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V.K. SANTOSH KUMAR
Karnataka's Medical Education Minister K. Sudhakar, who is spearheading the fight against the Covid-19 pandemic in Bengaluru and across the state, wishes that he could operate in a setting such as Singapore's.
"The strict enforcement of the government, people who are responsible, discipline and hard work, these are the key elements which have helped Singapore contain Covid-19 so ably," he told tabla! over the phone from Bengaluru.
"It is also easier to manage things there because of the small area and population. The country has a robust health system.
"It is vastly different in India with a big population and other medical infrastructure problems. I'm facing a long battle. It is important that civic sense should prevail and people must cooperate with the government."
Karnataka, which had 15 Covid-19 cases in March and 107,000 in July, has seen a spike recently, with a total of 533,850 cases reported till Sept 22.
The southern state is India's second hotspot of coronavirus infections with 101,148 active cases as of last Saturday. Around 8,145 people have died.
Its capital Bengaluru, dubbed India's Silicon Valley because of its large number of IT companies and start-ups, has also seen a spurt in cases over the past five weeks along with an ongoing shortage of beds with ventilator connection.
But Dr Sudhakar, a general physician who became a politician, maintained that the situation is changing.
"The cases in existing containment zones are easing out or saturated," said the 47-year-old, the youngest minister in the current Karnataka cabinet.
"New cases are appearing mostly in new areas, in second and third-tier cities. The numbers are going down."
He is not sure if the trend is good or bad "because the coronavirus is unpredictable and it is an unprecedented pandemic".
"Covid-19 can infect anybody," he said. "It can travel anywhere, especially where there is movement.
"The challenge is to ensure the health system is robust and there is preparedness.
"It is important to identify the infections early, hospitalise those who need immediate care, ensure they do not slip into needing intensive care and that they do not finish up at the ventilator stage. Not many come out of the last stage.
"The only protection we can offer is mask, handwash and social distancing measures as there is no medicine or vaccine available."
On June 9, Dr Sudhakar posted data on Twitter which showed Covid-19 infections and deaths in Bengaluru were running at about half the rate in New Zealand, a country acclaimed globally for reining in the disease.
The city - which has more than double the population of New Zealand - "stumps the Kiwis", said the caption to the image.
Then, only about 450 cases were recorded among Bengaluru's population of more than 12.5 million, compared with more than 260,000 cases across India and about 1,150 in New Zealand.
Thanks partly to a high-tech testing and tracing system monitored by masked officials on giant screens in a city "war room", Bengaluru had contained the outbreak better than cities like Mumbai, which had tallied more than 100 times as many cases, reported Reuters.
Three and a half months later, Bengaluru is seeing more than 2,500 new cases daily, mainly because the central government has eased the nationwide lockdown.
"The issue with Bengaluru is not the increase in the number of cases but that more people need intensive care (ICU) facilities," said Dr Sudhakar, who wakes up daily at 4.30am and spends at least 16 hours handling Covid-19 and other medical and education issues across the state.
"The city is experiencing a second wave and if the number of cases doubles or triples, the challenge will be to find sufficient ICU beds.
"No other city in the world has opened up like Bengaluru. But the people have to understand that Covid-19 won't go away quickly. They have to adapt and coexist."
According to Dr Sudhakar, experts are quick to blame Bengaluru for the fast spread of the disease, but they do not take into account the city's population density.
"Overall in India the density per square kilometre is 440 people," he said. "In Bengaluru it is more than 1,000, while in New Zealand it is less than 30. This is the primary difference in Bengaluru recording a high number of cases and the difficulty in containing the spread."
He also pointed out that the level of awareness among the people and the health infrastructure have to improve.
"Health infrastructure cannot be built overnight," he said. "But we are far better placed now than when we began."
The Karnataka government opened a Covid Care Centre at the Bengaluru International Exhibition Centre which with 10,000 beds was touted as the biggest such facility for the treatment of asymptomatic and mildly symptomatic patients in India.
But it was shut down on Sept 15 as it was not getting patients after the government allowed asymptomatic and mildly symptomatic patients to be isolated at home.
"We have enough beds and facilities for Covid-19 patients," said Dr Sudhakar.
"People naturally seem to have developed some kind of resistance to the coronavirus which is helping.
"Now 75 per cent of the cases are being isolated at homes and the rest are sent to the 12 Covid Care Centres.
"The high number of recoveries is due to good management."
According to Dr Sudhakar, the Covid-19 mortality rate in the state is decreasing.
"The mortality rate is 1.36 per cent in Bengaluru and 1.54 per cent in Karnataka," he said.
"The global average is 3.6 per cent. In some countries, it is as high as 10 per cent. Our aim is to keep the fatality rate below 1 per cent."
Due to economic reasons, Bengaluru cannot afford a lockdown.
Therefore, the minister outlined that it is important to educate the people about Covid-19.
"Importantly, we have to spread awareness among the communities. Educated people should step forward and join the government in this movement," he said. "Once people are aware, the spread of Covid-19 can definitely be contained."
He added that "marking out the population into smaller clusters, similar to polling booths, will help us handle the situation better".
"In such a setting managing and surveillance of about 1,000 people at a time with a team of health experts will be much easier," he said.
Dr Sudhakar is also counting on a vaccine to arrive quickly.
"A vaccine is absolutely essential," he said.
"But until that arrives the treatment should be robust. Anticoagulants, steroids and combination drugs should be used as viral loads are high."
He is confident that the situation in Bengaluru and across the state will improve after November.
"It is difficult to predict the exact situation but, based on clinical evaluation, the numbers are likely to increase in October and November," he said.
"Thereafter, once vaccination starts, we will see a decline. The numbers should start coming down from November and things will be much better from early next year onwards."
" I'm facing a long battle (to contain the spread of Covid-19 in Karnataka). It is important that civic sense should prevail and people must cooperate with the government." - Karnataka's Medical Education Minister K. Sudhakar.
