Rising infections: States on alert as Covid-19 cases hit 4-month high

As a spate of respiratory illnesses grips the country, states are once again on high alert.

Sample this: Covid-19 cases have risen to their highest level in around four months; there were less than 200 cases across India at the end of February, which rose to 618 as of March 16. The Ministry of Health and Family Welfare on Friday reported 796 fresh cases, even as deaths remained in single digits.

At least five states have relatively high positivity rates. The positivity rate is the number of tests that are positive for Covid-19 per 100 tests conducted. While the national average was 0.61 per cent for the week ended March 15, Gujarat, Maharashtra, Tamil Nadu, Kerala, and Karnataka had a positivity rate of between 1.1 per cent-2.8 per cent. Kerala and Karnataka topped the list.

On top of this, influenza cases are on the spike — there have been 583 cases, or around nine daily, since the first week of January, according to the ministry data.

Doctors have been noticing a surge in patients with flu-like symptoms. “We have seen a significant increase in viral cases in recent weeks, with the number of such cases rising by 90 per cent over the past month and 85 per cent over the past week alone. Every day more than 30-35 patients are coming with viral cases. While some of these cases are of H1N1 or other respiratory viruses, the majority of them are turning out to be of H3N2,” said Ambarish Joshi, pulmonologist with Primus Super Speciality Hospital in Delhi. According to Mumbai doctors, there is a 100-150 per cent rise in the visit of patients with flu-like symptoms.

In Mumbai, the state government has already briefed city hospitals to be ready for any surge in demand for hospitalisations in the coming weeks, informed Joy Chakraborty, COO, PD Hinduja Hospital.

Tamil Nadu is keeping 170,000 beds ready for respiratory illnesses at all times. Amid rising cases of H3N2 and other respiratory illnesses, the Puducherry government has declared holidays for schools for 11 days — from March 16 to 26 — in a bid to prevent the spread of flu.

The government machinery is active: The Centre wrote to six states — Gujarat, Maharashtra, Tamil Nadu, Karnataka, Kerala, and Telangana — on Thursday warning them of a rise in Covid-19 positivity rates there.

A senior government official said that influenza surveillance systems have been active since the pandemic, and therefore, even slight spikes are picked up easily.

Among the six states that have been asked by the Centre to focus on testing, tracking, treating, and vaccinating, four (Tamil Nadu, Karnataka, Kerala, Telangana) are from South India, indicating a spike in Covid cases in the region.

“We are not seeing any alarming trend in terms of Covid and other viruses. The state has always been on alert for the last two years and we are the only state that is still coming out with a daily bulletin, reporting the number of Covid cases. We also have over 170,000 beds available with us anytime,” said aid T S Selvavinayagam, director of public health and preventive medicine in Tamil Nadu.

Ministers, however, are asking people to stay away from crowded places. Maharashtra health minister Tanaji Sawant said: “The H3N2 virus is spreading in the state, but there is no need to worry. People must not go in crowded areas, wear masks, and maintain social distancing.”

India is witnessing a surge in H3N2 influenza virus cases, a respiratory tract infection caused by four distinct types of viruses (A, B, C, and D) belonging to the Orthomyxoviridae family. H3N2 has been the dominant subtype followed by H1N1.

In 2023 (until 28 February), a total of 955 H1N1 cases were reported. The majority of the H1N1 cases were reported from Tamil Nadu (545), Maharashtra (170), Gujarat (74), Kerala (42), and Punjab (28). A total of 3,038 laboratory-confirmed cases of various subtypes of influenza, including H3N2, were reported until March 9 by states.

The data from health facilities indicate that during January 2023, a total of 397,814 cases of acute respiratory illness/influenza-like illness (ARI/ILI) were reported from the country which increased slightly to 436,523 during February. In the first nine days of March, this number stood at 133,412.

The reason for concern is thus understandable. The problem seems to be that the symptoms persist for days after the primary viral infection heals. Manoj Goel, director, pulmonology, Fortis Memorial Research Institute, said that several patients are complaining of what we call post-viral bronchitis where the symptoms of coughing, breathlessness, and sore throat continue for 15-20 days after the primary infection.