Maharashtra is a clear outlier in terms of how it has been affected by the coronavirus disease (Covid-19). It ended on Wednesday with 1.12 million cases – it is the province with the most cases in the world – and 30,883 deaths, according to the HT panel. His cumulative positivity rate is still 20%. On Wednesday, his positivity rate was 24%. For six months a day, the western state has surpassed India’s daily Covid numbers in terms of daily cases. For much of this period, it has also topped the daily death tally. Only on Wednesday, it represented 474 of the 1,139 deaths in the country (41.6%) and 23,365 of the 97,932 cases (23.8%).
It is not clear why Maharashtra has been devastated by the disease. Sure, Mumbai, India’s commercial capital, has one of the highest population densities in the world, as do some of the largest slums, but many of Maharashtra’s health and social metrics are better than those of the called BIMARU states. The state of New York, similar to Maharashtra in some respects (like New York is similar to Mumbai) was affected similarly by the virus, but not as persistently as the Indian state. Cases in the US state peaked in early April and have been less than 1,000 a day for the last three months (and a little). It’s the kind of thing the Union Health Ministry and the Indian Council of Medical Research should be investigating. It is not clear why they are not doing it: understanding what is happening in Maharashtra can help us learn how to better fight the virus. Both urban and rural areas of Maharashtra have been affected, the former more than the latter, but that is also true in India, and all the major cities in the state have been hit hard.
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Maharashtra has never tasted enough. So far it has performed 5.5 million tests. That translates to just over 45,000 tests per million, but given the scale of the crisis in the state, it should be doing more. Its positivity rate has yet to traverse the trajectory seen in most countries: an increase with more testing, then a plateau, and finally a decline. Given the numbers, the Maharashtra contact tracing process is also likely not very effective, although it is unclear to what extent this could have made things better in a state where the virus has been in community transmission mode for months. But none of these adequately explain the scale of the crisis in Maharashtra.
Demographics might offer an explanation, but the state is not very different demographically from the rest of India. Sure, Maharashtra is home to 10.7% of the country’s population of people over 60 (a group vulnerable to Covid-19); 9.9% of its population is over 60 years old, but this proportion is higher in Kerala, Goa, Tamil Nadu, Punjab and Himachal Pradesh.
So could genetics, except that the genetic profile of the Maharashtra population is not markedly different from the Indian population as a whole, although previous studies have established that (unsurprisingly) it has more similarities to the populations of South India. than those of central India.
Also read: What these new Covid-19 figures reveal about Maharashtra
That leaves two other factors. The first is the society, culture and living conditions of Maharashtra in the state. The second is the state’s response to the pandemic. In the second, there is not enough evidence to suggest that the Maharashtra government was more proactive or less proactive than the administrations of other Indian states in managing the disease. And about the first, we just don’t know enough, although it is a fact that, at least in Mumbai, social distancing is not possible and that cases in the state have seen a renewed increase after the recent Ganesh Chaturthi festival.
And so the Maharashtra numbers will have to remain a mystery for now – the rare case of an early coronavirus disease hot spot that remains one six months after the pandemic.
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