When gas began leaking from a nearby chemical factory and drifting towards his house in southern India, there were no warnings and no alarms, welder Elamanchili Venkatesh said. Venkatesh, who staggered outside blindly, said he coughed up blood before losing consciousness.

The Brihanmumbai Municipal Corporation (BMC) on Monday claimed that around 75 per cent of the nursing homes in the city have restarted services, after its warning of cancelling their licences if they did not do so, on Saturday. The municipal commissioner has ordered the cancellation of licences of the remaining 25 per cent nursing homes. Action will also be taken against private clinics who continue to remain shut, under the Epidemic Diseases Act, 1897.

Warning issues
The associations of doctors, nursing homes have expressed fear to work during the COVID-19 pandemic without proper safety kits and strict guidelines. The BMC has several times offered to provide safety kits but most private clinics and nursing homes remain closed due to fear of transmission of COVID-19. On Saturday, the BMC warned nursing homes and clinics to restart immediately and refer patients who have symptoms of COVID-19 to its centres. On Monday, the BMC claimed that out of 1,416 nursing homes, 1,068 have restarted their service. "Out of 99 dialysis centres, 89 are working," said an officer with the health department of the BMC.

According to the press note issued by the civic corporation, the municipal commissioner has ordered the health department to start the process of cancelling licences of the 348 nursing homes which haven't started services yet.

Mayor in nurse's uniform

Mayor Kishori Pednekar visited Nair hospital to meet the nurses

Kishori Pednekar, mayor of Mumbai and a former nurse, donned on a nurse's uniform and visited the COVID-19-only Nair hospital on Monday morning. She was there to encourage nurses. The mayor will visit Sion hospital on Tuesday to communicate with nurses. Pednekar followed social distancing norms during her visit. "I was a nurse by profession and am aware of their challenges. I am getting many calls from nurses and their parents who expressed fear. This is a challenging time and we all should fight the pandemic," said Pednekar.

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Despite strict instructions from the Navi Mumbai Municipal Corporation (NMMC) and the state government, most private clinics in the area continue to remain shut. While patients are finding it really difficult to get treatment for other ailments, physicians claim that non-availability of PPE kits and sanitisation of clinics were their biggest challenges.

Following several complaints, Navi Mumbai Police Commissioner, Sanjay Kumar through his official twitter handle appealed to doctors on humanitarian grounds to remain open. The tweet says, "A humble and humanitarian request to all the doctors having private clinics to open up their clinics for non COVID-19 treatments... We are ready to extend all out support for the purpose."

Speaking about the problems doctors were facing, Dr Chetan Chhajed, orthopaedic surgeon, Navi Mumbai, said, "I run a private hospital in Kamothe, which is open but we face a threat to our lives because of the unavailability of PPE kits. They are not available. We have somehow arranged for some masks for our staff but the local authorities are not sanitising the clinic. We allow only patients with serious conditions to visit the clinic, the rest are given consultation online. Another problem is that no transport is available and not all patients have vehicles."

Dr. Pratik Phake runs a private clinic in old Panvel, which has been declared a containment zone. He gives appointments to his patients in advance and opens his clinic twice a week for three hours. Speaking to mid-day, he said, "The non- availability of PPE kits, thermal guns, housekeeping staff and medicines are challenges. Some shops are selling PPE kits and thermal guns at very high price, which needs to be looked into. Apart from this, sanitising the clinic is a major problem."
Meanwhile, Dr N Yewale, who runs a private clinic in Kamothe, said, "The society where our clinic is has locked its gate and we are not getting water supply, which is why I have shut the centre and have been speaking to patients over the phone. Maybe the society people are scared. Unavailability of PPE kits and sanitising of the clinic are other challenges."

Similar situation in city

The doctors in Mumbai are facing similar issues and despite warnings of legal action from the BMC, they haven't opened their clinics.

National vice-president, IMA headquarters, Dr Anil Pachnekar, who has his clinic in Dharavi, said, "Doctors in Mumbai have smaller clinics where it is difficult to follow social-distancing rules. The doctors are also scared due to the lack of PPE kits and N95 masks." "Different types of patients visit doctors' clinics and not all of them wear masks and use hand sanitizers. In such a situation, the clinic should be sanitised by the local municipal corporation," Dr Pachnekar added.

