Maharashtra now has more Covid-19 cases–over 600,000–than South Africa, the sixth worst-hit country globally. South Africa has reported 5,89,886 Covid-19 cases as per the reference website worldometers.info.

With 5,612,027 cases, the US tops the list of countries with maximum cases in the world. Brazil has reported 3,363,235 cases, India 2,701,604 and Russia 927,745, according to the website. Maharashtra alone recorded 604,358 cases till Monday, according to the state health department.

Maharashtra crossed the 600,000 mark nine days after it recorded half-a-million cases on August 8. It recorded 8,493 cases on Monday and 11,111 on Sunday. Maharashtra has now 155,268 active cases.

The state recorded first 100,000 cases in 96 days, the second in 22, third in 14, fourth in 11, and the fifth in just 10 days. In the first 17 days of August, Maharashtra reported 182,834 cases, or around 10,754 daily. It is much higher than previous months. As many as 247,392 cases were recorded in July, 102,172 in June, 57,157 in May, 10,196 in April and 302 in March.

Dr Subhash Salunkhe, a public health expert who heads the state government’s communicable diseases prevention control and technical committee, said the cases were rapidly rising in rural areas since the lockdown restrictions have been eased.

“Distribution of cases started soon after the state opted for unlocking the restrictions. Before that, cases used to be reported only from urban areas but now it [infection] has spread to semi-urban and rural areas. The overall cases are also increasing in an accelerated fashion,” Dr Salunkhe said.

Officials said another major cause of concern was Covid-19 fatalities. In the first 17 days of the month, the state has reported 5,271 deaths compared to 6,988 in July, 5,638 in June, 2,286 in May, 449 in April, and 10 in March. The case fatality rate (CFR) in Maharashtra was 3.35% on Monday. It continued to be second highest in the country after Gujarat with 3.54% CFR and 2,785 deaths and 78,680 cases till Sunday, according to government data.

Dr Sanjay Pattiwar, a public health expert, said the government does not have resources in terms of specialised staff and health infrastructure to deal with the situation, especially in rural areas.

“Tertiary care treatment can only prevent Covid-19 fatalities. We need specialised staff to treat critical patients. Both the state and the Central government could not provide that quality of trained health staff and infrastructure in rural and semi-urban areas,” said Dr Pattiwar.

He said the state needs to train its doctors and health staff in rural areas. There should be a system for regular interaction between doctors from semi-urban and rural areas with the members of task force formed to reduce Covid-19 casualties, which is not happening, added Pattiwar.