Maharashtra COVID-19: On Friday, the state recorded 4,205 new COVID-19 cases.Mumbai: Maharashtra Chief Minister Uddhav Thackeray on Friday discussed the COVID-19 situation with senior government officials and explored the possibility of making face masks mandatory again in Mumbai suburban trains in view of the rising cases.An official statement issued by the Chief Minister's Office (CMO) said Mr Thackeray reviewed the prevailing COVID-19 situation in the state, which has been recording a steady rise in new infections, especially in Mumbai and some other big cities.The chief minister, at a virtual meeting with senior bureaucrats, also discussed the possibility of making face masks mandatory for suburban train commuters, the statement said.The mask mandate option was discussed as a measure to curb growing cases of the novel coronavirus infection in the Mumbai Metropolitan Region (MMR), it said.Maharashtra withdrew its mandatory mask rule in early April and made it optional in view of a sharp drop in daily cases."Coronavirus cases are on the rise in the state, chiefly in Mumbai, Thane, Pune, Raigad and Palghar districts. People should follow COVID-19-appropriate behaviour on their own," the CM was quoted as saying in the statement.Maharashtra recorded 4,205 new COVID-19 cases on Friday, a day after breaching the 5,000-mark. Of the new cases, Mumbai alone reported 1,898 infections.PromotedListen to the latest songs, only on JioSaavn.comThe number of active cases has gone past 25,000, indicating a widening gap between new patients and those recovering from the infection.(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
Good morning, Battling to save the Maha Vikas Aghadi government, CM Uddhav Thackeray left his official residence, which turned into a late-night show of strength. In an emotional speech, Uddhav said he is willing to resign if the MLAs and Sainiks tell him to his face that they do not want him to continue. Here’s what you should know about the deepening political crisis in Maharashtra:🔴 Sources told The Indian Express that the decision to fly out the rebel Shiv Sena and Independent MLAs from Surat to Guwahati, both in BJP-ruled states, was taken after it was learnt that at least two Sena MLAs were not on the same page as rebel leader Eknath Shinde — and that Surat was “too close to Maharashtra”, which might lead to the revolt failing.🔴 The Indian Express has also learnt that since 2015, Eknath Shinde and BJP chief Devendra Fadnavis moved from being just Cabinet colleagues to close friends. So much so, the sources said, that “in 2019, had the Shiv Sena and BJP contested the assembly elections separately, Shinde would have been BJP’s candidate from Thane constituency.”Yashwant Sinha, the Opposition’s consensus candidate for the July 18 presidential polls, speaks to The Indian Express about the election being an ideological battle, Droupadi Murmu’s candidature, and why it is too early to conclude that he does not have the numbers to win.Sentiments of pride and hope echo across the streets and villages of Rairangpur municipality in Odisha’s Mayurbhanj district, the home of NDA nominee Droupadi Murmu, who, in all likelihood, will become India’s first tribal woman President. Her daughter, Itishree, says, “Tribal people fear going to a police station or court… When they see a tribal person at the top post, they will have some faith. Glass ceilings will be broken.”Denying allegations of illegal demolition of private properties in the state following violent protests over remarks on the Prophet, the Uttar Pradesh government has told the Supreme Court that action was “carried out by the Kanpur Development Authority and Prayagraj Development Authority strictly in accordance with the Uttar Pradesh Urban Planning and Development Act, 1972”, and “had no relation to the riots”.With coaching centres across Aligarh under scrutiny after protests against the Centre’s Agnipath scheme took a violent turn, many such centres are now closed. On Wednesday, all centres in and around Tappal, a little over 100 km from Delhi, had their shutters down. Across Aligarh district, 76 people have been arrested and 68 taken into preventive custody, of whom at least 11 are operators of coaching centres. Most of the arrests of coaching centre operators were from the Tappal region.In our opinion section today, Suhas Palshikar writes on what school textbook deletions tell us about the ruling establishment’s idea of democracy and its understanding of social sciences: “In purely tactical terms, this could be a calculated deletion to keep the Congress quiet by an unstated quid pro quo: We delete what we don’t want but we also delete what you may not want. It will be interesting to see how the Congress responds to this and whether, after more than four decades, it has the courage to make course corrections on this issue and admit its mistake.”Mumbai witnessed a six-fold rise in deaths due to heart attack in the first six month of 2021 when the city was under the grip of the second wave of Covid-19. In the period between January-June 2021, nearly 3,000 people lost their lives to heart attacks every month which was around 500 in 2020. The information was revealed through an RTI filed by an activist Chetan Kothari.What caused the surge: Dr Avinash Supe, in-charge of the Covid-19 death committee, sees three major reasons for the surge in deaths related to heart attack – possibility of development of thrombosis among the Covid-19 recovered patients, delay in diagnosis of patients amid the pandemic and better recording of data.Does lifestyle change due to Covid have anything to do with it? Other than the critical risk factors, the prolonged lifestyle changes in the pandemic added to the risk of developing heart attacks, experts say.Doctors have witnessed an increase in the prevalence of diabetes, hypertension, smoking, alcohol use and an unhealthy lifestyle in the last two years.Shubman Gill is coming straight from a rich vein of form in the IPL. It was not just his most successful one (483 runs at 34) but also the one he has been most influential, one wherein he found the formula of batting in T20 cricket without tampering with his fundamental game. His tour of England will test some of his traits — the slow weight transfer to the front foot and the tendency to flick around the front pad. Can the talented youngster course-correct his stop-start Test career?In today’s episode of the ‘3 things’ podcast: Central banks raise interest rates to tackle inflation, CBI arrests five in Biocon Biologics bribery case, and the dangers of bird strikes on aircraft.Until tomorrow,Rahel Philipose and Sonal Gupta
