“The virus does not follow mathematics,” said endocrinologist Shashank Joshi, responding to projections that Mumbai will see a runaway spike in Covid-19 cases by the end of this month.
“Variability is an inherent characteristic of the biological world. And, therefore, no prediction model will ever be accurate because a virus never follows mathematics,” Joshi, a member of Maharashtra’s Covid taskforce, told BusinessLine, as Mumbai braces for the worst.
While the city’s hospital infrastructure and healthcare workers are already stretched, projections for the nation’s financial capital were far worse. A Central team had projected that Mumbai would scale 40,000 Covid cases by end-April and a whopping 6 lakh plus by mid-May. This fuelled anxiety among residents on whether Mumbai was set to mimic New York’s surge in Covid numbers and deaths.
But Mumbai’s Covid cases and death-toll, though high, were still less than the projection made by the Central team that visited the city, late April. As on Tuesday, the city recorded over 30,000 cases and over 1,000 deaths, accounting for a bulk of Maharastra’s Covid cases, at over 50,000 with a death toll of over 1,600.
Not there yet
“Mumbai accounts for 21 per cent of India’s cases and 25 per cent of its deaths, just like New York is to the United States,” said Ravi Duggal, an independent researcher and activist, of the striking similarity. And though Mumbai is headed in that direction, it may not get there, he added, as there are other variables like ‘invisible’ cases and migration that make the picture incomplete.
Mumbai’s administrators expect to see about 40,000 cases by May-end and have been taking under their wing, sports complexes, the race-course and private hospitals, in an effort to bolster quarantine and treatment facilities across Mumbai. “That is being prepared as an abundant precaution, in the event the number of patients goes up, because they had predicted the peak somewhere between May 15 and 31,” said Joshi, adding that the extended lockdown had given the city time to prepare for the worst.
Projections go wrong in an unpredictable environment, said Duggal, adding that cases were also being under-reported across the country. A clearer picture on the deaths from Covid will emerge only when data is collated on deaths from other diseases, he added.
And while big cities may be closer to the true picture, he said, they need to test at least 1 per cent of the population, besides undertake random sampling.
‘Robust’ Indian host
Another researcher pointed out that numbers may not match projections due to lower testing. Joshi clarified that statistical models do not factor in the robust “Indian host who has done better than the rest of the world”, except for those with co-morbidities like diabetes, hypertension, obesity, chronic kidney disease and chronic liver disease, and senior citizens.
Mumbai’s Covid preparation was “to err on the cautious side”, said Joshi, who had earlier worked actively on HIV/AIDS. Lifting the lockdown in the city will have to be graded and done with extreme caution, he said, adding that people would have to follow the “SMS principle” — social distancing, masks and sanitisation — for a long period of time.