Inside maximum city’s mysterious surge
PremiumThe form and velocity of this wave is unlike anything Mumbai had seen last year. Is a new variant to blame?
Gudhi Padwa, the Maharashtrian New Year which coincides with harvest festivals of other communities, was hastily observed on 13 April this year. The festive Gudhis—flag poles with garlands, mango and neem leaves, and a special thread of sweets, all topped by an upturned copper or silver kalash—raised outside homes at dawn to signify auspiciousness and abundance were muted, tokenistic and devoid of festive cheer.
“We simply observed Gudhi Padwa; we didn’t celebrate it. How to invite abundance and wealth when illness and death are playing a macabre dance?" asked Dr Meena Vaishampayan, author and former vice president of The Asiatic Society of Mumbai. In the cities most ravaged by the second wave of covid-19—Mumbai, Pune, Nashik, and Nagpur—WhatsApp groups buzzed not with celebratory wishes but requests for help for hospital beds, oxygen cylinders and medicines like remdesivir that are in acute short supply.
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1 min read . 08:41 AM ISTA staggering 63,729 covid-19 cases were registered across Maharashtra three days after Gudhi Padwa. This tally was two-and-a-half times the highest daily caseload at the peak of the first wave last September. Mumbai’s covid-19 death toll of 333 till mid-April was 55% more than for March this year.
Case fatalities rose, thousands of beds in jumbo covid centres were fully occupied, corridors and lobby areas of hospitals turned into makeshift wards, vaccination queues snaked long at every centre, citizens stocked up on essential goods with a mix of desperation and déjà vu, and the Maharashtra government had to spar with the Centre over urgently air-lifting oxygen to Mumbai’s hospitals.
By the time chief minister Uddhav Thackeray announced the state-wide curfew from 15 April to 1 May, it was clear that the government and the people had been blindsided by the second wave. The impact was devastating.
“My father’s youngest brother Allwyn Bappu was diagnosed with covid last Tuesday; overnight his oxygen level dropped to 40," said an emotional Jovita Aranha, a media professional. “We called private hospitals begging for a bed, coordinated with war rooms for ventilators, beseeched friends... somehow found an ambulance and took him from one hospital to another. By the time he got a bed, he was gone. We couldn’t even bury him, just watched his cremation on our mobile phones." There are many such stories.
Even the form and velocity of this wave of covid-19 is unlike anything Mumbai had seen last year. The second wave hit large numbers of people in housing societies who were relatively untouched earlier; it showed a rural spread in infections that had not been seen before and provoked a repeat of last year’s exodus of migrant workers; and it brought a tentative economy—slowly getting back its rhythm—to a sputtering halt for the second time.
To make matters worse, experts reckon that the virus had new variants of concern or had mutated, which made detection difficult. Sure, the second wave will peak in the coming weeks, but questions remain: Why did it smack so hard; what did the state government miss; how is the impact this time around?
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The politics
The Thackeray government spent almost a month discussing various restrictive measures before announcing a curfew in mid-April; in the bargain, numbers surged. The second wave began early-to-mid March after a lull of four months. Thackeray wanted to decide counter measures by consensus and consultation, unlike Prime Minister Narendra Modi’s lockdown decision, and this took time, said sources in his party Shiv Sena. Moreover, the command-and-control approach of the Centre has robbed Maharashtra, India’s worst-affected state, of the room to manoeuvre.
“We have tried our best. We are doing our best at every level but Maharashtra has been discriminated against by the Centre on vaccine distribution to (remdesivir) injections," state health minister Rajesh Tope told Mint. “I don’t want a blame game but I wish the Centre would work hand in hand with us," he added.
Meanwhile, BJP leader and former chief minister Devendra Fadnavis has bellowed in press conferences that “Thackeray’s government has failed." Fadnavis’ own role in “procuring" Remdesivir injections from a supplier supposedly to give to the Maharashtra government has also come under a cloud.
“The fact that the (central) government got blindsided by the second wave is testament to the poor quality analysis which informs policy," Murad Banaji, lecturer of mathematics at Middlesex University, UK, who number-crunches India’s covid-19 data, told Mint. “For example, instead of trying to understand why Maharashtra had been so badly hit in the first wave from an epidemiological point of view, it was easier to imply that the state government had been lax," Banaji said.
Politics apart, Mumbai is not behaving like one city. Instead, there seem to be multiple pandemics playing out, calling for localised or micro-local containment strategies. The virus has clearly breached Mumbai’s class divide. Twelve of the city’s 24 municipal wards recorded a higher-than-average growth rate in new cases in the week leading to 16 April. Most of these house upper or upper-middle class residents and have superior infrastructure.
At 2.13%, this growth rate was the highest in H-West (Mumbai’s civic wards are tagged alphabetically), which includes the posh areas of Bandra-Khar-Santacruz. The city average was 1.57%. Nearly 600,000 Mumbaikars were in home quarantine last week, a large majority of them in housing societies.
The Brihanmumbai Municipal Corporation’s list of active containment zones showed this starkly too. On 16 April, for example, 94 slums and chawls with nearly 500,000 residents were sealed; the corresponding number was 11,569 buildings or floors within buildings encompassing nearly 2.1 million non-slum Mumbaikars. This has been the trend for March-April.
