COVID-19: Maharashtra’s High Numbers are not just Due to a Faltering Government

On Tuesday, June 16, the Maharashtra government courted controversy after its COVID-19 'data reconciliation' exercise showed an additional 1,328 deaths, of which 862 were from Mumbai alone. The case fatality rate in the state shot up to 4.88%; it was 3.73% on Monday. The total number of deaths in the state rose to 5,537 deaths as well, as did Mumbai’s fatality rate, which went up to 5.26% with 3,165 deaths in the state capital as of Tuesday. The state also had a total of 1,13,445 COVID-19 cases with the number of active patients at 50,044. 

The total number of COVID-19 patients in India are 3,54,065, with 11,903 deaths due to the disease so far. Out of the total, 32% of the cases are from one state – Maharashtra. Of that total, 53% of the cases in the state are from Mumbai. The numbers paint a grave picture and raise questions about how the state has handled the pandemic. There are multiple reasons why the situation went out of hand: 

Failure at Airports

The first patient in the state was found in Pune on March 9. The very next day, two more patients were found in Mumbai. The three had travelled to Dubai as tourists and were part of a group. Out of the group, which comprised 46 people, ten tested positive for COVID-19.  

It should have provided the state government with enough reasons to enforce strict scanning and quarantine measures for passengers who arrived at the Chhatrapati Shivaji International Airport from other countries. While the first COVID-19 case in India was found on January 30 in Kerala's Thissur, the Centre’s guidelines, issued on January 18, did not allow the screening of passengers from the US or the UAE. 

On March 17, Rajesh Tope, Maharashtra’s Minister of Public Health and Family Welfare, said in a press conference that 16 out of 40 patients in the state had travelled to Dubai. In his address to the state on April 14, Chief Minister Uddhav Thackeray said that despite his government’s request, the Centre did not issue strict guidelines for international passengers, saying that it possibly resulted in the spread of the novel coronavirus in the state. 

There were daily flights from Dubai to Mumbai until the lockdown was put in place. “It should have been avoided in the first place. We need to understand that Dubai is the world's busiest transit airport after Frankfurt. There is a huge amount of daily traffic between Mumbai and Dubai. We could have stopped many possible carriers of the virus had the guidelines for UAE been in place," said a senior IAS officer of the Maharashtra government, who is part of the state’s COVID-19 task force.  

The BMC’s Initial Passive Response

Initially, it wasn’t just the Centre which had its eye off the ball; Asia’s richest municipality, the Brihanmumbai Municipal Corporation (BMC), was late with its response as well. 

Senior Journalist Pandurang Mhaske, who has covered the BMC for 15 years, said that while the body had implemented contact tracing since the beginning, “it was testing only three persons at that time.” Mhaske said that while the number was increased to seven later, the initial policy was “completely wrong”. 

The BMC's healthcare system also showed its cracks by April. PPE and testing kits were in short supply initially, and as the number of patients mounted, the lack of oxygen in some hospitals has become an issue. The opposition alleged that two dozen patients at the BMC hospital in Jogeshwari died due to the lack of oxygen. Doctors in facilities like KEM Hospital and Nair Hospital were initially seen struggling due to the lack of PPE kits. 

A highly-placed source in BMC's Health Department told NewsClick that the department “was constantly getting contradictory guidelines from the state's health department initially. There was confusion on a number of things, including regarding treatment.” The official said that the department’s Arogya Sevika and other foot soldiers were “directionless” in the beginning. “For example, they initially used to sanitise the area where the patient was found, and testing was done later. There was no clear direction on whether the building or the entire area will be sealed,” the official added, saying that foot-soldiers cannot be “kept confused” in such a situation.

According to senior epidemiologist Dr. Mukta Gundi, Mumbai is paying for years of a lack of attention to its public health system. "Preparedness of the public health system and the infrastructure takes years to build. The pandemic is a crisis which is adding an enormous burden to an already weak ecosystem of public health. How much percentage of the GDP has the state spent on health? Less than two per cent?” she asked.  

Bureaucratic Rivalry

The state's current Chief Secretary, Ajoy Mehta, is on his third three-month-extension. His tenure will end on June 30, unless there is a further extension. Before taking on the role, Mehta was the BMC Commissioner. 

When COVID-19 came along in March, the BMC had Pravin Pardeshi as Commissioner. According to reports, all was not well between the two senior officers. It took a toll on the relationship between the state and the BMC administration – despite the ruling Shiv Sena at the helm in both.

An officer who was present at one of the many meetings between the state and the BMC in April, described the situation to NewsClick. “Both of them used to fight over data, provision of medicines and over efforts to curb the spread of the infection. It used to happen in front of all the concerned officers. How can you expect results in such a situation?" asked the officer. 

At the time, Dharavi and Govandi, two of the major slums in Mumbai, had been affected. With its high population density, Dharavi posed a tough challenge. As the number of cases started increasing in Matunga Labour Camp at Dharavi, the BMC administration panicked. "Even by that time, Pardeshi had not visited Dharavi. Can you imagine? The state health minister visited Dharavi even before the BMC Commissioner!" said the officer. 

The events culminated into Pardeshi’s transfer, and Iqbal S. Chahal was brought in as BMC Commissioner. Chahal had a history with Dharavi and knew it well, having cancelled redevelopment bids for the area on five occasions for different reasons, in another capacity.  By the third week of June, Dharavi was out of danger.  

Not Just Mumbai

Although Mumbai has been the epicentre of COVID-19 in the state, other parts are facing serious challenges as well. Neighbouring cities like Mira Bhyandar, Vasai, Virar, Thane, Kalyan Dombivli, Navi Mumbai, Panvel, Ulhasnagar, Bhiwandi, Ambarnath, Badlapur are also witnessing cases on a daily basis. 

