Heroes of Mumbai The Leaders Who controlled the COVID Second Wave

By Dr. S S Mantha
(Former Chairman AICTE and Chancellor KL University)

Mumbai, May 14

As the second COVID-19 wave sweeps across India, accompanied by macabre images, a crescendo of death wails, leaving in its wake a collapsed health system and economic devastation, leaving behind only darkness and desolation. In this scenario, it is easy to miss the bright spots —people and institutions — who have been working tirelessly to get the country back on its legs, undefeated by the unending deluge of bad news and disheartening data. 

The financial capital of the country was struck in the face and left reeling as COVID-19 cases surged uncontrollably in the beginning of April. Cut to May, and the worst seems to be over for the city — even as the national capital and India’s own Silicon City, among many other cities and towns, sink deeper into the gloom of death and despair. 

What Mumbai and its administration, faced with the twin pressures of a massive population and a stretched infrastructure, and pulled off in those intervening few weeks is nothing short of a miracle. The Mumbai Model, or the BMC Model, that helped save the city in the face of almost overwhelming odds, could not have been without the many unsung heroes who made it possible starting from Mumbai Municipal Commissioner Iqbal Singh Chahal and his fellow officers.

Chahal was no novice to the crisis. He was brought in as the Bombay Municipal Corporation chief during the height of the first wave last year to manage the pandemic. That he performed that job commendably is an understatement. A city with the world’s largest slum, bursting at the seams with people packed like sardines in makeshift houses clinging to each other, offers the perfect setting for a virus that has beaten science and human ingenuity so well. But soon after Chahal was brought in, Mumbai became a model of containing the virus. 

When the second wave exploded in the city as it was trying to get back to normality, Chahal knew the virus well, what it could do, and what needed to be done to control it. He was the man the moment needed.

One of the first steps the BMC chief took was to ensure that decision-making structures were laid out in clear terms. Then he did something very innovative and counter-intuitive – he decentralized the civic body’s response to the pandemic. The engineer with a defence background said a ”decentralized fight is the key,” and believed in it.

He set up 24 “war rooms”, one in each civic ward. Each war room was a control centre in itself with multiple telephone lines and operators, doctors with medical support staff, and ambulances that would run round the clock. Dashboards were created within each ward, with information such as the availability of beds displayed in real-time. It was a data-driven approach, with data and action plans managed and coordinated through the 24 ‘war rooms.’ The dashboards, available in the public domain, were constantly updated by each ‘war room’ and each hospital, be it government-run or private. It displayed the availability of beds and many other data points. The approach prevented a single central control room from getting overwhelmed by requests and panic calls as the pandemic swept the city.

Chahal also ensured that COVID-19 test results were not directly shared with patients by the laboratories, which triggered daily rounds of panic, but only to the BMC. The war rooms would be sent test results of patients in their respective wards by 6 a.m. every day. These steps eliminated panic, cut response time, and built up adequate infrastructure to manage the crisis.

The BMC chief knew from previous experience that communication, clear and sharp, was the key. It was mandated that only specific people from the task force, so tasked, would be communicating about the situation with employees and external agents like the media, investors, customers, suppliers, the State Government, etc. It was important to agree internally about what will be communicated before any announcements were made so that messaging was consistent across different audiences.

The BMC’s hospitals form the bulwark of the COVID-19 management system in the city. The team created and actionized protocols on cleanliness, cleaning, and disinfection of touch surfaces, restrooms, doorknobs, kitchens, and dining areas, ensuring healthcare workers had appropriate personal protective equipment, even the cleaning methods that might aerosolize pathogens like pressure washing, steam cleaning, etc., were avoided. Everything was thought through and specified, down to the last detail, and nothing was left to chance. 

Even the emergencies were planned for. What was to be done if an outbreak occurs in offices, cooperative housing societies, or slum clusters; what should be done first, second and third? Who is authorized to make the decisions so there is no delay in responding to the crisis? Who should be informed? By what communications methods? What messages should they hear? What are the protocols for providing updates? It was planning at a level of detail that is not often seen in India’s administrative systems. The idea was to contain the pandemic and halt it in its tracks. 

The plan did not ignore the foot-soldiers who are central to its success — as many such plans do, unfortunately. It ensured that non-salaried employees, the casual workers, were not left to live in hope that their needs will be taken care of, but went beyond. by building steps to avoid, bias, discrimination, and exclusion. 

What all this led to was the establishment of a smooth supply chain and production, management of lockdowns with minimum public disturbance, cooperation with partnering institutions, and respect for procedures and rules.  About 40% of Mumbai’s present capacity is in hospitals with ‘jumbo centres’ — an idea that has worked well in the city’s fight against COVID-19.

Availability of vaccines is a concern. The commissioners’ idea of issuing global tenders to buy vaccines from wherever they are available must be lauded and supported by all. In the ultimate analysis, this battle can be won only when everyone is vaccinated. Still, the COVID-19 protocols must all be followed. They are as simple as washing hands often with soap and water for at least 20 seconds; or using an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available; avoiding touching eyes, nose, and mouth with unwashed hands; avoiding close contact with people who are sick; and coughing and sneezing through tissue and then throwing the tissue in the trash. The key is to keep continuing with all these protocols even when one is fully vaccinated with two doses.  

When things go wrong, the leaders are castigated. It follows that when things do succeed, the leaders should be patted on the back. They too are COVID-19 heroes like the innumerable doctors, nurses, para-medical staff, and healthcare workers on the ground. The “Mumbai or BMC model” has a hero the city’s Commissioner Iqbal Singh Chahal, who must be lauded and whose actions celebrated.

Chahal, Maharashtra Health Minister Rajesh Tope, and Chief Minister Uddhav Thackeray are all men on a mission and already moving ahead to prepare for a third wave if and when it happens. These leaders are great simplifiers who cut through argument, debate, and doubt, to offer solutions everybody can understand – and execute. The management model that Mumbai followed is a source of pride for the city in particular and Maharashtra in general —and accolades are flowing in from the Prime Minister and Health Minister to the Courts. Surely there are lessons here for the rest of the country as well.

We may see a third, fourth, or even a fifth wave — or we may not see them. But one must never neglect the details. As Colin Powell, a retired U.S. general and secretary of state say: “When everyone’s mind is dulled or distracted, the leader must be doubly vigilant.” That Maharashtra and Mumbai have such leaders is its great fortune.