Maharashtra is responsible for a third of all cases, forms Covid map

Health workers make a selection and collection of samples in Dharavi labour camp (Express photo by Nirmal Harindran)coron

In the nearly three months, the Coronavirus has been in India, the enduring trend has been the predominance of Maharashtra in the growth of Covid in the country. In any case, this has not ceased to grow stronger over time.

On the 24th of March, when the first countrywide national blockade was imposed, Maharashtra had a fifth part of all the infections by Coronaviruses in the country. Two months later, as India, the number of cases has gone from 1.3 lakh, Maharashtra, the proportion has increased to more than a third. In the last ten days, more than 40 percent of the new infections detected in the country they have come from Maharashtra.

This is the domain that always Maharashtra has managed to curb its growth for a time, has decreased the national rate of growth as well. And, the opposite has been true. In fact, the curve for the total national growth rate closely resembles that of Maharashtra (see chart). Same is true when it comes to doubling time of cases.

In other words, if the outbreak in Maharashtra is somehow contained, or its rate of growth slows down, an important part of the problem in the country would be taken care of. But this is easier said than done.

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“From a perspective of containment, it is good if a large number of infections are concentrated in a small geographic area. Theoretically, this entire area can be isolated, and the movement to and from this area can be restricted. Even in Maharashtra, the state is not affected by the same. An overwhelming number of infections are only in the two cities of Mumbai and Pune and its suburbs. This is a contiguous region that is the biggest problem of the area. Theoretically, if we are able to ensure that no infected person comes out of this area, the time of the illness of the tires in this area, without contributing much to the spread to other places,” said Sitabhra Sinha, Institute of Mathematical Sciences in Chennai, which has been tracking the spread of the disease. But the idea of putting entire cities under quarantine has enormous practical difficulties, especially if cities are so important to the industrial and financial welfare of the country like Mumbai and Pune.

Gautam Menon, a professor of computational biology and theoretical physics, also at the Institute of Mathematical Sciences, said containment probably would have been easier if, instead of being in Mumbai, a similar number of cases are located in any other place, even if the geographic distribution was a little more than the size of Mumbai.

“In some ways, Mumbai is the representative case of how difficult it is to contain an infectious disease in dense urban settings. A similar situation is developing in other cities such as Ahmedabad, Delhi, or Chennai as well. But, even among these cities, Mumbai, probably presents the most complex challenge. I’m not very surprised to see that it is of Mumbai, where we are seeing this type of growth and not of any other city or region,” Menon, said.

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Unlike many other states, the growth of infections in Maharashtra has been without ceasing, and that never had a “passive” phase.

Sinha said this was not unusual. “In fact, Maharashtra is probably the only state that has followed almost text book example of an epidemic curve. The growth was made a bit slower due to the blockage, but, in general, the curve is exactly what one would expect it to be. In many other states, there has been interruptions, whether caused by specific triggers like a super-spreader event, or the reporting of inconsistent or poor quality of the data,” he said.

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What has been a little unexpected, however, is the fact that the number of reproduction of Maharashtra has continued to decline, even more than two weeks after the blockade of the relaxation. The reproduction number, or R, is the average number of individuals that are infected by an already infected person, and is a very good measure for assessing how fast an infectious disease spreads in a population.

“For now, the R-number of India, as well as Maharashtra are at the lowest point during this pandemic. I was waiting for this value to begin to increase around May 15, as a drop of the relaxation in the lock of the rules. The R-number of Maharashtra is a little higher than that of India as a whole, but is still at its lowest level, and that is a little surprising. I was going to wait a few more days to see if this is a temporary hiatus, or part of a larger trend. I am waiting for the R-number of ascent, and, in consequence, it is likely that there is an increase in Maharashtra numbers in the coming days,” Sinha said.

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Even more so when the national airline services to resume operations Monday, industrial and other activities in the areas outside of the municipal limits of Mumbai and Pune have a green light to start work.

The task is to cut, said Vineeta Bal, an immunologist at the Indian Institute of Science Education and Research (IISER) in Pune. “Finally, success in containing the spread of the disease, especially in a city like Mumbai, this will depend largely on how power and effective of the local authorities in dealing with this crisis,” he said.

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