Maharashtra inches towards 7,000 Covid-19 cases, Mumbai and Pune have highest

More than a month into the lockdown to arrest the spread of Covid-19, Maharashtra’s case count is nearing the 7,000-mark, the highest for any state in India.

Within the state, Mumbai and Pune have the highest number of cases. On Friday, Maharashtra’s count touched 6,817, with 394 new infections. The death toll rose to 301 after 18 deaths were recorded the same day.

Friday was also the 21st consecutive day the state saw a three-digit spike in cases. This is the reason 6,519 cases were registered in April alone. Of the new cases, 5,279 were in Mumbai Metropolitan Region.

In Mumbai also, the tally went up to 4,447 as 242 new cases were recorded. There were 11 deaths in the city, taking the total number of deaths to 178, according to state health department data.

On Friday, the number of cases in Dharavi, India’s largest slum cluster, rose to 220 with six new cases and the death of a 60-year-old woman. There was also a new case in Dadar, taking the total in the area to 29, and one case in Mahim, taking the total in that area to 25.

After the first case on March 9, Maharashtra took 30 days to cross 1,000 cases on April 7, and it crossed the 2,000-mark six days later. From 2,000 to 4,000 cases, it took another six days.

But from 4,000 to 6,000 cases, it took just four days. Though the numbers are high, senior officials said the state is yet to reach the community transmission stage – when the source of infections is not known – as there was no exponential growth.

“The two 14-day cycles of incubation period of the infection were completed on April 20. It had begun from March 22, when international traffic was stopped. We will have to wait for another seven days to see the trend. If the rise continues and if the fresh cases rise by more than 50% (over the previous day) on a daily basis, then it can be called exponential growth. Only then we can say the stage of community transmission has arrived,” said TP Lahane, director of the Directorate of Medical Education and Research (DMER).

The state’s mortality rate has dropped to 4.40% (283 cases till Thursday) from 7.41% (148 cases) on Monday. However, it was still higher than the national mortality rate of 3.11% on Thursday.

Infections have also been reported from more areas of the state. One more district — Nanded — was hit by the virus after a case was found on April 22. Only the three districts of Wardha, Bhandara and Gadchiroli have reported no cases.

The state health department has conducted 102,189 tests at public and private facilities. Of them, 94,485 people tested negative. A total of 957 patients were discharged from hospital after recovery.

The state has kept 8,814 suspected patients at government quarantine facilities, while 119,161 are home quarantined. The state also has 512 containment zones, and 7,702 survey teams have screened more than 2.8 million people.

The lockdown was imposed in the state at midnight on March 23 and partially lifted after 27 days on April 20. The relaxation was revoked the next day because of multiple violations of norms. The state has empowered several municipal corporations to allow activities that are essential.

The Maharashtra government is now ready to start clinical trials of plasma therapy as the Indian Council of Medical Research (ICMR) has given permission.

DMER director Lahane said: “Once it is cleared by the ethics committee of the state, plasma therapy is going to be started in the next three to four days at Sassoon Hospital in Pune. It will also be started at JJ Hospital in Mumbai, Indira Gandhi Medical College in Nagpur and Solapur Medical College once permissions are in place.”

State health minister Rajesh Tope said after a meeting with Union health minister Harsh Vardhan on Friday that Maharashtra has also got the nod from the Centre to start pool testing for Covid-19. The state will now begin pooled tests, where up to five samples are used in a single test.

Plasma therapy uses antibodies from the plasma of a recovered Covid-19 patient to treat others. The concept behind the therapy is that the plasma of a recovered patient contains antibodies with the specific ability to fight the Coronavirus.

The pool testing method involves putting multiple swabs together and testing them in a single real-time polymerase chain reaction (RT-PCR) test. If a batch tests positive, then everyone whose samples were a part of that batch will have to be tested separately.

Tope said the state has suggested the use of portable pulse oximeter and chest X-ray tests to help diagnose Coronavirus patients and to decrease the mortality rate. The state health department also said it had suggested that PPE kits be disinfected and used again, and this was appreciated in the meeting of the Union health minister and state health ministers. Tope also said the Centre is positive about allowing new testing facilities at six medical colleges in Maharashtra.

So far, the state government has provided counselling to more than 47,000 migrant workers who wanted to return home. This is being by psychiatrists and health staff, said Tope. More than 600,000 migrant workers are staying in 944 shelter homes prepared by the state government.

The state government has also directed Brihanmumbai Municipal Corporation (BMC) to increase the number of beds in the city’s hospitals to 7,000 from the current 2,000. This follows an official estimate that Covid-19 positive cases in Mumbai will rise to 70,000 by the middle or end of May.

Currently, 80% to 90% of patients are asymptomatic and don’t need hospitalisation, and going by this trend about 7,000 people (10%) of the projected 70,000 are likely to need hospital beds.

In Mumbai, over the past 10 days, the number of people quarantined at home by BMC has doubled. As of April 15, there were 43,249 people quarantined at home for a fortnight, and the figure increased to 92,112 on Thursday. The number of people under institutional quarantine was 3,271 on April 15 and it rose to 6,000 on Thursday, officials said.

According to BMC’s data, 10,968 people were under home quarantine on April 6 and this rose to 43,249 on April 15, and then to 57,700 on April 17 and 92,112 on April 23. Those home quarantined include high risk case, low risk contacts of positive patients, those with a travel history, and those identified from fever clinics. A majority of those advised to be home quarantined are low risk contacts followed by high risk contacts who are asymptomatic.

BMC has sanitised 47,829 premises, including government buildings. BMC has started pre-monsoon works on roads and desilting rivers with safety measures to ensure there is no flooding. It has allowed construction in private real estate projects, but only related to pre-monsoon works with several riders.