Maharashtra prepares for 1.2 million active Covid cases in third wave
Maharashtra is preparing for an active Covid-19 caseload of 1.2 million during the peak of the anticipated third wave
Maharashtra is preparing for an active Covid-19 caseload of 1.2 million during the peak of the anticipated third wave, according to projections made by the Centre and shared with the state. The projections are based on Maharashtra’s highest active cases recorded during the second wave and district-wise peaks recorded between March and June this year.
In addition to strengthening existing jumbo Covid-19 facilities and hospitals, preparations include readying 531 oxygen generation plants and processing tenders to stock up on eight essential medicines used for Covid-19 treatment.
The state’s peak active caseload – 698,354 – was recorded on April 25 this year. However, different districts peaked at different times. Considering the variation in the peaks, state officials estimate a peak active caseload of 800,000 and are preparing for a surge 1.5 times that number. “We are preparing for 1.2 million active cases in the third wave,” said N Ramaswami, commissioner, National Health Mission, Maharashtra, a vertical of the union health ministry that works closely with the state.
Experts, however, are divided over the nature of the third wave. For instance, virologist Dr T Jacob John of Christian Medical College, Vellore, said in a recent online conference that the worst is over for Maharashtra and a third wave is unlikely. Physician Dr Jalil Parkar of Lilavati Hospital in Bandra said with the vaccinations and caution among people, the third wave will likely be a mild one and it will not stretch the state’s healthcare infrastructure like the first two. “But if the virus mutates to something worse, we don’t know how the wave will be,” said Dr Parkar.
Dr Parkar said some doctors anticipate a stronger third wave, perhaps driven by a variant that will attack the unexposed and unvaccinated population such as minors and may be dominated by re-infections and breakthrough (post-vaccination) infections. “But it’s hard to be sure,” said Parkar.
“We considered all scenarios and decided to not put any existing plans and preparations on hold. However, we are not encouraging any new projects,” said Ramaswami, adding that, of the 513 oxygen generation plants, 68 were donated by the PM Cares Fund. Of the 68 plants, 65 have already been set up.
The state is looking at a 70:20:10 oxygen formula for each district which includes 70% oxygen supply through liquid medical oxygen (LMO) storage tanks, 20% through oxygen generation plants and 10% through other sources such as cylinders.
Ramaswami said the state has also placed orders to ensure enough stock of eight medicines commonly used for Covid-19 patients, including repurposed drugs such as Remdesivir and Tocilizumab, steroids, anticoagulants, and intravenous immunoglobulin (IVIG), among others. The state had also made a budgetary provision to procure monoclonal antibodies that have been found effective in patients with mild to moderate symptoms. However, the plan has been put on hold as the Indian Council of Medical Research (ICMR) is yet to include the cocktail therapy in its treatment protocol.
Infectious disease expert and state task force member Dr Om Srivastava said that a lot of thought has gone into deriving the projection of active cases. “There will obviously be talk about wastage of resources if the third wave does not occur. But it’s a wise strategy to be prepared for a disaster,” said Srivastava, who believes that a third wave is likely in December.
According to Srivastava, based on the current situation, the third wave seems manageable. “But the situation might change. We didn’t anticipate a severe second wave, but it stretched each and every resource,” he said.
High-burden cities such as Mumbai and Pune have been asked to stay vigilant and focus on vaccinations as well as strict implementation of Covid-appropriate behaviour. Mumbai, for instance, had the highest active case load of 91,100 on April 11. Going by the state’s formula, Mumbai active cases may peak to 136,000 during the third wave.
“We go by the projections made by the state and the Centre,” said additional municipal commissioner Suresh Kakani, who has been managing BMC’s Covid-19 response in Mumbai. “We have kept our jumbo facilities intact, and strengthened them with paediatric beds. We also have created more facilities in the western and eastern suburbs for a worst-case scenario.”