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Maharashtra’s Covid-19 cases cross 100,000-mark; Mumbai’s toll goes past 2,000

By Surendra P Gangan, Mumbai
PUBLISHED ON JUN 13, 2020 12:27 AM IST

Ninety-six days since the first Covid-19 case was reported in Maharashtra, the state crossed the 100,000-mark on Friday, with an addition of 3,493 cases. The state’s coronavirus count stands at 101,141 cases. Fatalities in Maharashtra also rose to 3,717 as 127 more deaths were reported.

Mumbai, which is the worst-hit city in India, recorded 1,366 new cases, taking its tally to 55,451, while 90 deaths took the city’s toll past the 2,000-mark to 2,044.

With the state reporting more than 3,000 cases daily for the past three days, the state government and health experts remained unsure about projections and trajectory of the virus curve.

While the rise of infections in Mumbai has been arrested over the past couple of weeks, with hotspots such as Dharavi and Worli Koliwada leading the way, cases across the state have seen a spike. Over the past week, the state has recorded 20,912 cases and 868 deaths – a daily average of 2,987 cases and 124 deaths till Friday.

Health officials said Mumbai’s case curve may flatten first, going by the current trend.

The city’s daily rise in cases has dropped in comparison to the overall state figures over the past three weeks. Mumbai accounted for 63.73% of the state’s new cases on May 14, 56.47% on May 28, 49.06% on June 4 and 39.10% on Friday.

“This clearly indicates that the cases in other parts of the state are on the rise because the number of cases in Mumbai has dropped in the proportion of its percentage with the state level cases,” said a health department official, on condition of anonymity. “The plateau in Mumbai cases is a positive sign. We are more worried about the poor health infrastructure in some of the other districts such as Amravati.”

Dr Om Shrivastava, infectious diseases specialist and a member of the taskforce appointed by the state government for the clinical management of critically-ill patients, said the curve in Mumbai will stabilise soon. “The number of cases in Mumbai has come down significantly in the past four weeks. We may expect flattening of the curve soon. But at the same time, in the rest of Maharashtra, the number of cases may rise. In June and July, the number of cases may keep rising and we need to be more cautious and observant. Once we get through these months, we will be in a position to see which direction we are moving,” he said.

Dr Avinash Supe, former KEM dean and member of the expert committee appointed by the state to recommend steps to curb the spread of the virus, said rise in the cases should not be a cause of worry to some extent.

“There are different trends and phenomena in different areas in the state. While there is a plateau in some parts of the state, a few areas are emerging as hotspots. As long as we are ready with the infrastructure to handle the cases and treat the patients, as per their conditions, this should not be a cause of concern. It is difficult to predict when we can see a downward trend, but the next two weeks are important and by end of June, we will have a clearer picture,” he said.

A senior health department official admitted that the state had been hoping to flatten the curve by May-end. “We had been expecting the flattening of the curve by May-end and the chief minister had directed the authorities to set targets accordingly. In the current scenario, it seems to be difficult even by June-end. However, we have been successful in keeping our count much below projections by various agencies, including the Central government, for Mumbai and Maharasthra,” said the official, who did not want to be named.

Given the unpredictability of the disease, the government is unlikely to offer any relaxations now and will observe how the existing relaxations have impacted the state’s case tally.

“Many commercial and industrial activities have been allowed, except in Red Zones. Opening of shops, private offices and allowing outdoor physical activities from June 3 to 8 may lead to surge in cases in the next few days. We are very closely observing the trend and no more relaxations will be given at this stage,” said a senior bureaucrat, who is part of the core group that finalised the strategy on handling the Covid-19 pandemic in Maharashtra.

Officials from the state government, districts collectors and municipal corporations have been directed to concentrate on “chasing the virus” and at the same time “containing it”.

“It is a two-fold strategy. We have directed local authorities to ramp up infrastructure while tracing the high- and low-risk contacts within 24 hours after patients test positive. At the same time, they have been told to strictly implement the lockdown in containment zones. In rural and semi-urban areas, the spread is rapid through the people travelling from big cities like Mumbai and Pune. We have asked local authorities to monitor these travellers strictly,” the bureaucrat said.

The health department official pointed out that the rate of the doubling of cases had improved to more than 16 days, and even the case fatality rate (CFR) is in control (3.7% as of Friday). He said although the Centre has raised a red flag over high CFR in Mumbai, Thane, it is much lower than what it was three weeks ago.

Scientists believe the lockdown helped reduce the infection rate, or R0 (referring to the number of people infected by one Covid-positive individual).

Professor Bhalchandra Pujari of Savitribai Phule Pune University said R0 in most states, including Maharashtra, is estimated to be between 1 and 2 as INDSCI-SIM, the first India specific epidemiological developed by the Indian Scientists’ Response to Covid-19 (ISRC). ISRC is a voluntary group of more than 500 Indian scientists, engineers, doctors, technologists and public health researchers.

“Before the lockdown, RO was estimated to be between 2.5 to 3, which has significantly reduced to 2 owing to the lockdown,” said Pujari, who was member of the team that developed INDISCI-SIM. “The main purpose of the lockdown was to push the peak, flatten the curve and give space to prepare health infrastructure. Our earlier report, stating that peak infections will occur in June-July, still stands.”

According to Dr Pradip Awate, state’s surveillance officer, the health department has witnessed possible chances of community transmission in some parts of the state and this could be the reason for the continued increase in cases. “We are seeing signs of community transmission not only in Mumbai, but also across Maharashtra. We are getting cases in clusters without the source of infection. The lockdown, to a great extent, has helped to control the spread of infection,” said Dr Awate.

While the number of positive cases in Mumbai is on decline, the state authorities are worried about the lapses in health services emerging over the past few days. The shortage of beds for Covid-19 and non-Covid-19 patients and reports of hardship faced by citizens is worrying.

“It is true that the reports about bodies and patients going missing and deaths reported due to non-availability of beds are not a good sign for the Maharashtra Vikas Aghadi (MVA) government,” said a senior state minister, who did not want to be named. “The Opposition has been cornering us, pointing at these lapses. The acquisition of the beds from private hospitals has not been done as per expectations and there are complaints of a few hospitals playing spoilsport. Health minister Rajesh Tope has asked municipal commissioner of Mumbai to ensure that 80% beds in private hospitals are acquired at the earliest.”

State health minister Rajesh Tope said strict action has been taken against the officials responsible for the negligence over treatment to patients. He said the cases of negligence at Shatabdi Hospital or the one in Jalgaon have been “taken up seriously”.

With inputs by Snehal Fernandes and Rupsa Chakraborty

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