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“It is difficult to predict when we can see a downward trend, but the next two weeks are important and by end of June, we will have a clearer picture,” he said.

A senior health department official admitted that the state had been hoping to flatten the curve by May-end. “We had been expecting the flattening of the curve by May-end and the chief minister had directed the authorities to set targets accordingly. In the current scenario, it seems to be difficult even by June-end. However, we have been successful in keeping our count much below projections by various agencies, including the Central government, for Mumbai and Maharasthra,” said the official, who did not want to be named.

Given the unpredictability of the disease, the government is unlikely to offer any relaxations now and will observe how the existing relaxations have impacted the state’s case tally.

“Many commercial and industrial activities have been allowed, except in Red Zones. Opening of shops, private offices and allowing outdoor physical activities from June 3 to 8 may lead to surge in cases in the next few days. We are very closely observing the trend and no more relaxations will be given at this stage,” said a senior bureaucrat, who is part of the core group that finalised the strategy on handling the Covid-19 pandemic in Maharashtra.

Officials from the state government, districts collectors and municipal corporations have been directed to concentrate on “chasing the virus” and at the same time “containing it”.

“It is a two-fold strategy. We have directed local authorities to ramp up infrastructure while tracing the high- and low-risk contacts within 24 hours after patients test positive. At the same time, they have been told to strictly implement the lockdown in containment zones. In rural and semi-urban areas, the spread is rapid through the people travelling from big cities like Mumbai and Pune. We have asked local authorities to monitor these travellers strictly,” the bureaucrat said.

The health department official pointed out that the rate of the doubling of cases had improved to more than 16 days, and even the case fatality rate (CFR) is in control (3.7% as of Friday). He said although the Centre has raised a red flag over high CFR in Mumbai, Thane, it is much lower than what it was three weeks ago.

Scientists believe the lockdown helped reduce the infection rate, or R0 (referring to the number of people infected by one Covid-positive individual).

Professor Bhalchandra Pujari of Savitribai Phule Pune University said R0 in most states, including Maharashtra, is estimated to be between 1 and 2 as INDSCISIM, the first India specific epidemiological developed by the Indian Scientists’ Response to Covid-19 (ISRC). ISRC is a voluntary group of more than 500 Indian scientists, engineers, doctors, technologists and public health researchers.

“Before the lockdown, RO was estimated to be between 2.5 to 3, which has significantly reduced to 2 owing to the lockdown,” said Pujari, who was member of the team that developed INDISCISIM. “The main purpose of the lockdown was to push the peak, flatten the curve and give space to prepare health infrastructure. Our earlier report, stating that peak infections will occur in June-july, still stands.”

According to Dr Pradip Awate, state’s surveillance officer, the healthdepartmenthaswitnessed possible chances of community transmission in some parts of the state and this could be the reason for the continued increase in cases. “We are seeing signs of community transmission not only in Mumbai, but also across Maharashtra. We are getting cases in clusters without the source of infection. The lockdown, to a great extent, has helped to control the spread of infection,” said Dr Awate.

While the number of positive cases in Mumbai is on decline, the state authorities are worried about the lapses in health services emerging over the past few days. The shortage of beds for Covid-19 and non-covid-19 patients and reports of hardship faced by citizens is worrying.

“It is true that the reports about bodies and patients going missing and deaths reported due to non-availability of beds are not a good sign for the Maharashtra Vikas Aghadi (MVA) government,” said a senior state minister, who did not want to be named. “The Opposition has been cornering us, pointing at these lapses.

The acquisition of the beds from private hospitals has not been done as per expectations and there are complaints of a few hospitals playing spoilsport. Health minister Rajesh Tope has asked municipal commissioner of Mumbai to ensure that 80% beds in private hospitals are acquired at the earliest.”

State health minister Rajesh Tope said strict action has been taken against the officials responsible for the negligence over treatment to patients. He said the cases of negligence at Shatabdi Hospital or the one in Jalgaon have been “taken up seriously”.

