Why does Pune lead all-India cases? Top govt official breaks it down

Over 40 per cent of Punekars are now suspected to have COVID19 antibodies Considering the substantial number senior advisor to Deputy Chief Minister and Punersquos Guardian Minister Ajit Pawar Dr Subhash Salunkhe feels one can expect herd immunity to set in soon Dr Salunkhe also heads the Maharashtra Communicable Diseases Prevention Control Technical Committee and is the chairman of the COVID19 taskforce in Pune Excerpts from an interviewWhy does Pune with just 40 lakh people account for the highest number of COVID cases in IndiaPune has a unique geographical and socioeconomic background due to two interconnected municipal corporations Pune and PimpriChinchwad and three rural talukas There are congested localities slum pockets where strict lockdown initially played wonders but people failed to maintain social distancing and follow other rules when it was liftedWhere did things go wrong for Pune Was it lapses in the systemI wonrsquot say lapses but there were gaps because this disease is new It has confused a lot of authorities both medical administrative and political so nobody can be blamed Perceptions will change as it is a dynamic situation Yes you can do postmortems and have a retrospective discussion but that doesnrsquot mean the earlier decisions were wrong I feel instead of analysing lapses now we should first ensure that people donrsquot die and the outbreak is controlledAs a communicable diseases expert what is your role right nowAs the chief technical coordinator and advisor to the deputy CM my role is to try and bridge the gap between the administration people and the NGOs The taskforce under my chairmanship has to ensure communication and public health strategies and take advantage of expertise in private healthcare The primary task is qualitative enhancement on the technical side Areawise I am focussing on Pune urban Pune district and Pune division with five districtsDr Subhash Salunkhe chairman of the COVID19 taskforce in PuneIs Pune heading towards herd immunityYes definitelySome people have doubts What is your viewI know there are doubts This is why the definition we are looking at for herd immunity can be debated But one thing is obvious mdash take areas like Rasta pet Bhawani pet that had a huge number of cases for example and the sero survey that indicated nearly 40 per cent people had antibodies Putting these statistics together we believe herd immunity plays a role as very few cases are coming up Though nobody can say with guarantee that it is herd immunityWhen do you anticipate it will completely set in in PuneWe are witnessing a drop in the number of cases from the otherwise affected areas of Pune Though no one can be 100 per cent certain May be by Novemberend things will start moving in that direction unless there is some change in the virusIs Pune witnessing community spread Stage 3 of the pandemicYes Pune definitely has community spreadDo you foresee a second wave of COVID19I think in Pune the situation will be minimal because by that time a large number of Puenkarrsquos will have the antibodies Unless the virus changes its antigenicity I donrsquot think Pune will have a second wave that might impact a large number of Puenkars againAre asymptomatic patients quarantined at homeNo at this stage we are not encouraging asymptomatic patients to home quarantinePune is one of the worsthit cities amid the COVID19 pandemic PicAtul KambleDo symptomatic patients have sufficient ICU and hospital beds with oxygenWe are anticipating a shortage for both oxygenated and ICU beds Preparatory steps are being taken by the administration By midOctober we will have to add another 250 incubated beds with ventilators and around 400 beds with oxygen support the administration is on the job By October 15 this additional setup will be functionalBut with a shortage of manpower do you think you will be able to handle the additional setupIt is a matter of concern Manpower shortage is a major problem at both government and private hospitals We are trying to find alternative strategies to recruit more healthcare providers by roping in those who are not directly dealing with COVID19 patients We are also trying to get home nurses who have just appeared for their examinations Also NEET exams just finished So we are considering how to use those studentsDo you think you would have been in a better situation to handle the COVID19 pandemic had you taken charge earlier when the pandemic started you were roped in later when the situation started going out of handNo actually my involvement is there for last three to four months but it was primarily in an advisory capacity but now in addition to advisory capacity I also have authority to not only recommend but ensure and monitor that feedbacks are given to me which can be passed on deputy CM there is a kind of administrative team and authority that has been given to me now I agree had it been a little earlier I would have done a better job but I do not want to bother about it Now that I am supposed to the job I will put all my focus to help the administration and people at largeWhat is the percentage of patients recovered with COVID19 Have you started postCOVID OPD for screening patients with postCOVID complications in civic and government hospitalsThe recovery of COVID19 patients is around 78 to 80 per cent in Pune The Post COVID OPD concept has already started but we are encouraging government hospitals including Sassoon hospital to widen the postCOVID OPD screening Also we are indulging private hospitals for screening post COVID complication cases without calling it a postCOVID OPD but they are screening follow up casesrdquoPresently out of all COVID19 positive cases how many are symptomatic and asymptomaticI do not have an exact figure it is already on the public domain on the Pune Municipal Corporation web site Pune on September 24 registered 1572 new cases taking the total tally to 147634 cases while 26 deaths took the death toll to 3355Are you also intending to rope in retired governmentcivic doctorsGeneral Practitioners to assist the administration to fight the pandemicWe are encouraging them to work at their own setups and also trying to find out with their qualifications if they are available to render their service we are looking at that front tooDo you also have age barrier for front line health care service providersYes we do not want to recruit anyone beyond 55 years of age for COVID duties but they can be very well used for telemedicine services for nonCOVID duty purposes so that is being attemptedAre you making data bank of all COVID cases symptomatic and asymptomatic and are you forwarding such