With Maharashtra reporting a 171 per cent jump in Covid-19 cases in the last month, the Union Health Ministry has asked the state administration to give a big boost to surveillance and contact tracing besides accelerating the vaccination drive with a special focus on the eight most affected districts.
Fearing a second Covid-19 wave, the ministry asked Maharashtra, which was the epicentre of the epidemic during the first wave, to focus on strict containment strategies, improve surveillance and augment the testing.
Also, the state has been told to plan for a worst-case scenario with sufficient lead time, rather than resorting to “measures such as night curfews and weekend lockdowns, which have very limited impact on containing and suppressing the transmission”.
In two letters to Maharashtra Chief Secretary Sitaram Kunte within a gap of three days, the Union Health Secretary Rajesh Bhushan pointed out the need to resurrect the “incident command” under the leadership of District Collector and Municipal Commissioner and strengthen the surveillance by an active house-to-house search in containment zones.
Sharing the report of a central team that visited Maharashtra from March 7 to 11, Bhushan noted that the state must intensify its administrative mechanism to the level witnessed in August-September 2020 in order to contain the ongoing Covid-19 transmission.
"ln all the districts visited by the central team, the test positivity rate was high, ranging from 51 per cent in Mumbai to 30 per cent in Aurangabad, implying that there are a lot many cases that are not being tested and there is high transmission in the community," the report said.
The fatality rate was very high among admitted cases in Government Medical College in Aurangabad and in Vasant Rao Pawar Medical College, Nashik which needed to be investigated in detail, including sending samples for whole genome sequencing, it suggested, underscoring the importance of resuming death audits.
Because of limited contact tracing, a large pool of asymptomatic and pre-symptomatic people among contacts was not tracked and tested, the report said, stressing that testing must be considerably enhanced and protocol laid down by ICMR followed. "The absence of rigorous tracing, testing and containment is leading to sustained community transmission," it said.
"The case-contact ratio is more than 1:20. Though it appears high, a deep dive into the methodology of contact tracing revealed that the main concept of contact tracing was not clearly understood by field-level staff, who were mainly listing the immediate family and neighbourhood contacts, for the sake of listing.”
As a consequence, the high-risk contacts in workplace settings, social settings and family settings were not investigated and listed.
The western states had 36,917 cases on February 11, but the number ballooned to 1,00,240 on March 11 – an increase of 171.5 per cent.
Underlining the importance of vaccination to protect the vulnerable, Bhushan said since the state could not use 50 per cent of its vaccine stock and another 13 lakh doses would reach by March 18, there are enough doses available to speed up the vaccination drive.
Maharashtra received 54.17 lakh doses of the Covid-19 vaccines, of which the state used 23.98 lakh doses till March 12. Additionally, 12.74 lakh doses are being sent by Thursday. “Adequate stocks are now available with the states for increasing the pace of vaccination,” he wrote.
Meanwhile, the vaccination number has increased all over the country as more than three million doses were administered for the first time on Monday. Nearly 25,000 new cases 131 deaths were reported in the last 24 hours.