COVID-19 situation 'stabilising', says Centre, but worrying stats pour in from Bengal, UP, Gujarat and MP

India reported its smallest daily increase in coronavirus infections in nearly three weeks on Saturday, but the deaths due to the 2019 SARS coronavirus were still high with 3,890 reported dead in 24 hours. Meanwhile, West Bengal, which just came out of a "super spreader election", was forced to go into a 15-day lockdown due to an incessant rise in cases and fatalities and the state's hospitals remained swamped.

The Central Government, however, insisted that the situation is "rapidly stabilising" in the country. The overall positivity rate, it said, had dipped to 19.8 percent this week from 21.9 percent last week. India, however, was still ranked second in Asia in terms of COVID-19 positivity rate (given as a rolling 7-day average) after Nepal which had shown an exorbitantly high positivity rate of 46.7 percent as of 13 May, 2021.

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The deadly second wave of coronavirus wreaked havoc in several parts of the country, with some days clocking over 4 lakh daily coronavirus cases and fatalities more than 4,000.

Meanwhile, Randeep Guleria, director of AIIMS Hospital in Delhi warned that secondary infections like mucormycosis or "black fungus" were adding to India's mortality rate with states having reported more than 500 cases recently in COVID-19 patients with diabetes.

In the past 24 hours, India added 3,26,098 new infections and 3,890 deaths, taking its tally of cases to 2.43 crore and toll from the virus to 2,66,207, health ministry data shows. But the slow growth may also reflect test rates that are at their lowest since 9 May. Besides, experts believe that India has been accused of undercounting the number of COVID-19 cases.

Situation challenging in UP, AP, Gujarat: Health Minister

Health Minister Harsh Vardhan on Saturday noted that Gujarat has displayed a gradual increase in the positivity rate since April and the recovery rate stands at 79 percent, which is lower than the national average. Nearly 100 percent ICU beds in Ahmedabad, Vadodara and Mehsana and 97 percent and 96 percent of oxygen beds in Ahmedabad and Vadodara, respectively, stood occupied indicating saturation, he said.

Andhra Pradesh has had an increasing positivity rate since early April and the weekly growth rate was as high as 30.3 percent, he said, adding that Chittoor, East Godavari, Guntur, Srikakulam, Visakhapatnam were flagged as districts of concern in the state.

Uttar Pradesh saw an exponential growth in cases in a six-week period (5,500 to 31,000 cases and two percent to 14 percent positivity rate) with Lucknow and Meerut having more than 14,000 active cases with all categories of bed showing more than 90 percent occupancy.

In Madhya Pradesh, 10 districts have more than 20 percent positivity with over one lakh active cases all over the state. Indore, Bhopal, Gwalior and Jabalpur were flagged as districts of concern by the health minister on Saturday.

Overall situation improving: Centre

The overall COVID-19 situation in the country is stabilising though it is a mixed picture across the country in terms of the trend of daily new cases in various state, according to NITI Aayog member VK Paul.

"It is evident that we can see a certain amount of stabilisation of the second wave of the pandemic. Some states have shown a clear pattern, in some states there are concerns and in some others there is a trend towards an increase. It is a mixed picture. But overall, the situation is stabilising and we hope and we will work towards ensuring further stabilisation and rapid decline of this pandemic," Paul said.

At a media briefing by the Health Ministry, its Joint Secretary Lav Agarwal said a decline in the active cases has been observed since the last 12 days. On 3 May, the active cases were 17.13 percent, which has declined to 15.1 percent and recovered cases stand at 83.8 percent.

Agarwal also said the containment efforts are working and the overall COVID-19 positivity rate in India, which stood at 21.9 percent last week, has now fallen to 19.8 percent.

He said that 10 states account for 85 percent of the total coronavirus cases in the country. While 11 states have over one lakh active COVID-19 cases, 17 have less than 50,000 cases while eight have active cases between 50,000 and one lakh.

