The outbreak in Maharashtra is particularly serious in the regions of Nagpur, Aurangabad, Amravati, Thane and Mumbai. In this file picture, view of CSMT from the terrace of BMC. (Anshuman Poyrekar/Hindustan Times)
The outbreak in Maharashtra is particularly serious in the regions of Nagpur, Aurangabad, Amravati, Thane and Mumbai. In this file picture, view of CSMT from the terrace of BMC. (Anshuman Poyrekar/Hindustan Times)

Govt says 2nd wave in Maharashtra; PM’s meet today

  • The PM is expected to raise the issue of states where the virus appears to be taking hold once again, and is likely to stress on the need to accelerate vaccinations, according to officials who asked not to be named.
By HT Correspondent, Hindustan Times, New Delhi
UPDATED ON MAR 17, 2021 06:12 AM IST

Prime Minister Narendra Modi will hold a crucial meeting with the chief ministers of all states and Union territories on Wednesday as alarm grows over the resurgence of Covid-19 cases in India, particularly in the state of Maharashtra, which is at “the beginning of its second wave”, according to central officials who prodded the state to step up containment efforts.

The PM is expected to raise the issue of states where the virus appears to be taking hold once again, and is likely to stress on the need to accelerate vaccinations, according to officials who asked not to be named.

“A detailed directive was issued by the health ministry on measures that states such as Maharashtra should take in order to curb the transmission cycle. It includes intensifying disease surveillance by effective testing and tracing to identify cases. States that are reporting a surge also need to quickly expand their vaccination coverage and deal with vaccine hesitancy among the target group. The review is likely to focus on these details,” said one of the officials cited above. “And it is not just regarding states that are reporting a surge, others will also have to keep their guard up,” he added.

Infection trends in at least eight states show they are in a new wave of infections. Except for Kerala, Odisha and Bihar, almost all regions are showing an increase in their outbreak, according to the University of Michigan’s India vid-19 metrics tracker that shows all of the other regions with an R number of above 1. Since a low of roughly 11,000 cases a day in the second week of February across India, there are now approximately 23,500 a day on average (over the last seven days). The trends threaten to quickly erode India’s advantage of starting its vaccination programme while the outbreak was largely under control.

Union health secretary Rajesh Bhushan wrote to the Maharashtra chief secretary after the central team’s visit last week. “Maharashtra is in the beginning of a second wave of Covid-19 pandemic. Efforts to track, test, isolate cases and quarantine contacts are limited there with no adherence to Covid-19 appropriate behaviour among people both in rural and urban areas,” Bhushan wrote in the letter.

Maharashtra’s R number is at present 1.34. The R number, or the effective reproduction number of the virus, is an epidemiological measure that indicates the number of people each case infects on average – if it is above 1, it means onward infections, and thus the outbreak, is continuing to grow. The outbreak in Maharashtra is particularly serious in the regions of Nagpur, Aurangabad, Amravati, Thane and Mumbai. Nagpur civil surgeon Dr Devendra Patulkar said several factors may have contributed to the rise. “After December 2020, the public had let their guard down. They did not follow precautionary measures like wearing masks and maintaining social distances. Soon, the chain of infection started which is now spreading across the district,” he said. “However, so far, we haven’t received any case of virus mutation in the district,” he added.

Dr Sundar Kulkarni, civil surgeon from Aurangabad, too said public carelessness was to blame.

The letter highlighted what the central team said were lapses in the contact tracing process. Officials in Maharashtra reported they were tracing 20 contacts for every positive case, but, “a deep dive into the methodology of contact tracing revealed that the main concept of contact tracing was not clearly understood by field level staff”, the health secretary said. The central government recommended the state should plan for surges while it still has time and that the practice of auditing deaths be brought back. “Surveillance needs to be strengthened by active house to house search for active cases/contacts in containment zones (as per the containment plan),” said the letter. Contact tracers were mainly listing immediate family and neighbourhood contacts for the sake of listing, the official said in the communication. “The high-risk contacts in workplace settings, social settings and family settings were not investigated and listed,” the official said, citing the report.

The central team also highlighted vaccine hesitancy among health workers. Experts said the government must step up efforts to identify variants of the Sars-Cov-2. “We have assurance from government that there are no imported variants, but given the scale of the rise in cases, the possibility of a local high transmission variant cannot be ruled out,” said Dr Gagandeep Kang, one of India’s top vaccine scientists.

The Union government on Monday also rushed a three-member team of senior experts to Haridwar, Uttarakhand, to review medical care and public health arrangements for the Kumbh mela that begins from April 1. Experts said a lack of restrictions on how many people can gather for a dip in the river threatens to turn the religious event into a Covid-19 super-spreader. The resurgence brings the focus back on coronavirus vaccinations, which has averaged around 1.4 million doses over the last week. The country has targeted delivering 300 million doses by the end of July, with a little over 33 million done since January 16. “Expanding vaccination will help in two ways. It will protect the many who are still vulnerable to severe disease if infected and will reduce the transmission,” said Dr K Srinath Reddy, founder, Public Health Foundation of India. “Ensuring adherence to public health measures, especially masks and avoiding gatherings in ill ventilated places, is also crucial. These measures will guard against various forms of the virus, including mutants,” he added.

Reddy also called for the need to step up genomic sequencing. “The rising case count in Maharashtra is worrisome. Mutant strains may be contributing but without extensive genomic analyses of virus samples from new cases, we cannot say to what extent the mutants are propelling this acceleration.”

In a letter to the Union government, Maharashtra health minister Rajesh Tope said the state needs at least 22 million doses of coronavirus vaccines, with at least 2 million being sent each week.

“The state is planning to immunise 60-plus age group and 45-plus population with co-morbidities. It needs supply of 2.20 crore doses of Covid-19 vaccine (Covishield and Covaxin) during the next three-and-a-half months. You are requested to supply 20 lakh doses per week to Maharashtra,” Tope said in the letter sent on Monday.

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