Maharashtra Epidemic Update: One More Mismanagement Alert

The second wave of the Wuhan virus is finally ebbing across India, but it is doing so in a regretfully irregular and uneven manner. Some states are well and truly in the clear, while others are still in the grip of the contagion.

This asymmetry of regression is sorely impeding a return to normalcy, and the reopening of our economy, since it bears the risk of triggering a pan-Indian third wave.

Bihar, for example, has consistently reported less than three hundred fresh cases for the past 10 days, while at the same time, the daily average in Maharashtra persistently hovers around the 10,000 mark. That is a difference of two whole orders of magnitude.

Kerala, with an undiminished cumulative positivity of over 15 per cent, and a dozen very large clusters still proliferating, may present the gravest risk.

But Maharashtra is not far behind; its Kolhapur district alone, reported nearly 2,000 new cases on 30 June. That is more than the number of new cases in Gujarat, Uttar Pradesh, Rajasthan, Bihar, Haryana, Jharkhand and Delhi combined.

Leaving aside the impact of such an unhealthy situation on the economy, its prevalence for so long, causing so much distress to so many people, begs a question: why does the Wuhan virus refuse to leave Maharashtra? The answer is painfully self-evident: gross inefficiency.

Maharashtra’s epidemic data speaks for itself:

From the top of the chart, the first observation is of a decline in testing levels (purple curve). This is quite unfortunate, since Maharashtra had done well to ramp up testing to around three lakh samples a day during the peak.

In fact, it is those high testing levels during April and May 2021, which bent the curve, and brought the test positivity ratio down (TPR; green curve). It also bent the cumulative positivity curve (orange curve).

Unfortunately, that is also precisely when the Maharashtra government took its foot off the pedal. From early June 2021, just when the TPR was declining into single digits, the testing levels were brought down.

This was a mistake, because now, the situation is that the TPR has actually risen once more in late June, rather than dropping further.

This decision to reduce testing also resulted in daily case counts entering into a long and unhealthy plateau. Note how the red daily cases curve in the plot above stops declining in early June, to enter into a plateau phase.

The administration should have known that for such a large state, with so many large clusters, even a slight dip in the daily rate of sample collection would have a deleterious impact on constraining virus transmission.

Surely, this direct correlation, which was obvious to the rest of the country, should also have been patently obvious to the Chief Minister.

The concept is simple enough. As Swarajya has explained on multiple occasions previously, you have to maintain daily testing at peak levels even after the peak has passed, and pretend that the second wave isn’t over, if you are to prevent a third wave.

This is because testing is the only monitoring tool available, to identify vectors, isolate them, and to break the chain of transmission (something everyone learnt in April 2020). Only then will the cumulative positivity, which is a truer measure of how the epidemic is being managed, decline at a healthy clip to requisite levels.

On the contrary, though, the Maharashtra government’s focus appears to have been on TPR; what other explanation can there be, for a sustained reduction in testing from late May onwards, as soon the TPR dropped to single digits?

For a sense of proportion, and inspiration, the state’s leadership might care to compare their approach with that of Uttar Pradesh:

Chart 2 above shows that the current daily case count in Maharashtra (thin, red dashed line) is where Uttar Pradesh was a month and a half ago (bold red line). Also note the steep, consistent decline of the UP cases curve, while the Maharashtra one settles rather languorously into a high, unwholesome plateau, instead of declining further.

Similarly, note how Uttar Pradesh raised testing levels in two phases (bold purple line): first over March and April, to comprehensively reverse an alarming TPR rise (bold green line); and then, over May and June, to ensure that the cumulative positivity (bold orange line) was brought down to under 4 per cent, while the state’s TPR was firmly forced to be under 1 per cent.

In Maharashtra, instead, see how the black cumulative positivity curve refuses to come down to a single digit, even after months. Indeed, even Maharashtra’s TPR is higher than UP’s cumulative positivity, and if that fact doesn’t put things in perspective for the Maharashtra administration, then nothing will.

Still, this is no time for recriminations, or for harping on a truly near-congenital inability to efficiently contain the crisis; the focus has to be on eradicating this microscopic menace, which has festered for simply far too long in Maharashtra.

For this, the state government should quickly raise testing levels once more, to over three lakh samples a day. It should simultaneously pay specific attention to tracing and isolation in districts of concern like Pune and Kolhapur, where scrutiny has been lax. And, it should resume the reporting of detailed daily testing data at the district level.

The bottom line, therefore, is that the second wave is far from over in Maharashtra. Urgent remedial measures are required to be implemented, as recommended, within the next few days, if the state is to beat the virus, save lives, and effect a return to some minimum normalcy.

If not, and if the Maharashtra administration persists instead with its present approach, then it will become, like Kerala, a dangerous breeding ground that could trigger a third wave in other states.

If that happens, then the benefits of the ongoing national vaccine drive could be disastrously undone. Let’s hope it doesn’t come to that.

All data from Covid19india.org.