Non-adherence to precautions, mutation, super-spreading events may be driving spurt
The novel coronavirus disease (COVID-19) is now spreading to areas in Maharashtra that were so far unaffected, said a report released by Union health ministry March 6, 2021.
The team that visited the state said though some areas are moving towards herd immunity, the virus is now making inroads to second-tier towns.
The seroprevalence has gone up to more than 50 per cent in some areas, indicating that more than half the population there have been infected and developed antibodies, the report said. Therefore, the virus is going to new areas where it can find potentially more susceptible individuals.
The virus is also spreading to rural areas, which is a major cause for concern, the report stated. “People in the villages were so far not following COVID-19-appropriate behaviour since they thought the disease is essentially urban,” the team observed.
The team has also said ‘internal mutation’ in areas like Amravati may be driving the spurt there, thus pointing to the role of variants that have been found specifically in India.
These mutations may make the virus become more infectious (spread faster) although it is less virulent (not leading to severe disease). Almost a 10 degree variation in daily temperatures might be becoming conducive for the virus during parts of the day.
Residents were found to be not paying heed to the mandatory precautions in most parts of the state. The report attributed this attitude to lack of fear of the disease and pandemic fatigue.
The report could not pin-point to state-specific causes as such since non-adherence to COVID-appropriate behaviour is prevalent in other states too. However, the report added that other possible factors could be missed out cases, super-spreading events, enhanced aggregations due to recent gram panchayat elections, marriage season, opening of schools, crowded public transport, among other things.
“People are not strictly following quarantine or getting tested,” the central team said.
The team also accused the state health machinery of adopting a lax attitude following a downward trend in cases since September. "Some among the doctor fraternity, especially in the private sector — may not be counselling patients for testing or following protocols, dismissing it as flu.”
In Nagpur, for instance, senior doctors and specialists do not attend to COVID-19 patients, leaving the management to juniors, the team said. This is affecting nuanced critical care such as oxygen therapy and ventilator management. “Unqualified attendants or quacks may be looking at patients following the protocols but they are not doing the job right. They need to be sought out, retrained and reoriented regarding protocols,” the report said.
Surveillance of patients in home quarantine also needs to be improved. "The strengthening of field teams and regular listing of patients to be followed up with for oxygen saturation levels and other health statistics and timely referral of deteriorating patients to hospitals may reduce mortality,” the document said.
It also called for more meticulous testing of high-risk contacts.
The team added that what needs to be done overall, to contain the surge is known well. The effort has to be directed on ‘getting it done’ by the respective district and police administrations, while health officials enhance their response.
The saving grace, the observers said, is that most cases are asymptomatic, and therefore, may be mild. “The sense is that the current wave is less virulent,” the team noted.
Though the report was about Maharashtra, the team issued warnings for other states too. States like West Bengal, where elections are coming up and campaigning is going on, could ‘flare up too’, the report said.
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