The apparent lack of fear of the pandemic among people, recent local body elections and crowded public transport are among factors that may have contributed to the surge in COVID-19 cases in Maharashtra, a central team of experts that visited the state has said.
The three-member team comprising Health Ministry Joint Secretary Nipun Vinayak visited Maharashtra on March 1 and 2 to understand what was causing the surge in cases.
"While the exact causes of surge are not known -- since laxity in COVID-19 behaviour is not specific to the state -- the possible factors are COVID-inappropriate behaviour due to lack of fear of disease, pandemic fatigue; miss outs and super spreaders; and enhanced aggregations due to recent gram panchayat elections, marriage season and opening of schools, crowded public transport, etc.," according to a report shared by the government.
It advised the state to continue contact tracing, surveillance and testing and ensure strict compliance of protocols.
"Don't let the guard down. Stay to basics of surveillance, contact tracing and testing. Micro plan and ensure strict compliance of protocols. Strengthen teams to ensure meticulous home quarantine, do focused testing of 100 per cent population in hotspot areas repeated at five days, and isolate positives to check spread," it said.
According to Health Ministry data, there are over 90,000 active coronavirus cases in Maharashtra.
The government also observed that the virus is spreading to areas that were unaffected so far or had mostly asymptomatic cases.
"People are not forthcoming for strictly following quarantine or getting testing done. Sense is that the current wave is less virulent. The health machinery also may have become lax after cases came down after September.
"Some amongst the doctor fraternity - especially private - may not be counselling patients for testing or following protocols, dismissing it as flu. District/ State - wise participative plan, engaging the community may yield better results rather than knee-jerk reactions. Revenue machinery needs to take full charge," the government experts' team noted.
The central team visited Nagpur, Yavatmal, Amaravati, Khamli, Devnagar on the first day and Pune, Mumbai and Thane on the second day.
The team said the state government had asked that the centre indicate the numbers to be vaccinated and the actual inoculation drive is left to the state with more flexibility, inclusion of private hospitals, time flexibility and even data management.
"The Chief Minister, Chief Secretary and Principal Secretary Health were sensitized. The Chief Minister suggested that a direct video conference with Collectors from Union Ministry level will help," it said.
A massive campaign, collective behavioral change and influencing for COVID-19-appropriate behaviour was the need of the hour, the team suggested.
It said that those who are opinion makers, like political leaders and doctors, may themselves not be following these.
"Renewed effort at motivation, communication, engagement with opinion makers and strict enforcement is a must. Media orientation/engagement will be useful. The state has now started a campaign -- 'mi jababdaar' (I am responsible) -- that needs to be strengthened," it said.
It also suggested ensuring early reporting of COVID-19 cases and treatment according to protocol.
"There is some feedback from Nagpur that at some places senior doctors and specialists do not actually attend COVID patients, leaving management to juniors, affecting nuanced critical care such as oxygen therapy, ventilator management."
"Some private doctors, unqualified quacks which are first point of contact may not be advising/managing as per protocol. They also have to be reached out to, retrained and reoriented regarding protocols. The treatment protocols may be further clarified to all, including private doctors. Death audits be done at institutional level to derive actionable public health issues to prevent future deaths," it suggested.
With additional inputs from PTI