Mumbai's COVID-19 crisis mirrors India's deep pandemic turmoil; September spike complicates situation in financial capital
Mumbai's case fatality rate across age-groups has seen a drop of less than 5 percent in September, which was 7 percent initially.
Mumbai has reported more than double COVID-19 cases from 1 to 22 September as compared to the same duration in the last month, thereby registering a surge of 104 percent in the total number of confirmed COVID-19 infections.
The financial capital had reported 20,031 cases between 1 to 22 August, reported Hindustan Times.
Mumbai's daily COVID-19 cases surges by 104% in Sept from Aug
Medical experts and officials from Brihanmumbai Municipal Corporation's (BMC) public health department have attributed this increase to the surge in the daily COVID-19 cases. The city's COVID-19 graph, which had begun to stabilise, is showing an upward curve again, due to Mumbai's unlock plans and the recent Ganesh Chaturthi festival.
The report further quoted Suresh Kakani, additional municipal commissioner in charge of the civic health department, as saying, "The increase in the number of active COVID-19 cases is also a result of the shift in the spread of COVID-19 from slums to high rises. As more affluent people are now turning positive, rate of self admission in private hospitals has increased, and these residents are opting to prolong their treatment in a private hospital."
Also, 47 patients succumbed to the virus taking the toll to in the city to 8,549. On the contrary, as many as 1,52,204 patients have recovered till date and the number of active cases in the city is now pitched at 26,644.
Maharashtra's COVID cases nearly one-fourth of India’s total
At the start of this month, Maharashtra had 1.98 lakh active cases, which has gone up to more than 2.72 lakh now, an increase of more than 74,000.
With 18,390 more people testing positive in Maharashtra in the past 24 hours, the overall count of the state on Wednesday climbed to 12,42,770.
The Union health ministry on 11 September had said that though the daily cases are increasing, the situation should be seen 'in the context of population' and cited increased testing as a reason for the higher numbers.
Union Health secretary Rajesh Bhushan pointed out that the positivity rate remained at seven percent and cited five states – Maharashtra, Andhra Pradesh, Karnataka, Delhi and Tamil Nadu – where the maximum number of cases are concentrated.
Between 7,000-9,000 tests were conducted daily in August and between 10,000-15,000 this month. Till now, over one million tests have been conducted in the city with an overall positivity rate of 18.22 percent.
Health experts said despite increasing daily testing, Mumbai is behind Bengaluru and Delhi in the total number of tests.
"The number of tests is equally proportionate to the number of positive cases. So, the more we test, the more cases will come out. This might create panic among people, but it will help to break the chain of infection. In fact, the civic body should have increased their testing much earlier, considering Mumbai is the most populated city," said Anant Bhan, a public health expert to Hindustan Times.
Easing of travel restrictions to blame?
Earlier in September, Health Minister Rajesh Tope had said that the state government as part of restarting the economic activities has removed restrictions on inter-district travel, dropped e-pass requirements for travelling and allowed more government employees in the offices, which have cumulatively led to the rise in infections.
After registering an approx of 14,000 positive cases per day during the end of August, the tally crossed over 20,000 on a single day since the beginning of September.
On 17 September, the Mahrashtra government ordered an extension of restrictions on movement and gatherings in the city under Section 144 starting from 18 September midnight.
"Mumbai continues to be threatened with the spread of COVID-19 , it is considered expedient to issue prohibitory order for restricting any presence or movement of one or more persons in public places or gathering of any sort anywhere, including religious places..." the order stated.
Movement of one person or more persons will be prohibited within the city except for the listed emergency and non-emergency service, the Mumbai Police said.
Influx of COVID-19 patients in Mumbai; ICU bed availability shrinks
Gautam Bhansali, the chief coordinator between the BMC and the private hospitals in the city for managing the beds told Scroll: "In September, we have definitely seen a big surge in the number of cases. There are two or three reasons for it: One is that the lockdown has almost entirely been relaxed, and people are also coming from other places for treatment. Due to that, you could say, it is like a second wave – cases have increased in Mumbai."
He further said that the number of cases shot up also due to the influx of patients from other places – from Sangli, Dhule, Kolhapur, Nasik, Pune to receive treatment as they assume Mumbai has better health infrastructure and skilled health professionals.
About 30-40 percent of the people admitted in Mumbai hospitals (nursing homes and big private hospitals) are from outside the metropolitan region – from Bhiwandi, Thane, Kalyan, Dombivli, Navi Mumbai, Ulhas Nagar, etc.
According to Times of India, earlier in September, a BMC dashboard showed that of the 1,399 COVID ICU beds in the city, 1,258 were occupied and only 141 were available.
At present, there are 2,600 COVID beds in the 33 big private hospitals – Bombay Hospital, Breach Candy, Hinduja, Lilavati, Jaslok, etc. Of these, 1,600 are oxygenated beds and 590 ICU beds. In the 27 nursing homes, there are 390 ICU beds and 1,700 oxygenated beds. In government hospitals, 50 percent beds are designated for COVID and 50 percent for non-COVID part.
Kakani had said despite the rise in demand for beds, the situation was not out of control. "There is a bit of a bed crunch in the private sector, but ICU beds are available in the public sector," he said.
Rise in occupancy of beds
An analysis of the BMC’s data showed that occupancy for different kinds of beds has increased by 21 percent to 35 percent, according to Times of India.
It showed that occupancy of ICU beds jumped from 1,240 on 7 September to 1,583 on 19 September. The number of patients on oxygen support increased from 4,563 on 7 September to 6,081 on 19 September — indicating a 33 percent jump. The occupancy of ventilator beds rose 21 percent.
Dip in Mumbai's COVID-19 fatality rate
Despite substantial rise in fresh infections in the city, Mumbai's case fatality rate (CFR, or ratio of deaths to positive patients) across age-groups has seen a drop. Mumbai's CFR has dropped to less than 5 percent in September, which was 7 percent initially.
In the first 22 days of August, 990 deaths were reported. They dropped to 862 over the same time this month.
"If the number of infected people had increased, the positivity rate, too, should have risen. But it has declined and that proves Mumbai's COVID-19 case graph hasn't shot up," said Kakani.
Hovering around the 50s range for the fourth day, Mumbai recorded 49 deaths on Wednesday— and the toll increased from 8,555 to 8,604.
The city's mortality rate has dropped to 2.2 percent in the last 30 days from 4.85 percent in the previous month. The national fatality rate is 1.63 percent.
BMC chief IS Chahal said fatalities between 20 August and 20 September showed a big decline despite a rise in positive cases.
"In the last 31 days, the average COVID-19 death rate under BMC has come down to 2.2 percent and the overall death rate has consequently fallen from 5.4 percent to 4.6 percent," said Chahal.
With inputs from agencies
The health ministry said more than 5.58 crore balance and unutilised COVID-19 vaccine doses are still available with the states and UTs to be administered
The daily positivity rate was recorded at 2.50 percent and the weekly positivity rate was 2.63 percent
The number of daily new cases has remained below 50,000 for the last 78 consecutive days