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New Delhi: Mumbai has the highest number of confirmed Covid-19 cases in India because the metropolitan is carrying out more tests compared to other cities, Brihanmumbai Municipal Corporation (BMC) Commissioner Praveen Pardeshi said Tuesday at the digital version of ThePrint’s Off the Cuff.

Speaking to ThePrint’s Editor-in-Chief Shekhar Gupta, Pardeshi said while the large number of cases is worrying, the good news is that 81 per cent of the patients are asymptomatic, who are being kept in Covid care centres as they don’t need hospital care.

The city’s aggressive testing and contact tracing helped avoid a larger outbreak, the BMC chief said.

With over 3,090 positive cases as of Tuesday, Mumbai has more Covid-19 cases than any other Indian city.

“The fact that we have the largest number of cases should be correlated to the fact that comparatively speaking we have done the largest number of tests as a city,” said Pardeshi.

Pardeshi said the BMC has conducted close to 50,000 tests in Mumbai. In comparison, the state of Kerala has done only 20,000 tests till now.

The BMC’s aggressive contact tracing strategy also allowed it to identify over 81,000 close contacts of patients and isolate them. Of these, at least 5,354 people who were at high risk were shifted to quarantine facilities.

“These included people from slum areas, for whom home quarantine cannot work, because sometimes there are as many as ten people living in a room. We have put them up in lodges, away from the rest of the community,” Pardeshi said.

Identifying and quarantining over 2,500 patients at an early stage is likely to have helped prevent a much worse situation in a city that has a dense population of over 1.84 crore.

During the conversation, Pardeshi elaborated on the steps being taken to fight the outbreak of Covid-19 infection in Mumbai.

Also read: Covid-19 fight is a Test match, not a T20. Here’s what India needs to do to win

Hospital care

Of over 3,090 Covid-19 cases in the Maharashtra capital, only 40 have been critical and needed ventilator support, Praveen Pardeshi said, pointing out that only 1 per cent of the patients needed critical care.

Mumbai has a total bed capacity of over 11,000, of which only 4,400 had been used, he said, adding that the BMC is trying to increase the number of ICU beds for patients who need critical care or oxygen support.

A large number of deaths are among patients in the age group of over 50, Pardeshi said.

Mumbai has so far seen 138 deaths.

A large number of patients in this age group had hypertension and diabetes — comorbidities that increase the death risk in Covid-19 patients, according to Pardeshi, who pointed out that many deaths happened within a few hours of hospitalisation.

Hydroxychloroquine use in Dharavi

Asked to elaborate on whether anti-malarial drug hydroxychloroquine (HCQ) was being administered to people in the slums of Dharavi, the BMC chief said close contacts of those tested positive for Covid-19 are being administered HCQ as a preventive measure after consultation with doctors.

Along with them, frontline health workers are also being given HCQ, which the BMC had procured in advance.

Praveen Pardeshi said he is also taking HCQ under doctor’s advice.

In an advisory dated 22 March, the Indian Council of Medical Research (ICMR) had said HCQ could be used as prophylaxis in people who were at high risk of the coronavirus infection. This included both close contacts of patients, and healthcare workers.

Epidemiologists have been asked to examine the data and ascertain whether these drugs had a benefit in preventing the disease, Pardeshi said. “Hopefully in three months we will be able to discern whether the drug had any benefits,” he added.

So far, there are no studies to show that HCQ is an effective prophylaxis against Covid-19. Moreover, the anti-malarial drug can have side effects, which is why the public is advised not to take it without prescription.

Also read: ICMR asks states to stop using rapid Covid-19 tests after complaints of patchy results

The Dharavi situation

The increase in Covid-19 cases in Dharavi is not very high and people have been cooperative, Praveen Pardeshi said, adding that if this situation is maintained for 15 days, then a further spread in the area will be prevented.

“I am keeping my fingers crossed. So far, the new positive cases are coming from contacts of patients we already identified,” he said. Contacts of those who have tested positive are being isolated at the Rajiv Gandhi Sports arena and Sai Hospital.

Instead of making the whole of Dharavi a containment zone, high risk pockets have been identified within the slums to make management easier, Pardeshi said. A network of over 6,000 CCTV cameras is keeping a watch over these areas to prevent movement of people.

The BMC has also set up ‘fever clinics’ in slum areas, where those with fever and cough are asked to come and get tested. “Through these clinics we have tested over 5,428 people, of whom 43 tested positive. These are people with no known travel or contact history,” he said.

Plasma therapy

The BMC chief said the Mumbai governing body has also started collecting blood plasma from Covid-19 patients who have recovered as some initial studies have shown that blood plasma from recovered patients contains antibodies against the infection.

Delivering blood plasma from former patients to those who are currently infected may be a promising treatment. It has already started in Delhi and Karnataka. However, Mumbai is yet to receive the required permissions from ICMR to carry out this therapy.

Meanwhile, the BMC is encouraging recovered patients to donate blood in order to create a bank for the plasma therapy. “We have already bought the machine required for separating blood plasma,” Pardeshi added.

Corporate support

Praveen Pardeshi also noted that the support of corporate entities was essential at this time, explaining that money was not the only way they could pitch in.

“All of the corporates, including Tata, Reliance and Mahindra” have stepped in with private aircraft to ensure “at least 35,000 PPEs were made available every week”, according to Pardeshi.

“The PPEs were in a factory in Tamil Nadu — we paid for them. But they had to be brought by trucks in the lockdown period,” he said, pointing out that it would take a long time for these to reach Mumbai.

“The corporates sent their airplanes to pick them up free on a daily basis,” he said. A lot of items that had to be imported from places like South Korea were brought directly to Mumbai with the help of these flights.

“A big CSR group, involving Amit Chandra, D.S. Kothari and others, has ensured that ration packages, masks, and sanitisers are delivered to over 3 lakh people in the Dharavi area,” Pardeshi said.

Grocery chains like Big Bazaar also contributed by making foodgrains available free of cost, he added.

Also read: Infection rate in 18 states offers hope but MP, Rajasthan, Bengal, Maharashtra are worries

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