Yearender 2021: Mumbai’s journey through second wave of Covid-19

After battling a devastating first wave of the coronavirus outbreak Mumbai as the rest of the country started the year 2021 with a hint of normalcy The Covid19 restrictions were eased and it appeared that the city was on its way to flatten the curveWith the onset of the second wave however Mumbai touched a few grim milestones It not only logged 88710 Covid19 cases in March 475 per cent higher than February but its positivity rate too hit 2024 per cent from an average of 89 per cent in the preceding monthsThe surge in cases strained the alreadyburdened health infrastructure as the city fell short of oxygen beds and lifesaving drugs At that time Mumbai had 11082 oxygen beds 2861 ICU beds and 1444 ventilator beds There were 21717 beds for moderate to critical patients and 25365 beds for patients who were asymptomatic or had mild symptoms With 15 per cent of the patients requiring oxygen these facilities were proving to be inadequate The state then was producing around 1200 tonnes of oxygen of which nearly 9501000 tonnes was being utilised daily but as the cases continued to spike the demand increasedShortage of oxygen cylinders in the VasaiNalasoparaVirar areas also led to COVID19 deaths PicHanif PatelDuring this time the city also witnessed the horrors of hospital fires At least 11 people died and 10 others were injured after a fire broke out at a private Covid19 hospital in Bhandup West on March 26 On April 23 a fire broke out at an ICU of the Vijay Vallabh Covid care hospital in Virar killing 15 Five days later at least four persons died in a fire at a nonCovid healthcare facility in ThaneThe rising cases of mucormycosis or black fungus worsened the situation and caused several casualties128 between February and June alone The city was not only treating its own patients but also tending to black fungus patients from different parts of the stateFrom being under immense strain Mumbai emerged as a role model for others to emulate with its effective handling of the Covid crisisA City Emerges StrongA defining moment came on the intervening night of April 1617 when BMC commissioner Iqbal Singh Chahal received distressed calls about oxygen shortage from six civic hospitals In an overnight rescue operation lives of 168 patients were saved after they were transferred from the hospitals to jumbo centres in cardiac ambulancesThe incident though was a reminder of what may lie ahead Working on a warfooting the Brihanmumbai Municipal Corporation BMC not only appointed teams for coordination between oxygen suppliers hospitals and assistant municipal commissioners to ensure seamless oxygen supply it also sought a protocol for oxygen consumption from the statersquos COVID19 task force The wardlevel teams were tasked with moving surplus oxygen from one site to another The screening tracking and isolation to restrict transmissibility too were ramped upAround March Mumbai had 11082 oxygen beds 2861 ICU beds and 1444 ventilator beds Pic Nimesh DaveDr Sanjith Saseedharan Consultant amp Head Critical Care SL Raheja Hospital says ldquoThe 4T model that involved Tracing including doortodoor screening Tracking Testing and Treating was key to restricting the second wave Also the effective training of junior staff in the public health sector went a long way in achieving this goal considering the population in MumbairdquoMumbai Police introduced a colourcoded sticker system in April for smooth functioning of vehicles engaged in essential services but it was later discontinued Pic Nimesh DaveTo cope with the crisis the city also rapidly added beds to its field hospitals turned toptier private hospitals into Covidcare centres and 800 vehicles into ambulances Dr Saseedharan says ldquoThe masterstroke was the decentralisation of the central war room into multiple wardwise war rooms The telephonic followup of patients isolated at home also played a big part in keeping things under controlrdquoAmong other unique measures Mumbai Police introduced a colourcoded sticker system in April for smooth functioning of vehicles engaged in essential services but it was later discontinued owning to the confusion it caused and reintroduction of the epass systemThe result of successful resource management and realtime monitoring was that Mumbai saw the positivity rate drop to 6 per cent by May and 179 per cent in the first week of JulyChase the virusThese efforts alone though could not combat the swift rise in infections We needed to chase the virus said ChahalA proactive approach focused on 55 slums including Asiarsquos largest Dharavi where a strict lockdown was accompanied by aggressive sanitisation of public toilets mass screening and a huge volunteer effort to ensure that nobody went hungryMumbai logged 88710 Covid19 cases in March 475 per cent higher than February Pic Syed Sameer AbediAll positive test reports in the city were routed through lsquowar roomsrsquo manned by doctors who would triage cases and decide where to send the patient irrespective of ldquowhether he is a minister a big shot or a slum dwellerrdquo the BMC chief saidHealthworkers conduct doortodoor screening in Dharavi slum PicAFPA decision that proved to be more crucial was to not dismantle the infrastructure put in place during the first wave of the pandemic ldquoThere would have been chaos if we hadnt kept jumbo COVID centres field hospitals oxygen beds ICU beds ready before the start of second waverdquo Mayor Kishori Pednekar said in MayDr Rahul Pandit who is a member of the national and state Covid19 taskforce says ldquoThe lsquoMazha Kutumb Mazhi Zavabdarirsquo drive My family my responsibility to reach out to people and sensitise them on the Covidappropriate behavior proved to be effective As part of the programme extensive screening and vaccination camps were organised along with public awareness outreaches in every slum areardquoSupreme Court lauds MumbaiAmid a nationwide oxygen shortage in May the apex court lauded Mumbai for its oxygen management and asked Delhi to take note of it ldquoBombay Municipal Corporation has done some remarkable work and not disrespecting Delhi but we can maybe see what was done by BMCrdquo Justice DY Chandrachud said taking note of the submissions of Solicitor General Tushar Mehta that Mumbai managed with 275 MT of oxygen even when the active cases crossed 92000On December 13 the Bombay High Court too said Maharashtra was ldquoone of the pioneersrdquo in successfully tackling the Covid crisisLeading by ExampleAs the number of fresh cases receded and those vaccinated rose the state government resumed local train services for the fully vaccinated from August 15 Close to 23 million people boarded the local trains on the first day of restart Setting a milestone Mumbai also became the first district in the country to complete one crore vaccinations against Covid19 on September 4Prepared for a third waveOn December 4 a 33yearold marine engineer from KalyanDombivli was found to be the first patient Omicron in Maharashtra The statersquos Omicron tally stood at 54 as on December 19Mumbai became the first district in the country to complete one crore vaccinations against Covid19 on September 4 Pic Pradeep DhivarDr Lancelot Pinto Consultant Pulmonologist and Epidemiologist at PD Hinduja Hospital amp MRC Mahim says ldquoThe Omicron variant which has been reported with increasing frequency to cause breakthrough infections can cause a third wave but the healthcare system may not get burdened to the same extent as a majority of Indians have antibodies either from vaccination or past infectionrdquo Whether the antibodies will last without a booster dose remains to be seenrdquo he addsDr Pandit says ldquoThe risk of third wave certainly exists If people do not follow Covid19 norms then the third wave is inevitable Therefore maintaining Covid19appropriate behavior is a mustrdquo