Background Ahmedabad implemented South Asia's first heat action plan (HAP) after a 2010 heatwave. This study evaluates the HAP's impact on all-cause mortality in 2014–2015 relative to a 2007–2010 baseline. Methods We analyzed daily maximum temperature (Tmax)-mortality relationships before and after HAP. We estimated rate ratios (RRs) for daily mortality using distributed lag nonlinear models and mortality incidence rates (IRs) for HAP warning days, comparing pre- and post-HAP periods, and calculated incidence rate ratios (IRRs). We estimated the number of deaths avoided after HAP implementation using pre- and post-HAP IRs. Results The maximum pre-HAP RR was 2.34 (95%CI 1.98–2.76) at 47°C (lag 0), and the maximum post-HAP RR was 1.25 (1.02–1.53) estimated at 47°C (lag 0). Post-to-pre-HAP nonlagged mortality IRR for Tmax over 40°C was 0.95 (0.73–1.22) and 0.73 (0.29–1.81) for Tmax over 45°C. An estimated 1,190 (95%CI 162–2,218) average annualized deaths were avoided in the post-HAP period. Conclusion Extreme heat and HAP warnings after implementation were associated with decreased summertime all-cause mortality rates, with largest declines at highest temperatures. Ahmedabad's plan can serve as a guide for other cities attempting to increase resilience to extreme heat.

ObjectivesTo study the percentage seropositivity for SARS-CoV-2 to understand the pandemic status and predict the future situations in Ahmedabad.Study designCross-sectional study.SettingsField area of Ahmedabad Municipal Corporation.ParticipantsMore than 30 000 individuals irrespective of their age, sex, acute/past COVID-19 infection participated in the serosurvey which covered all the 75 Urban Primary Health Centres (UPHCs) across 48 wards and 7 zones of the city. Study also involved healthcare workers (HCWs) from COVID-19/non-COVID-19 hospitals.InterventionsSeropositivity of IgG antibodies against SARS-CoV-2 was measured as a mark of COVID-19 infection.Primary and secondary outcomesSeropositivity was used to calculate cumulative incidence. Correlation of seropositivity with available demographic detail was used for valid and precise assessment of the pandemic situation.ResultsFrom 30 054 samples, the results were available for 29 891 samples and the crude seropositivity is 17.61%. For all the various age groups, the seropositivity calculated between 15% and 20%. The difference in seropositivity for both the sex group is statistically not significant. The seropositivity is significantly lower (13.64%) for HCWs as compared with non-HCWs (18.71%). Seropositivity shows increasing trend with time. Zone with maximum initial cases has high positivity as compared with other zones. UPHCs with recent rise in cases are leading in seropositivity as compared with earlier and widely affected UPHCs.ConclusionsThe results of serosurveillance suggest that the population of Ahmedabad is still largely susceptible. People still need to follow preventive measures to protect themselves till an effective vaccine is available to the people at large. The data indicate the possibility of vanishing immunity over time and need further research to cross verify with scientific evidences.

Background Health Care Workers (HCWs) are at higher risk for Covid19. Sero-surveillance among HCWs using IgG antibodies can add further value to the scientific findings. Objectives To estimate seropositivity among HCWs and to correlate it with various factors affecting seropositivity. Methods Population based large scale sero-surveillance among HCWs was carried out during second half of August’20 in Ahmedabad using “Covid-Kavach” IgG Antibody Detection ELISA kits. Seropositivity among HCWs was estimated and compared with various demographic & other factors to understand their infection & immunity status. Proportions and Z-test were used as appropriate. Results As on August’20, Seropositivity among HCWs from Ahmedabad is 23.65% (95% Confidence Interval 21.70–25.73%). Seropositivity of 25.98% (95%CI 23.47–28.66) among female HCWs is significantly higher than 19.48% (95%CI 16.53–22.80) among male HCWs. The zone wise positivity among HCWs closely correlate with cases reported from the respective zone. The sero-positivity among HCWs from the earliest and worst affected zones have lower level of seropositivity as compared to the zones affected recently. This might be pointing towards the fact that the IgG Antibodies may not be long lasting. Conclusion As on August 2020, the seropositivity of 23.65% in HCWs indicate high level of disease transmission and higher risk of infection among HCWs in Ahmedabad. The seropositivity is significantly higher among female HCWs. Zone wise seropositivity, closely correlate with the reported cases from the respective zone. Their comparison also indicates the possibility of reducing IgG seropositivity, which necessitates further in-depth scientific research to generate greater scientific evidences.

Indian cities struggle with some of the highest ambient air pollution levels in the world. While national efforts are building momentum towards concerted action to reduce air pollution, individual cities are taking action on this challenge to protect communities from the many health problems caused by this harmful environmental exposure. In 2017, the city of Ahmedabad launched a regional air pollution monitoring and risk communication project, the Air Information and Response (AIR) Plan. The centerpiece of the plan is an air quality index developed by the Indian Institute of Tropical Meteorology’s System for Air Quality and Weather Forecasting and Research program that summarizes information from 10 new continuous air pollution monitoring stations in the region, each reporting data that can help people avoid harmful exposures and inform policy strategies to achieve cleaner air. This paper focuses on the motivation, development, and implementation of Ahmedabad’s AIR Plan. The project is discussed in terms of its collaborative roots, public health purpose in addressing the grave threat of air pollution (particularly to vulnerable groups), technical aspects in deploying air monitoring technology, and broader goals for the dissemination of an air quality index linked to specific health messages and suggested actions to reduce harmful exposures. The city of Ahmedabad is among the first cities in India where city leaders, state government, and civil society are proactively working together to address the country’s air pollution challenge with a focus on public health. The lessons learned from the development of the AIR Plan serve as a template for other cities aiming to address the heavy burden of air pollution on public health. Effective working relationships are vital since they form the foundation for long-term success and useful knowledge sharing beyond a single city.

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