Covid-19: What you need to know today
M aharashtra is a clear outlier in terms of how it has been affected by the coronavirus disease (Covid-19). It ended Wednesday with 1.12 million cases – it is the province with the most cases in the world – and 30,883 deaths, according to the HT dashboard. Its cumulative positivity rate is still 20%. On Wednesday, its positivity rate was 24%. For six months to the day, the western state has topped India’s daily Covid numbers in terms of daily cases. For much of this period, it has also topped the daily death tally. On Wednesday alone, it accounted for 474 of the 1,139 deaths in the country (41.6%), and 23,365 of the 97,932 cases (23.8%).
It isn’t clear why Maharashtra has been ravaged by the disease. Sure, Mumbai, India’s commercial capital, has among the highest population densities in the world, as also some of the largest slums, but many of Maharashtra’s social and health metrics are better than those of the so-called BIMARU states. New York state, similar to Maharashtra in some ways (just as NYC is similar to Mumbai) was similarly roiled by the virus, but not as persistently as the Indian state. Cases in the US state peaked in early April, and have been fewer than 1,000 a day for the past three months (and a bit). It is the kind of thing the Union health ministry and the Indian Council of Medical Research should be investigating. It isn’t clear why they aren’t doing so -- understanding what’s happening in Maharashtra may help us learn how to fight the virus better. Both the urban and rural parts of Maharashtra have been affected – the former more than the latter, but that’s true of India as well – and every large city in the state has been hit hard.
Maharashtra has never tested enough. It has so far carried out 5.5 million tests. That translates into a little over 45,000 tests per million, but given the scale of the crisis in the state, it should be doing more. Its positivity rate is yet to traverse the trajectory seen in most countries – an increase with more testing, then a plateau, and finally a decline. Given the numbers, it is also likely that Maharashtra’s contact-tracing process isn’t very effective – although it’s not clear to what extent this could have made things better in a state where the virus has been in community transmission mode for months. But neither of these adequately explains the scale of the crisis in Maharashtra.
Demographics could offer an explanation – but the state isn’t very demographically different from the rest of India. Sure, Maharashtra is home to 10.7% of the country’s population of people over the age of 60 (a group vulnerable to Covid-19); 9.9% of its population is over the age of 60, but this proportion is higher in Kerala, Goa, Tamil Nadu, Punjab, and Himachal Pradesh.
So could genetics – except the genetic profile of the Maharashtra population isn’t markedly different from the Indian population as a whole, although previous studies have established that it (expectedly) bears more similarity with south Indian populations rather than central Indian ones.
That leaves two other factors. The first is Maharashtrian society, culture and living conditions in the state. The second is the state’s response to the pandemic. On the second, there isn’t enough evidence to suggest that Maharashtra’s government was either more proactive or less proactive than administrations in other Indian states in managing the disease. And on the first, we simply do not know enough, although it is a fact that, at least in Mumbai, social distancing isn’t possible and that cases in the state have seen a renewed surge after the recent Ganesh Chaturthi festival.
And so, Maharashtra’s numbers will have to remain a mystery for now – the rare instance of an early hot spot of the coronavirus disease continuing to be one six months into the pandemic.