Is Maharashtra Denying ‘Community Transmission’ or is the State Just Behind the Curve?

Maharashtra's total number of COVID-19 cases was 1,52,765 on Friday, including 7,106 deaths. India's total number of patients is close to 5 lakhs with 15,301 deaths across the country. Nearly half of the overall death toll and almost 35% of the cases are from the state of Maharashtra. While the state government has clarified that there would not be another lockdown, in the municipal areas of Thane, Navi Mumbai and Kalyan Dombivali a strict lockdown had been extended. All services except essentials have been closed down. The MMR (Mumbai Metropolitan Region), which includes nine municipalities and three zila parishads, is witnessing a continuous rise in the number of COVID-19 patients.

On May 31, Maharashtra’s tally of patients was 67,655, with the first COVID-19 cases coming to light on March 9. So, after almost three months, Maharashtra had reached over 67,000 cases. But, on June 26, the tally was more than 1.5 lakhs; 85,110 patients were added in the last 26 days. The numbers lead to a simple question: Is Maharashtra in a stage of community transmission?

Dr Pradeep Awate, the head of the state's epidemiology department, believes that community transmission has not begun in Maharashtra. "As per ICMR guidelines, community transmission occurs when contact history cannot be traced for 20% to 30% patients. But this is not happening in Maharashtra. There are still more than twenty percent of patients who are either from containment zones or in contact with others," he said.

The Indian Council of Medical Research (ICMR) recently conducted a survey in Pune, Thane and Mumbai. The results of the survey are awaited, and are expected to provide a clearer picture of the COVID-19 exposure in these three cities. "We are expecting the results of the survey within a week. Only then we will get an idea about these big cities," said Dr Awate.

In May, ICMR had conducted surveys in six districts of the state – Parbhani, Beed, Nanded, Sagali, Ahmednagar and Jalgaon. A total of 2,385 samples were collected to find out the position of the spread of the novel coronavirus. It was found that only 1.13% persons had antibodies for the virus in them.

However, the rise in numbers from the MMR is worrying for Maharashtra. The data also shows that some of the cities in this region show an extremely higher positivity rate. As per the health department, 3,250 tests have been conducted in the Bhiwandi Nizampur municipality so far, of which, 1,588 persons have been found to be COVID-19 positive. The percentage that tested positive for COVID-19 is 49%, much higher than state's average of 18%.

In Kalyan Dombivli, 14,783 tests were conducted out of which 4,873 were positive, at an average of 33%. The Mira Bhayandar percentage of positivity is 36% and is at Thane 18%. The city recorded its highest single-day number of patients on Friday, at 365. The same is case with Kalyan Dombivli municipal area, which had 358 patients on the same day.

This resulted in both city commissioners announcing a strict lockdown in the containment zones. "We are announcing new hotspots for COVID-19 in the city. There will be strict lockdown in those areas," said Thane Mayor Naresh Mhaske. KDMC commissioner Dr. Vijay Suryavanshi said that only essential services will be allowed in the city. "All other activities have been stopped. Also, we have taken back relaxations given in the last few weeks. We appeal to people to follow the guidelines," said Dr. Suryavanshi.

The fatality rate from COVID-19 is also higher in Maharashtra. The national case fatality rate (CFR) is 3.12%, but Maharashtra's CFR is 4.65%. Maharashtra accounts for almost half of the deaths in India. "The number of cases is expected to rise in July and August but we are working to bring down the CFR. The number of ICU beds and doctors will be increased," said state health minister Rajesh Tope.

The state's head of the COVID-19 Task Force and senior epidemiologist, Dr. Sanjay Oak, said that the number of patients that have been cured is increasing in comparison to the active patients. "Right now, there are 65,829 active cases and the number of cured patients are 79,815. More than 52% of the total patients have been discharged. This is the result of constant tracing and aggressive treatment," said Dr. Oak.