Maha coronavirus fight enters battle mode
State’s daily case count continues to rise; experts blame poor health infrastructure in certain districts, say next 15 days crucial
*Shortfall due to reconciliation of figures with ICMR portal.
MUMBAI: Maharashtra’s share in India’s Covid-19 tally has declined over the past two months, but it still remains the state with most infections (300,937) and fatalities (11,596). On May 18, Maharashtra accounted for 40.9% of that day’s Covid cases in India – 2,033 of 4,970 cases in 24 hours. The state’s share in the daily rise in infections dropped to 27.6% on June 18, and it was 23.8% on July 17. This is primarily because the state has managed to contain the spread of the virus, while cases in other states have risen at a greater pace.
The case fatality rate (CFR), however, has remained a constant worry for Maharashtra, as it stands at 3.85%, second only to Gujarat (4.54%), and more than the national CFR of 2.53%.
The state has reported 62,476 infections in the past eight days, with a daily average of 7,809 cases, while the fatalities during the same period are 1,702 at a daily average of 212 deaths.
Mumbai, the state’s worst affected city, has 100,350 cases and 5,650 deaths, but the rise in infections in the city has plateaued over the past fortnight. However, other cities in the Mumbai Metropolitan Region (MMR), Pune, Pimpri-chinchwad, Nashik, Aurangabad and Jalgaon remain a cause for concern as the cases in these cities have witnessed a massive spike.
Currently, the eight civic bodies of Thane, Kalyan-dombivli, Bhiwandi-nizampur, Mira-bhayandar, Vasai-virar, Navi Mumbai, Panvel and Ulhasnagar contribute to 30% of the total cases in Maharashtra. These civic bodies have witnessed more than three times rise in infections in the past four weeks. Many of these cities have poor health infrastructure and it has been the primary reason for the rise in cases, high mortality rate and poor recovery.
“Kalyan-dombivli, Bhiwandi, Mira-bhayandar, Vasai-virar, Panvel in MMR and Pune, Jalgaon, Solapur have poor health infrastructure. Besides, the local bodies have failed to aggressively track, trace and isolate suspected contacts of Covid patients. We had directed them to trace at least 10 people per patient, but in some cities, it has not happened, leading to the rise in the cases,” said a senior government official, on condition of anonymity. “Civic bodies like Kalyan-dombivli, Bhiwandi, Pune and Jalgaon could not ramp up their facilities with oxygen beds and ICUS and failed to cope up with the surge witnessed in the past few weeks. We had to change commissioners of at least six civic bodies in MMR over the past month.”
While Mumbai still tops the daily rise in cases – between 1,200 and 1,300 – it is closely followed by Pune, which has reported a daily average of 1,023 cases over the past week. In MMR, Kalyan-dombivli’s daily average is 470 cases, the highest among other civic bodies.
Solapur has the highest CFR (7.4%), followed by Mumbai (5.63%), Jalgaon (5.5%) and Akola (4.9%).
Dr Shashank Joshi, member of the 11-member task force constituted for clinical management of patients, said local authorities of areas with the high number of cases need to ramp up their facilities. “I am personally not happy with the infrastructure and the tracing-testing-isolation done by some of the civic bodies like in Kalyan-dombivli. Testing for coronavirus takes two days and another three to four days for the report to come. They need to go for capacity building for testing, apart from aggressive tracking of the suspected contacts. The civic bodies and districts are also facing shortage of doctors and health experts. If they can match up to these challenges and ready themselves to fight the surge, then it is possible to contain the spread.”
The state government, meanwhile, has been closely monitoring the areas with constant rise in cases. “We have been giving projections for 15 days to every district to enable them to ramp up their infrastructure. Barring a few districts or civic bodies like Pune, and civic bodies in MMR, rest of Maharashtra is well equipped to take up the additional load. Even in Pune, they have added 600 oxygen beds two days ago and have started acquiring private hospitals. It is true that in exceptional cases the patients are facing hardships owing to the weak infrastructure, but we have been putting in constant efforts to augment it,” said Dr Pradeep Awate, state surveillance officer. Joshi said Mumbai has reached its peak of the infection, while the rest of MMR has entered into peak mode and may stabilise in the next two weeks. “The rest of the state is entering the peak and may see a rise in cases over the next few weeks. In the next four weeks, the entire state can be stabilised,” he said.
Awate said they expect the descending limb of the virus spread to begin by mid-august, which is also considered the midpoint of the monsoon season. He said that with more than 35,000 tests daily and introduction of rapid antigen tests, the government expects rapid containment of the transmission of the virus and a drop in CFR.
Dr Anil Pachnekar, national vice president of the Indian Medical Association and a private practitioner in Dharavi, said the model used to contain the spread of coronavirus in India’s largest slum will help other parts of the state too. “Dharavi pattern has shown the way by aggressively implementing ‘chase the virus’ mantra with the help of various stakeholders of the society. It has been widely applauded and needs to be implemented across the state, especially in areas with rising numbers. The coronavirus test has been freed from the compulsion of having a doctor’s prescription in Mumbai, while antigen and antibody testing has been introduced across the state. This will help in effective containment of the virus over the next few weeks,” he said.