Fighting Covid-19: What Chennai can learn from Bengaluru

CHENNAI: With the Tamil Nadu government replacing Beela Rajesh with J Radhakrishnan as health secretary and planning to bring in Pankaj Kumar Bansal as Greater Chennai Corporation commissioner, the Covid pandemic management in Chennai is all set for course correction.
Two new people at the helm means the city will re-draft its Covid management plan and hopefully look at its neighbours to draw inspiration. Bengaluru, for instance, has recorded just 617 Covid positive cases (until Friday) and 27 deaths. Here are six things Chennai could do better.

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Testing
Testing remains a critical exercise in the interest of larger public health. While 1.22 lakh samples have been tested in Chennai until June 7, in Bengaluru, it is around 50,000. Chennai, which tested 16,903 people per million till June 7, should persist with testing as per ICMR’s Intelligent Testing Strategy and ramp up the numbers from the current nearly 6,000 samples a day in the city instead of bringing it down to quell panic. In mid-May, the government reduced the testing numbers, worried by the surge of cases, drawing flak from health experts. With lockdown in process then, epidemiologist felt that a golden opportunity had been frittered away when testing and optimal early containment could have checked the virus spread to such alarming levels.

Contact Tracing
With Chennai’s geographical spread comprising areas of packed colonies and slums, containing the Covid spread has proved challenging. Initially, contact tracing was meticulous. Teams found that there were roughly five close contacts for a primary infected person and 10 to 15 ‘other’ contacts. But as the number of cases soared, the contacts multiplied and the search too lagged. With Bansal being roped in to head surveillance and containment, a woman health worker traced 120 contacts of an index patient, a record of sorts. In contrast, Bengaluru has kept up a search for contacts, identifying them and putting them under quarantine.
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Containment Zones
Containing a positive zone has been tough. There are 200-odd containment zones in Chennai; Bengaluru just 40. There is little discipline within these areas in Chennai with asymptomatic positive contacts moving around. Three to five policemen are posted at the entrance of a street that marks the beginning of a zone. But few zones in the city follow the rules, social distancing and masks being scarce. Ensuring social responsibility and self-discipline has been the one challenge for health teams. BBMP took to containment zone mapping and predictive modelling, sealing the locality and regulating movement.
Isolation/Quarantine
With Covid numbers reaching alarming levels in Chennai, isolation and quarantine is a growing concern. With clusters expanding and the number of travellers coming into the city on the rise, Covid teams are grappling with insufficient institutional facilities for quarantine. The situation is worse in the 1,900 slums in the city, including the 1,200 notified ones, where Covid numbers are in thousands and social distancing near impossible. While the state opened up the option of home isolation/care to reduce the pressure on its health care system, the queue of the less privileged at hospitals and Covid Care Centres is growing. Whereas in Bengaluru, authorities are providing institutional isolation even for secondary contacts. On Monday, the Karnataka government tweaked its quarantine rules for travellers entering the state, to make them tighter
Coordinated strategy
It is difficult to ask for a happy working relationship between twelve committees/task forces and umpteen departments. In such a pandemic situation, however, there is little option but to coordinate smoothly. But officials are caught up with summarizing ground operations in offices instead of monitoring and guiding ground level teams. Egos have come in the way of coordinated strategizing. The shunting of officers was an unfortunate fallout. In Bengaluru, team heads cracked the whip to make sure the various agencies worked harmoniously. Officials put aside differences to ensure coordination between the civic agency, health department and the home department was effective.
Transparency
There have been allegations of fudging of records and juggling numbers to present a not-so-alarming picture of the Covid-19 onslaught in Chennai. The attempt to suppress the true mortality figures is not just a poor reflection of the government’s credibility but also its inefficient management of the pandemic. Epidemiologists have been crying hoarse about the possibility of community spread. They reason that the government should stop feeling guilty about the rising numbers from more testing and focus on intervention strategies to check the spread and provide good health care. While fighting a pandemic such as the Covid-19, being upfront with the people can pay off in the long run.
In Video:What Chennai can learn from Bengaluru in fight against Covid-19