Maharashtra coronavirus crisis: How Mumbai became a COVID-19 hotspot

Mumbai used to be a city of dreams, a city that never sleeps. Then came the COVID-19 pandemic. It hit the faultlines of Mumbai, a densely populated metropolis with crumbling infrastructure. And in two months it has turned into a global corona hotspot.

First, let's understand why Mumbai got hit the most? Mumbai's urban population is estimated to be over 22 million. The population density of the city is approximately 73,000 per square mile, which makes Mumbai one of the most densely populated cities in the world.

With the sea on one side, it had little potential to grow horizontally. Thus, many people in Mumbai reside in multi-storey apartments with common sharing space and co-existence.

On the other hand, the percentage of people living in slums is estimated to be as high as 41.3% in Greater Mumbai, meaning that over 9 million people live in these areas.

Also Read: Covid-19 hotspot: At 25,317, Mumbai has more coronavirus cases than 158 countries

People in Mumbai mostly live on a shared space basis, such as in slums or flats. The commuting is also no less challenging. Mumbai's suburban railway system- the local trains carry 7.5 million passengers every day. A glimpse of how overcrowded these local trains are, even on footrests, will only reinforce the fact that Mumbai is a human jungle.

Crowding is in the DNA of Mumbai, whether it's at home or commuting to workplace. Space is the biggest infrastructure constraint in Mumbai and the city represents the complete antithesis of what social distancing is all about.

Thus, the problem and much of it relates to structural faultlines in the unplanned rapid urbanisation and neglect of infrastructure.

The skewed budgetary allocations can be found by an analysis of Municipal Corporation of Greater Mumbai's (MCGM) current year budget which reveals that establishment expenses take away 67% of the total revenue (i.e. 2/3rd)  and are increasing while the operation and maintenance expenses which have a much smaller budget at a distant 20% of revenue budget are set to contract by 12% from a year ago.

COVID-19 Emergency in Mumbai

To understand the gravity of the COVID-19 pandemic situation in Mumbai, let us look at some basic numbers. The numbers are based on BMC data as of June 03, 2020.

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The hospital beds and ICUs are already running on an occupancy of 94% and 98%, and the capacity of CCC2 and O2 beds are also filling fast. With days of doubling of cases at 20 now, Mumbai in the next fortnight will have the toughest challenge of making enough beds. Additional 7,000 beds are reportedly being planned by June 2020.

With the reopening of Mumbai under 'unlock 1.0', cases are going to spike. The worst is not over yet, hence, it is time for the state government to deploy the best of its preparedness measures. While the medical and bureaucracy team may work out a detailed action plan to deal with the emergency situations, a planned way of optimal utilisation  of existing resources on a non-discriminatory basis, regular communication with people and engaging them on the changing situation will be of help to improve the perception and inspire confidence among Mumbaikars.

Also watch: How lockdown has hit India's COVID-19 hotspot, Mumbai

What may be done

1. Centralised Command Centre (CCC) and realtime Info dissemination

The resources are limited, hence managing them optimally in a fair and transparent way is the challenge. A Centralised Command Centre (CCC) headed preferably by an epidemiologist may be put in place. The CCC should have full functional autonomy, as CEO of all COVID-19 facilities management.

The CCC should be technologically enabled to monitor the requirements and availability of beds on a real-time basis (the way Uber app works for vehicle hiring), 24x7 helpline for those not familiar with web-based applications. The CCC should have control over ambulances and arrange for to and fro movement of patients and hospitals. Mumbai's tech brains can partner with the medical fraternity to develop a user-friendly interface.

2. Daily press briefing

Let there be a daily press briefing from the Mumbai control room on the current status of critical infrastructure and efforts being taken, and progress thereof in ramping up critical care. Images of dying patients due to lack of ambulances, beds, ventilators, and officials' apathy are building up fear psychosis among the public.

3. National appeal to seek help from the Centre and other states

Mumbai accounts for more than 6% of India's economy contributing 10% to factory employment, 30% to income tax collections, 60% to customs duty collections, 20% to central excise tax collections, 40% to foreign trade, and Rs 40,000 crore in corporate taxes to the Indian economy. Mumbai's health is of national concern for the economy to revive.

Mumbai's own health infrastructure is now woefully short. The city needs doctors, nurses, ambulances, and critical facilities like ventilators, etc from central resources or other states, who are in a position to spare, in the form of healthcare personnel, equipment, and kits. The metropolis also needs the support of other warriors like paramilitary/military to strictly enforce social distancing in the opening of the city.

At the end of the day, we have to live with COVID-19. So, let's deal with it, as it is, in the best possible way. Mumbai has faced many crises in the past too, including bomb blasts, terror attacks, returning to normal in no time. Together we can emerge stronger from the coronavirus crisis too and build up Mumbai dreams that look shattered now.

(The writer is a public policy analyst and columnist)