Rise and fall of second Covid-19 wave in Maharashtra
Maharashtra has seen a 55.2% drop in the number of active Covid-19 cases over the past one month, with its weekly positivity rate down to 10.46%. A look at the numbers – on March 27, Maharashtra’s active Covid-19 cases were 303,475, which rose to 672,434 on April 27. After 30 days, on May 27, the number of active Covid-19 cases is 301,041. Also, the state’s weekly positivity rate, which was 24.26% in the week from April 28 to May 4, came down to 11.06% between May 19 and 25. A look at how the state did it.
Public health officers claimed 22 of the 36 districts have witnessed a fall in the weekly positivity rate. According to the Medical Education and Drugs Department (MEDD) report, districts such as Satara, Raigad, Sindhudurg and Ratnagiri that were reporting high positivity rate have seen a plunge. For instance, the weekly positivity rate in Satara district fell to 21.93% in the week from May 19 to 25, from 34.37% between April 28 and May 4.
The analysis of the data indicates a gradual drop in the pandemic curve, especially after the lockdown was imposed in April. However, public health officers claim essential decisions such as ramping up of daily testing, timely detection of mutated strains of Sars-Cov-2, the virus that causes Covid-19, and isolation of close contacts among others, too, helped in the fight against the second wave, which was more infectious than the first one.
TEST, DETECT AND ISOLATE
When the second wave started in the middle of February, some districts such as Amravati, Yavatmal and Akola were recording the highest number of daily Covid-19 cases. For instance, on February 1, Amravati had 92 Covid-19 patients. By February 5, the figure increased to 233; on February 10, it was 369 and on February 20, the patient count reached 1,058. The positivity rate jumped to around 50%, which also raised the eyebrows of the Centre.
The public health department then ramped up the daily testing. On an average, they started to conduct 2,600 tests in Amravati daily and also increased contact-tracing to 45 people per infected patient.
Suspecting a mutation of the virus, samples from the three districts were sent to National Institute of Virology (NIV), Pune, for genome sequencing. Of the 275 samples sent, the ‘preliminary examination’ showed that four samples from Amravati had a mutation (E484Q). Another four samples from Yavatmal showed a second mutation (N440K).
Dr Subhash Salunkhe, state advisor to Covid-19 treatment, said the mutated virus was more infectious and more people from the same family were contracting the infection. “There was a change in the pattern of the virus. It wasn’t as deadly as the first wave, but was spreading faster like the mutated viruses found in Europe. So, after the confirmation of the mutation, we designed a containment plan,” he added.
Lockdown-like restrictions were imposed in Amravati from February 22, which helped bring down the positivity rate from 48% to 9%. “We were the first ones to declare localised restrictions, which helped break the chain. Before the lockdown, there were around 800-900 cases, which dropped to 300,” said Dr Dilip Ranmale, district health officer (DHO).
Soon, districts like Mumbai, Pune, Thane, Nagpur and Palghar started reporting the highest number of cases. The positivity rate in Mumbai rose to over 22% in April, which is now down to 4.7%. Similarly, Nagpur recorded a positivity rate of 31.28% in the third week of April.
The public health department ordered ramping up of daily testing, and boosted RT-PCR testing. Government laboratories were run in three shifts around-the-clock. The state also deployed three mobile labs at Nagpur, Pune and Aurangabad.
Dr Pradeep Awate, state’s surveillance officer, said, “In the first wave, we never crossed one lakh tests in a day, but in the second wave, we ramped it up to around three lakh. This helped in early detection and increased contact tracing. At present, the testing has been reduced as the number of high-risk contacts and close contacts is low, with the decline in positivity rate.”
VACCINATION A PROTECTIVE SHIELD
Maharashtra started the mass immunisation programme from January 16. Since then, 21,352,332 vaccinations have been recorded; 4,431,707 beneficiaries have even got their second dose. “Healthcare and frontline workers who work in close proximity with infected patients got vaccinated, which helped control the infection rate. In the third phase, people above 60 years, considered the most vulnerable group, got inoculated. This helped control the spread among the elderly,” said Dr Rahul Pandit, part of the state Covid-19 task force.
The state and the Brihanmumbai Municipal Corporation (BMC) now plan to ramp up vaccination even for the population below 45 years. “If we are heading towards a third wave, we want to vaccinate as many people as possible. Due to unavailability of vials, we put restrictions on immunization programmes for younger population. But as we have seen in the second wave, young adults and children are more vulnerable. We will try to prioritise immunising them as soon as we get more vials,” said Suresh Kakani, additional commissioner, BMC.
However, the success doesn’t mean the guard should be down, say doctors. “Until we are able to vaccinate all people, the pandemic isn’t over. Until we get the vials, social vaccination is the only shield we have to save ourselves from contracting the infection. People need to follow safety rules such as maintaining social distance, wearing masks and avoiding crowded places. They have to decide if they want a third wave or not,” said Dr Pandit.