Between 1 June to 30 June, the total number of COVID-19 cases in Bengaluru city increased from 385 to 4,555. In terms of the total number of positive cases, Bengaluru is still far behind other metros like Mumbai (76,294), Chennai (86,224) and New Delhi (85,161). But the massive 1083 percent increase in one month has the Karnataka government worried.
The spike in the COVID cases in June can be divided into two stages. First, the gradual but worrying increase between 1 June to 26 June. Second, the sharp increase in cases since 27 June.
Both spikes have different explanations. While the Bruhat Bengaluru Mahanagara Palike (BBMP) claims that the recent spike is due to an accounting error, the earlier gradual rise is due to multiple factors including ‘Unlock 1.0’, changing weather patterns in the city, and possible community spread.
‘The Accounting Error’
Since 9 March, when the first COVID case was reported in Bengaluru, until 26 June, the average number of new COVID-19 cases was around 20 per day. But after lockdown restrictions were eased, between 1 June to 26 June, the average number of new cases increased to 61 per day.
But between 27 June and 30 June the average soared to 655 cases per day.
BBMP Commissioner Anil Kumar says that an earlier accounting error in calculating positive cases resulted in the alarming spike between 27 June and 30 June. Due to this error, over 1,200 (exact numbers were not provided by officials) cases had to be added in retrospect.
This addition took place after the COVID-19 war room pointed out the unreported positive cases to the BBMP.
BBMP officials say that to avoid panic, the backlog was cleared by adding numbers in batches. However, the spike in cases has been considerable even if you don't include these 1200 'error' cases in the maths.
Between 26 to 27 June, Bengaluru recorded a 313.9 percent increase, with the number of new cases jumping from 144 to 596 during these 24 hours. The trend continued with the city reporting 783, 738 and 503 new cases in the three days that followed.
The BBMP commissioner has also accepted that the entire spike was not due to backlog, but that a large part of the spike in numbers was due to the lifting of the lockdown.
Quoting experts, the BBMP commissioner said the spike in the number of cases is expected to continue till 15 July.
Explaining The 1 June-26 June Spike
Even if the sharp spike from June 27 onwards is set aside, between 1 June to 26 June, Bengaluru reported a 402.5 percent increase in positive cases. Compare this to May when the city reported an increase of 146 percent.
The Quint spoke with government officials and experts to understand how, from having just 385 cases at the start of June, the authorities in Bengaluru gradually lost control over the virus through the month.
Post Lockdown Complacency
Bengaluru city had one of the strictly enforced lockdowns in the country, and this played a crucial role in controlling the number of cases in the city. However, by 8 June, the city was back to a pre-lockdown situation.
Unrestricted vehicle movement was allowed in the city during the day, private offices were allowed to operate, and malls, stand-alone stores and markets were allowed to re-open.
BBMP commissioner Anil Kumar said that complacency had set in among shopkeepers and the public about the precautionary measures to be followed. He pointed towards supermarkets and other shops that allowed large crowd inside their establishments without following social distancing as an example.
In the context of this non-compliance, comes a second problem - the changing weather.
Changing Weather And Influenza
18 percent of Bengaluru’s COVID-19 cases are the result of Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI), as per the latest figures provided by the BBMP.
ILI and SARI patients are vulnerable to COVID-19 since their immunity is weak due to fever and cough.
According to Dr Sudarshan Ballal, the chairman of the Medical Advisory Board of Manipal Hospitals Group, the monsoon season sees an increase in the ILI cases in Bengaluru.
“Between June and November, with the change in the weather, Bengaluru sees an increase in the number in such cases. During this period, there is a spike in dengue cases and respiratory illness like H1N1. Now COVID is added to this list.”Dr Sudarshan Ballal.
A high prevalence of weather-related illnesses and the recent complacency about taking preventive measures are said to be a key reason for the increase in the number of cases.
Apart from the 18 percent of the cases, where ILI and SARI are known to be the reason, in 61 percent of COVID cases in Bengaluru, the cause of the virus is unknown or under investigation. According to government officials, this 61 percent of cases could also include a large number of ILI and SARI cases, since it is difficult to find the origin in such cases.
This ambiguity over the source of infection is the next factor over which the city administration has lost control.
The Unknown Origins of The Virus
A vital aspect of the Bengaluru’s success in the keeping COVID-19 under control was active contact tracing. As of 1 June, the travel history and contact information were unavailable for only 9 percent of the cases, but by the end of the month, this increased to 61 percent.
Karnataka government has increased the number of health workers deployed for contact tracing. However, two BBMP officials told The Quint that the contact tracing system is slowing getting overwhelmed.
“You must be aware of the fact that the government had stopped providing the data of source of the virus and the contact history, a couple of days ago. The reason was that there was no data available.”A BBMP official.
“If you look at earlier data, we could link most of the cases to someone with a travel history or a patient. Now, in most of the ILI cases, we don’t know the origin of the virus. People are getting the virus without travelling to any hotspot or meeting any positive patient that we are aware of,” the official added.
This aspect points at the most significant worry – community transmission.
Is Bengaluru at Community Transmission Stage?
According to the World Health Organisation, the widespread inability to trace the infection back to a carrier is when an epidemic is considered to be in ‘community transmission’ stage.
Origin of the virus remains unknown in 61 percent of cases and health care workers admit that locating the source has become difficult.
While the government still denies it formally, several senior doctors in the city have said that Bengaluru is in the community transmission stage already. Dr CN Manjunath, director of Jayadeva Institute of Cardiovascular Sciences and Research and member of Karnataka COVID task force said:
“We are in community transmission. This will happen because nature is ahead in everything. If you look at the nature of the cases across countries around the world, it is about six months. We are now in the fourth month. This will go for two more months. This looks like the beginning of the peak.”Dr CN Manjunath
According to him, since the city has reached a stage where health workers are unable to establish contact with a COVID-19 patient or locating travel history, the government has to revisit its testing policy. More random tests of sub-groups such as health care workers, policemen, delivery executives, auto-rickshaw drivers etc, should be conducted, he added.
Even BBMP commissioner Anil Kumar has acknowledged that the city in community transmission stage.
How long will this spike last? The government is already preparing to treat a large number of cases by converting two prominent indoor stadiums in the city into COVID care centres.
According to experts, the spike will continue for a couple of months with the curve spiking and dropping at regular intervals. Meanwhile the people of Bengaluru have to wake up and go back to precautionary measures practised during the lockdown period, they added.