It’s become the model for containment zones now being declared in many cities across the country. The Bhilwara model. A positive story of how a much-maligned district and state administration successfully contained the country’s first corona hotspot.

Today, there is reason to cheer the news from Bhilwara. All the 25 COVID-19 positive cases have recovered as on April 9th. (The first positive case emerged on March 19th. Out of the total 28 infected since, two had died earlier). Though the news of a fresh positive case on April 10th came as a dampener, it is only the second case since March 30th.

All the unprecedented and stern measures taken from Rajasthan’s textile city to contain the virus now finds echo in many government corridors. Especially in the country’s 62 plus ‘hotspot’ districts containing 80 percent of COVID-19 cases who are being advised to follow Bhilwara’s aggressive containment action. “Ruthless containment is the key to prevent the spread of COVID-19 in any city,” said Rajendra Bhatt Collector and DM of Bhilwara.

It is a case study of a determined district administration and committed health and other government workers on the ground that deserves to be highlighted. Bhilwara has been under strict curfew, mahacurfew as local media described it, since April 3rd, with Sec 144 having been imposed on March 20th, four days before the countrywide lockdown. Everyone has stayed indoors and essential commodities are being supplied at citizen’s doorsteps.

“We will wait and watch till April 14th and then review whether the ‘mahacurfew’ is to be continued,” said Rajendra Bhatt. “We have to ensure 28 days’ containment, so the border will remain sealed with continuing strong public health measures and restrictions on movement”.

The team of healthcare officials under Dr Mustaq Khan, chief medical and health officer, did a commendable job as they worked simultaneously on precautions, treatment and now regularly tracking patients who have been discharged.  “We are screening people at two levels: one in community survey and another in hospital OPD, then testing the symptomatic cases,” said Dr Mustaq. A COVID-19 testing laboratory has now been set up at Bhilwara’s Government hospital which awaits ICMR nod.

Bhilwara’s many firsts

Bhilwara was the first place to initiate intensive screening of the entire town’s population. “The screening teams comprised government staff, teachers and Asha workers who did a mammoth door to door survey, screening and put quarantine stickers where needed,” said Bhatt. “There were 916 people in quarantine in good facilities, some even in 3-star hotels,” said Bhatt. The MG district hospital became the dedicated COVID hospital with 200 isolation beds, with beds in four private hospitals too being commandeered.

“Over 2000 teams were made to screen the 25 lakh population of Bhilwara district. The 16,382 found with cold and cough were screened again. The 1215 still suffering from cold were isolated at home, guarded by Government staff,” said a local journalist, even as the media dubbed the town as the “Wuhan” of India. According to information shared by Bhatt, 3072 teams were deployed for door to door screening in the city in three phases and 1937 teams were engaged in the rural survey in two phases.

It had all started with the carelessness of the first corona positive person, a doctor at Brijesh Banger Memorial Hospital, who put all the 6000 patients and staff at risk.  He had met foreigners from a corona-infected country at his home and continued to go about his work. The patients had spread to five states and 15 districts of Rajasthan.

“The doctor had seen so many patients both at hospital and home and there was no record of home patients,” Bhatt said. “As even the asymptomatic could transmit the virus, this was a scary situation.”  The administration called each of the 36 patients from other states and 498 patients from other districts, asking if they had any COVID-19 symptoms and advised them to get checked at a local hospital. They also called up the respective district collectors, who advised these people to stay in home quarantine.  Luckily none of these people tested positive.

“No one goes hungry”

The district collector immediately outlined five urgent tasks (see box). The first phase started from March 20-April 2 with essential services open.  The second phase started from April 3-13 with more restrictions as everyone was instructed to stay home with essential commodities supplied at people’s doorsteps.

“We have a 3-tier system for food distribution to ensure no one goes hungry in town,” said Sunil Verma, District Supply officer, Bhilwara. “Free cooked food packets are given twice a day to those below poverty line, physically disabled and other needy people. Then free ration consisting of 10kg flour, 10kg rice and spices adequate for a week for a family of four members is supplied. These include migrant labourers, brick-kiln workers, those engaged in fishing near dams and those in kachhi basti (temporary settlements). For everyone else, essential commodities are provided on payment. Food grains are procured from Cooperative bhandars and 45 vehicles assigned to supply in city wards while 50 vehicles carry fresh fruits and vegetables from Krishi mandi.”