Why Bengaluru with a population of 1.2 crore has just 385 COVID-19 cases

According to experts and officials in the government, the measures taken in Bengaluru – tracing, tracking, testing and treating – were similar to other cities. The difference was in implementation.
Why Bengaluru with a population of 1.2 crore has just 385 COVID-19 cases
Why Bengaluru with a population of 1.2 crore has just 385 COVID-19 cases
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For a population of approximately 1.2 crore, Bengaluru city has had just 385 reported cases of COVID-19 infections as of June 1, way less than what cities like Chennai and Mumbai report in a single day. 

In comparison, Chennai has 15,770 cases, Mumbai has 40,877 cases, and New Delhi has 20,834 cases as of June 1. Out of Bengaluru's 385 cases, 237 have recovered, and only 136 people are under treatment for the virus. 

How did Bengaluru swing this miracle? Was it sheer luck, or is there a successful ‘Bengaluru model’ that worked?

According to experts and officials in the government, the measures taken in Bengaluru – tracing, tracking, testing and treating – were similar to other cities. The difference was in implementation. 

Where Sarkar Trusts Experts 

The first smart call taken by the Karnataka government was allowing experts to run the show without political interference. The bureaucracy did not question or ignore the medical experts advising them. 

Dr Giridhar Babu, who is part of the ICMR's research task force on Epidemiology and Surveillance, and a part of Karnataka state's Technical Advisory Committee, told The Quint that the independence given to the technical committee in Karnataka, is something other states should replicate.

“In Karnataka,the driving force (against COVID) was the health department. We never had an instance where they turned down our suggestions. Even if an idea was counter-intuitive, after deliberations, they implemented it. The trust placed in the experts was astonishing.”
Dr Giridhar Babu 

(Here is comparison of state wide COVID-19 test per million population, and comparison with nationwide testing figure. (Source: Department of Health, Karnataka government)

Effective Contract Tracing

Bengaluru reported its first COVID-19 case on 8 March. In the days that followed, Karnataka's health department along with the Bruhat Bengaluru Mahanagara Palike (BBMP) prepared a list of 2,666 people who had come in touch with the 40-year-old techie who had arrived from the US. For over a month, these primary and secondary contacts were sent into home quarantine and were monitored for symptoms.

(Image credit: PTI)

While the number of primary and secondary contacts for the cases that followed were not as high as the first case, the Health Department conducted detailed investigations in each case. "In some of the earlier cases, we traced contacts as far back as one month," said an official at the COVID-19 war-room.

Over 90 percent of COVID-19 cases in Karnataka are asymptomatic, and credit for identifying them goes to competent contact tracing.

(Source: Department of health, Karnataka government)

As of June 1, out of 3,408 cases in Karnataka, the origin of 2,132 have been traced to domestic travel. The source of infection for 879 have been tracked as contacts of COVID-19 patients. Only for 267 cases, the contract tracing is either underway, or the contact information is not available.

Apart from contact tracing, testing the right people helped the state keep a check on the spread. On 15 April, Karnataka had decided to test all persons suffering from influenza and Severe Acute Respiratory Illness (SARI). To help identify cases, the health department asked all medical stores to take the details of those buying medicines for these specific ailments.

Apart from this, a massive door to door survey is underway across the state. So far, the survey has covered 72 percent of the state’s households.

Technology, Naturally

Close to 2 lakh personnel from various government departments form the core team undertaking contact tracing. A similar number of staff are on standby in case the numbers go up.

Since multiple districts were involved in the process of contact tracing, bureaucratic processes had led to delays initially. “Earlier, if a primary contact was in one of the districts, we had to send a report to the district collector to track it. This information was then sent to the tracking staff on the ground. This was time-consuming,” said a war room official.

To resolve the matter, the state launched an app. Whenever a new case is reported, and the patient shares contact details, the details are fed into this app. “Now, since the information is available on the cloud, respective officials are alerted directly and sooner for tracking. This app cuts down all the bureaucratic processes and delays,” he added.

Getting 'Containment Zones' Right

The inability to control clusters like Dharavi in Mumbai, Koyambedu market in Chennai and the Tablighi Jamaat conference in Delhi, led to these respective city administrations losing control over COVID-19. But Bengaluru was able to control its containment zones more efficiently.

One of the first clusters in Karnataka was a pharmaceutical company in Mysuru, which produced 74 cases. The entire district was under one of the strictest lockdowns, and within 56 days the whole district was declared COVID-19 free.

In Bengaluru, the BBMP takes pride for (arguably) introducing the concept of completely sealing off an area. Padarayanapura, a crowded locality in west Bengaluru, was identified as a high-risk area. On April 10, BBMP physically sealed off the area, and only health workers were allowed to enter.

(An entry point to Padarayanapura during lockdown.)

The decision paid off as the Padarayanapura reported 23.6 percent of total COVID-19 cases in Bengaluru, as of May 22. “It was a big task providing daily rations to each household and conducting the screening. But we did it and ensured no one from the area got out,” said a senior police officer.

In the last week of May, BBMP conducted around 400 random swab tests in Padarayanapura. All the results were negative.

Apart from effectively sealing off containment zones, Bengaluru had one of the most strictly implemented lockdowns. “The police had closed around 50 percent of the main roads in Bengaluru to discourage traffic. Checkposts were set up across the city, which was effective in reducing people's movement,” said Bhaskar Rao, Bengaluru police commissioner.

What Next After Unlock 1.0?

Dr Babu, who is part of Karnataka government's technical committee, says reopening the lockdown is inevitable and strong surveillance is the way forward. He suggests that three steps would help sustain the low prevalence of coronavirus in Karnataka, especially in Bengaluru.

Step 1: Expanding the symptoms

“We need to expand the definition of COVID symptoms. We need to include loss of smell, loss of taste, weakness, muscle pain etc. If anyone has two of these or existing symptoms, we should home isolate them.”

Step 2: Prevent cluster formations

“We need to ensure there are no cluster formations. Nearly 80 percent of the cases across the world are caused by 20 percent of people, in clusters. So, all large gatherings like marriages, conferences, working in closed places, etc, should be avoided over the next few months.”

Step 3: Identifying super spreaders

“Third step is to identify the super spreaders quickly. If we can successfully home isolate the most symptomatic, we can contain the super spreaders. A strong surveillance strategy would play a key role in this.”

This story was originally published on The Quint and has been republished with permission. Read the original here.

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