The health ministry said Maharashtra, Uttar Pradesh, Gujarat and Chhattisgarh, which are recording a high number of novel coronavirus cases, are also reporting a decline in active cases.

Twenty-four states have a COVID-19 positivity rate of more than 15 percent while Delhi, Chhattisgarh, Daman and Diu, Haryana and Madhya Pradesh have reported a major drop in case positivity, it said.

The active cases have reduced to 36,73,802 and comprise 15.07 percent of the total infections, while the national COVID-19 recovery rate has improved to 83.83 percent, it stated. On Friday, the active cases in India had reduced to 37,04,893.

Lockdowns work

Maharashtra and Delhi's improving situation inspires confidence that lockdowns and stricter curbs on public movement actually help.

The National Capital, which is under lockdown, recorded 6,430 new COVID-19 cases and 337 fatalities on Saturday while the positivity rate dipped to 11.32 percent.

This is the second consecutive day when Delhi has recorded less than 10,000 cases. The National Capital had recorded 8,506 new cases on Friday and a positivity rate of 12.40 percent.

Delhi is under lockdown since 19 April till 17 May, a date which is expected to be pushed further until the positivity rate falls below the recommended 3 percent.

Likewise, Maharashtra on Saturday reported a further decline in new COVID-19 cases with 34,848 infections coming to light. The caseload increased to 53,44,063 and death toll reached 80,512, the state health department said.

For the fourth straight day, recoveries outnumbered new cases. As many as 59,073 patients were discharged from hospitals, taking the total recoveries to 47,67,053. Maharashtras active caseload dropped below five lakh and settled at 4,94,032.

The state's COVID-19 recovery rate increased to 89.2 percent from Friday's 88.68 percent, while the fatality rate was 1.51 percent. The case positivity rate (percentage of tested people turning out to be positive for COVID-19) was 17.33 percent.

Citing the case of Bengaluru, Union minister Sadanand Gowda also said that lockdown has been yielding results.

"Lockdowns have been successful and have yielded results, cities like Mumbai, Delhi, Bengaluru are examples. There has been a decline (in Bengaluru) since the last couple of days," Gowda said.

Karnataka is currently under complete lockdown till 24 May.

Bengaluru is witnessing steady decline in the number of daily cases with 13,402 new infections on Saturday. The city had reported 14,316 new cases on Friday and 15,191 on Thursday, respectively, from over 20,000 cases during the last weekend. Saturday also saw 34,425 patients getting discharged after recovery.

On the other end of the spectrum is Goa. More than 70 people have died in four days from medical oxygen shortages at hospitals, an opposition party in the region said. A court ordered emergency supplies of oxygen to be sent to Goa Medical College Hospital to prevent more deaths.

While the state's main Opposition party said that patients died from a lack of oxygen, the government said the cause of death had not been determined. Goa authorities nevertheless said they had asked the Central Government to nearly double the state's oxygen supply to 40 tonnes per day.

Coronavirus restrictions in Goa had been relatively relaxed until the current wave of infections. The virus is now causing more than 60 deaths a day in the region and Goa has one of India's highest infection rates.

More states impose lockdown

West Bengal joined the states that have imposed a complete lockdown to contain the COVID-19 pandemic, while many of them have extended the restrictions even as the nationwide tally of active cases declined marginally.

"Additional restriction measures to cut down the mobility of people and limiting human contact through assembly and congregations is essential to cut the transmission chain of the virus and to contain the pandemic," West Bengal chief secretary Alapan Bandyopadhyay said on Saturday, announcing the lockdown from 6 am on 16 May till 6 pm on 30 May.

The decision comes on a day when Bengal reported its highest number of deaths since the beginning of the pandemic, the proportion of coronavirus tests coming back positive also reached an all-time high of 9.8 percent. The state has reported 13,137 deaths and over 11 lakh cases so far.

The Chhattisgarh government has asked authorities in all the 28 districts to extend the COVID-19 lockdown till 31 May even as it granted more relaxations in economic and other activities, an official said.