Some of Mumbai’s spiffiest addresses such as Pedder Road, Nepean Sea Road, Altamount Road and Breach Candy are in D ward. It has a higher growth rate of cases than the city’s average and the second highest number of sealed buildings or floors. “We are seeing nearly 400 cases a day here compared to 100-150 last year, but what’s remarkable is that 85% are from high-rises, not slums," said a civic official on condition of anonymity.
This reflected also on social media timelines which were awash with desperate requests for help while tagging political acquaintances and people in high offices. The well-heeled were hit harder in this wave.
“By July 2020, the epidemic died down in the slums to a large degree but never really wound down in middle-class localities especially in northern suburbs and these localities led the second surge. The third phase, what we are seeing this year, is different. In terms of cases, it’s massive, and it is likely that the speed at which infection has been spreading is the highest ever," said Banaji.
The spread
Beyond Mumbai, the pandemic is playing out differently. Despite its overwhelming absolute numbers—nearly 371,000 in a month—and a near-breakdown in health infrastructure, Mumbai ranks fourth after Nashik, Nagpur and Pune if cases are calculated per million people, which is a more accurate metric given the wide differences in population between cities. Healthcare systems in Pune and Nashik are days away from collapse, said healthcare workers there. Districts such as Amravati, Akola and Beed remain a cause for concern.
There are a few discernible reasons for the surge in Mumbai and Maharashtra, epidemiologists and doctors on the covid-19 task force told the government last week. It can partly be attributed to “pandemic fatigue" among people leading to non-use of masks and foregoing covid-appropriate behaviour which a central study team had flagged off in early March.
Increased and aggressive testing played a part too. The near-normal resumption of local trains from February and workplaces calling all staff to offices meant Mumbai and Pune were seeing crush-loads which made a mockery of physical distancing.
The lull since October last year led to two behaviours—gram panchayat elections were held in 14,000 villages in January with full-throated campaigns followed by victories rallies for which internal migrants returned to their villages from Mumbai-Pune-Nashik for voting, possibly taking the virus with them. Also, a large number of weddings and social functions were organised.
Health minister Tope agreed that these factors might be cumulatively responsible for the surge but added that “people could not be locked up forever". However, he asserted that these are only partly responsible; the other part is “without any doubt" a virus mutation on which the Centre has not shared enough data or protocols.
The commerce
The slew of restrictions that Thackeray’s government placed on economic activities and public places since March, which eventually culminated in curfew, did not go down well with commercial Mumbai. Unlike last year when most industry and trade associations went along with the pan-India lockdown, voices arose in protest.
Retailers’ association president Viren Shah said, “If we have no income flows for the second time in a year, how will we pay salaries, taxes, rents for our shops? The second wave will break many of us."
Delegations of various trade associations like hotels and restaurants, and gems and jewellery, are still petitioning Thackeray that their activities are, indeed, essential to them.
When he declared the state-wide curfew, Thackeray rolled out a ₹5,500-crore relief package for the poor and informal sector workers to ride out rough days. Yet, Mumbai’s railway terminals witnessed a surge of migrant workers last week. Tickets for trains to Uttar Pradesh, Bihar and Bengal were going at four times the official price.
“The government’s relief packages for different categories of people aren’t enough," pointed out Ulka Mahajan of Sarvahara Jan Andolan, “The 3kg wheat and 2kg rice per person is welcome, but what of those who are not covered under the National Food Security Act? Besides, the uncertainty is damaging."
As with the first wave, so with this one—economic repair and recovery are secondary to managing the health crisis. The strained health infrastructure coupled with an exhausted workforce of medical and healthcare professionals is a deadly combination in the face of the second wave, say doctors.
“We are not even talking about mental health issues yet, either of patients or the medical fraternity. It’s a silent storm gathering," remarked Dr Rajesh Parikh, psychiatrist and director of medical research, Jaslok Hospital.
The road ahead
The state’s covid-19 task force cautiously estimates the second wave to peak in end April or May but, importantly, has briefed the Thackeray government that the current surge is unlikely to be the result of only covid-inappropriate behaviour of people or government measures. New variants may be at play, doctors reckon.
“We have made the April-May projection but there are ‘unknown’ factors such as the variants which we don’t know everything about. We should have had better results from genome sequencing. The progression of disease and treatment protocols may have to change. We must be prepared for things to get worse before they get better," said a renowned doctor in the state’s covid-19 task force on condition of anonymity.
In 61% of samples collected between January and March this year, double mutation had occurred and a new variant, the B.1.617, was found, according to information that the National Institute of Virology has shared with government officials. The Centre confirmed the double mutation in samples from Maharashtra. However, this variant has not been conclusively linked to the surge in cases yet.
What this means is, given the many unknowns, professionals are finding it difficult to create models or make accurate predictions of a third wave—except that there’s likely to be one. Mumbai and Maharashtra’s covid-19 woes seem unending for now. For now, one can only hope that Gudhi Padwa next year will bring some cheer.
Smruti Koppikar is a journalist, writer and urban chronicler.
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