Bengaluru adopts Mumbai model to tackle second wave of Covid-19

Mumbai Commissioner of Police, Hemant Nagrale at a Covid-19-health care centre | Pic/Satej Shinde

Taking a cue from the Brihanmumbai Municipal Corporation (BMC)'s success in tackling the second wave of Covid-19, Karnataka issued directives to set up Ward Decentralised Triage and Emergency Response (DETER) Committees for Covid-19 management in all 198 wards in Bengaluru based on the Mumbai model.

The ward level committees will have officials of the Bruhat Bengaluru Mahanagara Palike (BBMP), ward committee members, government officers, volunteer RWAs and civil society organisations.

"This will help in the decentralisation and provide better supervision for ward-level Covid-19 governance," read the directives issued by the Revenue Department's principal secretary, N. Manjunath Prasad.

The directive also stated that ward level Community Triage is seen as a successful intervention in many cities including Mumbai. "Currently there is a delay in informing the test results to the patient due to the centralised ICMR process followed by BU number generation process," the directive notes.

"The ward DETER committees (WDC) will now be set up in all 198 wards of the BBMP and they will be entrusted with activities related to Covid-19 management," the directive explained.

According to this directive the WDCs will be headed by a ward nodal officer and the order states that ward level war rooms can also be set up. The main objective of setting up the WDCs is that it becomes the first point of contact with the government for Covid-19 patients or their attendees in Bengaluru.

The focus of these ward level committees will be to help people access hospital beds. In particular, the role of a triage coordinator is outlined in the order. This is someone who offers community triage services with the help of a support staff. A competent and trained doctor can guide the triage centre while doctors, interns, final year students of MBBS, Dental, Nursing or AYUSH doctors will also be at the triage centre. This centre will work with the WDC.

"To reduce delay in results and avoid panic, positive cases are relayed to the triage coordinator directly from the PHC throughout the day. The triage coordinator will delegate numbers to relevant citizen volunteers. The volunteers must be trained to do triage to identify persons who need to be admitted to ICU and those who require hospitalisation or should be sent to Covid-19-Care Centres or isolated at home," reads the order.

The data of those in ICU, hospital, CCC or at home will be maintained by the triage centre.

The order also discusses an efficient exit strategy to ensure bed turnaround time in hospitals is reduced. This includes limiting hospital admissions to people with severe illness and shifting those with moderate illness to CCCs in five days. The WDCs will be tasked with doing bed audits thrice a day and prioritise admissions to those who need it the most.

Each ward level war room will be equipped with a call centre and training will be given in the use of oxygen and pulse oximeters.

The WDCs will also work with RWAs and social organisations in their respective wards. COVID-19 testing coverage will also be increased and vaccination drives will be conducted in different wards when the stocks of vaccines are replenished.

Until now, the Covid-19 response in Bengaluru was coordinated with a main helpline number 1912 and zonal level helplines for each of the BBMP's eight zones "East, West, South, Bommanahalli, Dasarahalli, Mahadevapura, Rajarajeshwari Nagar and Yelahanka."

The decision to decentralise comes after the Supreme Court's observations on May 5 in the case of Delhi's management of Covid-19 cases. It told the Union government to "look to Mumbai and take note" of its successes in managing the supply of oxygen. So far, Mumbai has had no reported deaths from lack of oxygen.

"Bombay Municipal Corporation (BMC) has done some remarkable work and not disrespecting Delhi but we can maybe see what was done by BMC. I understand that Maharashtra also produces oxygen, which Delhi can't do. If you draw from experience and figure out how the holding corporations can be done in Delhi...Then we will have a module for Delhi in place based on the successful model in Bombay, which is a large metropolis," Justice D. Y. Chandrachud had observed on May 5.

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