'Help the society'

When contacted, Navi Mumbai Municipal Commissioner, Annasaheb Misal told mid-day, "This is my appeal to all doctors to help the society and keep their clinics open for the people in need. The PPE kits are available in the market and we will extend full support to them. We have not taken any action yet and don't force us to do so."

"Many clinics have resumed operations. The health department is checking nursing homes first. Today itself 15 nursing homes restarted their services," said Dr. Daksha Shah, executive health officer, BMC. Speaking about the health issues he has been facing, Kharghar resident, Abrar Chaudhary said, "I have a neurospine problem since almost a year and I get my primary treatment from Bombay Hospital. I have been consulting some local doctors in Navi Mumbai but due to the lockdown they are not available at their clinics. They do undertake online consultations but respond as per their wish. I have swelling all over and am unable to walk without a support. Doctors need to check me first before prescribing medicines."

Worli resident, Anurag Singh, said, "It has been very difficult to find a doctor in our locality. A couple of days ago I had fever but when I went to my personal physician's clinic, it was closed."

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Amid the rising number of coronavirus cases in Maharashtra, the India Meteorological Department (IMD) issued a thunderstorm warning in several parts of the state for the next five days till May 1. IMDs Mumbai centre issued warning for 15 state across Maharashtra include places such as Kolhapur, Pune, Raigad, Satara, Sangli, and Latur among others.

WEATHER INFO-
Nowcast warning issued at 1515 Hrs IST Dated 28/04/2020
Thunderstorm accompanied with Lightning, Rain and Gusty winds with speed reaching 30-40 kmph likely to occur at isolated places in the district of Nanded and Hingoli during next 4 hours.

-IMD MUMBAI pic.twitter.com/Z70XbHQNeT

— K S Hosalikar (@Hosalikar_KS) April 28, 2020

While speaking to Mumbai Mirror, K S Hosalikar, deputy director general of meteorology, India Met Department said that the thunderstorms warning predicted by IMD is for the next five days until May 1. According to IMDs weather bulletin, thunderstorms accompanied by lightning, aand rains will occur in several parts of Maharashtra amid the COVID-19 crisis.

Thunderstorm warnings by IMD today for Maharashtra for coming 5 days.
29 & 30 April, watch for severe TS in Madhya Maharashtra, south side with possibilities of hailstorms in some areas.
Pl Watch for all weather updates & nowcast warnings further daily.
Take appropriate care pl. pic.twitter.com/fK9HIsnr3P

— K S Hosalikar (@Hosalikar_KS) April 28, 2020

"Nowcast warning issued at 1515 Hrs IST Dated 28/04/2020. Thunderstorm accompanied with Lightning, Rain and Gusty winds with speed reaching 30-40 kmph likely to occur at isolated places in the district of Nanded and Hingoli during next 4 hours. - IMD," Hosalikar tweeted.

The IMD also stated that on April 29 and 30, there will be severe thunderstorms in Madhya Maharashtra, south side with possibilities of hailstorms in some areas. In an earlier tweet, Hosalikar urged people to follow all necessary safety guidelines during lightning/thunder issued by DM GoM and NDMA. He also urged farmers to look after their crops.

Thunderstorm warnings in Maharashtra for coming 5 days by IMD.
Keep watch on updates & pl follow up Nowcast warnings that would be issued daily afternoon onwards.
Request follow all necessary Safety Guidelines during lightning/thunder issued by DM GoM and NDMA.
TC of Crops too. pic.twitter.com/7bzT3rIO0D

— K S Hosalikar (@Hosalikar_KS) April 27, 2020

He said that the quality of air during the lockdown in Mumbai and Pune has been good. Throwing light on Mumbai's weather, IMD said that the maximum temperature in Mumbai on Tuesday was 35 degree Celsius, while the minimum temperature was 26 degree Celsius. IMD also stated that Mumbai will witness clear skies with a relative humidity of about 74 percent in Santacruz and 88 percent in Colaba.

While the total number of coronavirus cases in India reached 29,435, Maharashtra continues to remain the worst state with nearly 9,000 cases in the state.

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