New Delhi: With a surge in international travellers returning to the state and a relatively flexible approach for testing those admitted in hospitals for respiratory illnesses, Maharashtra has seen a spike in the number of Covid-19 positive cases. Between Friday and Monday morning, the number of cases detected positive for Covid-19, the infectious disease caused by coronavirus, rose from 48 to 89.
A curfew was declared in the state after it reported 89 Covid-19 cases and two deaths. Of the two victims, one man had travelled to Dubai and one had travelled to Surat in Gujara with his wife.
However, the state’s Health Minister Rajeh Tope has denied that there has been any case of community transmission in the state.
Of the 89 cases, 66 are from Mumbai and Pune alone, including Pimpri-Chinchwad municipal limits.
The figures reflect the challenge faced by Mumbai, India’s financial capital, Pune, the state’s cultural capital and overall by Maharashtra, the second-most populous state in the country.
For context, Maharashtra’s population is greater than that of the United Kingdon, Germany and France.
Senior officials from the state health department and Brihanmumbai Municipal Corporation (BMC) said tough screening and quarantine measures, categorisation of patients based on risk-assessment and flexible testing approach form the bedrock of the state’s response to the disease.
Further, the state government has taken the unprecedented step of disallowing Mumbaikars from using its suburban railway lifeline with the exception of those who work for essential services.
Maharashtra has screened 2.3 lakh international travellers -- Indians and foreigners -- arriving in the state. Of them, 7,452 are under home quarantine and observation, 1,876 are in isolation wards of government and private hospitals and 1,592 people have tested negative for the virus, according to a state health department note.
The state was also one of the first ones in the country to stamp the back of the palms of persons being put under observation in home quarantine.
A few travellers News18 spoke to said the local police came to check on them at their homes in Navi Mumbai and Mumbai during the home quarantine period.
“We have categorised patients in three categories -- A, B and C -- based on the grade of risk they face. Those in category A are largely ones who have travelled abroad and have symptoms of Covid-19, those who came in close contact with them and have symptoms. Those who have symptoms at airports are directly sent to isolation and even those in close contact are being sent to isolation centres,” a senior official said on the condition of anonymity.
“If some persons have no symptoms but have been in contact with international travellers, they are being tested too. Category C patients are ones who have travelled but don’t have symptoms at all. They are put in home quarantine,” the official said.
Maharashtra has made arrangements for 2,500 beds in isolation wards across the state, Dr Archana Patil, state Director of Health Services, said. “We had a large number of people who came back from abroad and that is one of the reasons why we have such a high number of cases. Most of the infections are linked to the international travellers and few cases are of those who came in contact with such travellers. We are now also testing asymptomatic people who came in contact with them,” Dr.Patil said.
Since the National Institute of Virology, Pune, the country’s apex virology research institute is based in Pune, it has also helped the state government carry out tests at a greater speed, officials said.
Besides NIV, Pune, samples are being tested at six laboratories in the state -- Kasturba Hospital, King Edward Memorial (KEM) Hospital and NIV’s field unit in Mumbai; BJ Medical college and Armed Forces Medical College, Pune; and Indira Gandhi Medical College in Nagpur.
In Mumbai, Kasturba Hospital is the primary centre for isolation wards and patients are also being kept at Seven Hills hospital. One of the challenges, though, is to trace contacts of those who have tested positive for Covid-19.
The BMC’s local ward-level tuberculosis departments are coming in handy to work on the contact tracing.
“We are being flexible about testing. Those who are coming to outpatient departments of government medical colleges with flu symptoms are being considered for tests. We are also getting calls from government hospitals to check if patients with severe respiratory illnesses can be tested and those with serious conditions are being tested,” said Dr Daksha Shah, Deputy Executive Health Officer of the BMC.
According to Dr Shah, over 160 tests are being conducted in Mumbai on a daily basis, as of now.
Dr Arun Bamne, former executive health officer with the BMC who had worked on the H1N1 outbreak, said an increase in testing facilities is required to tackle the crisis.
“H1N1 and the novel Coronavirus are not very different as both viruses spread via droplets. The precautions required are similar and so is the level of infectiousness. Scaling up testing, which will be done now through the revised strategy of ICMR will be important,” Dr Bamne said.
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