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Updated: Apr 24, 2020 23:50 IST

After 32 days of lockdown, the number of coronavirus positive cases in Maharashtra reached 6817 cases on Friday with 394 new cases. 5279 of these cases are in Mumbai Metropolitan Region (MMR) alone, which saw all the relaxations that came into effect on April 21withdrawn within a day.

Friday’s increase was less compared to Thursday that saw 778 cases—the highest in a day since March 9 when the first Covid 19 cases were registered in the state.

In Mumbai, the case count went up to 4,447 as 242 new cases were registered in a day.

Monday was also the 21st consecutive day when the number of new cases in the state was in three digits. This is the reason why most of the cases -- 6519 -- are registered in April month alone.

Maharashtra took 30 days to cross 1000 cases on April 7 but crossed the 2000- mark within six days on April 13. The rise from 2000 to 4000 cases was also completed in six days on April19. The addition of next 2000 cases, taking the tally past 6000, only took four days.

Though, the numbers are high, senior officials said the state is yet to reach community transmission stage as there is no exponential growth in Covid 19 cases.

“The two 14-day cycles of incubation period of infection were completed on April 20. It had begun from March 22 when international traffic was stopped. We will have to wait for another seven days to assess the rising trend. If the rise continues and if the fresh cases are rising by more than 50% (over the previous day) on daily basis then it can be called exponential growth and only then can we say that the stage of community transmission has arrived,” said Dr T P Lahane, director, Directorate of Medical Education and Research (DMER).

He clarified that exponential growth is also of two types: one is 50% rise in daily cases and another is doubling of cases, meaning 100% rise in a day.

“If exponential growth starts than the state government will also have to extend the lockdown period for another three weeks till May 24 to break the incubation cycle,” Dr Lahane said.

The death toll also crossed 300 mark in the state with 18 new deaths registered. Of them, 11 were in Mumbai, five in Pune and two were in Malegaon of Nashik. The total number of casualties in Mumbai increased to 178.

Of the 18 deaths, 12 patients had co-morbidity conditions said the health officials.

The mortality rate of the state has significantly dropped to 4.40% (283 cases till Thursday) from 7.41% (148 cases) since last Monday (April 13). However, it continues to be higher than the national average of 3.11% till Thursday, as per the state medical education department data.

As the cases are rising, the epidemic is also spreading to more areas of the state. Nanded reported its first case on April 22. With this, only three districts - Wardha, Bhandara, Gadchiroli - are left without a single case of Covid 19 as of now.

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The state health department has conducted 1,02,189 tests at various public and private facilities till date, 94,485 of these have tested negative. State currently has 512 active containment zones. Around 7,702 survey teams comprising doctors and assisting staff have screened more than 28.88 lakh for the virus. Around 957 patients have been discharged from the hospitals after recovery.

It has also kept 8814 suspected patients at government quarantine facilities while 1,19,161 are home quarantined, states the state health officials.

The Maharashtra government is also ready to start clinical trials of plasma therapy in the coming days after finally receiving the nod from the Indian Council of Medical Research (ICMR). In the beginning, it will be started at Sassoon Hospital in Pune as permissions for other three hospitals in Mumbai, Nagpur and Solapur are still awaited. The state has also got permission for pool testing for Covid 19 that allows for using five samples in a single test. So far, only one sample is being tested at a time.

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Once clinical trials are successful, the state can start plasma therapy as a treatment for Covid 19 patients.

“We have received permission from the Centre for conducting clinical trials of plasma therapy in the state. Once cleared by the ethics committee of the state, it is going to be started in the next 3-4 days at Sassoon Hospital, Pune. It will also be started at JJ Hospital in Mumbai, Indira Gandhi Medical College in Nagpur and Solapur Medical College in Solapur once permissions are in place,” said Dr Tatyarao Lahane, director, Directorate of Medical Education and Research (DMER).

The plasma therapy uses antibodies from the plasma of a recovered Covid-19 patient to treat those are affected. The concept behind the therapy is that the plasma of a recovered patient contains antibodies with the ability to fight the coronavirus.

State health department officials said that with the new form of testing the state’s capacity would increase 10 times. The pool testing could help clusters or hotspots faster, officials added.

The testing method involves putting multiple swab samples together and testing them in a single real-time polymerase chain reaction (RT-PCR) test. If a batch tests positive, then everyone whose samples were a part of that batch would have to be tested separately. Conversely, if a batch tests negative, then all the samples are negative.

Tope said that the state has also suggested use of portable pulse oximeter and chest X-ray test to help diagnose coronavirus patients and to subsequently decrease the mortality rate. A statement from the state health department said that it was suggested that the PPE kits should be disinfected and used again; this suggestion was appreciated in the meeting of union health minister and health ministers of all the states. The minister also said that the Centre is positive about allowing new testing facilities at six medical colleges in Maharashtra.

So far, the state government has also done counselling of over 47,000 migrant workers wanting to go back to their native villages. This is being done with the help of psychiatrists and health staff, said the health minister. More than 6 lakh migrant workers are staying in over 944 shelter homes prepared by the state government.