‘We are preparing for worst... but on most parameters situation in Pune under control: state health min Tope
Yogesh Joshi of Hindustan Times spoke to Maharashtra health minister Rajesh Tope on the situation in PuneUpdated: Aug 31, 2020, 18:04 IST
After six months since Pune reported the first Covid-19 case in Maharashtra, the city’s Covid tally on Sunday crossed 1 lakh mark while Pune district has already surpassed Mumbai in the number of total Covid cases. Yogesh Joshi of Hindustan Times spoke to Maharashtra health minister Rajesh Tope on the situation in Pune, Mumbai and rest of Maharashtra. Following are the excerpts:
Pune cases have reached the 1 lakh mark. How do you see the situation here?
Pune has almost reached its peak as it touched the 1 lakh mark. Now the city’s tally of fresh cases must come down from here on and I am very optimistic about the situation in Pune. Having seen the graph of various cities across the world, I can tell you that every city reaches the peak at some point and then gets plateaued before the tally comes down. This has been a global trend in the Covid situation and Pune will be no exception.
While cases are rising, the bed situation in Pune city and the rest of district has somewhat eased.
As a government, it is duty bound to be prepared for the worst. Now we have been preparing for the worst in Pune and Pimpri-Chinchwad. As part of our efforts, we have set up jumbo facilities in both cities with each having 800 beds. Both have been made operational now. There is no bed shortage now and we are further ramping up our bed capacity.
Besides Pune and PCMC, rural parts are also reporting cases in higher numbers.
This is because the virus is spreading in nearby areas and we cannot control it. Covid-19 is a highly contagious disease. Can we stop people from stepping out of home? No. In Maharashtra, we started lockdown earlier than the Centre while extending it till June. Now we are into unlocking mode.
Are you satisfied with the case fatality ratio (CFR) of Pune?
This is a contagious disease and it will spread. While the spread is not a big concern even as it creates a fearful situation, what we have to pay more attention to is the Case Fatality Ratio (CFR). In Pune, the CFR is below normal and it currently stands at 2.4 per cent. Considering that Pune has reported 1 lakh cases, CFR of 2.4 per cent is not bad. The death rate for Covid has always been around 3 per cent. The doubling rate has also increased and is almost 30 while recovery rate is almost 80 per cent. So on most parameters, the situation in Pune is under control. For administration, whatever guidelines, notifications have been issued; will have to be enforced in letter and spirit. Be it 80 per cent beds being taken by government, the order has to be implemented properly. At the same time, we have prescribed rates– be it for treatment or RT-PCR tests. These things are to be properly monitored by administration. On the availability of drugs also, there is no issue at all as Remdesivire and Tociluzumab are in ample quantity. From government side, we have to see preparedness and we are prepared for the worst even as numbers are increasing.
In Pune, the number of people succumbing to the virus is growing along with the number of positive cases.
People are dying because of two major reasons - co-morbidities and late detection or lack of knowledge. Many people are reporting late because of stigma. If we analyse the situation in any district of Maharashtra, most people are dying within 48 hours of reporting because they reported late. Many people are not coming out on their own even if the health department is trying best to aggressively carry out contact tracing and identifying affected patients. The three things I believe that are most important are information, education and communication and we should be insisting on this always.
On unlocking- we are still to relax curbs on many things including temples, gyms or e-passes for travelling.
We have adopted a staggered opening approach. The chief minister, Uddhavji Thackeray is conservative in opening up things. There is a demand, and political parties have staged an agitation.
Is there a chance that gymnasiums, temples and other such sites will open in September?
We have to do it at some point. We have to take a call on this as many things have already opened. But the chief minister is very much conservative on this.
NCP chief Sharad Pawar backs opening up, but the CM has a different stand.
Well, we have to achieve the via-median between what Sharad Pawarji is saying and what CM thinks. We can’t open everything 100 per cent, which will allow virus to spread even rapidly and create a burden on the health infrastructure. We will only earn a bad name if people find no beds in hospitals. We have to do it slowly. Without opening also, we are having 14,000-15,000 cases daily in Maharashtra. On Saturday, state reported 16,867 cases in one day.
In Mumbai, the daily cases are once again rising.
In a big city like Mumbai, having population of around 1.5 crore, if 100-200 add more or less to the tally, it is not a point of worry at all although it is showing a trend that cases are increasing. However, I do not believe that it is an indication of second wave.
There are couple of other places which can act as an example. Dharavi in Mumbai and Malegaon in North Maharashtra have shown the way cases can be brought under control. In Malegaon, which has population of 3 lakh who live in congested place – Its population density is 19,000 persons per square kilometre and is highest in Maharashtra – we have been able to control it. I believe we are heading towards herd immunity in these places.
Are we reaching herd immunity in other places too?
Ultimately, all these places where the tally subsides, we will reach herd immunity. We are approaching 25-30 per cent of the people getting infected. This is in the direction of achieving herd immunity. Once most people are immune to virus, I don’t think there fresh positive cases will come this way.
Sero surveys showed 51.50 per cent and 57 per cent individuals in Pune and Mumbai were exposed to Sars-Cov-2 and recovered owing to the antibodies produced. How do you look at the scenario?
Even if the sample size of these two Sero surveys were relatively small, they collected samples from various areas. In Pune, the survey covered people from slum and non-slums. It definitely has some significance. It gives an indication.
In rural and semi-rural parts of Maharashtra, more and more cases are coming up.
The cases are definitely growing in rural parts of Maharashtra. However, I can say with all certainty that the picture is not scary as over 80 per cent people are asymptomatic or with mild symptoms. The number of critical or serious patients is around 2 per cent. If we take precaution, each one of us can defeat Covid-19.
On the broader side, how optimistic you are about Maharashtra?
I am 100 per cent optimistic and at the same time, I and my department are cautious and alert to deal with any eventuality. Now that we are past six months, most of the frontline staff is working relentlessly.
There have been complaints about hospitals overcharging or doctors not opening clinics
Doctors should have empathy and sympathy while treating patients. Most of 5.5 lakh recovered patients who have returned home are because of doctors’ treatment. However, there are some who require working on mission mode. They should not just treat patients for the sake of treatment. It should come from the heart. We are witnessing that at some places, doctors are not treating patients properly may be because they are scared. There is human touch required while treating patients. I am constantly telling them it all depends on you as we as lay person can’t treat anyone. Doctors should have humanitarian and sympathetic approach. The entire society is dependent on the doctors’ fraternity.