If Maharashtra were placed on the worldwide tally of confirmed Covid-19 cases so far, it would rank fifth. In other words, its caseload is higher than every country except for the US, India, Brazil and Russia. As India continues to register the highest number of daily fresh cases for some time, it basically boils down to five states that contribute a significant proportion of the virus spread.

On Thursday, India reported 95,735 fresh cases of infection – yet another high and a new world record, as has been the case for most of the current month. The total confirmed cases in the country so far stand at 44,65,863 as of Thursday.

Whereas the US has registered the highest number of confirmed cases at 65,88,163 (and 1,96,328 deaths) so far, India has displaced Brazil (42,39,763) as the second most affected country. Russia, at the fourth rung, has 10,46,370 cases so far, according to the Worldometer database .

In the 24 hours to Thursday morning, of the 95,735 new cases in the country, 60% were reported from only five states. Maharashtra contributed more than 23,000 and Andhra Pradesh more than 10,000, a health ministry bulletin said.

Indeed, Maharashtra with total confirmed cases so far at 9,67,349 would be placed just behind Russia and ahead of the fifth most affected country, Peru (7,10,067). Compared to the death toll of 30,344 in the South American country, Maharashtra has suffered a loss of 27,407 lives so far.

As for the total number of active cases, India’s figure stands at 9,19,018 as on Thursday. More than 74% of them are in nine States. Only three of them – Maharashtra, Karnataka and Andhra Pradesh – have 49% of the country’s total active cases. Maharashtra is leading this tally with more than 2,50,000 whereas Karnataka and Andhra Pradesh follow with more than 97,000 each.

A total of 1,172 deaths were registered in the country during the 24-hour period. As many as 32% -- nearly a third – of the deaths were in Maharashtra (380) followed by Karnataka (128), and Tamil Nadu (78). Of the total deaths, 69% are concentrated in five states/UT of Maharashtra, Tamil Nadu, Karnataka, Delhi and Andhra Pradesh.

Making testing more efficient
India has of late relied on the 3T strategy of testing, tracking and treating. In Delhi, which pioneered extensive and widespread testing, the numbers are again on the rise, crossing 4,000 new infections a day this week – a new high. As the economy opens up and the metro services in various cities resume after close to five months, the virus seems to be spreading more and more. This has prompted efforts to boost the efficacy of the testing.

The health ministry, meanwhile, has noted that in some large states, symptomatic negative cases tested by Rapid Antigen Tests (RAT) are not being followed up by RT-PCT testing. The Guidelines of ICMR as well as the ministry clearly state that the following two specific categories of persons must necessarily be retested through RT-PCR tests.  
 
The ministry and ICMR have jointly written to all the states/UTs and urged them to ensure that the all symptomatic negative cases of RAT are mandatorily retested using the RT-PCR test. This is necessary to ensure that such symptomatic negative cases do not remain untested and do not spread the disease among their contacts. This will also ensure early detection and isolation/hospitalization of such false negatives. It has also been reiterated in the joint letter that while the RAT is being used to increase access and availability of testing in the field, RT-PCR remains the gold standard of COVID tests.
The ministry has also urged the states/UTs to urgently establish a monitoring mechanism in every district (a designated officer or a team) and at the State level to follow up such cases. These teams shall analyse details of RAT conducted on a daily basis in the Districts and State and ensure that there are no delays in retesting of all symptomatic negative cases. The aim of States/UTs should be to ensure that no potentially positive case is missed out. They have also been advised to undertake an analysis on a regular basis to monitor the incidence of positives during the RT-PCR tests conducted as a follow up.