data collected to the state and central government for future reference And is the data referred by doctors for telemedicineBoth the municipal corporation Pimpri Chinchwad Municipal Commissioner Pune Municipal Commissioner and the district administration have these data and the same is shared with the government The doctors on telemedicine duty do make use of the data collected for such servicesHas Pune witnessed relapse of COVID19 in patients who were treated for COVID19 tested negative while discharged but were again tested positive a few weeks laterYes there are such cases but the number is quite limited And these are quite natural such relapse can happen and this is because if the body produces antigens for a particular strand of virus they do not work as mutant against the same virus which is seen in case of SARSCoV2 and therefore while patients recovered with COVID19 may develop immunity for a particular virus but it may not against a mutant version of the same virus and they can get infected againHave you seen any trend in cases of COVID19 positive patients in Pune impacting multiorgan other than respiratory or lung involvementAs a matter of fact there are a lot of cases now coming with cardiovascular involvement nephrological impact is seen in kidneys and neurological impact in brains etc primarily lungs and respiratory tract were getting affected in COVID19 patients but the extend of disease adversely affect either heart kidney or even brain making the case not only severe but also complicated with multiorgan involvement and some cured patients therefore may need a longterm follow up medical careIs it people with comorid issues having such multiorgan risk due to COVID What is the age group of patients with such an issueMore than 50 per cent of the patients having multiorgan issues are those with comorbid conditions like diabetes hypertension etc but we are seeing a trend of youngsters having uncontrolled diabetes and hypertension having similar issuesTo explain the steep surge in COVID cases in Pune was there something specific that went wrongWhat went wrong is that people did not follow the social distancing norms as soon the lockdown was lifted the mobility was absolutely intense and this was also added with Ganpati festival and we are now worried about the coming festival season of Navratri and Diwali Now the focus is how to make people aware about the danger and we expect them to have an introspection of the situation and we want them to take a call from within rather than enforcing social distancing and wearing masking compulsory than using legal recourse We will soon be starting a campaign where there will be ownership from Punekar wherein they will take responsibility for their own action which will be in line with Maharashtra Government Campaign lsquoMaze Kutumb Maze Jababdarirsquo My family My responsibility lsquoMe Punekar Maji Jabadarirsquo I am Punekar I am responsible a campaign which will begin from October 2The Baramati pattern or say the Dharavi model are believed to be a success and if that is so why these patterns were not tried in PuneBaramati and Dharavi models are workable within the limited geographical areas and with very intense public cooperation Pune in comparison is much larger and we feel that the compliance of the public health norms is not workable in such largescale areas But having said so this has worked out in areas like Bhavani Pet and Rasta Pet and the number of cases has come down drastically low from these pockets after adopting the DharavBaramati model Earlier we would get 150 plus cases a day from these places which has now drastically come down to 7 to 8 cases We are now trying to adopt these models DharaviBaramati in other congested areas of Pune and in noncongested middleclass areas the strategy will be differentIs it true that PMC is not having manpower to run the Jumbo CCC a setup constructed near Engineering College Pune spending a whopping Rs 200 crore So why was it constructed without thinking on the manpower issueIt was definitely a problem now private players have been roped in and they are now taking care of the Jumbo CCC we have outsourced the entire Jumbo hospital set up to private players Just last week the State Health Minister and I was also there we have reviewed the situation and things are improving as compared to what it was three weeks ago the number of nurses required have been recruited for the 400 bed and now they will be escalating the beds to 800 Initially the problems were there but now it is being resolvedKnowing the high mortality rates in Pune whether arrangement for quick cremation or burial have been put in place The former mayor who died of COVID19 his body was taken four cremation ground but could not get spaceYes that point has been addressed two days back when we had a discussion with the Pune Municipal Commissioner Kunal Kumar and this is a priority action task and minimum delay is to be expectedIn Pune are COVID19 bodies wrapped in polythene sheets laced with Sodium hypochlorite Experts say it might be an environmental hazardI think it is being done But the municipal authority will be a better agency to comment on thisInvolvement of Private Hospital in COVID management Is it as aggressive as seen in Mumbai and MMR areas wherein private hospitals as well as private medical colleges are shouldering a significant portion of the responsibilityYes we are getting similar cooperation from private hospitals Just a few days ago deputy CM Pawar who is also the guardian minister for Pune spoke to all private hospital representatives appreciated their efforts but also informed them to enhance the availability of beds in these hospitals also substantiallyStaggering of working days of the working population on alternate days as seen in Bengaluru are you intending to do something similar in PuneNo I think it is an administrative and political decisionAre you planning for a complete temporary lockdown in Pune to control spreadOn last Friday this issue was discussed by the hon Deputy Chief Minister who is also the guardian minister of the district he has asked the administration both municipal commissioner PCMC and PMC mayors important leaders MLArsquos and MPrsquos from Pune and the matter is being still discussed at that level which will depend mostly on the ground level situation in coming daysKeep scrolling to read more newsCatch up on all the latest Mumbai news crime news current affairs and a complete guide from food to things to do and events across Mumbai Also download the new midday Android and iOS apps to get latest updates MidDay is now on Telegram Click here to join our channel middayinfomedialtd and stay updated with the latest news