On Wednesday, the death of a 56-year-old man from
Covid-19, pushed an already-stretched administration into red alert.
The man, a garment seller, who had tested positive earlier in the day was a resident of Dharavi. The slum spread over 2.2 kilometres has a population of about eight lakh and is one of the most densely-populated areas in the world. A community spread in Dharavi, they knew, would be lethal to Mumbai’s fight against coronavirus.
A team of five: medical officer (MO) Dr Tejaswi Kakade, assistant medical officer (AMO) Dr Nazish Shaikh, a sanitary inspector (SI) and two community health volunteers (CHVs) armed with just a notebook, a pen, a set of questions, and a stoic dedication, became the frontline warriors in stemming any possible spread. This team reached the man’s house in one of the congested by lanes off the 60-feet road, on Wednesday evening and began taking down details of his travel history and his family.
The big question in their mind was whether the man had attended the Tablighi Jamaat markaz in Delhi. They were told that he had not left Mumbai, but a few men from a jamaat — it was unclear which one — had visited him some days ago. In fact, the family added, the man had also allowed these visitors to stay in a flat which he owned in the neighbourhood, and which had been lying vacant.
The BMC team alerted the police and categorized the man’s family as high-risk and instructed that they be quarantined. Their neighbours were classified as high-risk while a list of the family’s acquaintances was readied and all the people on that list were categorized as low risk and alerted.
One of the health officials revealed that they usually ask the patient to recall their activities of the last two weeks in minute detail as also their mode of travel. “In this case however, with the man already dead, we had poor quality information. All we knew was that the man did not have a passport, so there was no foreign travel history. What we do know is that he had been feeling poorly since March 23 and had visited a local doctor and then some days later, when he still did not feel well, he went to Sion Hospital,” said Kiran Dighavkar, Assistant Municipal Commissioner (AMC), G-North Ward.
With time being crucial, the BMC team fanned out in the area to inspect the building, to talk to the neighbours and all the places the deceased had been to in the last two weeks. The team also inspected the common spaces between closely constructed squad of five buildings. With the help of the man’s children the team began to literally retrace his steps.
“The team then reached the local doctor whom the man had gone to see first. This work went on until 11.30 pm,” said Dr Virendra Mohite, the medical officer who heads the six coronavirus health teams in the ward.
“As the man had died the same day, the family was anyway traumatized, and we had to be mindful of that. Slowly they grew tired and their answers became slower and slower. They could not help us with any jamaat contacts, and only said that he went to the masjid to pray regularly. As we were pressed for time, we left their house and began tracing all the contacts we had got,” said Mohite.
Based on the family’s answers, the BMC created a list of 15 immediate high-risk contacts. These included the deceased’s wife, his four sons, two daughters, immediate neighbours, the local doctor the man had visited and two of the staff at the doctor’s clinic. The doctor revealed that he had referred the man to the Sion Hospital OPD, which has since Thursday been shifted outdoors while the BMC sanitizes the building. All the high-risk contacts have been tested and their samples have been sent to Kasturba Hospital. In addition, the BMC has made a master-list of the entire colony.
There are 300 flats in the Slum Rehabilitation Authority (SRA) scheme where the man lived. The scheme also has 91 shops. The man owned one of these shops from where he ran his garment business. The area is called Dr Baliga Nagar and has eight buildings in all. Each flat admeasures 320 sq ft and has a toilet/bathroom unlike in other parts of Dharavi which has to make do with community toilets.
A team of its pest control officers (PCO) was pressed in service to disinfected the entire building and about 2,500 residents of Dr Baliga Nagar were stamped for quarantine and a team of police has been stationed outside the colony to ensure the quarantine is not violated. From the master-list, the BMC team then made a list of all those who were above 60 and who had co-morbidities like hypertension, asthma and diabetes.
“In the first round we picked those who were above 60 and also suffered from some respiratory disease. We got 36 such contacts. Among them nine are particularly vulnerable so on Thursday, we have sent their throat swab samples for testing too. If we get more positive reports then we will send all the 125 senior citizens samples for testing. We will then move all these people, the senior citizens and those with underlying health conditions, to the District Sports Complex for isolation,” said Dighavkar.
Even as the area is put on the containment list, the BMC deployed a junior engineer at the site as its containment officer (CO). He will coordinate with the police, the BMC and the residents to ensure the residents get essential supplies like food, milk, water and medicine every day. In addition, a rota of certain residents — six volunteers — has been created who are the only ones who can step out for essentials.
Even while this contact tracing was going on, the BMC, in parallel, set about creating a 300- bed facility at the sports complex which is just 300 meters from the contained enclave. In case the high-risk contacts test positive, then then all of them, including the senior citizens and those with underlying health conditions, will be moved out there for isolation.
“The District Sports Club has given the club premises to help the community and quarantine suspected Covid-19 patients in view of the rising number of suspected cases in surrounding areas of Dharavi and BKC. We hope the use of the facility for quarantining will make the jobs of our healthcare and frontline workers slightly easier,” said Suraj Samat, committee member of the District Sports Club.
A BMC response team is now visiting the mosques in the area. “We are trying to find out who the four men who visited the deceased were. They are the next challenge for us. The family has told us that they were not from the Tablighi Jamaat but we can’t be sure until we reach them. The family will go through the man’s phone and give us all his contacts. In this the police too are helping us out,” added Dighavkar.
A WhatsApp group called ‘Corona Task Force G-North’ is the constant link between the BMC, police and Fire Brigade officials. In all a team of 300 men and women is part of the Contain Dharavi operation. This includes labourers, BMC officials, engineers, doctors and the police. The BMC has sealed buildings from number 2 to 8 including shops on the ground floors. “However, it’s a challenging task to control things in Dharavi which is full of narrow lanes, congested localities and very small houses,” said Raju Korde of the Dharavi Development Committee.
At the time of going to press, 24 hours had passed since the man in Dharavi died, and there had been no new case reported from Asia’s largest slum.
BMC sweeper tests positive
A 52-year-old man who works as a sweeper with the BMC has tested positive for coronavirus. He has no international travel history, but is a resident of Jijamata Nagar in Worli and his work area was Dharavi. Both areas have reported COVID-19 related deaths recently.
The patient has been admitted to SevenHills hospital in Andheri and is undergoing treatment. About 23 of his family and friends have also been quarantined.
A senior civic official told Mirror that he had had no contact with the 56-year-old who had succumbed to the disease in Dharavi. “We have asked all the sweepers who came in contact with him to go into quarantine. We will send their samples for testing based on symptoms,” the official added.