The rapid increase in COVID-19 cases in M East ward, known as the tuberculosis (TB) hotspot of Mumbai, has become a great cause for concern. Experts fear that the exposure to SARS-CoV-2 will have a lethal impact on this population with already compromised lungs.
On Monday morning, M East ward, which covers slum clusters of Govandi, Deonar, Baiganwadi, Mankhurd, Shivaji Nagar, Cheetah Camp and a part of Chembur, had 82 COVID-19 cases, the fourth highest in the city’s 24 wards.
“The case fatality rate will be extremely high if COVID-19 cases explode in this ward,” said chest physician Dr. Vikas Oswal, who practises in the area and is also attached to the civic-run Shatabdi Hospital in Govandi.
M East ward currently has 2,800 residents on active treatment for drug-resistant TB, the biggest cluster of patients in the city. While the lockdown has helped keep people within the limits of the ward, the chain of transmission within the population is hard to contain because of the living conditions.
“The challenges we faced here with TB are the same for COVID-19. The areas are overcrowded, there is a lack of ventilation, sanitation and overall living conditions are poor. All these issues pose a problem in fighting infectious bacteria and viruses,” said chest physician Dr. Vijay Chavan, who is attached to the Médecins Sans Frontières clinic in Govandi.
While TB is a bacterial infection and COVID-19 is viral, both attack the lungs. “TB patients may have fever and cough even when they are on medication. If infected with SARS-CoV-2, they are most likely to ignore their symptoms. With already bad lungs and low immunity, such patients will have severe manifestations of COVID-19,” Dr. Chavan said.
The Brihanmumbai Municipal Corporation (BMC) has taken aggressive measures in the slum pocket of Dharavi to contain the spread of COVID-19. Experts said similar measures have to be initiated in M East ward.
City’s leading pulmonologist, Dr. Zarir Udwadia, said TB patients, often left with weak lungs even after they are cured of the disease, are going to be hit extra hard if they contract COVID-19. “The effects of COVID-19 threaten to reverse the progress we have made in TB control globally,” he said.
Dr. Udwadia said many TB patients are not able to reach hospitals and chemists due to the lockdown to get their medicines. “TB is one disease where failing to take even a few days’ drugs can have disastrous effects. We are looking at video and e-consultations to ensure our critical extensively drug-resistant TB patients are under constant supervision.”
Meanwhile, a building designated for a maternity hospital in Govandi has been converted into a 52-bed isolation facility. The BMC had assigned a team of doctors, and is awaiting nursing staff.