The state government had tried to seal district borders to prevent the spread of COVID-19.  However, almost 60% of workers who provide essential services to Mumbai come from these areas. When the number of patients in Kalyan Dombivli started rising, the administration tried to ban those coming from Mumbai. However, it had to revoke the order, with 80% of its people travelling to Mumbai for work on a daily basis.  

In districts like Sangli and Nagpur, the administration did a remarkable job of not letting the situation get out of hand. A family of 23 members had tested positive for COVID-19 in the first week of April. The town of Islampur in Sangli had to shutdown completely for three days. 

However, the case fatality rate in Jalgaon, at 8.98% , has been worrying for Maharashtra. It is much higher than the national average of 3.36% and even the state’s figure of 4.88%. 

In the rest of Maharashtra, Thane (20,167 cases), Pune (13,250 cases), Palghar (2,691 cases), Raigad (2,067 cases) and Jalgaon (1,936) are the most affected districts after Mumbai. In terms of fatalities, Pune (610), Thane (642), Solapur (184) and Jalgaon (176) were badly off.  Districts like Wardha (14), Gadchiroli (50), Chandrapur (56), Nandurbar (72) and Beed (77) have the least number of patients. 

Senior journalist Padmabhushan Deshpande said that “pro-active” efforts in some parts really helped. “I think, it depends on the local officers, the administration and the political leadership. We got results in Nagpur because there is an IAS officer like Tukaram Mundhe. The same happened in Malegaon because of someone like Dada Bhuse (State Agriculture Minister),  who went on a bicycle on the day before Eid, convincing people to stay at home. The state government should have shown that it is willing to do it everywhere, not just in some parts," he said.  

State vs Centre 

Since the Bharatiya Janata Party was unable to form the government in Maharashtra, there has been constant politicking on every issue. 

The BJP allegedly used Governor Bhagat Singh Koshyari's presence to disturb the state government. It all began with CM Thackeray's nomination as MLC. Koshiyari kept it on the back-burner until the CM called Prime Minister Narendra Modi about it. By that time, almost twenty days (April 10 to May 2) had gone by.  During this period, there was an uncertainty over the fate of the Maha Vikas Aghadi government with the bureaucracy treading cautiously.  

Later, the battle between Governor Koshyari and the government reached college campuses. The former opposed the government’s decision to allot aggregate marks to third year students, without an examination. The issue is still pending

The state versus the Centre was also playing out on other fronts, namely, the Shramik Special trains, local trains in Mumbai’s suburban areas for workers providing essential services and on an adequate number of PPE and testing kits. The situation escalated to a level that Railways Minister Piyush Goyal and the MVA government trained their guns at each other. 

Did the Inexperienced CM Falter?

Maharashtra’s opposition leader and former CM, Devendra Fadnavis, said in a press conference that Uddhav's lack of experience was hurting the state. The CM has not even held the position of an MLA before ascending the top seat. He has handled his party’s affairs for the last twenty years, and ran the BMC indirectly during the same period as well. However, was that enough?  

The MVA's senior ministers have rejected Fadnavis' charges. NCP's state president and cabinet minister, Jayant Patil, backed Thackeray. "He listens to everyone before taking any decision. He does not interfere in anyone else’s work," said Patil, while attacking former CM Fadnavis. 

Though the MVA leaders are putting up a brave face in public, the fact that all is not well within the government, is not hidden. The Congress, a minor partner in the government, has said that it is being ignored. The party’s state president has said that he would meet CM Thackeray and inform him about their reservations. 

Members of the bureaucracy are miffed with the CM's working style as well, with the issue of CS Ajoy Mehta's extension becoming a talking point. “When Thackeray addressed his first meeting with all principal secretaries and department secretaries as CM, he ensured us that we will work as a team and there will not be any favouritism from his side. However, an undue extension to Mehta in March sent the wrong signal to the bureaucracy. There is talk that the CM is highly dependent on Mehta, which is not good," said an officer of principal secretary rank. 

When asked to respond, a senior minister from the Shiv Sena, who did not wish to be named, reacted with a one-liner. “We are aware of the issue and you will see that it gets sorted out very soon," he said. 

When will Maharashtra Flatten the Curve? 

For the common man, these squabbles are hardly of significance. What matters is when the curve is flattened. 

In a recent interview with Mumbai Mirror, Chief Secretary Mehta was asked the same question. "Let's be honest we have now plateaued. Everyday we see almost the same number of new cases in Maharashtra and Mumbai, plus of minus five percent. There are some districts of concern. The journey from here depends on how people behave – whether they wear masks, maintain hand hygiene and follow social distancing. A lot will depend on the speed with which we open up and how people interact," he reportedly said.  

The state government maintains that the pandemic will be under control soon. Health Minister Rajesh Tope told NewsClick that the situation was improving. "We have succeeded in bringing the doubling rate down to 26 days. Almost 48% of patients have been cured and discharged. The challenge now is to bring the fatality rate down. We are adding more beds and taking specific precautions for the aged and diabetic or BP patients. It will certainly bring positive results," said Tope. However according to COVID-19India.org, an independent tracker of COVID-19 cases across the country, the doubling rate for Maharashtra is approximately 21 days. 

On the other hand, Dr Gundi asked the state government to be more alert and prepared from here on in. “It is difficult to accurately predict when the curve will flatten. Projections, predictions and learning from other countries shows that even if the curve flattens for some time, one could see a second wave of infections. Instead of focusing the entire public health machinery on flattening the curve, it would be better if public health is addressed in a holistic manner," the doctor added.