Thane Municipal Corporation

Response to

COVID-19

Report for 29 June 2020 to 5 July 2020

Background

After more than three months of the world battling the COVID-19pandemic caused by the SARS-CoV-2 virus, countries have started to see aflattened curve. With several countries opening up their economies, even Indiasaw the coronavirus-induced lockdown restrictions getting eased starting 8June 2020, in the form of Unlock 1.0. Maharashtra accounts for about 30 percent COVID-19 positive cases in the country and Thane City comprises of 5.5per cent of cases in the State. Municipal governance of Thane City is lookedafter by the Thane Municipal Corporation.

Population – 1.89 Million

Area (sq. km) – 147

Population Density (persons/sq. km) – 12,857/20,530

Administrative division

9 Administrative Wards; 3 Zones

Topographical Distribution (area-wise) Urban (Non-slum), Slums (traditional/vertical), Hills

The first COVID-19 patient in the city, a Thane resident returning fromFrance, was detected on 13 March 2020. Thane being such a denselypopulated city with varied demographics and topographies, early analysishighlighted the threat of spread of disease in slums, which would be theprobable hotspots. As the lockdown progressed, we saw a steady rise in thenumber of cases initially. It took 30 days for the case tally to reach 100 and 63days for it to reach 1000. The thousandth case followed a spike in daily casestaking the average case/day to 100 within a week’s time. Detection of newpositive cases in hotspots started growing rapidly and as detected, worst hitareas were the densely packed informal slum settlements where socialdistancing, general hygiene and sanitisation were difficult to follow.

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TMC Ward-wise Map

Initiatives Taken andOutcome Expected

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Initiatives Outcomes

Senior Citizen Survey in Containment Zones Early detection, Lower Death Rate

Proactive tracing of COVID-19 Positive patients

and Centralised Hospital Allotment as per status

of symptoms

Ease in Hospitalisation

Thane COVID Hospital, Balkum: A thousand

bedded dedicated COVID hospital facility as an

extension of existing CSM Hospital, Kalwa

Access to vulnerable/needy population (Municipal

Hospital facility at rates less than Private

Hospitals)

Effective Contact Tracing and Containment Zone

Activities via Digital Solutions for efficient

workflow (covi-guard app)

Early containment activities resulting in curtailing

the spread of disease

Ramping up testing within City premises (45%

rise)

Improved case detection has aided maintaining

control over the outbreak

Citizen outreach via DigiThane App Educating citizens about precautions, guidelines

and SOPs for emergency situations

Distribution of Homeopathy Medicines in Slums,

Containment Zones and Buffer Zones

Enhanced immunity of population more prone to

contracting COVID-19

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1000 Bed TMC COVID Hospital

“Focus on Capacity Building,

Patient care and

Infrastructure.”

How were cases in Hotspots controlled?

Challenge in Lokmanya Nagar-Savarkar Nagar

Lokmanya Savarkar Nagar has an estimated population of 3,22,000, 70per cent of which resides in informal slum settlements. The residents mainlycomprise of construction workers, industrial workers, immigrants from states ofUttar Pradesh and Bihar, daily labour workers, auto rikshaw drivers andworkshop labourers.

Lokmanya Savarkar Nagar saw its first case on 27 March, which led tothe total tally reaching 50 by end of April and 799 by end of May. Enforcementof the lockdown was followed strictly with Drones being used for monitoringinter Containment Zone movement. Any delinquency within the sealedperimeters were reported to Assistant Municipal Commissioners who wereempowered to take penal action against anyone violating the lockdown.Combined effort by Medical Officers, Ward Officers, Councillors and the PoliceOfficers ensured that the lockdown served its purpose of slowing the spread ofVirus. COVID Yoddhas were identified in order to compensate for shortage ofworkforce and were deployed for carrying out extensive IEC campaign foreducating citizens regarding COVID-19, distribution of homeopathic immunityboosters (Arsenic Album -50), Vit. C and Vit. D tablets, conducting extensivefever surveys in Containment and Buffer Zones. This helped generate awarenesswithin the lower income group and educate them to report anyone with COVID-19 symptoms in the neighbourhood.

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To reduce the infection fatality rate, a special survey to identifypeople above the age of 50 and the susceptible population was conducted toestablish a direct communication line and constantly monitor their status forproviding rapid help in case of emergency. General practitioners operatingduring the outbreak were identified to obtain a daily list of patients withcomplaints of COVID-19 symptoms. These patients were reached out to andadvised admission at Quarantine Facilities as most of them did not haveprovision for isolating themselves at home. All these initiatives workedcohesively to break the chain and curtail the spread of infection in one of thefirst Hotspots of Thane City.

Tracking Testing Treating

How were cases in Hotspots controlled?

Challenge in Mumbra

Majority of population resides in unauthorized chawl settlements andvertical slums, typical to the ward alone. The demographic composition ofMumbra has an Islamic majority. The densely populated sections of the ward,comprise of communities that are dependent on Essential Service – jobs likeauto-rikshaw drivers, vegetable vendors, etc.

