Author: Tarun Sharma @talktotarun
Publication: Money Control
Date:  April 11, 2020
URL:      https://www.moneycontrol.com/news/trends/health-trends/the-bhilwara-model-those-behind-the-successful-containment-of-covid-19-5134601.html

On March 18, Bhilwara reported its first case of Coronavirus and within days there were reports that this city could become India’s next COVID-19 hotspot. That is when the local administration took action.

For the longest time, Bhilwara was known as the textile city of India. But the city had no idea that it was to go through one of the toughest tests of its fabric of resolve in the face of COVID-19 crisis.

On March 18, the city reported its first case of Coronavirus and within days there were reports that this city could become India’s next hotspot for the outbreak of the deadly disease.

But there was one man who, along with his team, showed the world how it’s done.

Thanks to Bhilwara’s District Magistrate Rajendra Bhatt and a group of determined individuals, Bhilwara has risen as a successful example for the world to emulate in tackling the COVID-19 crisis.

"We got to know on March 18 about the first case of Coronavirus in Brijesh Bangur Memorial Hospital, and thereon we understood that this can’t be the only case in the town,” 56-year-old Bhatt tells Moneycontrol, adding, “We were facing a delicate situation because the very first patients was found at the hospital itself, which was a clear indication of the beginning of disaster and the long haul fight to stop the community spread.”

Bhatt, an Indian Administrative Service officer, hails from a family of bureaucrats. His brother, also his role model, had retired from Indian Police Service as Director General of Police.

Fake News

Bhilwara saw one of the first cases of community spread of the virus when a doctor of the Brijesh Bangur Memorial hospital got infected.

Early reports said that he had contracted it from one of the guests at his home who had come from Saudi Arabia, but the doctor came out and clarified that there was no truth in such reports.

As they say, the first casualty, when war comes, is truth.

Necessary Evil

Bhilwara is about 250 KM away from the capital city Jaipur and depending on their resources was not an option.

It was a team of district administrators, including the Collector himself and Superintendent of Police, who cobbled together a plan and executed it with military precision. This not only helped the district to contain the spread of pandemic but also helped flatten the so-called curve.

Bhatt acknowledges that the district administration was a bit harsh on people when they first started implementing the operation to safeguard the district from COVID-19 on March 19, but that was a necessary evil at that point in time.

Fast-forward to the present day and the Bhilwara model of containment is being considered as a Standard Operating Procedure to contain the virus in the whole country.

As It Happened

The administration first collected the Out Patient Department, ICU and CCU patients’ data. The ones who visited the hospital around that time.

Bhatt informs, “We got to know around 6,000 to 7,000 patients had visited the hospital so we started searching for those people and sent them to home-quarantine.”

Contact-tracing is a rigorous but crucial exercise that authorities are doing to place, quarantine or treat possible patients.

Bhatt adds, “We got to know that the doctor from the hospital had also got the same infection and hence later we had to run through the lists of those patients who visited him at his home for a consultation and mostly there wasn’t any record available for such patients.”

The administration conducted around 25,000 screenings in the entire district – this is the highest even when compared to the whole state of Rajasthan.

As far as testing is concerned, over 3200 tests have already been done so far in the Bhilwara district, where the population is about 24 lakh.

In contrast, the state capital Jaipur has conducted only 4,200 tests, where the population is around 40 lakh.

Conditions in the capital of the state were reflective of the other districts in the state.

“This was a perfect recipe for disaster and hence to contain the spread, we immediately informed the Chief Minister Ashok Gehlot and sought his permission to seal all the borders of the district,” says Bhatt.

“Initially, we thought to seal just the city, but then we realised it would be necessary to seal the entire district if we have to contain the spread. Hence on March 19, the district was totally locked down. Entire state machinery was at our disposal, thanks to the CM who was actively monitoring the situation, which helped us to get quick orders to even halt buses and trains for the town,” said Bhatt, who is set to retire in four years.

This was the first time when the district was under such a lockdown where no one could either enter or exit the district on any condition.

The Next Step

In the second phase, the authorities started knocking on people’s doors.

