has come to the 4% fatality range now, but as the base is higher, it will take time for the overall fatality rate to come down. We are the only city in the country, which has ventured out with permission from the chief minister, to discover unreported, home deaths. In March and April, Mumbai’s testing capacity was limited and thousands of people had come from abroad – almost 1.7 lakh people had arrived in flights and many were testing positive. At this time, many people passed away at their residences without treatment, without BMC’s knowledge, without approaching us. There were cases where swab sample results were taking 10 days, 12 days or 15 days. In one case on April 4, the results came on April 22, this is on record. In the meantime, the person passed away at home. BMC went ward-wise and discovered such deaths. The chief minister courageously said, “Let us be transparent.”
On a single day, a press note announced 862 deaths were added to the city’s total deaths. That is how our fatality rate jumped from 2.9% to 6% in a day. I say either the rest of the country should say there have been no home deaths, or they should comply [with the rules]. Mumbai has exercised its choice by stepping up, in the process spoiling our record, but we have been transparent.
Has BMC completed reconciling previous death figures?
The backlog of reporting old deaths that have occurred in hospitals is clear. From July 3, all deaths that BMC announces at the end of the day in its press note have occurred in the past 48 hours only. I started imposing this discipline from June 8, and it has taken me 24-25 days to put it in check. But we are now examining the reason for deaths of patients outside the hospital, also these unreported home deaths. We are still trying to locate their papers. This will be a continuous process. It is very easy to decide the reason of death for a patient who passed away in a hospital, because all case papers are available. But what about patients who passed away in their homes? There is this one case that was brought to my notice. One expatriat woman came from Europe, and one day she was found dead in her house. Later, her maid and driver also died in their homes in slums. These deaths may not have been accounted for yet.
Are there instances where a cured and discharged patient has died at home after recovery?
Yes there are, but not more than five to seven people. There are only two such cases known to me. One was a policeman who was discharged on Day 14, and he passed away on Day 22. He was co-morbid. Maybe, he got a heart attack. The behaviour of the virus is not known to anyone in the world. In some cases, an asymptomatic unidentified Covid-19 positive case has infected others and those persons have died. There was a case in Nariman Point in a family of nine, including four doctors. They called a person home for massage on a Sunday. One member got the massage done from an asymptomatic positive. He transferred the virus to all nine people, and four died. The world is still not aware of the complexity of the virus. That is why these cases are happening.
Mission Zero started in June. Has it been successful?
Yesterday [Monday], there were 18 containment zones in northern wards, and 14 containment zones had zero cases in the past 14 days. So this is a good sign.
You took charge over two months ago. What has been your priority? Has it changed?
When I took charge, I was aware that the battle against Covid-19 can go on for one more year from today, if the vaccine doesn’t come. No one can claim that I can make cases zero, without a vaccine. The Covid war is going to be fought long term, over six or eight months, or a year. Unless systems are built and everything is on autopilot, it will not work. Everyday one cannot manually coordinate bed and ambulance availability. It has to happen naturally. It came to my mind on day one that there needs to be a standard operating procedure on autopilot as this is a long-term battle.
There are four pillars to this fight – testing labs, ambulances, hospital beds and doctors. If these four things are tied up, the problem will be solved. We are concentrating on field weapons such as testing, tracing, tracking, quarantining and treatment. In case of testing labs in Mumbai, a report that used to take days to come now comes in 24 hours. In the past one month, not a single report has come after 24 hours. It came from Metropolis, and I suspended them for three weeks. Now they have fallen in line.