In his first policy changes after taking charge, Municipal Commissioner I.S. Chahal has decided to declare contiguous parts of the city as containment zones instead of a piecemeal approach, and streamlined the Brihanmumbai Municipal Corporation’s (BMC) testing policy for COVID-19.
The BMC will now allow testing of pregnant women even if they are asymptomatic. The new policy has also brought clarity on testing people undergoing surgery or dialysis.
The decision to have fewer but contiguous containment zones is supposed to help the BMC effectively monitor the spread.
Recently, the BMC sealed seven slums in K West ward from Juhu to Jogeshwari. The slums have a total population of 1.2 lakh. Of these, Juhu Koliwada had reported few cases, but was sealed for effective monitoring. The same pattern will be followed across the city.
Suresh Kakani, additional municipal commissioner (health), said, “Initially, we had contained single buildings, but now the plan is to have compact containment zones. For example, if there are five pockets in a large slum but areas in between have been left out, they will be declared contiguous zones, so that movement is restricted.”
But doing so will mean that more than one lakh people will be living in containment zones.
“Yes, but a piecemeal approach does not work. Instead of sealing single buildings, when we contain an entire area, people also become more aware and we can contain the spread,” Mr. Kakani said. The idea is to make containment zones watertight. The move will allow the BMC to carry out home visits and look for patients in the newer areas. In non-slum areas, large societies that have positive cases will be kept under observation. The commissioner had already asked for coordinators to be appointed for each zone. Till recently, the city had around 2,500 containment zones.
New policy
According to the new testing policy, the BMC will continue to test symptomatic people — foreign travellers within 14 days of travel, contacts of confirmed cases, healthcare workers — and hospitalised patients with Severe Acute Respiratory Illness (SARI).
In an important change, all pregnant women living in clusters or containment areas or in large migration gatherings or evacuees from hotspot districts currently in labour or likely to deliver in five days’ time will be tested even if asymptomatic. It will be the responsibility of the healthcare facility where the woman is supposed to deliver to collect and transport the sample to the testing lab.
Besides, all symptomatic people found in SARI clinics, fever clinics and hospital out-patient departments will be tested.
Emergency surgeries cannot be stalled for want of COVID-19 tests, while for elective surgeries or ones that can wait for 48 hours, a test will be conducted only if authorities have a strong suspicion of the patient being COVID-19 positive.
Dialysis patients will not require a COVID-19 test report before every procedure. A test can be asked for only if there is strong suspicion of infection, and such a patient will be referred to a separate COVID-19 dialysis facility.
No home testing
The BMC has also clarified that registered medical practitioners, including government and private ones, can prescribe COVID-19 tests in specific format. BMC has retained the earlier rule that asymptomatic high-risk contacts are to be tested between days 5 and 14 since coming in touch with the infected person.
Home testing continues to be prohibited, and labs are required to issue test reports within 24 hours of getting a sample. The BMC has issued detailed guidelines for swab collection, testing and reporting for civic officials as well as private stakeholders.
Other guidelines about testing mild symptomatic and critical patients before discharge remain the same.
Former municipal commissioner Praveen Pardeshi had come under fire for changing testing policies several times. The BMC was mulling disallowing private practitioners from prescribing tests, but later revoked the order.
