Unlock complacency, contact-tracing fatigue — more than one reason for Bengaluru’s spiral

While Chennai, Mumbai, and Delhi are showing signs of slowing infection, the reverse is true for Bengaluru, which, until last month, was leading the big-city performance charts.

A deserted thoroughfare in Bengaluru amid fresh lockdown restrictions imposed last week | ANI

Bengaluru: Karnataka capital Bengaluru has seen a 600 per cent increase in the number of Covid-19 cases between May and July, a period that has seen the IT hub go from a shining example of efficient pandemic control to a situation where it seems to be losing the plot. 

While cities like Chennai, Mumbai, and Delhi are showing signs of slowing infection, the reverse is true for Bengaluru, which, until last month, was leading the big-city performance charts with its low caseload. 

As of 30 June, the Covid War Room of the Bruhat Bengaluru Mahanagara Palike (BBMP), the city’s civic agency, had recorded 4,904 cases. This number stood at 31,777 cases on 19 July.

The city accounts for nearly 50 per cent of all Covid-19 cases in Karnataka, which has 30 districts  — while Karnataka had a total of 63,772 cases as on 19 July, Bengaluru’s tally was 31,777. 

The positivity rate, or the number of people testing positive as a proportion of the tests conducted, has increased to 14.43 per cent from 1.17 per cent in May. There has been an average increase of 12.9 per cent in daily cases since 1 July, and 8.9 per cent with respect to deaths. 

Of the 1,331 deaths recorded in Karnataka until Monday, 667 were in Bengaluru. 

Experts say there’s no one reason for Bengaluru’s spiralling situation, listing the primary factors as mismanagement by the authorities and a complacency among residents with regard to Covid-19 prevention guidelines. The Karnataka government, meanwhile, insists that the situation in Bengaluru is under control, even as it points a finger of blame at arrivals from other states.

Many factors at play

After having enforced lockdowns in a stricter manner than the rest of the country, Bengaluru, say experts, went back to pre-lockdown ways as soon as Unlock entered full force on 8 June.

“The disease spread is because people don’t follow the rules of social distancing and wearing masks. People should adhere to guidelines,” said Dr S. Sachchidanand, Vice-Chancellor of the Bengaluru-based Rajiv Gandhi University of Health Sciences who is also the head of the Covid-19 clinical experts committee, set up by the state government to help combat the pandemic.

“Unlocking was essential, but the present lockdown is to break the chain. We are yet to see what effect it has,” he added, referring to the seven-day lockdown imposed in Bengaluru from the evening of 14 July.   

Citizens, he said, should be more responsible in ensuring the standard guidelines of SMS (social distancing, masking and santisation). 

Prof. Vijaya Satchidanandam of the Indian Institute of Science, Bengaluru, says the state administration has been “incompetent and the situation mismanaged”. 

“If you have a policy that asymptomatic people will occupy all your beds, how can you expect to provide enough for those who need them?” he said, referring to the government’s policy of hospitalising even asymptomatic patients. The policy was tweaked last week, with the government advising hospitals to only admit moderately to severely ill patients. 

Epidemiologist Giridhar Babu said it was not so much mismanagement as a lack of manpower.

“The BBMP has been using manpower to identify people, they are also being used to transport patients to hospitals instead of just contact-tracing and ramping up testing, they are involved in multiple roles,” he added. 

“The unique feature of all urban centres is that unless you strengthen human resources at primary health centres, it will continue to be difficult,” Babu added. 

Dr C.N. Manjunath, member of the state government’s Covid-19 task force and director of the Sri Jayadeva Institute of Cardiovascular Sciences and Research, said the surge could also be attributed to cramped living conditions in slum-like areas.

“They share common facilities and the spread is much higher in these places. There are pockets in Bengaluru that have gone into community transmission… These places where the population density is very high,” he added.

“Nature is ahead of technology. It took six months in other countries. We are now in the fourth month. This may be the beginning of the peak,” he said. 

Other experts and epidemiologists working closely with the Karnataka government also attributed the spurt to the backlog of tests that has built up because of the shutting down of two major test laboratories — Bangalore Medical College and Research Institute and National Institute of Mental Health and Neuro-Sciences — after infections emerged on their premises. The two labs together handled close to 2,000 cases a day.

Govt defends its handling

Karnataka Medical Education Minister Dr K. Sudhakar said the situation had not gone out of control in either Bengaluru or Karnataka. 

“You cannot say we have lost the plot. We are bang on target and following all the precautionary measures and guidelines set by the WHO,” he told ThePrint. “We have stuck to our 5T (Tracking, Tracing, Testing, Treatment and Teamwork) principles. We need 14 days to break the chain in Bengaluru,” he said.

According to Sudhakar, the rise in the number of cases could be attributed to the “influx of people from hotspot neighbouring states such as Maharashtra, Tamil Nadu after Unlock”. 

“We did not have a staggered approach for their coming in or closure of the borders. They would have infected at least their primary contacts. We cannot expect the same numbers we saw in March or April in July,” he said. 

When asked specifically about the increase from 4,000 to 25,000 in the first two weeks of July, the minister accepted that there has been some amount of fatigue among the contact-tracing staff, which he said has caused a lag. 

Karnataka is aiming at bringing its mortality rate below 1 per cent, he said, adding that the government has been effective in early detection and treatment. 

The mortality rate of Bengaluru was 2.1 per cent on 20 June, and Karnataka’s was 2.08 per cent.

Sudhakar said a new government strategy — to appoint a minister and a senior IAS officer for the eight different zones in Bengaluru — will help in containing the pandemic. 

“We are now focusing on strengthening local management to contain the spread of the virus. Electoral booths will be the basic structural and functional units. We have set up 8,154 booth-level task force committees in Bengaluru,” he added. 

“Every booth-level task force will cover 300-400 households or 1,000-1,500 population and conduct door-to-door surveys to identify vulnerable people, including senior citizens, people with comorbidities, influenza-like illness (ILI) and severe acute respiratory infection (SARI).”