MUMBAI: The public health department has projected that active cases in Maharashtra could exceed 3lakh by April 4, leading to a shortage of treatment facilities in several districts, especially Nagpur and Thane, if they do not scale up. Projections are based on the weekly average growth rate of nearly 1%. Future caseload is predicated on the current surge, but the forecast signals an alarming rise in fatalities, with toll spiralling beyond 64,000 over the next 11 days. As of Wednesday, the state had reported 2,47,299 active cases and 53,684 deaths.
Using a cumulative case fatality rate of 2.27% — a figure based on all deaths since the March 2020 outbreak – the department has arrived at 64,613 possible mortalities against a total caseload of 28,24,382. Effectively, it means a projection of up to 1,000 deaths a day over the next two weeks! An expert speaking on condition of anonymity said a more accurate indicator for future deaths would have been the more recent weekly fatality rate that was under 0.5% in the third week of March.
Covid death audit committee head Avinash Supe said weekly death rate has been under 1% since February. The disease appears to be less virulent now though more transmissible. “Death rates are low because patient management is better than what it was last year… but we have to ensure hospitals are not overwhelmed with patients,” he said.
Principal health secretary Dr Pradeep Vyas has shared the projections with all districts in an apparent bid to forestall shortages. According to the numbers, the state has adequate non-oxygen beds, ICU beds and ventilators, but needs to be outfitted with nearly 4,000 more beds with oxygen support. Nagpur and Thane may prove unequal to the task unless they build up an inventory of beds in the thousands over the next 11 days.
Currently, over 41% of active cases are in hospital, of which 8% are critical and 0.71% are on ventilator. Going by the figures, active cases in Pune district will be highest at 61,125, followed by Nagpur (47,707) and Mumbai (32,927). A senior critical care physician said these were conservative projections as Maharashtra has added more than a lakh cases in the last 3-4 days. Vyas has said all bed allocation in Dedicated Covid Hospitals and Health Centres must be based on clinical condition of the patient and no other consideration. Those who have recovered and have no fever, cough for three days and have more than 95% oxygen saturation should be promptly shifted to stand-down Covid Care Centres, he said. Vyas said there should be four-hourly, six-minute walk tests and checking of oxygen and temperature so that deteriorating patients are picked up early.
Reacting to the warning, Thane collector Rajesh Narvekar said work has begun to add 3,000 beds in the next four days. “Several of our Covid centres that were shut down will be activated. Patidar Hall in Kalyan Dombivali and Dombivli gymkhana are also being active,” he said. A 1,000-bed DCHC in Bhiwandi readied last year but not commissioned will be activated as well. Nagpur municipal commissioner Radhakrishnan B said, “Around 250 beds were added in private hospitals in the last two days. More than 90 beds were made available at the government medical college and another 45 beds will be made available in government hospitals.”
Health minister Rajesh Tope said 85% of cases are treatable at home. The 80:20 formula of bed sharing by private hospitals, if fully implemented, will ensure there is no shortage in beds, he added. Vyas has also instructed that officers and staff involved in vaccination are kept separate from those for surveillance and containment. Immunisation centres must not get overcrowded, he warned, or they could become super spreaders venues. He also asked districts to ensure private hospitals do not block Covid vaccine doses.