Expert Speak Health Express
Published on Apr 28, 2020
Hacking the pandemic : Lessons from the Silicon valley of India

In the fight against COVID-19, the focus has rightfully remained on the cities acting as hotspots for the virus, having recorded the highest number of confirmed cases – Mumbai, Delhi, Ahmedabad, Indore and Jaipur. Taken together, these five cities constitute 44% of the country’s total confirmed cases. The missing point here is while the major metropolitan cities are under the microscope, Bengaluru is largely ignored in the talks around COVID-19. Bengaluru, India’s third largest metropolitan city which has a population of nearly 96 lakhs spread across 2196 Sq. Km has successfully achieved in containing the spread of the virus.

(As of 1200 Hrs, April 27, 2020 | Source: https://www.covid19india.org/)

Bengaluru, as of April 27, has a mere 133 confirmed cases which make up 26% of the total cases in Karnataka and 0.47 % of the total confirmed cases in India. The first confirmed case in the city was detected on March 08 which suggests that in the last 50 days the cases haven’t spiked compared to those in cities like Mumbai, Delhi. The daily trends of COVID-19 cases in Bengaluru show that for four consecutive days from April 18 to April 21, there was no case reported; the overall increase in the daily cases has been quite low. It is important to see that the recovery rate is higher than the nation’s recovery rate i.e. 88.07%.

(As of 1200 Hrs, April 27, 2020 | Source: https://www.covid19india.org/)

Bengaluru has been successful in doing so using a three-pronged approach also known as “The three Ts – Test, Trace and Treat. Firstly, it responded to the global spread of the virus by putting passengers arriving from COVID-19 affected countries in home quarantine. Secondly, it responded to the spread of the virus internally within India, on the lines established by national and state actors. Lastly, it has also strictly adopted the model contact tracing system, similar to the one practiced in South Korea. For every suspected or confirmed case in the city, they immediately traced primary and secondary contacts with the infected person and putting them under strict quarantine at their homes or hospitals has helped them in keeping the pandemic under control. A few steps taken at by the State Government as well as the Bruhat Bengaluru Mahanagara Palike (BBMP) have curbed the spread of the virus even in the rural areas by strictly monitoring the cases.

(Date wise COVID-19 Cumulative figure of Confirmed Cases, Recovered Cases and Deaths in Bengaluru as of April 26, 2020. Source – BBMP War Room Bulletin)

Firstly, starting from March 02, 2020, passengers flying from COVID-19 affected countries were identified and put under home quarantine. Passengers that showed some symptoms were tested. The same was also practiced at sea ports. As of April 25, a total of 1,40,439 people were screened at air ports and sea ports and put under home quarantine. Passengers who were tested positive during their period of quarantine were immediately transferred to the nearby isolation facility and their primary and secondary contacts were identified and put under quarantine. An important step was taken by the Government of Karnataka on March 10. When the first death in the state was recorded, the Karnataka Government notified the Karnataka Epidemic Diseases, COVID-19 Regulations and invoked the Epidemic Diseases Act, 1897 with the aim of controlling the spread of the virus effective March 11. The notice was issued with immediate effect for a period of one-year. Pursuant to this notice, the district administration has the authority to put any area under containment and also ensure that the citizens take necessary public health measures to prevent the outbreak. As a result, all shopping malls, cinema halls, weddings, bars and other large gatherings in the state were banned for a week.

On March 20, 100 teams consisting of a doctor, public health servants, nurses, and Medico Social Workers were formed to closely check on contact tracing within the BBMP area. On March 22, the state government identified nine districts including Bengaluru as COVID “Hotspots” and imposed a lockdown until March 31. Karnataka was the first state in doing so. Section 144 was imposed in Bengaluru to enforce the lockdown The police also detained and arrested individuals under Section 269 (negligent act likely to spread infection of disease dangerous to life) and 270 (malignant act likely to spread infection of a disease) of the IPC. PM on March 24 announced a nation-wide lockdown with curfew-like restrictions.  One week post the lockdown was imposed in Bengaluru, the state was the first to set up an exclusive 2,500-bed hospital with ICU facilities. BBMP has listed 38 localities across the city as Covid-19 containment zones based on at least one or more positive cases recorded in the last 28 days. If more than 50 people are under quarantine at any given point, the area becomes a hotspot. The state government has also released statements to make the citizens differentiate between the red, orange and green zones for containment plan; the state government has released a cluster-wise classification of the same. The containment zones will see a restricted movement of vehicles as well as people and also intensive screening from door-to-door.