With inputs by Snehal Fernandes and Rupsa Chakraborty bage,” the bench, which also comprised justices Sanjay Kishan Kaul and MR Shah, remarked during the hearing of the case.

The Supreme Court registered on Thursday the suo motu case over issues surrounding the treatment of Covid-19 patients and handling of the bodies of Covid-19 victims in hospitals. Chief Justice of India (CJI) SA Bobde took cognisance of media reports highlighting the issue and assigned the matter to the three-judge bench.

“We direct that the chief secretaries of the states shall immediately take appropriate notice of the status of patients’ management in the government hospital in their respective states and take remedial action. Status reports with regard to government hospitals, patient care and the details of the staff, infrastructure, etc. should be brought before the court so that appropriate directions can be issued by the court as found necessary on the next date of hearing,” the order passed by the court said.

The bench also expressed concern over reduced testing of samples in the national capital and described the situation in Delhi as “horrific”.

LNJP hospital is a dedicated Covid hospital with 2,000 beds out which only 870 beds are occupied.

“The patients are in the wards and the dead bodies are also in the same wards. Dead bodies are seen also in the lobby and waiting area. The patients were not supplied with any oxygen support or any other support, no saline drips were shown with the beds and there was no one to attend the patients. Patients are crying and there is no one to attend to them,” the court noted in its order.

The court issued notice to LNJP Hospital as well. The director or medical superintendent of LNJP Hospital has to offer an explanation about the state of affairs in the hospital highlighted by the media

Commenting on the court’s observation on the LNJP health facility, the Delhi government spokesperson said it was the biggest Covid-19 hospital in Delhi and “right now around 2,000 beds are operational there for the coronavirus patients”.

“Many critical patients from the central government and the private hospitals in Delhi are being referred to LNJP Hospital for better medication. So far, over 2100 patients from LNJP hospital have successfully recovered from Covid-19 infection and returned to their homes,” the spokesperson said. “National Human Rights Commission (NHRC) is an autonomous body and their team visited the LNJP hospital on Thursday. They expressed their satisfaction after scrutinising facilities at the hospital. We will appraise the honourable Supreme Court about this as well,” the spokesperson added.

According to the Delhi Corona app, there are 5,814 beds for Covid-19 patients in Delhi’s government hospitals out of which only 2,620 beds are occupied. Despite that, patients suffering from Covid-19 are running around desperately for admission in hospitals.

“The large number of beds in government Covid-19 hospitals being vacant in a situation where patients suspected of Covid-19 are running from pillar to post to get admission in any hospital tells about the mismanagement and sorry state of government hospitals in Delhi,” the order said.

The court’s order also mentioned “the grim situation in other states also, more particularly, in the states of Maharashtra, Tamil Nadu, West Bengal, and Gujarat.”

The court also took note of the insensitive manner in which bodies of Covid-19 patients were being handled by hospitals in violation of a directive issued by the central government on March 15.

“The patients’ relatives are not even informed for several days about the death of the patient as has been reported in the media. It is also brought to our notice that the details of cremation as to when the dead body will be cremated are not even informed to their close relatives due to which the families of the patients are not even able to see the dead bodies or attend their last funeral rites,” the order said.

In a text reply, Bhushan Gagrani, principal secretary and member of Maharashtra’s task force to handle the Covid-19 crisis, who is authorised to speak on behalf of the government, said, “We can comment when the state government examines the order and decides on an appropriate response.”

In West Bengal, senior Trinamool Congress leader and minister of state for parliamentary affairs Tapas Roy said, “The Supreme Court did not make any observation on West Bengal. It has served a notice to the state, seeking its reply. The court’s observations were related to Delhi and Tamil Nadu.”

The Bharatiya Janata Party (BJP) in Bengal was critical. “The Bengal government does not wake up as long it is not pulled up by the judiciary,” said BJP state president Dilip Ghosh.

A senior official from the Tamil Nadu directorate of public health, who did not want to be named, said: “We keep on expanding services based on the expected numbers. There is no shortage at any point of time.”