Mumbai COVID-19 cases may rise in July, BMC says ready to handle surge

. "While there is no decision yet from Central government, local trains may be allowed restricted services. And as public transport slowly resumes, chances of transmission goes up. We are anticipating a rise, are cautious but not worried," Kakani said.

Since May 22, when the city recorded over 1700 new cases in a day, the tally has hovered around 1100-1500 new cases per day.

“Since reopening on June 8, the rate of growth in cases in Mumbai has been minimal; however we are looking at opening up in a phased manner. Places, where cases rise fast, will see strict containment and lockdown,” Kakani said.

Mumbai has increased the case doubling rate to 41 days as of June 25 and the overall growth rate of COVID-19 cases in Mumbai (between 16 - 22 June) was under 2 percent.

BMC says there is adequate bed capacity and more are being added to handle the anticipated surge. As of June 25, one in three of the 18,000-odd COVID-19 beds available were vacant. Almost one in five of the 7000-odd oxygenated beds were vacant.

“Even on ICU bed capacity, we are now seeing on an average 50-60 beds (4-5 percent) of the total 1300 beds vacant on a daily basis. This is a major relief from the time last month when we were almost full always,” said Kakani.

On June 25, around 100 ICU beds out of the total 1362 were vacant.

BMC is in the process of adding 300 more beds by the end of week  and 500 ICU beds by end of the month.

However, more than adding beds it is the focus on providing oxygen concentrators in wards, communities to help patients at home that has reduced dependence on ICU and ventilator beds said Kakani. As more and more suspects were identified through regular surveillance and fever clinics, many were provided with oxygen concentrators to manage breathing at home. This has helped said Kakani.

While cases in South and Central Mumbai wards are rising at a lower pace, wards in North Mumbai are now seeing a surge. The average doubling rate in North Mumbai wards is less than 22 days and the growth rate is higher than 3.2 percent, indicating a rapid rise in cases. There are 937 containment zones in North Mumbai wards and the region is in a state of a lockdown. BMC has launched “Mission Zero” i.e. Rapid Action Plan to break the chain of COVID-19 in Borivali, Dahisar, Malad, Kandivali, Bhandup and Mulund.

The successful strategy of ‘chase the virus’ that helped control spread in slums of Dharavi and Worli are deployed in these regions and aggressive containment policy is being used says Kakani.

“We hope with fever clinics and door to door surveillance and institutional quarantine of suspects we will be able to slow down spread in North Mumbai wards in 8-10 days.”

BMC however says the city is not seeing community transmission as of date. All positive cases have been traced back to index cases. The city is maintaining the ratio of 1 : 15 in contacts being traced for every positive case.

A massive reconciliation process to record all old deaths as per COVID protocols is underway and this will be a regular process now. All the backlog of will be cleared in 8-10 days, Kakani  said.

As part of this, on June 17, Mumbai had added 862 of COVID-19 deaths, which were found to have gone unreported. Statewide, at least 1,328 deaths of COVID-19 positive patients were added that day. This sparked a controversy on whether BMC was hiding the real COVID-19 fatalities. Kakani said that while the reconciliation process should have been started earlier, BMC is not trying to hide anything. “We are assessing all hospital documents and are declaring all old deaths proactively.”

Mumbai has so far reported 3962 COVID-19 deaths till June 24. The case fatality currently stands at 5.6 percent.

In the last two weeks, the city has been updating smaller number of ‘missing’ deaths in a staggered manner. For instance, on June 24, out of the 120 deaths reported in last 24 hours, 38 deaths were in last 48 hours and 82 deaths were recorded from the previous period. On June 23, 65 old deaths were reported.

On June 12, 55 deaths were added that happened between May 20 to June 9.

Reportedly, the discrepancy in the data when one hospital reported a large number of deaths in a single day. The process of reporting a COVID-19 death is a long administrative process and may require a few days to fully ascertain the actual cause of death. Kakani said severe staff shortage in hospitals in the first 2 months of lockdown delayed the collection & compiling of data on deaths and hence reporting.

The BMC has so far received 200 complaints of private hospitals overcharging for COVID-19 treatment despite the state-imposed cap.

Almost 150 of these complaints have been resolved and nearly Rs 1.25 crore has been refunded to patients and patients’ families, Kakani said.

Kakani said that most of the overcharging was on account of higher deposits being charged and many smaller hospitals still not following the price cap orders. Certain miscellaneous items like fumigation charges, sanitisation and inflated rates of PPEs were also reported in hospital bills.

Refunds of around Rs 1 lakh have been made in certain cases, Kakani added.

BMC has also appealed to the citizens to report any instances of overcharging by private hospitals for the treatment of COVID-19. Last month auditors for various private hospitals were appointed by BMC after receiving complaints of some facilities overcharging for COVID-19 treatment.

Under the Epidemic Diseases Act, Maharashtra state government has taken over 80 percent beds in all private hospitals and capped the rates of COVID-19 treatment for those regulated beds in private hospitals at Rs 4,000 per day for a general bed; Rs 7,500 per day in the intensive care unit (ICU); and Rs 9,000 per day if a patient is on a ventilator. The charges will also include treatment fees, consultancy fees of doctors, basic tests and meals.