Amid case surge, dire estimate, state says do not panic

Maharashtra on Wednesday recorded 431 coronavirus disease (Covid-19) cases, the fourth day in a row 400 or more cases have been reported, taking the number of infected

Maharashtra on Wednesday recorded 431 coronavirus disease (Covid-19) cases, the fourth day in a row 400 or more cases have been reported, taking the number of infected people in the state to 5,649. However, the state government said the hotspots in the state have reduced to five from 14 a few days ago.

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The toll rose to 269 with the deaths of 18 people. Of these deaths, 10 are in Mumbai, two each in Aurangabad and Pune, one each from Kalyan-Dombivli, Solapur, Jalgaon and Malegaon.

The state government has claimed that the mortality rate had reduced and the rate of doubling of cases has improved to 7.01 days, up from 3.1 days earlier this month, even as a Central team that visited Mumbai and Pune projected a sharp spike in cases in the next two to three weeks. The team has advised the Maharashtra government to prepare for a worst-case scenario. However, state health minister Rajesh Tope on Wednesday said there was no need to panic over the projection of a massive surge in the number of cases in Mumbai between April 30 and May 15, saying that the projections were based on the rate of increase in cases, which would not be applicable now.

“There is panic among people about a spike between April 30 and May 15. It is a mathematical model. There is surely a science behind it, but certain things have been assumed in this, such as the doubling rate at 3.5 and that it is kept static We have taken a lot of preventive measures. We are carrying out surveillance, tests, etc.”

He said that such a spike would only happen if the state government wasn’t taking any measures.

In the past four days, 2,001 cases have been reported in the state, while 58 people died during this period. So far, Mumbai has 3,683 cases and 161 deaths.

Of the 431 new cases, 232 are in Mumbai. Of the 18 deaths, five were above that age of 60, while 12 were in 40-60 age group and one was below 40 years. Twelve of these patients had high-risk comorbidities such as hypertension, diabetes, asthama and heart ailments.

The mortality rate in the state dropped 4.80 % on April 21, much below the rate of 7.21% on April 11.

During a presentation before chief minister Uddhav Thackeray and chief secretary Ajoy Mehta, the five-member inter-minister Central teams reportedly projected an exponential rise in Covid-19 cases in Mumbai. It believably said that cases in the city may touch 42,604 by April 30 and increase to 6.56 lakh by May 15. Officials from the health department, however, said that the figures do not substantiate the present trend. “Those are figures assuming the doubling of the cases to be two days. But at present, cases are neither rising at that rate, nor are we conducting testing to reach that number by May 15. Even the percentage of cases against testing ranges between 5-8% and with that rate, figures appear to be unrealistic,” said the official.

Tope said the doubling rate now is 7.01 days, and added that it will go up further. He added that the mortality rate has also improved in the state. Tope said, ”Earlier, it was 7%, now, it has come under 5%, and with efforts, it will reduce further.” The minister said that the hotspots in Maharashtra have reduced from 14 to five — Mumbai, Mumbai Metropolitan Region (MMR), Pune, Nagpur, Nashik.

Meanwhile, Tope rejected the notion that the Central government had sent a team to Maharashtra as it felt that lockdown measures are not followed properly in the state. The minister said the state is faring well in terms of mortality rate and the doubling rate now, which are crucial parameters to judge the size of the pandemic.

Tope said, “Nobody has said that lockdown norms have not been followed [in Maharashtra]… In an epidemic, the situation is always serious. The cluster containment strategy is being properly implemented. If there is any lacuna, we are immediately identifying and resolving it… There are two important things — doubling rate and mortality rate. The doubling rate has improved. Earlier, cases doubled in three days, then in five days, now it is happening in seven days. It is will increase further. The death rate is also improving. Earlier it was over 7%, now it is under 5%. The number of cases are increasing and would increase in the coming days. But they are not growing exponentially.”

A senior state government official said that the Central teams, which visited Worli-Koliwada on Tuesday, Dharavi and other slum pockets in Andheri (East), has sought data of residents of the slums, from the government. It has also sought the number of tests conducted in these areas. An official added that the team has advised that people should be shifted to quarantine facilities to curb the spread of infection in densely populated areas. “In Mumbai, around 75,000 people have to be taken from their homes and shift them into institutional quarantine facilities. We have spaces, including schools and grounds, where this can be erected. Institutional quarantine will aggressively start in Mumbai from Thursday,” Tope said.

