As Maharashtra crosses 5-lakh Covid case milestone, ‘worst not over yet’Updated: Aug 09, 2020 00:29 IST
Maharashtra crossed the grim 500,000 Covid-19 cases milestone on Saturday, 153 days after reporting the first case in Pune, and health department officials said “the worst is not over yet”, as the state has not reached the peak of infections. The officials said Maharashtra is also witnessing “early signs of community transmission”, but it is not a cause for concern as the spread would remain “local”.
Health experts and state officials said Maharashtra could continue to witness a rise in the number of daily Covid cases till next month, but the growth rate of transmission will remain low.
September is crucial
A senior health department official said while the state will continue to see higher number of cases as testing, too, has increased, the downward curve of Covid-19 infections will begin by September-end.
Dr Pradeep Awate, state surveillance officer, said although the absolute number of cases is increasing, the growth rate is not high. “There are indicators that suggest the outbreak is under control. It also suggests transmission is not happening rapidly. The doubling rate has improved. The overall growth rate is 3%, and in some cities, it’s fewer than 2%. The positivity rate, too, is much lower now despite the increase in daily testing. On Friday, we tested 81,655 samples and the positivity rate was around 12%,” Awate said.
In the past seven days, the state has averaged 9,735 cases daily. From August 1 to August 7, the state added 68,144 cases to its tally. “We have not reached the peak yet; we are still getting there. The absolute cases are expected to increase for some more weeks. We could see the decline in cases by September-end or early October,” said Awate. “But the virus will not vanish. There will be scattered cases coming in from areas as we had seen in the case of H1N1 (swine flu). When H1N1 outbreak happened in 2009, we thought it would go away the next year, but even today cases are reported every alternate year.”
Kerala was the first state in India to announce that two coastal towns had reached community transmission stage. Community transmission is when the index case from where a person contracted the virus is not traced.
State health minister Rajesh Tope had recently denied that the state has entered the transmission stage. However, Awate said the state is “showing early signs” of having reached the stage.
A senior health department official, who did not wish to be named, said, “The ICMR has a parameter for community transmission stage – when 20% of cases cannot be traced back to the source. Therefore, it is a contentious issue because no local body or district administration has followed the process to trace the index cases. For instance, if a city like Pune is reporting 1,500 cases daily, it does not have the manpower to do the tracing. Whether or not Maharashtra has reached the stage can only be announced after a go-ahead from ICMR.”
Awate, who is also an epidemiologist, said, “We are seeing signs of community transmission. There have been cases where source of the infection has not been traced.”
Deaths a concern
The case fatality rate (CFR) of the state stands at 3.49%, second only to Gujarat’s 3.82%, as of Friday. The national CFR is 2.04%. The absolute number of Covid-19 deaths, too, is a worry for the state government. Between July 7 and August 7, 8,066 fatalities were reported in the state. These constitute 47.19% of the total deaths in the state due to coronavirus.
The Central government has also expressed concern over the high number of Covid-19 deaths in Maharashtra and has listed 10 districts that need to do more to tackle the crisis. These districts are Pune, Mumbai, Thane, Palghar, Raigad, Nashik, Ahmednagar, Jalgaon, Sangli and Nagpur.
Chief minister Uddhav Thackeray on Friday directed the district and municipal officials to work on lowering fatalities on priority. A state health department official said, “Districts have been asked to ramp up tracing and testing. Densely populated areas are being looked at.”
“Death rate is a concern and we have been modifying our standard operating procedure. Drugs like hydroxychloroquine, dexamethasone, etc, are being used extensively,” Awate said.
Unlocking the state
The state has been cautious in announcing the lifting of lockdown restrictions. Several civic bodies have been announcing their own versions of lockdowns to contain the spread of the virus. Earlier this month, the government announced opening of malls and market complexes, but food courts, cinema halls and gymnasiums have been kept shut. “Initially, industries, factories, shops were allowed. Now, further relaxations were provided to start the cycle of economic activities. We wanted to give these relaxations in July, but in view of the rising cases in the MMR, the state did not go ahead. Cases in Mumbai have now stabilised. The government will gradually see how things are going and ease restrictions further,” said a bureaucrat.
Dr Lancelot Pinto, Mumbai-based pulmonologist and epidemiologist, said the number of cases going up is a “price to be paid for opening up”. “Looking at the situation from the point of view of cases rising wouldn’t necessarily give a complete picture. One has to check the severe cases, ICU beds occupied, etc. Mumbai has certainly improved in terms of availability of beds. Testing has been made easier, therefore, we are picking up cases that we did not earlier. All centres need to learn from what Mumbai learnt after initial days. Everywhere the cases will start and peak; all the cities will go through this cycle,” said Pinto.