Biggest one-day spike takes Maharashtra virus tally, toll to 22,171 and 832

Maharashtra also registered its highest one-day toll of 53 Covid-19 deaths on Sunday, which took the toll to 832.

Maharashtra on Sunday recorded a single-day jump of 1,943 coronavirus disease (Covid-19) cases, including highest number of new cases —1,278 — in a day and 665 patients from the past few days as per the Indian Council of Medical Research (ICMR) list, taking the state tally up to 22,171.

Migrants gathered in large number for travel pass were sent back by Police at Dharavi Police Station in Mumbai, India, on Sunday, May 10, 2020. (Hindustan Times)

Maharashtra also registered its highest one-day toll of 53 Covid-19 deaths on Sunday, which took the toll to 832.

Mumbai crossed the 500-mark for Covid-19 fatalities as it recorded 19 deaths, taking its toll to 508.

Of the day’s cases, Mumbai accounted for 875, which is also the highest the city has recorded in a day. Total cases in Mumbai now stand at 13,739. Pune recorded 402 new Covid-19 cases on Sunday, taking its count to 2,377.

Besides Mumbai, Pune and Jalgaon recorded five deaths each; three deaths were recorded in Dhule; and one each in Vasai-Virar, Pimpri-Chinchwad, Ahmednagar, Aurangabad, Nandurbar, Solapur. In addition, 14 deaths were registered in Malegaon between Apr 27 and May 10. One person from Madhya Pradesh also died in Mumbai, the state health department said.

Maharashtra has recorded over 50% of its toll in the past 12 days. According to the data of the Medical Education and Drug Department (MEDD), out of the 832 Covid-19 victims in the state, 432 or 51.92% of deaths were recorded between April 29 and May 10.

Even as the mortality rate has reduced drastically from 7.12% on April 12 to 3.85% on May 9, the toll continued to rise. The Union health ministry, too, has expressed concern over the deaths in Maharashtra. State health minister Rajesh Tope said that besides comorbidities, late admission in the hospitals is one of the major reasons for the rise in death count.

Tope said that aggressive behavioural changes and communication exercises need to be taken for removing the stigma against reporting Covid-19, which shall contribute towards timely reporting, clinical management, and reduction in fatality rates. The minister said that around 30% of the deaths reportedly occurred between 24 to 48 hours of admission to the hospital.

“Comorbidity, as we know, is the major factor, but besides that, people today are scared of social boycott if their community gets to know that they have tested positive for coronavirus. Therefore, they do not report despite showing symptoms. Addressing this stigma would lead to people reporting early for diagnosis and treatment,” he said.

According to MEDD data, around 72% of the people who died had an underlying illness, while 28% of the people did not have comorbidities. The data also said that around 250 people are currently “critical” at various locations.

The health minister accepted that the situation is “complicated” in Mumbai, which alone has recorded over 13,000 Covid-19 cases. He said that slum pockets in Mumbai are the problem areas where the virus is spreading fast.

“The situation is complicated in the slums. If we leave Mumbai, cases are not much in other places. I accept there are issues in Mumbai. There is a shortage of beds and institutional quarantine facilities. We are trying to double the institutional quarantine facilities by adding facilities with additional 15,000 beds. The sheer volume is huge,” Tope said.

Maharashtra health department will start implementing the new discharge protocol after a revised guideline was issued by state health secretary Pradeep Vyas. With the new guidelines, mild, very mild and pre-symptomatic cases admitted to a COVID care facility will undergo regular temperature and pulse oximeter monitoring and the patient can be discharged after 10 days of symptoms onset and no fever for three days in such cases. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow the home isolation for further 7 days.

According to the guidelines, the government said that the cases that are clinically classified as “moderate cases” will undergo monitoring of body temperature and oxygen saturation. “If the fever resolves within three days in moderate cases and the patient maintains saturation above 95% for the next four days without oxygen support, such patient will be discharged after 10 days of symptom onset in case of absence of fever without antipyretics, resolution of breathlessness and no oxygen requirement,” said an official from the health department.

For severe patients, clinical recovery and one coronavirus test by RT-PCR after the resolution of symptoms is required as against two RT-PCR tests mandatory earlier.

Tope said that the new discharge protocol would reduce the stress on laboratories in the state. “The new protocol says patients with certain symptoms can be discharged in 10 days. I had followed up with the Centre over the number of days before asymptomatic patients can be discharged. The labs are also burdened,” he said. Maharashtra has so far tested 2,38,766 samples. A health department official added that the revised protocol will reduce the burden on institutional quarantine facilities and other healthcare infrastructure.

Dr Lancelot Pinto, an epidemiologist from Hinduja Hospital welcomed the move by the Centre. He said, “Basically the thought process behind it is that the swab can remain positive for a long time, but a positive swab does not necessarily mean that it is live virus. In cases of Tuberculosis too, PCR-based tests sometimes remain positive even two years after a person had TB. These tests are extremely sensitive. The RNA from a dead virus will be detected by the test and therefore, giving so much importance to the swab becoming negative may not be important. All of this in the context of the shortage of beds is also important. The guideline is just not for a negative swab. Once the patient is stable, just waiting for the swab to turn negative is not very scientific. It is an excellent move.” He added that if there is a necessity to remain in the hospital, nobody would remove the patient.

Prime Minister Narendra Modi has convened a meeting with all chief ministers of the state via video conference on Monday afternoon to discuss the response to the relaxation in lockdown as per zones and further course of action.

The state government on Sunday issued an order stating that Chief Minister Relief Fund would sponsor the train ticket fare of the migrant labourers that are stuck in Maharashtra and also for train tickets of the state’s migrants that are stuck in other states. As per the government resolution issued by the state, those migrants who are unable to bear the ticket fare for the ‘Shramik Express’ trains, the Chief Minister Relief Fund would pay for it through the district collectors. The facility will only be applicable for the special trains that depart till May 17, the order stated.

According to the Pune district collector office, 1,172 labourers from Madhya Pradesh who were stuck in Daundh and Purandar talukas of the district were sent back to their state via the Shramik Express train on Sunday evening.