Five districts in Maharashtra report highest Covid CFR

As Maharashtra recorded 67,013 new cases on Thursday, taking the total cases to over 4 million, five districts have emerged as areas of concern with respect to the case fatality ratio (CFR; the percentage of deaths per 100 cases) and in at least three of the districts where data is available, test positivity rate (TPR; number of positive cases per 100 tests) as well

As Maharashtra recorded 67,013 new cases on Thursday, taking the total cases to over 4 million, five districts have emerged as areas of concern with respect to the case fatality ratio (CFR; the percentage of deaths per 100 cases) and in at least three of the districts where data is available, test positivity rate (TPR; number of positive cases per 100 tests) as well.

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In the period from April 15 to April 21, as Maharashtra recorded its highest seven-day average in both cases as well as fatalities, the CFR of five districts posed the most concern. Of them, Ahmednagar recorded the highest at 1.4%, followed by Nagpur (0.95%), Mumbai (0.64%), Nashik (0.62%) and Pune (0.33%). The TPR, however, was the highest in Nagpur with 34%, while Pune district recorded 26.64% and Mumbai posted 17.21% in the same period. Nashik and Ahmednagar did not reveal their tests, and therefore the TPR could not be calculated.

State-wide, the average daily cases touched 64,238, while daily deaths averaged 443 -- highest ever in the pandemic in the country – in the same time period. The state’s TPR averaged 24.81%. The CFR was 0.69% in the same period.

To be sure, the CFR in Maharashtra has been consistently falling since January 31. On that day, the overall CFR stood at 2.52%. This fell to 1.54% on April 21. The main reason for this was that deaths have not increased in the same proportion as cases. On January 31, Maharashtra recorded 2630 cases and 42 deaths. On April 21, it recorded 67,468 cases and 568 deaths, its highest one-day death toll.

Ahmednagar faces a huge shortage of oxygen cylinders, and all the hospitals are full. The local authorities on Tuesday sought oxygen from Chakan in Pune. When the tanker reached the border, it was stopped by the Pune based authorities and made to halt for two hours. Chief Minister Uddhav Thackeray had to intervene to offer reprieve to the patients.

The Maharashtra Government announced a total lockdown which will come to force on Thursday night to contain the virus.

The high number of cases in these places has resulted in the burdening of the medical infrastructure which means the shortage of hospital beds, oxygen cylinders and medicines.

Maharashtra health minister Rajesh Tope has requested for supply of medical grade oxygen for the hospitals, following which the Centre has made a road map on supplying oxygen to the state.

The Centre has earmarked 1661 metric tonnes (MT) of oxygen to reach the state from various states, but it is as yet unclear when the oxygen is scheduled to reach.

“We have taken various steps to ease the solution and would like the central government to cooperate with us to get out of this crisis. The Centre needs to increase its quota of oxygen cylinders and Remdesivir for Maharashtra,” Tope said.

In Pune, the total deaths due to Covid-19 have now reached to 8890 ever since the outbreak of the virus. Many of the small hospitals have stopped admitting patients due to the lack of oxygen. On Wednesday, the district recorded the largest number of cases and there are now 121,284 active cases.

In Nagpur, a shortage of Remdesivir, an anti-viral injection, and medical grade oxygen prompted the Nagpur bench of the Bombay High Court (HC) to take suo moto cognizance of the shortages. On Wednesday night, at a late hearing, it pulled up the Centre for lessening the supply of oxygen from a Bhilai-based supplier, from 110MT to 60MT in a communication dated April 18.

At a time when the supply of oxygen should have been increased it was reduced instead, the HC noted and ordered that the supply be restored. The region, it noted, was facing a shortfall of at least 100MT.

Earlier in the week, it had asked the Central Controller of Drugs in India to ensure that 10,000 vials of Remdesivir be given to Nagpur. Two days later, the Court rapped the Maharashtra Government for its failure to comply fully with its order.

Nashik has become another hotspot for the virus as there are currently 46,253 active patients on Wednesday and has registered a total number of 2701 deaths. The city is facing huge shortage of oxygen and families of patient are frantically searching for Remdesivir injections. “We need at least 125 metric tonnes but are getting only 85 metric tonnes. Even that is very erratic as it sometimes gets caught in various problems,” said senior NCP Minister Chhagan Bhujbal.

On Wednesday, one of the tankers supplying oxygen to patients receiving treatment for the coronavirus disease at Dr Zakir Naik Municipal Hospital malfunctioned, which led to the death of 24 persons.

In Mumbai which has 84,450 active cases, the government is pulling all stops to beat the shortage. “We are making all efforts to save the lives of the people,” said Mumbai Mayor Kishori Pednekar.

Dr Wiqar Shaikh, professor of medicine, Grant Medical College and Sir JJ Hospital, said the people in metros are getting the virus due to various reasons.

“These election rallies were super spreaders and thousands of people are coming from there in flights and railways. This has played a major role in hike in numbers,” said Shaikh.