NCDC team finds a rise in COVID-19 transmission and positivity rates in rural Maharashtra

A health worker in a RT-PCR testing van for COVID-19 in Mumbai on February 11.

Nine districts in Maharashtra have been identified as showing a high positivity rate of COVID-19. The districts of Amravati, Wardha, Yavatmal, Akola, Gadchiroli, Bhandara, Nandurbar, Ratnagiri and Nanded have become the latest coronavirus hotspots, reporting higher than usual cases.

On February 9, Chief Minister Uddhav Thackeray held a review meeting with State Health Department and other officials along with a team from the National Centre for Disease Control (NCDC). The agenda was to create a more focussed virus control strategy and a more effective clinical management.

In the first week of February, a three-member NCDC team led by its Director Dr. Sujit Singh had visited Mumbai, Amravati, Akola, Nagpur and Yavatmal. While their findings did not indicate a spike in cases, they did find a high level of continued transmission and positivity rates in the rural areas of Amravati, Akola, Yavatmal and Bhandara districts. Given the fact that there is an overall fall in transmission rates even in places of high urban density like Mumbai, the rise in transmission rates in these rural areas is a cause for concern.

While a total of 14 districts have registered a spike in active infections, nine have shown a high positivity rate. In the period from January 8 to February 8, Amravati district recorded a rise in active cases from 375 to 856. The district also reported clusters of cases in certain taluks and villages. Nandurbar had a high positivity rate of over 10 per cent though it actually saw a drop in active infections. Bhandara had the highest death rate in the State at 7.69 per cent.

The increase in COVID-19 cases in rural areas is being partially attributed to the return of migrant labour and cross-migration from other States. For instance, the cluster cases in Amravati district could be an indication of this.

The possibility of a new strain of the coronavirus having emerged is also being considered. There are 440 mutations of the coronavirus that have so far been detected in India, but none are as pernicious as the United Kingdom or the African strains. Kerala has reported six mutated strains of COVID-19..

Maharashtra Health Minister Rajesh Tope announced that genome sequencing will be done of asymptomatic, moderately ill and severely ill Covid-19 patients to try and assess whether the fresh cases are a result of viral mutations.

Yet another reason could be that the focus has so far been on Mumbai, Pune and other urban clusters, leading to lower rates of testing in rural areas. And related to this is the possibility that community tracing and testing has been inadequately carried out.

Shortage of trained staff is also a part of the problem. Rajesh Tope said doctors will be given online training to improve the clinical management of the virus. As before, it comes down to tracking, testing and treatment.