Worrying increase in Maharashtra COVID cases

Maharashtra’s COVID count rises again, this time more in the districts, but the government says things are under control.

A mask seller near Chhatrapati Shivaji Terminus. Wearing a mask in public places is compulsory in Mumbai after the surge in COVID-19 cases. Thackeray in his address on February 21 told the people that they would have to wear masks if they wished to avoid another lockdown.

M aharashtraChief Minister Uddhav Thackeray struck an ominous note in his public address on February 21 when he mentioned the possibility of another lockdown. He made it clear that the decision rested with the people, not with him or his government. “Those who don’t want a lockdown will wear their masks. Those who want a lockdown won’t wear a mask. I request you to wear your masks, wash your hands and stay home unless you really need to go out,” he repeated for the umpteenth time. “I don’t like keeping you at home,” he said, “but we must remember that this is a war and having a sword and a shield is just part of the victory…. Knowing how to use it is what really brings you victory. Your sanitiser and your mask are like your shield. Use them.” He also declared a State-wide ban on religious, social and political gatherings.

He held out the assurance that the vaccination programme would pick up just as the public health services had picked up. “Last year we had shortages of oxygen, no ambulances, no testing labs except for two. But we fought all this and now we have more than 500 labs,” he said. Reiterating that complacence would be a mistake, he reminded the public that the West had to reimpose lockdown because they slacked off in the basic protocols. “We opened up because we needed to, but with this comes a responsibility. Earlier we had the slogan Majhi Kutumb. Majhi Jababdari [My Family. My Responsibility]. Now I am making it even more specific. I am saying Meech Jababdar [I am responsible].”

The Chief Minister’s 30-minute speech was prompted by the rise in COVID-19 numbers in Maharashtra. He said he was “worried at the way the numbers started rising after February 10”. The lockdown threat was not realised only because the recovery rate remained high. In Mumbai, for instance, though the city was reporting around 1,000 new cases daily, the recovery rate was 93 per cent.

The Centre has acknowledged a rise in cases all over the country. It announced on February 28 that Maharashtra, Kerala, Punjab, Karnataka, Tamil Nadu and Gujarat accounted for 86.37 per cent of the new cases in the past 24 hours, that is, February 27. In Maharashtra, 8,293 new cases were reported on that date. The Brihanmumbai Municipal Corporation (BMC) data showed 12 active containment zones in Mumbai and 133 sealed buildings. Also read: Is India on the verge of a second COVID wave?

The rise and fall in COVID-19 cases mirrored the pattern of the worst days of the crisis last year. On February 25 and 26, the count was 1,000 and 1,145 active cases respectively in Mumbai. On February 27 the number dropped to 987, only to rise again to 1,051 on February 28. On February 26, Dharavi saw 16 new cases, its highest since October. Dharavi was one of the city’s hotspots that went on to become a model for virus containment methods.

On March 1, there was a drop in new cases in Mumbai. There were four deaths in the city and 30 fatalities in the rest of the State. On the same day, there were 855 new cases in the city and 6,399 in the rest of Maharashtra. As of March 1, the total number of cases in the city was 3,26,770. The death toll since the virus was officially recognised is 11,474.

Worryingly for the government, there has been a steady rise in cases in the districts since the middle of February. Pune registered 790 new cases, Navi Mumbai 153, Thane 211, Amravati 632 and Nagpur 796. A State Health Department official said that the districts had been relatively unscathed through the worst phases of the pandemic and for cases to spring up when hotspots like Mumbai were “cooling down” was “a matter of concern”.

The eastern district of Amravati went into complete lockdown on February 21 for a week, which was later extended to March 8. Hingoli in central Maharashtra had curfew from 7 a.m. to midnight from March 1 to 8. For all practical purposes, this was like a lockdown except that essential services and deliveries could function, and also banks but only for administrative reasons. Pune, too, is under curfew until March 14. Also read: Uddhav Thackeray's Government resists BJP's destabilising attempts

While a complete lockdown in the State seems a remote possibility, considering that economic activity is just about resuming, there is the very real chance of new curbs and limitations being imposed if the numbers keep rising. While a low death rate and a high recovery rate are reassuring, the new surge has to be investigated. Maharashtra seems to be in an ideal position to lead this investigation considering that the State has led in terms of case numbers and seen a rise and dip in numbers through the crisis.

Why the spike

The sudden increase in the number of people using the local train services is thought to be one reason for the surge. Within three days of the local train services opening up on February 2 about 33 lakh passengers had ridden the Central and Western Railway trains. This is still not even 50 per cent of the pre-COVID ridership and the numbers are bound to increase. The laxity in not wearing masks, congregating in numbers, holding large functions and going out even for non-essential activities have all played their part in promoting the surge.

Sero-prevalence studies in Mumbai and Pune seem to indicate that more than 50 per cent of the population have had exposure to the virus. But there is no clear strategy to take this a step forward and develop an understanding about the virus. There is no strategy designed to measure if re-infection is happening, whether certain areas or regions or age groups or any other category have shown more signs of sero-prevalence. As the Health Department official said, “at present the virus is still at least one step ahead of us”.

This time around, much of the rise in Mumbai’s numbers is from areas that house the privileged classes. One explanation for this could be that residents of such areas had the luxury of remaining indoors through the lockdown. Now, as they emerge from their homes with an easing of restrictions, they are more susceptible to infection.

BMC figures show a sharp contrast between the statistics of June 2020 and the current figures. In June last year, when the pandemic was at its peak, the number of people living in containment zones was around 61 lakh. Of these, about 47 lakh were from slum or lower-middle-class housing areas. In these areas there were 726 designated containment zones. The remaining 14 lakh or so people were in middle- and higher-class housing areas. Buildings in containment zones totalled 5,831. Also read: Road to pandemic recovery in Maharashtra

Current data show almost the opposite trend. First of all, there are no vast containment zones. They are more localised and restricted to single buildings or clusters of buildings rather than entire areas and slum colonies. At present there are 12 containment zones and the number of buildings sealed is 1,849. A building is sealed only if there are five or more coronavirus cases in it.

Increased testing and greater willingness to get tested is a possible reason for the surge. The BMC’s sheer doggedness in this regard has broken down the earlier fears and stigmas associated with testing. The threat from the virus, however, is far from over. Dr Michael Ryan, executive director of the World Health Organisation's Health Emergencies Programme, said during an online press conference, “I think it will be very premature, and I think unrealistic, to think that we’re going to finish with this virus by the end of the year.” Or, as Uddhav Thackeray said in his more earthy way, “We are yet to behead corona.”