key: cord-0750722-uxx9d8gf
authors: Khaparde, Sunil; Aroskar, Khyati; Taralekar, Radha; Gomare, Mangala
title: Interventions to respond to COVID 19 pandemic in Mumbai and way forward
date: 2021-05-05
journal: Indian J Tuberc
DOI: 10.1016/j.ijtb.2021.04.013
sha: 55ad27bd5cf17800dde8cf8bad0a554562260d54
doc_id: 750722
cord_uid: uxx9d8gf

With the emergence of COVID 19 pandemic, the approach used by Municipal Corporation of Greater Mumbai (MCGM) was based on all guidelines of COVID 19 prepared by Ministry of Health and Family Welfare (MoHFW). However, Mumbai undertook a special innovate model used in the mission Mumbai – Dharavi for COVID 19. Additionally, MCGM undertook a proactive approach of “chasing the virus” with its 4Ts: 1. Tracing 2. Tracking 3. Testing 4. Treating in high-risk slum clusters and it reflects the result of declining the incidence and case fatality due to COVID 19. Establishing public health surge capacities which include active surveillance, contact-tracing and follow-up besides early detection, isolation and management of cases are important steps for fighting the COVID 19 pandemic. Collaborating with all partners and setting up a Task force for establishing clinical management protocols was unmissable.

MCGM took a proactive approach of "chasing the virus" with its 4Ts: 1. Tracing 2. Tracking 3.

Testing 4. Treating in high-risk slum clusters, rather than waiting for cases to happen is a very J o u r n a l P r e -p r o o f timely response for containment of COVID 19 and it shows the result of declining the incidence and case fatality due to COVID 19. 4 Director General of WHO complemented Dharavi for focusing on community engagement and the basics of testing, tracing, isolating, and treating all those that are sick as key to breaking the chains of transmission and suppressing the virus.

The MCGM established teams consisting of a doctor, a community health worker, and a local volunteer; since April, these teams have knocked on doors of 47,500 Dharavi homes and screened 360,000 individuals, including measuring temperature and oxygen saturation levels.

Those having oxygen concentration of less than 95% are taken to a quarantine center, where they are provided comprehensive care. In addition, about 2,000 older people have been taken into protective quarantine. This active case search has helped to identify suspects much faster and to move them to local clubs and schools, which serve as quarantine facilities are very relevant approach to curb the COVID 19.

A multi-sectorial micro planning process in the slums was undertaken to -consider engaging with people's representatives, policy makers, civil society and other stakeholders to facilitate and ensure the community participation civil society and private sector engagement: Aggressive and accessible testing was part of the arsenal.

The government take strict vigilance with response to COVID 19 at individual and community level to take precautions and avoid getting infected with the virus. The Government officials and the leadership is bold and must be congratulated for strong actionFrom hourly live updates, unleashing the avalanche of information/ advisories/ notifications, awareness through social media, teaching cough etiquette, physical distancing, tracking of cases, contact tracing, quarantine/ isolation, (even forcible in few cases), to high level meetings, lockdowns, There is a need for strengthening the psycho-social support to as COVID 19 patients and their families as well as frontline workers. Mumbai established jumbo quarantine facilities where Yoga/ Breathing exercises were facilitated for improving physical and mental health.

pandemic due to extended lockdowns. Efforts must be made to address these and reassure public through a systematic approach led by social and mental health experts at a larger scale. 

Establishing public health surge capacities which include active surveillance, contact-tracing and follow-up besides early detection, isolation and management of cases are important.

Strengthening healthcare budgeting allocated to preventive health services, surveillance, outbreak investigations, trained epidemiological workforce and inter sectoral coordination will remain important. Involvement of Professional organizations, Self-help groups and Non-Governmental organizations to map out services effectively. Early testing and healthcare in this J o u r n a l P r e -p r o o f population could help significantly reduce the mortality toll of the epidemic. Routine hospital services remain key and the crux for priority action today. For tuberculosis and other communicable/ non communicable diseases, Antenatal Care, Immunization, Blood Transfusion, Dialysis services should not be hampered. Earmarking and public awareness of facilities and timings should be given wide propagation and it should be ensured that these services should not suffer. Equity should be maintained at all times particularly for the vulnerable of the society. The challenges of the crisis should be encountered through scientific evidence available.

World Health Organization (WHO) Rolling updates

Mapping Mumbai's slum challenge in coronavirus battle

MoHFW Laboratory testing advisory

ICMR guidelines private laboratory

We thank all the staff working in the all agencies and government institutions above for their wholehearted support.

The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest( such as honoraria: educational grants; participation in speakers bureaus; membership; employment, consultancies, stock ownership or other equity interest; and expert testimony or patient-licensing arrangements) or non-financial interest ( such as personal or professional relationships, affiliations knowledge or beliefs) in the subject matter or materials discussed in this manuscript The authors whose names are listed immediately below report affiliations or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript. None J o u r n a l P r e -p r o o f