With the monsoon just a month away, the Brihanmumbai Municipal Corporation (BMC), already stretched to the limit in the fight against the coronavirus, is staring at the prospect of dealing with a raging pandemic during the rainy months, when Mumbai is prone to flooding, waterlogging and a surge in other diseases such as dengue, malaria and leptospirosis.
While guesswork has driven theories about the impact of weather on the novel coronavirus, and has mostly proved wrong, doctors say the intersection of monsoon with Covid-19 in Mumbai will at the least make it harder to enforce social-distancing norms and carry out contact-tracing in flooded low-lying areas.
Civic officials, however, say the shortage of manpower is its biggest worry. While absenteeism among staff has been higher in the last few weeks over fear of contracting the virus, all available hands have been pressed into Covid-related duties.
Health workers, who would be otherwise deployed for immunisation and population survey before and during the rains, are deployed in the fight against COVID-19.
Medical officer Dr Jeetendra Jadhav worries the challenges will be manifold this monsoon in Kurla, 80 per cent of which comprises slums. The low-lying area witnesses floods every year. “We are so occupied with Covid-19, we have had no time to think about the monsoons. It is already difficult to ensure people remain at home. A few days ago, we had to deploy staff there just to ask people to go home. During the monsoon it will only get harder to ensure social distancing,” Jadhav said.
Increasing quarantine facilities by focussing on high-risk slums where people will not be able to socially distance themselves as their homes flood should be the way forward, he added. Across Mumbai, quarantine beds are set to be increased by 142 per cent – from 14,000 to 34,000 – for isolating suspected high-risk cases.
Fever clinics, currently checking suspected Covid-19 cases, may also have to double up for screening dengue, malaria and leptospirosis patients, Jadhav said. “We are yet to sit and chalk out a plan. We will prioritise, tackle one problem at a time,” he added.
Usually, 10 per cent or an entire ward is reserved in every municipal hospital for monsoon-related illnesses. This year, however, civic hospitals have diverted their resources towards Covid-19.
KEM hospital dean, Dr Hemant Deshmukh, said, “We will start reserving beds for monsoon diseases in June, when the rain starts.” The 1,800-bed KEM facility has currently reserved 340 beds for Covid-19 patients. By June, the other wards that are currently shut will be opened up to admit dengue and malaria patients.
Doctors are also worried about how coronavirus will interact with monsoon-related ailments, including gastroenteritis and typhoid. “We don’t know what symptoms a patient may come with if they are co-infected with dengue and Covid-19,” Deshmukh said.
Meanwhile, preoccupation with Covid-19 has affected essential pre-monsoon civil works. BMC has, so far, cleaned 15 per cent nullahs across the city, crucial to preventing flooding, while its insecticide department Thursday began pre-monsoon work against vector-borne dengue and malaria and bacterial infection leptospirosis, after a delay of two months.
Every year, BMC has to remove 5.38 lakh tonne silt from major and minor nullahs before May 30 — the official deadline to finish pre-monsoon works. However, this year, it is nowhere close to the deadline. According to civic officials, desilting has to be undertaken on 715-km network of nullahs, besides the 21-km-long Mithi river, known for wreaking havoc during monsoon, especially along the central and western railway lines. BMC officials said a 7-km stretch of the river had been desilted so far.
It has hired contractors for this year’s nullah cleaning work at the cost of Rs 140 crore. The flooding spots — at least 65 identified last year — were also to be mitigated before the rains, but have remained untouched. Ongoing infrastructure projects, such as Metro and roadworks, every year create newer flooding spots during the rains.
“The situation is bad as there are hardly any workers to speed up desilting. Although the cleaning of major nullahs has started, minor ones are yet to be touched. Apart from a labour shortage, the department’s officers, too, are not available in full strength. Some of them are stuck at their native places, a few others are scared to visit the sites amid Covid-19 outbreak,” an engineer with stormwater department (SWD) said. Last year by May 4, the BMC had completed about 40 per cent nullah cleaning across the city.
With nullah cleaning progressing slowly, Leader of Opposition in BMC Ravi Raja, expressed apprehension of increased flooding in Mumbai. “At many places, main nullahs adjoining main roads have been cleaned, but the smaller ones that carry rainwater to major nullahs, have not been cleaned. Moreover, BMC has brought a new proposal to install de-watering pumps at 291 locations. It means, BMC is anticipating flooding spots will increase,” he said. The Rs 70-crore proposal for installing 291 pumps will be tabled before its Standing Committee meeting Friday. The city has 470 km minor nullah network.
In areas like Sion, Matunga, Parel, Hindmata, Bandra, Santacruz, Andheri subway, Chembur, Kurla and Malad, which face intense waterlogging every year, the delay in nullah desilting has become a major cause of concern. Last year, heavy rain and flooding in Mithi river had submerged rail tracks near Sion, Kurla and Mahim, leading to a disruption in train services.
Assistant Municipal Commissioner of L-ward (Kurla, Sakinaka), Manish Valunje said there should be a protocol to handle monsoon-related diseases before they strike the city. “Since we are aware of the fact that there are chances of an outbreak of monsoon-related diseases, we have to chalk out a plan to deal with this situation. Labour shortage and fear among workers are huge issues and have affected cleaning work,” he said, adding the ward, where 70 per cent of the population lives in densely populated slums, is also a Covid-19 hotspot. More than 850 positive cases have been reported from Kurla alone.
The M-east ward (Govandi, Mankhurd), another Covid-19 hotspot with over 650 cases, also has a huge slum population. An official from the M-east ward said water-borne diseases are common in the areas and monsoon only worsens it. “If these small nullahs are not cleaned, the area will witness severe waterlogging in monsoon and will bring other ailments,” Rukhsana Siddiqui, Samajwadi Party corporator from Govandi, said. Cleaning of several nullahs near Baiganwadi in Mankhurd is also yet to start.
The insecticide department, which commences its pre-monsoon activities in March, has been working since last two months in three shifts to disinfect government offices, residential areas, police stations and hospitals where Covid-19 positive cases have been diagnosed. From Thursday, the department has begun work in high-risk pockets of dengue, leptospirosis and malaria as part of pre-monsoon work. It has been tasked to finish the work by June 10.
Every year the department inspects 7,201 government buildings to check 28,021 water tanks and other possible mosquito-breeding sites from January and a ‘mosquito abetment committee’ meets in March with various government bodies to clean these tanks. That meeting was cancelled this year because of the Covid-19 outbreak on March 11. “We will now send letters to government bodies to clear scrap, cover tanks to prevent mosquito breeding,” said Dr Rajan Naringrekar, head of the insecticide department.
Insecticide officers will also visit slums to put poison in burrows to kill rats, whose urine is said to be a common carrier of leptospirosis. Areas that recorded a high number of dengue cases will be visited to inspect and destroy mosquito-breeding sites. Construction sites will also be sprayed with ‘indoor resident spray’. “Dengue, malaria and leptospirosis are three diseases that peak during monsoons. Starting Thursday, we will focus on high-risk areas so that by the time rains start preventive measures are in place,” Naringrekar added.
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