Covid-19 third wave peak has lowest case fatality rate
Experts believe that January may have been the peak of the third wave at least for the bigger districts of the state, including Mumbai.
Mumbai: Even as the third wave saw an exponential rise in cases in January, Maharashtra reported its lowest case fatality rate compared to the peak months of the previous waves.
In January, the state recorded 1,042,288 Covid-19 cases in the month of January. The number of fatalities was 1,085, which means the case fatality rate was 0.1%. In comparison, in April 2021 — the peak of the second wave — the number of cases recorded was 1,789,406, while the number of deaths recorded that month was 29,562 which means the case fatality rate was 1.65%. In the first wave in 2020, the pandemic peaked in September, recording 593,192 cases and 12,024 deaths. The case fatality rate was 2.02%.
“The third wave saw a less severe variant in Omicron and it was up against a largely vaccinated population,” said Dr Shashank Joshi, member of the state’s Covid-19 task force. “Both these factors contributed to lower mortality. In addition to this, the healthcare providers had also evolved in managing the disease,” he said.
According to Joshi, Mumbai and many other districts in the state are past their peaks of the third wave. “Some districts will see a rise, but they will experience a fast rising-fast receding peak similar to what we saw in Mumbai and some other parts of the state. The hospitalisations and mortality that we are seeing now are largely linked to severe underlying diseases and risk factors,” he said.
The receding third wave is reflected in Mumbai’s hospitalisations. On Tuesday, 2,036 patients were hospitalized in the city and the overall occupancy of 23,300 beds was 9%. In the first week of January, the hospital occupancy stood at 20% (4,491 of the 22,205 beds).
The Intensive Care Unit (ICU) occupancy has gone up from 20% (507 patients in 2,577 beds) in the first week of January to 22% (677 patients in 3,098 beds) on Tuesday. The ventilator bed occupancy jumped from 23% (320 patients in 1,368 beds) to 29% (435 patients in 1,523 beds) during the same period.
Experts said that even as the wave has receded, a section of patients who develop severe disease require ICU and ventilator beds for a longer period, which explains the higher occupancy.
“Mumbai will continue to see deaths for the next 10 days as severe patients pull on for a longer period, but some of them succumb to the complications,” said Dr Avinash Supe, head of the Covid-19 death audit committee of the state. “Maharashtra is likely to see deaths for a prolonged period up to mid-March as the wave will peak in different districts at a different time,” he said.
Experts believe that January may have been the peak of the third wave at least for the bigger districts of the state, including Mumbai.
Supe said that hypertension and diabetes were the most concerning risk factors that contributed to mortality in all three waves. “Other concerning factors were thrombotic events triggered by the infection leading to strokes and heart attacks,” he said.
The nature of the third wave has been distinct because of the presence of self-testing kits which were used by many patients to detect the infection. But in absence of a strict mandate, positive reports were not updated by all patients on the Indian Council of Medical Research portal.
“Unfortunately, because of the widely used self-test kits, we have no idea of the true burden of the cases during the third wave,” said infectious disease expert, Dr Om Srivastava, who is also a member of the state’s Covid-19 task force. “Some deaths have possibly resulted because of late medical interventions. It is likely that some of the people who tested at home delayed seeking timely medical help,” he said.