(Left: Containment zone plan by BBMP as per the confirmed Right: Location of COVID19 Positive cases. Source: BBMP War Room Bulletin)

For the Silicon Valley of India, technology has been at its centre even in the fight against COVID-19. The Bengaluru COVID War Room was introduced by the BBMP for real-time monitoring and updates of positive cases and suspected cases as well as graphs of the growing situation at taluk and district levels. The war room also prepared heat maps for a better understanding of the situation for the citizens and identified and classified hotspots based on isolation period. The war room also has a hunger helpline for migrant workers as well as the poor. In addition to this, an app called “Corona Watch” was launched on March 28. This app was made with the Karnataka Geographic Information System to show the local people locations of the COVID-19 affected patients and their movement history in the last 14 days through the tracking of movements. The app also helped in identifying the nearest hospital as well as sample collection centres and testing labs. A stamping process was carried out for people under home quarantine wherein an inked stamp saying “Home Quarantine” was stamped on the individual’s hand. This was carried out for the general public and police force to identify the people who were under quarantine but were found in public spaces. The Government of Karnataka also promoted tele-medicine by allowing all Registered Medical Practitioners (RMPs) to practice Tele-medicine consultation on the condition of following the guidelines by the Ministry of Health and Family Welfare. To counter the rampant influence of fake news and disinformation, the government came up with a Telegram account to fact check information and broadcast advancements within two days of the Epidemic Disease Act coming into force. The Media bulletin on the State Government’s website has also been sharing press releases twice a day.

Even in the rural areas, the first case confirmed was on April 07. However, since April 14, there has not been a rise in the cases. In the view of containing the spread, on April 08, Karnataka State Board of Auqaf issued a notice to all managements to not allow any congregational prayers in the Masjids and Darghas throughout the state and to suspend the visit of public on the occasion of Shab-e-Barat on Thursday, 9th April 2020.

Bengaluru has achieved the success of a low infection rate, high recovery rate and a low daily increase in the number of cases with joint participation from all segments – volunteers, police force, BBMP, state government as well as the citizens. BBMP’s war room itself has seen participation from software engineers, doctors, pilots, research scholars, psychologists, Red Cross workers and common citizens. Volunteers of Accredited Social Health Activist (ASHA) have participated in the active surveillance carried out in the containment zones. One of the toughest tasks for the police force has been to convince people to stay indoors. They have successfully managed to do this in a creative manner by singing “Hum honge kamiyaab” thereby connecting with the citizens. As the lockdown was extended until May 04, the Bengaluru mayor urged people to stay indoors and not step out to get groceries. BBMP has launched a help-line number which would deliver groceries in all areas. From April 16, the city has also see testing kiosks specially to increase the testing in the hot sports and containment zones.

However, the fight against COVID-19 hasn’t been easy for the city. Padarayanapura and Bapuji Nagar wards which have a high muslim population were sealed on April 10. A mob violence was instigated on April 19 by the residents of the two wards questioning why their wards were sealed while nearly 30 hotspots were not. They further complained about receiving bare minimum supplies leaving many hungry. This led to a communal spin creating a major roadblock. Recently, the city saw a spike in numbers especially in the densely populated, slum areas. A 54-year old migrant labourer from Bihar, resident of Hongasandra who was working on the metro project tested positive. While, BBMP hasn’t been able to trace where he contracted the virus from, they are also afraid that he might have spread it to several others. On April 22, when a woman was tested positive in a small hospital in Hongasandra, the hospital was sealed. The outbreak in Hongasandra added 19 cases on April 24 and has also provoked the state to move 96 primary contacts.

The timely policy interventions from the state government as well as the BBMP in Bengaluru with cooperation of policy actors at a social level, put the Silicon Valley of India in a good position to stay in control nonetheless. With intensive screening and contact tracing, the city is well versed with bringing the spread in control.

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