The dense population of the ward required higher screening (SpO2 andFever) of population in the Containment Zones to identify suspected High Riskand Low Risk contacts of COVID-19 positive patients. This was effectively carriedout using Thermal Imaging Technology for quicker scanning while alsomaintaining a safe distance of about 2m during the screening. Significantnumber of asymptomatic and mildly symptomatic patients were homequarantined and Geo-tagged using an internal mobile application calledCoviGuard to monitor movement and identify citizens defaulting theirquarantine. The application integrates lab reports of all suspects/confirmedpositive cases with Facility of Admission, Containment Zones and plans,highlighting Bed Availability to Citizens and directly linking al data to NationalCOVID-19 Portal for real-time data updation.

Extensive training and motivation of Medical Staff, weekly cleaningand Sanitization of Community toilets using Zoono Surface Disinfectant (effectslasting upto a month), and active participation of Anganwadi Workers, COVIDYoddhas and Councillors along with the extended medical field staff played avital role in increasing the doubling rate of Cases in Mumbra to 47 days.

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Identification of Risk Zones

Capacity Building

Extensive IEC

Going Digital

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COVID-19 is emerging to be an equally big data-management challengeas it is a health-care challenge. TMC, from the onset of COVID-19 infection, hasbeen leveraging digital platforms for better data management and for makingCOVID-19 facilities more accessible to citizens. Following two platforms werelaunched this week to enhance the efficiency further

1 Fever Survey App

2 Bed and Ambulance Allocation

3 E-Pass System

Fever Survey App

One of the most important step of tackling the virus spread is efficientcontainment and rapid tracing and tracking of Contacts of infected people. Theactivity is undertaken by the corporation through various teams deployed inContainment zones to carry out door to door fever screening.

Field Team Survey

Hand written Data transferred

to central cell

Data digitised

Analysis Done/Actions

Taken

Field Team Survey

Data input into app

Digitised analytics Dashboard formation

Actions Taken

Streamlining of Data through Fever App

Without Fever Survey app

With Fever Survey app

Going Digital

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The portal gives citizens who are experiencing COVID-19 symptoms adirect access to booking a bed in a hospital and booking an ambulance fortransportation to the hospital.

Bed and Ambulance Allocation System

A real-time dashboard can be monitored at the Corporation level. The status and severity of cases is displayed to ensure timely actions taken.

Citizen fills Information required on

Portal

Hospital Bed

Allocated depending on Severity

Ambulance Allocated

Digital Tracking of Ambulance

Timely SMS updates to the Patient regarding

status

The portal was launched by Hon’ble Minister of Tourism andEnvironment, GoM on 4 July.

With the help of two expert teams for bed allocation and ambulanceallocation, the system has successfully digitised what was earlier an entirelymanual, conversation based system. The digitisation allows fast-tracking ofactions to be taken for patients with severe symptoms. With in-built check pointslike OTP, the system allows for removal of any misuse of the platform.

Going Digital

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Owing to the lockdown being enforced in the city, TMC has launched anE-pass system that will allow citizens (Essential workers, emergencies) to procurea permission for movement within the city.

DigiThane E-Pass System

DigiThane’sE-pass System

Citizen Enters details and

applies for E-pass

Application ID or “Token Number” is

received

Request Processed within 36

hours

Citizen will Receive a QR code which can be used as the E-pass

The QR code to be used as an E-pass will be scanned by Policepersonnel at various checkpoints using a specialised App that will display thedetails of the pass holder, their movement boundaries once the code is scanned.

The dashboard allows for internal checks to monitor the location ofwhere the QR code was scanned, staff performance on approval/rejectionactions. It also has mechanism to send out warnings to companies as they nearthe e-pass permitted per firm.

Citizen Portal Police personnel App

The QR code system allows no scope fortampering and provides a quick response with the citizen information.

Way Forward

Last week of June has seen a sharp rise in testing of COVID-19 suspectsfrom the daily testing tally rising by about 45 per cent. This has led to a greaterextent of detection of COVID-19 patients, with the average daily cases risingfrom 150 to 330. Despite the rise in cases after a prolonged period of stagnation,the fatality rate of the infection remains constant in the range of 3.5-4. Thecorporation’s resolve of being able to suffice the hospitalization and isolationrequirements in the form of bed availability in Government, Municipal andPrivate Hospital Facilities is intact as current facilities are available foraugmentation.

TMC has ensured clear communication with all the stakeholdersthrough social media and through engagements. Along with a strict lockdownbeing observed in the city from 2 July to 10 July, TMC has outlined the COVID-19response approach as follows

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TMC’s aim>

Comprehensive Screening, Enhanced testing, Early detection,Early Treatment!

Tracking Testing Treating

Enhanced Contact Tracing to 1:25

Efficient Containment zone Compliance

Testing goal till 20 July> 3000 test daily

Bill Audit Committee to make treatment affordable and accessible

Healthcare Infra monitoring