With the threat of Omicron, the new variant of the coronavirus, looming large, the union health ministry has written to the Maharashtra government to align orders issued by the state with the ministry’s guidelines for uniform implementation.

The state government in its order dated November 30, for international travellers, mandated RT-PCR testing of all international travellers at the Mumbai airport irrespective of country of origin, mandatory 14-day home quarantine for all international passengers even if tested RTPCR negative upon arrival, and for international passengers planning to undertake connecting flights after disembarking at Mumbai have to undertake a mandatory RTPCR test subject to a negative RTPCR result.
 
Domestic passengers are required to have a negative RT-PCR test report 48 hours prior to the date of journey from other states to Maharashtra.

Union health secretary Rajesh Bhushan in his letter to Dr Pradeep Vyas, additional chief secretary, department of health and family welfare, Maharashtra, says, “This is in divergence with the SoPs and guidelines issued by the ministry of health and family welfare, Government of India. I would therefore urge you to align the orders issued by the state with the guidelines issued by the MoHFW, GoI so that uniform implementation of the guidelines may be ensured across all states/UTs. I would also advise that such modified orders of the state government are given wide publicity to obviate any inconvenience to travellers.”

While there is no reported case of Omicron in Maharashtra so far, BMC commissioner Iqbal Chahal earlier today said that passengers arriving from ‘at-risk countries will be sent to institutional quarantine RT-PCR tests will be done on the 2, 4 and 7th days for people in institutional quarantine. Those found positive will be sent to hospitals for treatment.   

He said that during November 10-29, 1,126 passengers from South Africa landed from different flights into Mumbai and spread into Maharashtra. After contact tracing in the last 48 hours, 86 passengers were found to be in Mumbai out of which 78 have been placed in isolation. 8 passengers have gone out of Maharashtra. One passenger in Mumbai and six in Maharashtra have been found positive and their reports have gone for genome sequencing.  

Chahal also said not all RT-PCR kits can detect Omicron S-gene and it is important for RT-PCR test to detect negative S-gene. Every lab has been told to detect S-gene also. He added that once research and data on Omicron is crystallised incoming 10-15 days, further strategy will be planned and added that BMC has 186 hospitals on a real-time dashboard to monitor hospital beds.
 
Earlier the Maharashtra government had requested GoI to ban international flights to metros. While GoI advised RT-PCR on landing passengers, Maharashtra had advised 7 days quarantine for passengers from ‘at risk’ countries. Chahal has also written to the GoI to reduce the gap between both doses from eight weeks to four weeks so BMC can then complete the vaccination of its 27 lakh citizens within a month.
In December 2020, after the surge in UK, the US and other countries, BMC had issued a circular for all passengers from these countries to be taken either for hotel or govt (free) quarantine centres after which they were tested. Passengers who tested positive were shifted to the hospital and genome sequencing of their samples was done. The protocol announced by the state government was based on the same procedure.

Speaking on the BMC’s preparedness in the face of the evolving situation and how the municipality will tackle caseloads in case of another wave, additional municipal commissioner Suresh Kakani said, “BMC is preparing to keep its Jumbo Centres ready with audit, oxygen availability, doctors, nurses and staff with required protocols. Ward war rooms are being prepared to be ready. Deans of all Jumbo Centres and ward officers have been instructed to keep facilities ready so they can be activated within a day. Private Hospitals have been instructed to keep at least one ward ready for Covid patients. Though our positivity is still below 1% and testing levels at present are 35% we are now increasing testing and trying to do 50,000 RT-PCR tests.”

He also said that the genome sequencing lab at Kasturba Hospital is testing samples. This surveillance is done to find the variant. “We are picking samples from hotspots and hospitals. Samples of all seriously ill patients, unusual cases, samples from hotspots and hospitals are being selected by Public Health Department and sent for genome sequencing. The reports are shared with us and we keep close contact with these patients. So far 4-5 cycles have been run.”

BMC has done five Sero Surveys, including one on children in June 2021. The next Sero survey is planned to be done soon.

Speaking on vaccination, Kakani said vaccination camps have been taken for people living in slums, vulnerable, disadvantaged, orphaned, handicapped, old, bed ridden and transgenders with the help of local corporator/councillors from each ward as well as NGO’s.

“Our coverage of 2nd dose is 74%. There is a closer follow up of people who are not coming for their second dose. Our mobile vans are going to areas where people don’t want to come out for vaccination. We believe that ‘If the community does not come to us, let us go to the community.’ Those who are due for a second dose, are being proactively followed up with to bring them to the centres for vaccination” he said.

The state govt has also emphasised upon all airlines to do inflight announcements for passenger’s to do mandatory RTPCR tests at airports especially from ‘at risk’ countries and the passengers will be followed up by MoH, PHD for further actions. BMC through a notification has also requested citizens to avoid physical gatherings on the occasion of Babasaheb Ambedkar’s Mahaparinirvan Diwas on December 6.

BMC deputy executive health officer Dr Daksha Shah said, “We are more experienced now as compared to earlier. This time we are much more aware and prepared to do the testing in our own centres especially in Kasturba Hospital and our physicians are also more prepared as compared to the 2nd wave. With genome sequencing available with us we can easily detect the variant before further damage is done. We do genome sequencing of breakthrough infections. With our field survey findings (sero surveys) we have a certain amount of confidence that the community has developed some amount of antibodies but we cannot be complacent.”

She added that in addition to follow-ups of all travellers for the last two years, they are doing contact tracing of all patients who test positive as well as their contact. “The MC has issued a directive that police, as well as the health department of BMC, should start imposing fines to people not wearing masks. Our focus is not money but to bring behaviour change in people,” she said.