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At 1 million cases, here's a look at Maharashtra's never-ending Covid pain 
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Five months ago, when 40-year-old Bhagyashree Jadhav joined Pune's Municipal Corporation Hospital as a frontline Covid worker, little did she know that the district she worked tirelessly for would become India's biggest coronavirus hotspot, and her state would turn out to be one of the most infected regions in the world.

On Friday, September 11, Maharashtra recorded yet another high of 24,886 new cases, taking the state tally to 10,15,681, making it the first Indian state to cross the 1 million-mark. Of these, over 2.7 lakh are active cases, 28,724 have died and over 7.15 lakh have recovered. If Maharashtra was a country, it would have the fifth-highest number of Covid cases in the world.

Bhagyashree, who arranges beds, oxygen and other facilities at the PMC Hospital's 'Covid war zone', blames the callous attitude of people for the mounting number of cases.

"Many people are not following protocols. They are not maintaining social distancing and refrain from wearing masks. They think life is back to normal, but it is not. For the last five months, I've worked tirelessly and never removed the mask off my face; I've been safe so far. After working in containment areas, we return home, take a bath and steam, and follow all necessary safety instructions. Why can't people do the same?" she complains to India Today.

Pune district is now among the world's biggest Covid-19 hotspots, averaging 4,700-4,800 new cases every day in the last one week. On Friday, September 11, it recorded over 5,200 new Covid cases, taking the district's total to 2,23,710, which is the highest in Maharashtra. Some 4,693 people have succumbed to the virus.

If Pune was a country, it would be reporting higher cases every day than all but 11 countries in the world. \

The timeline

Maharashtra crossed 1 lakh cases on June 13, some 94 days after it recorded its first Covid case. The time taken to record every subsequent 1 lakh cases kept on decreasing from two weeks in June to less than a week in September.

On an average, Maharashtra has been adding 21,000 new Covid cases every day for the last one week. However, officials say it shouldn't cause panic as the higher numbers are a result of increased testing.

Maharashtra health department state surveillance officer Dr Pradeep Awate told India Today that the spike in new cases is primarily due to rise in daily testing.

"If you look at the statistics, for the last few days, we are conducting more than 90,000 tests per day. This was 14,000-15,000 in May and June, which means we are conducting 7-8 times more tests on a daily basis. This rise in new cases could be attributed to the rising number of tests in the state," said Awate.

However, the test positivity rate in Maharashtra has not seen a decline despite increased testing. The seven-day rolling average of the state's TPR is still above 24 per cent and moving upwards.

According to the World Health Organization, TPR should be below 5 per cent. A TPR above 10 per cent indicates poor quality testing in a region. Since May 3, Maharashtra has not seen a TPR lower than 10 per cent on an average.

Active cases and deaths

Pune has the highest number of active cases in Maharashtra at 72,835. It is followed by Thane (28,689), Mumbai (27,995), Nagpur (20,921), Nashik (11,043) and Raigad (10,049).

Another frontline healthcare worker deployed at PMC Hospital, 50-year old Pallavi Gajarmal, feels that the situation is definitely going "out of hand".

"People are not taking precautions; they are not taking care of themselves. When I joined the Covid war room, the district had around 50 dedicated hospitals for the infection. The administration has increased this number significantly due to the rising number of patients," Gajarmal told India Today.

"The administration is trying its best to control the situation. The problem is not with the administration or the government, but with the people's attitude towards the virus," she added.

Deaths too are not showing a downturn. Maharashtra has so far recorded 28,724 deaths and the graph is only going up. This state alone accounts for 37 per cent of India's total Covid-19 fatalities.

Capital Mumbai has so far recorded over 8,000 deaths, which means over one in every 10 deaths in India is from this city. Taken together, Mumbai (8,067 deaths), Pune (4,693), Thane (4,118), Nagpur (1,243), and Nashik (1,033) account for 25 per cent of India's total Covid-19 deaths and 67 per cent of the fatalities in Maharashtra.

Here too, Awate said we need to look at the trends more than absolute numbers to assess the situation. "The growth rate of cases has seen a fall and the time taken for cases to double is also increasing, which are good signs. Our fatality rate used to be over 5 per cent in May, which has now come down 2.8 per cent," he said.

Citing studies on T-cells immunity and dark matters, Awate said the next few months are crucial. "Studies around immunity and dark matters from the United States and Sweden indicate that even asymptomatic carriers are building immunity against the virus. It may not impact immediately, but gradually in the next two to three months, we should expect a slower rate of transmission," he said.

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