How to solve the Bengaluru COVID-19 conundrum?

There should be at least one primary health centre and 5–10 health and wellness centres for each of the 198 wards

The current public health efforts in managing the pandemic in most urban areas are similar, with some minor differences. Bengaluru is no exception. In contrast to rural areas, the proportionate number of frontline health workers are not appointed by urban local bodies, and therefore, urban primary healthcare services suffer from a design weakness. Consequently, fewer trained persons are available for carrying a syndromic approach to detect suspected cases, subject them to targeted testing and carry on contact tracing. In the first wave, this was temporarily addressed by mobilising staff from other departments in Bengaluru, which cannot be sustained when the pandemic rages on for many months. In the absence of such personnel, expanded testing and self-referral were the mainstays of case detection as the cases started surging in April. However, with the increasing workload on conducting RT-PCR in the laboratories, results of the tests could be available with a delay of five days, defeating the purpose of early isolation. Hence, the Government was compelled to decrease the total RT PCR tests to test mostly symptomatic persons and fewer categories. This led to an increase in test positivity in the later half of April from below 10% to 39% by May 5, 2021. At the same time, many persons who are not tested continue to spread the infection. Also, the contagious nature of the newer variant, at least in part might be responsible for the higher number of cases due to population movement.