The lockdown, currently in force in all districts of the state, was set to end in most regions at 15 May midnight.

Bihar too has extended the lockdown, which was to end on 15 May, till 25 May, while Maharashtra has already announced the continuation of lockdown-like restrictions till June.

The Uttar Pradesh and Jammu and Kashmir governments also decided on Saturday to extend the partial coronavirus curfew till 7 am on 24 May. The curfew was scheduled to end on 17 May in both regions.

The Himachal Pradesh government has decided to extend the coronavirus-induced curfew in the state till 26 May.

Informing about the cabinet decisions, state Parliamentary Minister Suresh Bhardwaj told the media that the three-hour daily relaxation in the curfew would be provided for opening essential commodity shops.

The minister said hardware shops would also open on Tuesday and Friday. Bhardwaj urged the public to either postpone weddings or hold them in a simple way at their homes with not more than 20 people.

Mucormycosis in COVID patients growing cause of concern

Dr Guleria warned against the increase in the number of black fungal infections that are being reported from across the country and said that it is of paramount importance that hospitals follow protocols of infection control practices.

"It has been seen that secondary infections — whether fungal or bacterial — are causing more mortality. This disease, mucormycosis, can affect the face, infecting nose, orbit of eye, or brain, which can even cause vision loss. It can also spread to the lung," Guleria said.

He also said that the misuse of steroids is a major cause behind the spread of this infection.

"Chances of fungal infection increase in the patients who are diabetic, COVID positive and are taking steroids. To prevent it, we should stop the misuse of steroids," he said.

According to Guleria, mucormycosis spores are found in soil, air and even in food, but they are of low virulence and usually don't cause infection.

"Even before COVID, this disease could be seen mostly in diabetic patients, transplant and cancer patients, but it was rare among the general public. Now a large number of cases are being reported due to COVID treatment," he said, recommending close monitoring of blood sugar levels to prevent the infection.

At AIIMS, he said 23 cases of such infection were reported among COVID patients. Out of them, 20 are still COVID-19 positive while the rest are negative. Guleria said that many states have reported more than 500 cases of mucormycosis.

He also advised against using steroids in the early stages of coronavirus and said that if the patient has mild symptoms, steroids would do him more harm than good.

"Data shows that 5-10 days steroids are needed for the majority of COVID-19 patients," he said.

Niti Ayog member VK Paul too raised concerns over mucormycosis and appealed to people to control their diabetes as the disease is seen to spread among such patients more widely.

"Control your diabetes. Even when you have COVID, please ensure you don't forget to have your medicines. Another aspect of this is to use steroids judiciously," he said.

Paul said that while steroids are part of the treatment for COVID, it is important to prescribe it at the right time and in the right dosage, otherwise it could lead to secondary infections like mucormycosis.

"Steroids should not be prescribed lightly... This disease has to be prevented," he said.

Modi reviews COVID situation, says localised containment strategies need of hour

Prime Minister Narendra Modi on Saturday called for augmenting healthcare resources in rural areas to focus on door to door testing and surveillance, and asserted that localised containment strategies are the need of the hour, especially in states with high positivity rate in districts.

Chairing a high-level meeting, Modi said states should be encouraged to report their COVID-19 numbers transparently "without any pressure of high numbers showing adversely on their efforts", remarks that come amid reports that many states have been under-reporting their case and fatality tallies.

Modi also directed that a distribution plan for ensuring oxygen supply in rural areas should be worked out, including through provision of oxygen concentrators, a statement from the Prime Minister's Office (PMO) said.

Unlike the first wave of COVID-19 cases last year when rural India was not badly hit, rural areas have been seriously affected by the second wave in several states. Modi sought empowering ASHA and anganwadi workers with all necessary tools.

Testing needs to be scaled up further, with use of both RT-PCR and rapid tests, especially in areas with high test positivity rates, he added. The PMO noted that testing has gone up rapidly in the country, from around 50 lakh tests per week in early March to around 1.3 crore tests per week now.

With inputs from agencies