Maharashtra’s ‘alarming’ surge in Covid-19 cases due to relaxations, migration: Experts
Cases in India’s worst-affected state rose from 59,546 on May 28 to 164,626 on June 28, with the state recording five record one-day spikesUpdated: Jun 29, 2020 11:27 IST
On June 27, Maharashtra reported 6,368 new Covid-19 cases (after reconciliation of 1,050 cases), a record single-day spike not only for the state, but for India as well. This was the fourth consecutive single-day spike record for the western state, India’s worst-affected region that has seen 164,626 cumulative cases. From June 24 to June 28, excluding the record on June 27, Maharashtra recorded 3,890, 4,841, 5,024 and 5,493 new cases.
In the past week, until June 27, the state has recorded more than 4,400 new cases a day on average, compared to 3,400 the week before that. The doubling rate of cases – the number of days it takes for a given number of infections to double – has dropped from 24 days a week ago to 22 days as of Saturday.
The positivity rate, too, has shown no signs of slowing down. Two weeks ago, the state had an average positivity rate of 20.6%. Since then, it has slowly, but steadily been rising despite a big increase in daily tests — on June 27, the positivity rate stood at 22%. This means that the more samples that the state tests, the more the positive cases. Experts say it is an alarming sign.
In the two other states with high caseloads – Tamil Nadu and Delhi – as the testing has been ramped up over the past two weeks, the positivity rate has declined. In Delhi, the average positivity rate has dropped from 30.7% two weeks ago to 18.7% on June 27. The corresponding number has dropped from 12.2% to 9.9% in Tamil Nadu.
All three states have significantly ramped their testing in these two weeks. The number of average daily tests has increased from 14,000 to 20,000 in Maharashtra; 18,700 to 30,000 in Tamil Nadu; and 5,200 to 18,000 tests in Delhi in the past two weeks. Maharashtra tested 26,628 samples on Sunday, the highest since the first case was detected on March 9.
While Maharashtra’s overall cases have shot up, Mumbai’s cases have plateaued, albeit with a caveat – the number of tests has not risen significantly. For the 10 days from June 15 to June 24, Mumbai tested only 40,110 samples, giving an average of 4,011 tests a day.
However, even with a similar number of tests in May and June, Mumbai’s share in the state’s overall cases has fallen from 59.49% on May 28 to 45.89% on June 28. Simultaneously, districts like Pune, Dhule, Aurangabad, Nagpur, Nashik and Solapur among others have recorded almost 10 times rise in cases, say state-appointed district health officers.
Relaxation in the national and state lockdowns and migration of workers are the main reasons behind the surge, they say.
“In May, most cases were reported from Mumbai and Pune. We had eight orange and five green districts. Now, we don’t have any green districts due to rising Covid-19 cases,” said Dr Pradeep Awate, epidemiologist and state surveillance officer. “Districts like Nanded, Osmanabad, Beed and Bhandara have shown a 100% rise in the number of Covid cases in a month.”
According to data provided by the Maharashtra health department, between May 28 and June 27, Mumbai has seen a 118% rise in cases, but other hot spots such as Pune, Dhule, Aurangabad, Nagpur, Nashik and Solapur have recorded almost 10 times that.
For example, on May 28, Dhule had only 129 Covid-19 cases. On June 28, this surged to 962 cases. Jalgaon rose from 526 cases on May 28 to 3002 on June 28. Nashik went from 1,043 cases on May 28 to 3902 cases on June 28. On May 28, Pune Municipal Corporation had 6896 cumulative cases. On June 28, this rose to 20,870 cases. “Hundreds of people who were stuck in different parts of the country have returned, and this has contributed to the rise in numbers,” said Dr Awate.
The Mumbai Metropolitan Region (MMR), excluding Mumbai, has seen a similar alarming rise. Thane Municipal Corporation cases rose from 3226 on May 28 to 9264 on June 28. Palghar rose from 129 to 5,267 in the same period.
“A large portion of Mumbai’s population travels to MMR as they are economically dependent on the area. So, we not only need to control the cases in Mumbai but also in MMR,” said Dr Shashank Joshi, a member of the state Covid-19 Task Force.
HT spoke to 10 district health officers (DHOs), and each of them said the cases have surged primarily due to a relaxation in the national and state lockdowns and the human migration from metropolises to smaller cities and villages.
Dr Aniruddha Athalye, (DHO), Satara, said, “We have recorded 42 Covid-related deaths, but 40 of them were migrants from Mumbai who died within a few hours of admission in hospitals due to delay in treatment.” According to him, Satara has 1004 Covid-afflicted people, but 80% of them are those who came from Mumbai, Pune and Uttar Pradesh.
In Latur, of the 275 total Covid-19 cases, 95% are migrants. “With the relaxation in the lockdown, several migrants returned home. Gradually, asymptomatic infected people started spreading the disease to their family members. We had zero cases in the first week of May,” said Dr G Garaghe, DHO. Latur had 303 cases on June 28.
In Dhule, people got infected while trying to provide food and water to the migrants on Mumbai-Agra highway. “Though it was a noble cause, 45 people contracted the infection,” said Dhule DHO Dr Shivendra Shagle. “Those cases were just the beginning. Soon, it started spreading among others.” Dhule has 962 cumulative cases on June 28, up from 129 a month ago.
According to Dr Taranglushar Ware, DHO of Yavatmal, around 20 people who had visited the Tablighi Jamaat event in Delhi in April were the first patients from the district.
All DHOs HT spoke to said the general public has not been following physical distancing norms ever since the government announced a relaxation in the lockdown on June 3. “The national lockdown relaxation was implemented for economic reasons, but people are behaving irresponsibly. We are therefore unable to break the infection chain. We have asked the state to extend the lockdown,” said Dr AR Gita, DHO of Aurangabad where cases have increased to 4,833 (June 28) from 1,370 (May 28).
Apart from a lack of discipline, health activists blamed the state’s rigid testing policy behind the rise in cases. Dr Athalye said asymptomatic migrants didn’t qualify for a swab test for diagnosis. “Later, these carriers infected more people. If we had tested them earlier, we could have controlled the spread,” he said.
Dr Abhijit More, co-convenor of Jan Aarogya Abhiyan, a pan-Maharashtra health sector NGO, criticised the state government for failing to test all the migrants even when they fell in the vulnerable category.
He also claimed that due to an inadequate number of testing, thousands of cases are going unreported. “Though Mumbai has reached its plateau, the positivity rate is 22%. This means the number of infected people is high. Many districts may have reached their pandemic peak; so, if we run more tests then we can identify more cases,” said Dr More.