A central team report has said that Maharashtra is in the beginning of second Covid-19 wave, and asked the state to ?plan for a worse-case scenario with sufficient lead time?. The report stressed that testing must be considerably enhanced and protocol laid down by ICMR followed. It said that absence of rigorous tracing, testing and containment is leading to sustained community transmission.
For every positive case, at least 20 to 30 close contacts (including family contacts, social contacts? workplace contacts and other casual contacts) need to be promptly traced and tracked and the practice of isolating 80-85 pre cent of active cases kept in home isolation needs to be reviewed, Union Health Secretary Rajesh Bhushan said in a letter to state chief secretary Sitaram Kunte.
But What Led Maharashtra to an Extreme Situation?
• The cases in Maharashtra has been high ever since coronavirus began spreading in India last year. Mumbai, in fact, past the peak in Wuhan, where the virus first emerged. Some experts believe that since the Mumbai airport caters to a large number of international flyers, those working in and around the airport are more vulnerable and could lead to further spread.
• The infections started spiking in the financial capital around June last year when the Centre relaxed restrictions after three months of a stringent lockdown that was intended to curb the spread of the virus.
• Experts said that there was no option but to lift the lockdown as millions had lost their jobs and livelihoods and businesses were shutting down. Some other experts admitted that they were sort of baffled when they saw India?s relatively low Covid-19 numbers for weeks, despite the dense populations. They explained it as low testing rates.
• Another reason for spike could be resumption of local trains, some believe. Corona Task Force member Dr Shashank Joshi was quoted as saying by India Today that one of the reasons behind this may be the start of local train services for general public. ?New cases in the month December-January were under control and the rise is being witnessed since February. Local train services were opened for all from February 1,? he added.
• But the spike isn?t just in Mumbai, it?s the entire state. Everyday Maharashtra is breaking its own records in coronavirus cases. Hovering around 15,000 for the last few weeks, it is close to touching 18,000 with 17,864 new infections found on Tuesday. According to a Mint report, the authorities have attributed it to crowding witnessed during the gram panchayat elections held mid-January this year and a widespread disregard for the norms by common people as well as politicians.
• ?Look at the political rallies and gatherings that have taken place in January and February by ruling parties in the state, including after Nana Patole?s appointment as Congress?s Maharashtra unit chief,? PTI quoted a Mumbai-based political observer. NCP president Jayant Patil is too in the list who tested positive for coronavirus two days after celebrating his birthday at the party headquarters in Mumbai where party workers had gathered in large numbers.
• Dr Subhash Salunke, advisor to the Maharashtra government on Covid management, said, ?There should have been rigorous testing of people and contact tracing. These are the two basic but the most important tools of curbing the coronavirus spread.?
Most Important Rule: Test, Track, Isolate
• The central team report too highlighted that there is very limited active effort to track, test, isolate cases and quarantine contacts, and there is no adherence to Covid appropriate behaviour among people in rural and urban areas of Maharashtra. ?The case-contact ratio is more than 1:20. Though it appears high, a deep dive into the methodology of contact tracing revealed that the main concept of contact tracing was not clearly understood by field level staff, who were mainly listing the immediate family and neighborhood contacts, for the sake of listing. ?The high-risk contacts in workplace settings, social settings and family settings were not investigated and listed,? the report highlighted.
• Based on the central team report, Union Health Secretary Rajesh Bhushan has written a letter to the state government, stating ?measures such as night curfews, weekend lockdowns etc. have very limited impact on containing/suppressing the transmission? and urged the state to focus on strict containment strategies, strengthening surveillance and augmenting testing.
• ?The buffer zones need to be delineated. The perimeter control needs to be strictly enforced. For each containment zone, the Rapid Response Teams should develop an operational plan,? he said. Bhushan also stressed on augmenting testing to bring the test positivity rate to less than 5 per cent and strengthening surveillance by active house to house search for active cases/contacts in containment zones (as per the containment plan).Further, passive surveillance for ILI and SARI must be enhanced through health institutions, and involvement of private practitioners. ?The Incident Command under the leadership of district collector and municipal commissioner should be actively re-instated with whole of government approach to contain/ suppress the transmission. This should be monitored at the highest level,? Bhushan said.
• For every positive case, at least 20 to 30 close contacts (including family contacts, social contacts? workplace contacts and other casual contacts) need to be promptly traced and tracked and the practice of isolating 80-85 pre cent of active cases kept in home isolation needs to be reviewed, he said in the letter.
Maharashtra Skeptical About Vaccination?
• A survey conducted by LocalCircles has found that there is a varying degree of enthusiasm that has been observed amongst citizens ever since the inoculation of two vaccines — Covishield and Covaxin — commenced on January 16. ?58% citizens remain hesitant to take the coronavirus vaccine immediately,? Sachin Taparia, founder of LocalCircles, said in February.
• In his letter to the state, Bhushan too said, ?Vaccine hesitancy among frontline workers needs to be addressed as their services would be required if the trajectory follows the upward swing as is being witnessed now. The state should also expedite vaccinating those with co-morbidities and elderly.?
Maharashtra Cities Seeing Maximum Spike in Cases
• The spike is predominantly in the Vidarbha region. It is broadly made up of Nagpur and Amravati divisions and occupies a little less than one-third of the entire state. While Mumbai and Pune were witnessing a sudden rise in coronavirus cases every day, the daily number of cases in Nagpur have exceeded that in Mumbai and have made the district a hotspot. Other districts of the Vidarbha region including Akola, Yavatmal, Buldhana, Washim, Amravati, and Wardha have also seen a spike in new infections in recent days.
• Nashik and Aurangabad are other two districts that have been seeing a sudden increase. The central team report stated that the current case fatality was found to be very high among admitted cases in Government Medical College in Aurangabad and in Vasant Rao Pawar Medical College, Nashik which needs to be investigated in detail, including sending samples for whole genome sequencing, it said. Referring to the findings of the team, Bhushan said that containment strategy needs to be re-introduced, containment zones must be better defined based on contact listing, digital mapping of cases and contacts and should be much larger to include the area of influence of cases/ contacts.
Cities Under Lockdown
• The Maharashtra government on Monday extended restrictions imposed in containment zones till March 31 and issued fresh guidelines for the state. All offices in the state, except health and other essential services, will have to function at 50 per cent capacity. As far as possible, employees should be asked to work from home, the notification said.
• Thane, Nagpur, Wardha, Panvel and Aurangabad are among the cities were coronavirus curbs have been imposed.
States Wary of Maharashtra Travellers
• The Delhi government made it mandatory to carry Covid-19 negative test reports for people coming from Maharashtra. Rajasthan has also made it mandatory for travellers from the western state to produce a negative coronavirus test report upon their arrival.
• In Madhya Pradesh, Indore district magistrate Manish Singh issued Covid-related guidelines, which said passengers coming from Maharashtra must produce a negative report of RT-PCR test carried out no more than 48 hours before. In Bhopal, district authorities issued similar guidelines, saying passengers should produce negative coronavirus reports with the test carried out no more than 72 hours before.
• Karnataka government has also said that no one will be allowed to enter from Maharashtra without a Covid-negative certificate.
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