COVID-19 Containment: Bruhat Bengaluru Mahanagara Palike (BBMP) vs. Brihanmumbai Municipal Corporation (BMC)

Abstract

The Indian subcontinent reported its first case of COVID-19 on 30 January 2020 and has been taking active steps to mitigate the effects of this biological disaster. The population of 1.3 billion people, across diverse states, health inequalities, widening economic and social disparities, and distinct cultural values has differed in its preparedness and response to COVID-19 at the level of the various constituent states and districts of India. The main metro cities of India- Delhi, Mumbai, Chennai, Bangalore, Hyderabad, Kolkata, Ahmedabad and Pune, due to the high population density have been affected to a large extent. From the above metros, an active response, starting mid-March at war-footing, was seen in certain areas of Bangalore, under its administrative unit- Bruhat Bengaluru Mahanagara Palike (BBMP) which is responsible for civic amenities and infrastructural assets of the Greater Bangalore metropolitan area with a population of over 8 million. In contrast to this, as on 20 June 2020, the Dharavi slums in Mumbai, which were once a COVID-19 hotspot recorded only seven new cases - the lowest such rise in a single day. This was preceded by a steady decline in the number of cases in Dharavi in the four weeks before and followed by reporting just 1 new case on 7 July 2020. The population density of Dharavi, is considerably higher than Bangalore. Yet it could achieve disease control with a steep fall in the number of cases from April to July. In contrast, Bangalore has witnessed sharp increase in the number of positive cases from April to July, contributing to nearly 50% of the total cases and deaths every day in Karnataka. It is necessary to understand the reasons for this sharp rise in Bangalore. Acting under the guidelines issued by the centre and exercising its federal powers, the Government of Karnataka took strict containment initiatives and created a crisis management team to execute them. First and foremost, the ‘Crisis Management Team’ established a ‘Bruhat Bengaluru Mahanagara Palike War Room (BBMP)’ with support from other disaster management teams. An ‘Incident Command System’ was triggered in the BBMP to work exclusively on the management of the COVID crisis. Secondly, a ‘Special Health Team’, was put in place to address the needs of the population requiring uninterrupted or emergency care, like pregnant women and cardiac patients. These patients had to be identified and segregated from containment area, a task that was efficiently carried out by this team. ‘Perimeter control’ was one of the major and challenging issue to be dealt with for effective containment of the virus spread.A sudden surge in COVID-19 cases in Bengaluru was noted in July after the unlock phase started, with 60 per cent of Karnataka’s positive cases being reported here in the first week of July. 732 of the 1,272 cases recorded in the state on 1 July 2020 and 1235 of the 1,925 new cases in Karnataka on 5 July 2020 were from Bengaluru. This was attributed to the lack of coordination between the BBMP and state authorities. Despite good work and planning during the lockdown, BBMP lacked arrangements to track and contact-trace people coming into Bengaluru from other affected states. It has also been reported that the residential address given by the nearly 23000 people who were home quarantined were found to be wrong by the health care staff. The Brihanmumbai Municipal Cooperation (BMC) implemented 4Ts- Tracing, Tracking, Testing and Treating. BMC followed a “Chase the Virus” approach through strategic public-private partnerships, proactive screening in high-risk zones and fever camps. Available ‘private’ practitioners were mobilised through the drive conducted in ‘mission-mode’ and provided with PPE Kits, thermal scanners, pulse oxymeters, masks and gloves to do door-to-door screening. All private practitioners were asked to open their clinics which were sanitized by the BMC and the practitioners were provided PPE to attend patients. The BMC strategy with public health approaches like public-private partnership, 4’T’s strategy, reinforcement of individual information for effective control was very effective in controlling infection. Such sustained approach is also needed in other metros including Bangalore and urban areas of the country which may witness a further surge in the number of COVID-19 cases.