Nearly half of India’s COVID-19 casualties are reported from 22 districts of Maharashtra. In fact, Mumbai and Pune together make up for more than 75% of Maharashtra’s confirmed cases.

Maharashtra’s fight against COVID-19 began on March 9, 2020, when the first confirmed case of coronavirus was reported in Pune, the second-largest city in the State.

Though it was Kerala, the southwestern coastal state of India that reported the country’s first COVID-19 case, it’s Maharashtra that now records the highest number of coronavirus cases and fatalities.

Till the time of filing this report, Maharashtra had reported as many as 1,761 cases and 127 deaths. And what’s making the situation ‘worrisome’ is the fact that despite the total lock-down, the bulk of new cases are emerging in various parts of the state, especially Mumbai.

In fact, a fifth of all positive cases and nearly half of the nation’s casualties come from 22 districts of the country’s second-most populous state. And even though Mumbai and Pune are listed among ten coronavirus hotspots in the country identified by the Government of India, the State has seen a decent rate of recovery.

Here’s an analysis by Health Analytics Asia on various factors that contributed to make Maharashtra a hotspot zone.

Maharashtra’s first COVID-19 case was reported in Pune, when a couple, who had flown in from Dubai a week prior, tested positive. The next day, the couple’s three-year-old daughter tested positive too. The day after that, their cab driver and several fellow passengers were found to be positive as well. Within a span of two days, the tally rose to 11.

On March 13, the State declared the outbreak an epidemic, thus triggering a series of quick and firm measures aimed to contain the spread of the disease. On March 23, the entire State was put under lockdown, two days prior to the rest of the country.

Maharashtra is home to the financial capital of India – Mumbai. The megapolis gets a massive inflow of businessmen and professionals who have a wide contact-history, from what are now high-risk countries. Pune, on the other hand, has a huge number of foreign students and major industries. The degrees of possible exposure only adds to an already compound problem.

Mumbai and Pune together make up for more than 75 percent of Maharashtra’s confirmed cases as well as deaths. Mumbai’s adjoining suburban districts are understandably the next highest.

In mid-March, the State had only three laboratories for COVID-19 testing. By April 5, a total of 15 government and 14 private laboratories across the State have been conducting COVID-19 tests. This is more than any other state in India.

Maharashtra has also tested far more samples than any other State. Over 35,600 samples have been tested in the state so far. To give a point of comparison within India, the most populous state of Uttar Pradesh has tested only 11,855 – less than a third as many samples as Maharashtra has. Samples that have tested positive in Maharashtra are still around the national average of around 5 percent.

A total of 208 people have already recovered in Maharashtra. The state is seeing a recovery rate of over 11 percent, as compared to the national average of 9 percent. More than 60 percent of the deaths recorded in the state have been of patients over the age of 60 years.

Maharashtra’s statistics may seem like an outlier in India, but in the global context, they are well placed. Higher numbers are a direct consequence of the aggressive testing and contact tracing strategy adopted by the State.

The rate of increase in the number of cases in India is more likely to increase in the coming weeks, before showing signs of plateauing. As the richest State of the country, Maharashtra’s role is extremely critical.