COVID-19: Why does Pune lead all-India cases? Top govt official breaks it down

Over 40 per cent of Punekars are now suspected to have COVID-19 antibodies. Senior advisor to Deputy Chief Minister and Pune's Guardian Minister Ajit Pawar, Dr Subhash Salunkhe, feels one can expect herd immunity to set in soon. In a chat with mid-day, Dr Salunkhe, head of Maharashtra Communicable Diseases Prevention Control Technical Committee and chairman of the COVID-19 taskforce in Pune, explains the way forward for Punekars.

Excerpts from the interview:

Why does Pune, with just 40 lakh people, account for the highest number of COVID cases in India?
Pune has a unique geographical and socio-economic background due to two interconnected municipal corporations (Pune and Pimpri-Chinchwad) and three rural talukas. There are congested localities, slum pockets where strict lockdown, initially played wonders but people failed to maintain social distancing and follow other rules when it was lifted.

Where did things go wrong for Pune? Was it lapses in the system?
I won't say lapses, but there were gaps because this disease is new. It has confused a lot of authorities, both medical, administrative and political so nobody can be blamed. Perceptions will change as it is a dynamic situation. Yes, you can do post-mortems and have a retrospective discussion, but that doesn't mean the earlier decisions were wrong. I feel instead of analysing lapses now, we should first ensure that people don't die and the outbreak is controlled.

As a communicable diseases expert, what is your role right now?
As the chief technical coordinator and advisor to the deputy CM, my role is to try and bridge the gap between the administration, people and the NGOs. The taskforce under my chairmanship has to ensure communication and public health strategies and take advantage of expertise in private healthcare. The primary task is qualitative enhancement on the technical side. Area-wise, I am focussing on Pune urban, Pune district and Pune division with five districts.

Dr Subhash Salunkhe, chairman of the COVID-19 taskforce in Pune

Is Pune heading towards herd immunity?
Yes, definitely.

Some people have doubts. What is your view?
I know there are doubts. This is why the definition we are looking at for herd immunity can be debated. But one thing is obvious — take areas like Rasta pet, Bhawani pet that had a huge number of cases for example, and the sero survey that indicated nearly 40 per cent people had antibodies. Putting these statistics together, we believe herd immunity plays a role as very few cases are coming up. Though nobody can say with guarantee that it is herd immunity.

When do you anticipate it will completely set in in Pune?
We are witnessing a drop in the number of cases from the otherwise affected areas of Pune. Though no one can be 100 per cent certain. May be by November-end, things will start moving in that direction, unless there is some change in the virus.

Is Pune witnessing community spread (Stage 3) of the pandemic?
Yes, Pune definitely has community spread.

Are asymptomatic patients quarantined at home?
No, at this stage, we are not encouraging asymptomatic patients to home quarantine.

Pune is one of the worst-hit cities amid the COVID-19 pandemic. Pic/Atul Kamble

Do symptomatic patients have sufficient ICU and hospital beds with oxygen?
We are anticipating a shortage for both, oxygenated and ICU beds. Preparatory steps are being taken by the administration. By mid-October, we will have to add another 250 incubated beds with ventilators and around 400 beds with oxygen support, the administration is on the job. By October 15, this additional set-up will be functional.

Do you foresee a second wave of COVID-19?
I think in Pune, the situation will be minimal because, by that time, a large number of Puenkar's will have the antibodies. Unless the virus changes its antigenicity, I don't think Pune will have a second wave that might impact a large number of Punekars again.

But with a shortage of manpower, do you think you will be able to handle the additional setup?
It is a matter of concern. Manpower shortage is a major problem at both government and private hospitals. We are trying to find alternative strategies to recruit more healthcare providers, by roping in those who are not directly dealing with COVID-19 patients. We are also trying to get home nurses, who have just appeared for their examinations. Also, NEET exams just finished. So we are considering how to use those students.

Has Pune witnessed relapse of COVID-19 in patients treated for COVID-19?
Yes, there are such cases, but the number is quite limited. And these are quite natural, such relapse can happen. This is because if the body produces antigens for a particular strand of virus, they do not work against the mutated version of the same virus, which is seen in case of SARS-CoV2. Therefore, while patients recovered with COVID-19 may develop immunity for a particular virus, but they may not work against a mutant version of the same virus and they can get infected again.

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