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As cases rise, Dr Rahul Pandit says test, trace, isolate and treat



iNTERVIEW

Dr Rahul Pandit, Task Force Member As cases rise again in Mumbai, Dr Pandit says it is time to go back to the basics – test, trace, isolate and treat.

The Ganpati festivities and significant easing of restrictions on movement of people in Unlock-IV have led to a big spike in Covid-19 cases in Mumbai. The daily average numbers are up by 30 per cent compared to the pre-Ganpati period when the city seemed to have gotten a grip on the virus. State-appointed Covid-19 Task Force member Dr Rahul Pandit, however, is not unduly worried. He said while the spike is slightly sharper than what the Task Force had expected, Mumbai is more than ready for the challenge. “We managed to contain the virus in Dharavi. We will tame it again,” he said. Dr Pandit, who heads intensive and critical care at Fortis Hospital, said the Task Force, the state’s health department and the experts at BMC are unanimous that the city will have to go back to the basics – test, trace, isolate and treat. Excerpts from an an exclusive interview with Assistant Editor Lata Mishra.

Mumbai’s doubling rate on August 25 was 93 days. On Wednesday, it had dropped to 63 days. That is a steep fall. Shouldn’t we be worried?

Doubling rate below 65 days is referred to as “red zone”. So yes, it is a cause of concern. Also, for the past one week, Mumbai, on an average, has reported more than 1500 cases a day. However, all this is not entirely unexpected. During the Ganapati festival and now following Unlock IV, this spike was expected. There are two aspects to it – one, people stepped out in large numbers during the festival and crowds in the markets swelled; and two, testing numbers dropped during the same period. So now, with testing back to pre-Ganpati levels, the city is registering more cases. But the situation is not all that bad. There is no shortage of beds, no shortage of medicines, we have enough stock of Remdesivir and Favipiravir, and the line of treatment is clear. What we need is city’s cooperation. Every Mumbaikar must follow social distancing norms, wear a mask when stepping out, and wash or sanitise hands frequently.

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Is this a second wave? Maharashtra recorded 23,816 new Covid-19 cases on Wednesday, its highest single-day tally. State’s three major cities -- Mumbai, Pune and Nagpur are witnessing big spikes.

After restrictions on inter-district travel were removed in Unlock-IV, people began traveling from one district to another. So, rise in numbers was expected. This is not the second wave. The first wave never really ended. I can certainly say that the virus is simply spreading into new populations or resurging in places that let their guard down too soon.

What measures has the Task Force suggested to contain the spike?

There is unanimity among the task force members, state health departments experts, and the BMC that we must go back to the basics – test, trace, isolate and treat. It has been advised that the city’s full  RT-PCR testing capacity be utilised. Mumbai can carry out 12,000 tests a day. This will be complemented by antigen testing. We contained the virus in Dharavi, Asia’s largest slum, we will tame it again. We have also advised for house-to-house surveys. The rising numbers are a cause of concern as it could strain the health infrastructure. But we have not reached that stage yet. In a few districts, where cases are rising, we have sought the creation of jumbo centres. Experts from Mumbai are helping these districts.

But there is an acute shortage of ICU beds  in Mumbai. The situation is similar to what we witnessed in May and June.

The demand for ICU beds was always high. Since the new cases are all from middle class, uppermiddle class neighbourhood, the patients want to be treated in private hospitals. With 73 smaller nursing homes delisted recently as Covid centres, new patients have fewer options. But we have ICU beds available at BKC, NSCI, Dahisar and NESCO. I have visited these jumbo centres. Their ICUs are well equipped. In fact, in a recent discussion it was decided to increase manpower and start more ICU beds in jumbos.

But the mortality rate is still high.

I would not agree with that. In fact, the death rate has been dropping consistently. But yes, the aim is to bring the death rate down to 1 per cent. We are currently at 3 to 4 per cent. We need to send out a message that people must seek treatment early, especially those who are above 60 years of age and have comorbidities

Is Mumbai anywhere close to achieving herd immunity?

Yes, that is what our sero survey report suggests. In Dharavi, for instance, 57 per cent people have developed antibodies. However, how long these antibodies remain active is still a matter of research. Findings of the second phase of sero survey will be out soon.

The city has reported some cases of re-infection. Should we be worried?

Though these cases are very few, the fact remains that they fit the definition of a second-time infection. Again, it is a matter of research.

Pillows, beds and other unused material lying at BMC'S COVID Care Centre in Mahim Nature Park

Anything you would like to share on vaccine trials in India?

All I can say is that a vaccine is not round-the-corner, so why waste time thinking about it. Your mask is your vaccine. Never drop your guard. It is distressing to see people roaming around without a mask and not following social distancing.

Source : Mumbai Mirror

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