Mumbai: The state cabinet on Monday decided to adopt a wait-and-watch approach and not make mask-wearing mandatory though the state breached the 1000-case mark for the sixth day in a row, recording a 133.5% rise in cases over the previous week ending May 30, in a spike driven largely by Omicron variant’s offshoots, the BA.4 and BA.5 sub-lineages.
Mumbai, which recorded 676 fresh cases on Monday (out of the state’s 1,036 new cases) has played a big role in Maharashtra’s surge, contributing 60%-70% cases to the state’s daily tally since the last week of May, when the state-wide figures began picking up.
Health minister Rajesh Tope and other officials of the department on Monday offered a detailed analysis of on-ground situation to the state cabinet and chief minister Uddhav Thackeray. In the last seven days, Mumbai contributed 67.28% of the total cases recorded in the state followed by Thane (17.17%), Pune (7.42%), Raigad (3.36%) and Palghar (2%), the presentation showed.
“These five districts have recorded a [daily] positivity rate of between 3% and 8%. Looking at the high positivity rate, the local administration has been asked to ramp up the testing,” Tope said.
“Most of the infections [in the state] are from the BA.4 and BA.5 strains [of the Omicron variant], which are highly transmissible,” Tope said. There was no data available of what proportions of the new cases are of the BA.4 and BA.5
To be sure, the rate of hospitalisation in the state and in Mumbai continues to remain low.
“Hospital admissions are very low. As per the data, only 1% of the positive cases are admitted to hospitals in the state. So, severity is low and therefore it is not a major cause of concern,” Tope said.
Of the 24,579 beds in Mumbai, only 0.74% (185) was occupied on Monday. Of the 4,768 oxygen beds, only 0.29% (14) was occupied.
Tope reiterated his earlier statement, and said citizens were “encouraged” to mask up especially in public transportation and other sites of crowding. “Masks have to be worn by all, especially in the districts where positivity is high. However, masks are not made mandatory and not wearing them would not attract any fine. However, we appeal to the people to wear face masks and also administer the precaution dose, if they are eligible,” he said.
Last week, the state task force recommended that mandatory mask-wearing should be re-introduced — all restrictions, including mandatory mask wearing, were dropped on April 1. Additional chief secretary (public health) Pradeep Vyas wrote to district collectors twice last week, directing them to ramp up testing and encourage the wearing of masks in public places; Mumbai’s civic body chief Iqbal Chahal also issued a statement last week that the number of tests conducted daily (which have remained below 10,000) would be increased to 40,000.
Officially, however, the state government is unwilling to call this a fourth wave as yet.
Dr Pradip Awate, epidemiologist and state surveillance officer said that there was no new variant of the virus causing the rise in numbers. “Unless and until there is an entirely new variant, we are unlikely to see a fourth wave. We may be seeing a surge in cases but they are all sub-lineages of the Omicron variant that caused the third wave. There will be a rise in cases but within weeks, it is expected to come down,” he said.
To be sure, when the Omicron variant-led third wave peaked in Maharashtra on January 22, the seven-day average was 42,277 cases. The weekly TPR had a peaked a day earlier at 21.30%. Both cases and TPR declined after this peak.
Dr Vasant Nagvekar, infectious disease expert and state Covid-19 task force member reiterated that it was too early to call it a fourth wave. “Most of the cases are mild. We need to wait and watch and follow Covid-19 appropriate behaviour of masking, following hand hygiene and social distancing.”
The seven-day average of cases in Mumbai increased from 155 (on May 19) to 320 (May 30) in 11 days, but doubled thereafter to 697 (on June 5) in five days. The weekly TPR jumped from 1.8% in the week ending May 18 to 8.4% in the week ending June 6.
Maharashtra’s weekly TPR increased from 1.03% in the week ending May 18 to 4.61% in week ending June 6. In the past 24 hours, 15,988 samples were tested in state, and 6,897 samples were tested in Mumbai, making the daily TPR 6.48% and 9.8%, respectively.
A sustained weekly positivity rate of 5% or higher is considered a sign of a significant outbreak.
A number of prominent residents have reported turning Covid positive in the past week, including Bollywood stars like Shahrukh Khan, as well as politicians such as leader of Opposition Devendra Fadnavis, who took to Twitter on Sunday to announce his infection status.
State minister Aaditya Thackeray on Sunday had hinted that the state was taking serious note of the rise in numbers, when he said the state could be seeing the fourth wave of the Covid-19 pandemic, and added that Covid-19-related deaths were not seeing an increase.
“We are asking everyone to wear masks when stepping outdoors. We have not made wearing masks mandatory but will make it soon. I also appeal to the public to receive the booster dose of the vaccine on time,” he told reporters.
In Mumbai, private hospitals are seeing incidental Covid hospitalisations —patients who are admitted for surgery or other ailments but test positive as part of routine screening. People with mild symptoms and co-morbidities are also seeking hospitalisation.
Dr Pratit Samdani, internal physician and intensivist, Bhatia and Breach Candy Hospitals said, “Most of the Covid patients admitted in the hospital tested positive during the mandatory RT-PCR test done before surgery. Otherwise, Covid cases are on the rise but they are mild and require symptomatic treatment. We advise them home isolation.”
The weekly average of cases was under 200 from March 19 to May 8 (lowest on April 15: 86 cases). Cases increased slowly after this point, but picked up pace in the last week of May. For example, it took 25 days for the seven-day average to double from 151 on May 1 to 308 on May 25, but just a week to increase to 621 by June 1.
The state did not record any fatality due to Covid on Monday. The Mumbai Metropolitan Region, which consists of Thane, Palghar, and a part of Raigad district, recorded 933 cases on Monday. Pune city reported 46 cases, while Pune rural six, and Pimpri-Chinchwad 19 cases.
“This could be the beginning of the fourth wave as we see a steady rise in cases for the past few weeks. However, the directive would come from the ICMR or the Union Health Ministry. It is important the people should not panic, follow covid appropriate behaviour, and get vaccinated,” a senior bureaucrat, who did not wish to be named, said.