Over 1,950 teams of around 2-3 people for rural areas [of the district] and 332 teams for the city reached out to every household across the district to screen each and every person from the area where the first case was reported.

In these teams who were reporting directly to Additional District Magistrate, some individuals are designated as Corona Fighters and some as Corona Captains.

“This was a mammoth task in every sense since we are talking about a population of 2.35 million. We used election data where we got to know about the age limits in a particular area and the ones who are 18-year-olds. There is a possibility that such people will be available to us at their homes only.

“We took the help of officials who used to be in Swine flu teams and asked simple questions about whether they have visited any hospital or symptom of flu or cold. In this process, we found more than 16,000 suspected individuals and then we put them into home quarantine. All movements of the quarantined people are under our watch,” Bhatt explained.

Bhatt says that when the curfew was announced from March 19 and when some essential services were open people were not adhering to social distancing. Hence on April 2, the authorities decided on complete lockdown. All the essentials were being delivered at people’s doorsteps.

The Helping Hands

Bhatt says the credit for this goes to the state government that made everything possible without asking a single question.

He also thanks his three lieutenants - including Superintendent of Police, Chief Medical Health Officer of Bhilwara and Additional District Magistrate of the district government hospital who took the responsibility to contain the virus on their shoulders.

“Mentally, I am always in the state of preparedness since I hail from Jodhpur, which shares a border with Pakistan. As a child and even as a youngster I have seen the days of the war,” said Bhatt.

He says names like 'Corona Fighters' and 'Corona Captains' gave a feeling of war as we were fighting COVID-19 on a war footing.

When asked how he devised the whole plan, he says, “We have to do this. We don’t have any other choice. Even if this didn’t succeed there wasn’t any harm. When you start with a positive note and without any hidden agenda then god also is with you and shows you the way. I think that is what happened with us.”

“We were determined that we have to create such an environment that patients don’t think to go to Jaipur for any treatment,” said Dr Arun Gaur, head of the district hospital.

“We have sufficient infrastructure in the hospital in ICU and CCU. Anyways we treat many patients in CCU in usual days. So, we are confident that we will take care of these patients also. We segregated wards as per the health condition of patients. When we are positive things also turned positive,” adds Gaur.

Wuhan, Italy, and Bhilwara

Early on, people were comparing Bhilwara with Wuhan and Italy such as this report.

Bhatt was aware of that and he realised that without any strict steps, whether people like it or not, they will not get results.

“Bhilwara is a business hub and most of the people have links with metro cities especially Mumbai and Delhi. If we do not take a strict decision, as you know, one person can infect 406 people in 30 days then you can realise this number will be huge. Especially in the different parts of the state and the country,” worries Bhatt.

Paritosh Dudani, a resident of Bhilwara city who is a shop-owner told Moneycontrol, “Central Government should give Padma Bhushan stature award to the administration of Bhilwara who saved our lives.”

The Real Heroes

Bhatt is not very fond of movies, but Dr Arun Gaur is an ardent fan of Anil Kapoor and Rajesh Khanna.

Gaur says that he is very fond of the movie Nayak and Mr. India where an ordinary person shows resilience of a hero and this situation forced them to be like one.

Gaur explains, “No doubt we were not much confident initially but as patients started recovering and when the first patient was free from Corona, it boosted our confidence not only in myself but it gave immense confidence to my team also. That team which has been working tirelessly for the last 20 days.”

“One of the doctor’s wife is pregnant but he just uses a video call to check her health. Even lab technician who might go home but he stayed and continued working with us,” he adds.

Gaur thanks his family and the government, “This can’t be possible without teamwork and support of family. My wife is handling the kitchen of the isolation ward. Moreover, we are thankful to our Chief Minister Ashok Gehlot who has given all infrastructure support to our collector and in the last two years they have invested in health infrastructure which was dried up in previous government in the “Bhamashah scheme”. Now, most of the patients are taking service of the government hospital.”

After March 28, the so-called curve started flattening in the district and there are zero new cases in the district for 11 consecutive days. Not only that the cured patients are also returning to their homes.

In a country like India that needs such examples that inspire people, Bhilwara’s grit and fighting spirit stand tall.