New coronavirus infections reported on Saturday crossed 18,000, for the first time since January.
According to the Union Health Ministry 18,327 new cases were reported, with Maharashtra reporting the maximum at 10,216, followed by Kerala at 2,776 and Punjab at 808. The Centre has dispatched teams to Maharashtra and Kerala to visit hotspots and “ascertain reasons for the surge.” India has 1,77,435 active cases and 11.12 million confirmed infections since March.
Last week, a Health Ministry team had visited Maharashtra and reported that among the possible reasons for the growing number of cases in the city were — COVID inappropriate behaviour due to “lack of fear of disease,” pandemic fatigue, missed cases, super spreading events and crowds due to recent gram panchayat elections, marriages, re-opening of schools, and crowded public transport.
However, the report stressed that the situation in Maharashtra was not unique and a similar combination of events was responsible for a surge in other States too.
“The virus is spreading to hitherto unaffected areas and most cases are asymptomatic. People are not forthcoming for strictly following quarantine or getting testing done. Sense is that the current wave is less virulent. The health machinery also may have become lax after cases came down after September,” says the report based on a visit by a three member team of epidemiologists and health experts on March 1-2, which has now been made public.
“Some amongst the doctor fraternity — especially private — may not be counselling patients for testing or following protocols, dismissing it as flu. District/ State-wise participative plan, engaging the community may yield better results rather than knee-jerk reactions,” the report said.
The team consisted of Joint Secretary in the Health Ministry Nipun Vinayak, Deputy Director, National Centres for Disease Control Sanket Kulkarni, and Professor, National Insitute of Tuberculosis and Respiratory Diseases Ashish Ranjan.
The team called upon the Maharashtra Chief Minister as well as those at the forefront of the COVID management exercise. It also visited Amravati, Yavatmal, Nagpur, Pune and Thane to investigate COVID control behaviour and the policies being implemented.
Flexible vaccination process
According to the report, the State “desired” that the Centre should indicate the total numbers to be vaccinated and leave actual process to the State with “more flexibility” in vaccination, including use of private hospitals, time flexibility and data management.
The Central team suggested that Maharashtra involve Revenue and Police officials in “mission mode and zeal.” State administrative officials such as the Collectors, municipal commissioners ought to be leading from the front and coordinate with health authorities and sticking to the “basics” which involved surveillance, contact tracing and testing.
In Nagpur, the team reported, some senior doctors and specialists weren’t attending on COVID patients and leaving management to juniors. This was affecting “nuanced critical care” such as oxygen therapy, ventilator management etc.
“Some private doctors, Ayurveda practitioners, unqualified quacks which are first point of contact [for patients] may not be advising/ managing as per protocol. They also have to be reached out to, retrained and reoriented regarding protocols,” the report notes.
State officials reported problems in the CoWIN portal and app and ascribed the rise in cases in Amravati to a “possible internal mutation (of the virus).”
AYUSH (traditional medicine including Ayurveda and Homeopathy) practitioners were still not part of deliberations, according to feedback from the States and they suggested “mainstreaming of AYUSH” for managing cases at an early stage.
“Role of media has been erratic — focussing on non-issues such as AEFIs (Adverse Events Following Injection (with vaccine) and ignoring issues such as promotion of vaccination now that vaccine has arrived,” the report said.
Sero-surveillance — or checking for antibodies — showed high positivity in the population (avg 50%) that could be leading to ‘herd immunity’ and the infection spreading to 2nd tier towns and rural areas. Here, the report noted, people believed that this was a disease only of urban areas and were, therefore, not following COVID appropriate behaviour.
The report also warned that with elections coming up infections in States, such as West Bengal, could also flare up.