Ahmedabad features on top of the list of 15 districts worst-affected by COVID-19, with one of the highest caseloads. With 2,762 people testing positive for COVID-19, Ahmedabad accounts for 70 percent of the total cases for the state of Gujarat. The city also accounts for 67 percent of Gujarat's COVID-19 deaths.
City’s Municipal Commissioner Vijay Nehra says intensive surveillance and aggressive testing is what will help Ahmedabad slow down the spread of Coronavirus.
The city has the highest testing rate in the country with 4,150 tests per million being conducted.
However, with a high mortality rate of over 4.7, much higher than national average, the administration is now proactively screening the older people, those with other non-communicable diseases and super-spreaders like vegetable vendors and shopkeepers.
In a conversation with CNBC TV18, Municipal Commissioner Vijay Nehra said the city will partially open up for economic activities like construction work, municipal corporation work and offices that can operate with skeletal staff will be allowed too. “We are trying to find a way to learn to live with the virus.”
Q1: Ahmedabad has seen the steepest death rate, much higher than that of Delhi and Mumbai where cumulative number of cases is large. How is the administration tackling this? Where are we falling short? Ans: In Ahmedabad we are using strategy of ‘chasing the virus.’ Initially we had a problem with certain sections who were not co-operating, but now we have overcome that problem. We are going ahead with proactively doing intensive surveillance & aggressive testing. Need to identify as many cases as possible and as early as possible, otherwise it stays in the population and spreads.
Today we have reached 4,150 tests per million, that’s 10 times the national average and the highest as compared to any other state in the country. Higher testing has shown large numbers of positive cases in April, which will help me in the month of May to slow down disease spread. The number of days taken for cases to double has gone up from 3 days in April 15, to 5-6 days by 25th April. It is now at 8 day and the efforts are on to push it further to 10-11 days.
Q2: While you are doing aggressive testing proactively, but what explains the high mortality rates are patients reaching the hospital late? Ans: Most patients were reaching the facilities very late in the diease progression. We had seen deaths happening in 12-24 hours of hospital admissions. Initially minority communities were not co-operating. People from these areas were hesitant in reporting their symptoms and were reaching hospitals late and hence increasing mortality rates. 15-20 days ago, we were facing intimidation and challenges in communicating with minority communities.
Now we have reached out to many groups, involved religious leaders and these groups have also started co-operating. With community consultations have now been able to bridge the gap. We have a tertiary care hospital
Q3: More deaths are in older population and those with co-morbid conditions. What are the strategies for super spreader, older and vulnerable? Ans: We are following a 3-S strategy – super spreader, slums and senior citizen. We have screened 10,000 super spreaders in last 10 days, of which 2000 were tested for COVID19 and 115 super-spreaders were identified. We have now made masks compulsory for all when they step outside and for shopkeepers. We are distributing free masks to vegetable vendors etc. Any shopkeeper found without a mask will lose his licence for 3 months.
In slums, where 25,000 people live, we have screened all households. 270 people with symptoms were identified and tested and only 1 solitary case was tested positive. We are intensifying our focus on senior citizens above 60 years old and those with co-morbid conditions like diabetes and hypertension. We are now using the databases from pension office and mobile companies to list all people above 60 years and those 40 years and above with underlying conditions.
We are making people aware to keep the older people safe at home.
Q4: Are there special screening efforts for older and those with co-morbid conditions? Ans: Almost 3000 school teachers are surveying door to door to check on senior citizens. They are assessing their symptoms & identifying if any need medical attention. They are being shifted to hospitals and tested. We have also done screening of those with non-communicable diseases and another list is being created. Q5: As PM Modi has indicated the fight against COVID-19 will be fought at state and district level and districts will have control over how much lockdown relaxation they provide. Is Ahmedabad prepared to open up the city/district post May 3rd for economic activities? Ans: Attempt is to balance between economic interests, employment status and livelihood status and COVID fight. Am personally reach out to citizens to explain the need to undergo massive habit change. We are making wearing of masks compulsory and are starting hand washing and no-spitting campaigns. We are trying to find a way to learn to live with the virus. Q6: May 3rd, the deadline for second phase of lockdown is approaching. What will be the initial economic activities that you will allow in next few days? Ans: Premature to comment now as situation is changing rapidly on a daily basis. For the first time in last 7 days we have seen a dip in the rate of COVID numbers growing. 10 days ago the rate of growth in number of daily cases was almost 25-30 percent, we have pulled it down to below 10 percent in last week and today it was 6 percent. But we know we can have the spike every now and then and hence will be carefully monitoring how the disease is progressing.
When we have to open up, we will be more comfortable in starting activities where we have control like construction sites, where we can screen workers and there is no inter-mingling with outside population. We can start municipal corporation work like roads, bridges, drainage projects.There are huge numbers of Municipal Corporation work that is stalled projects, we would like to restart that. We can start offices which can work with skeletal staff, without the need for crowding. Works where we don’t need to transport a large number of people from one area to other.