The health minister said that the Centre anticipates a spike in the number of cases in the city and added that the state has reviewed its preparedness plan. “According to the preparedness plan, we are checking the availability of hospital beds, oxygen, PPE kits, etc. We are considering the worst possibility and the BMC is preparing for it. I have instructed BMC to increase testing facilities and quarantine facilities as well,” he said.

The minister also hinted that the lockdown could be extended beyond May 3 in areas where the number of cases are high. “Wherever cluster containment strategy is implemented and if there is any hindrance in implementing it and if the cases increase, we will have to take stricter steps,” he said.

After 67 patients were reported to have recovered fully on Wednesday, the total number of the patients to be discharged from the hospitals has reached 789. A total of 1,09, 072 people are home quarantined and 8,051 are under institutional quarantine.

State authorities have conducted 90,223 tests at government and private labs, of which, 83,979 tested negative. State has got 465 containment zones, with 6,798 health teams, which have 25.61 lakh people.

During its interaction with chief minister Thackeray, the IMCT [the central team] has asked the state government to prepare for the worst-case scenario. “They have directed the government machinery for strict monitoring of containment zones and aggressive outreach to curb the spread of the virus further. They also have pressed for contact tracing and aggressive testing of people in hotspots. The government has also been told to increase the number of health teams to trace more high and low- risk contacts,” said an official from the state government, on the condition of anonymity. The official also said that the Central team has asked the state government to take steps to avoid crowding on the roads during the month of Ramadan.

CM Thackeray apprised the team about the initiative taken in by the government to contain the spread in the hotspots, especially the slums in Mumbai and Pune. The team was told that the civic body in Mumbai has been reaching out to people, without waiting for them to report about symptoms. “We have increased the number of tests and it has resulted in the rise in the number of cases in the state. We expect the ICMR nod for the rapid testing at the earliest. The centre should also respond positively to the demand raised by us concerning the supply of PPE kits, N-95 mask and other equipment,“ he said.

Meanwhile, the state government fears an extreme reaction from more than 5.7 lakh migrants living in 4,618 camps across the state if the lockdown is extended again after May 3. “We do not want to repeat the Bandra migrant crisis after second phase of the lockdown ends. We have been getting harsh reactions from these migrants, who have been put up in camps for more than four weeks with every facility at their disposal. The state has already spend around ₹90 crore and huge machinery is engaged for the arrangements. At a few camps, the migrants have boycotted food, demanding for transport arrangements to take them to their respective states. Chief minister Uddhav Thackeray is keen on sending them back at the earliest,” said an official from the state government.

Meanwhile, reacting to the allegations of former Maharashtra chief minister Devendra Fadnavis that the BMC is suppressing the Covid-19 related death count in Mumbai, Tope said that the civic body has assured him that the deaths referred to by Fadnavis were not related to coronavirus. “I have spoken to Praveen Pardeshi, municipal commissioner. He has studied the cases; the patients were old and had comorbidities. The ICMR guidelines say that if a patient arrives in a critical or a serious condition, he or she must be stabilised first, and then swab should be taken. In this case, during the period of stabilising the patients had died. The ICMR guidelines also do not say that swab samples should be taken of [such] patients who died. The commissioner has told me that these are non-Covid-19 deaths,” he said.

Fadnavis, in a letter to Thackeray on Tuesday, said that patients registered as suspected Covid-19 patients were not tested and after deaths, the bodies were releases as non-Covid ones.. He said at least 44 bodies of “suspected Covid-19” patients have been released from the civic-run BYL Nair Hospital — a dedicated Covid-19 facility now — without the coronavirus test. There are several such instances from other hospitals too, said Fadnavis, who tweeted details of the letter he’s sent to chief minister Uddhav Thackeray.

“We are not hiding any information; there is no reason. The directives of the government of India, the protocol of ICMR, is being followed completely,” Tope added.

The minister added that there is a “question mark” over the rapid test or antibody test after the Centre directed the state government not to use the Chinese kits provided for tests. “There is still a question whether to do it (rapid test) at all. In the Chinese kits, the IgM and IgG bands are not visible properly. We will act as per the corrective instructions of the Centre.”

Meanwhile, Tope said that the state has got the go-ahead from the ICMR to try out the plasma therapy.