With his party rebel MLAs not backing down and the numbers clearly not on his side, Maharashtra Chief Minister and Shiv Sena chief Uddhav Thackeray, battling to save the Maha Vikas Aghadi coalition government, left the CM residence for his family home Wednesday evening, shortly after an emotional speech in which he said he is willing to resign if the MLAs and Sainiks tell him to his face that they do not want him to continue.Uddhav was seen leaving Varsha, the official residence of the CM, with wife Rashmi and sons Aaditya and Tejas. He left with personal belongings, and was accompanied by Shiv Sainiks all the way to Matoshree, the Thackeray family home.Earlier, in an address which was more an appeal to the Sena continued after rebel minister Eknath Shinde moved from Surat to Guwahati with his flock, Uddhav, who tested positive for Covid Wednesday, said, “If my own people are saying they do not want me, then shouldn’t they have come before me to say it instead of going to Surat and speaking there? They should have come here and said ‘Uddhavji, you are useless… forget the praise (for work done) during Covid… We don’t want you’. I would have resigned from the post of CM even if one MLA had said this to me.”“If you do not believe this, then I will immediately move to Matoshree from Varsha. I have no greed. I am not going to stick to the chair… I am the son of Balasaheb. But come here, say whatever you have to in front of me,” he said.This was Uddhav’s first public remarks after the revolt in his party. On Wednesday, Eknath Shinde claimed that he now had support of 34 MLAs, 30 of them from the Shiv Sena which has a strength of 55 in the Maharashtra Assembly.Late in the evening, Shinde, in a Twitter post, said, “Over the last two years under the MVA government, only the coalition partners benefitted while the Shiv Sainik was left frustrated. While our allies gained strength the Shiv Sena and Sainiks were deliberately weakened. For ensuring the survival of the party and Sainiks, it is necessary to step out of this unnatural alliance. For the greater good of Maharashtra, it is time to take a decision.”More MLAs are said to be on their way to join the Shinde camp. The revolt, hours after the Legislative Council elections Monday in which the MVA suffered a setback following cross-voting by MLAs, has put a question mark on the future of the coalition.In the House of 288 which is currently at 287 owing to the death of Sena MLA Ramesh Latke last month, the MVA needs at least 144 MLAs. Before the revolt, its strength in the House was 152 — Sena 55, NCP 53, Congress 44. The BJP strength is 106 while Others account for the remaining 29.Hoping to return to power and not willing to reveal its cards yet, the BJP, party sources said, is waiting for Shinde to rustle up the numbers that he needs to beat the anti-defection law.“More Shiv Sena MLAs are expected to join Shinde by Thursday, and it will no longer be a numbers game. Uddhav will be left with only a handful of MLAs. He has lost his pillar of strength… the shock of this development will make it easier for the BJP.”Once the picture is clear, the BJP hopes to make its move and get Devendra Fadnavis to stake claim with the backing of the Sena rebels, sources said, maintaining that the chain of events so far has been on expected lines.The rebel MLAs made public a resolution, appointing Shinde as leader of the Shiv Sena legislature party, saying “there is enormous discontent” in the party cadre “for forming the government with NCP and Indian National Congress who are ideologically opposed to our party”.The rebel list of 34 MLAs has signatures of 30 Sena MLAs – two MLAs are from the Prahar Janshakti Party and two are independents. More smaller parties are rallying behind Shinde who needs to have the support of 37 party legislators to avoid disqualification under the anti-defection law and form a separate group.The resolution of the rebels stated: “There has been compromise on the principles of our party Shiv Sena, which has been a party with a fierce ideological base, and was formed for fighting for the rights of local Marathi people. For the last two-and-a-half years, our party and its leadership have compromised party principles by aligning with contrasting ideologies for the sake of achieving power in the state of Maharashtra.”“The ideology of our party’s leader, Late Balasaheb Thackeray, was to give a clean and honest government to the people of Maharashtra… without compromising on the principle of Hindutva which was defeated the first day itself by aligning with opposing ideologies,” it stated.The resolution said party members were unhappy about “corruption” in the government and administration regarding police postings and referred to former “Home Minister Anil Deshmukh (who is in jail), and sitting Minority Minister Nawab Malik (also in jail).”“Our party cadre faced tremendous harassment and distress on political as well as personal grounds from the opposition ideological parties, who are now a part of the government, and were using their office and power to undermine the base and foundation of our Shiv Sena cadre,” the resolution stated.It said the Sena decision to sever ties with the BJP in spite of having a pre-poll alliance had a negative impact on the cadre of the party.“There was continuous hue and cry towards the party leadership for the act of aligning with the opposing parties. Ignoring this, the party leadership went ahead and formed a Maha Vikas Aghadi government. For the last two-and-a-half years, we, the Shiv Sena Legislative Party members, were facing tremendous pressure from their electorates/voters,” it stated.The resolution also stated that Bharat Gogavale had been elected and appointed Chief Whip of the Shiv Sena legislature party, and that the appointment of Sunil Prabhu had been cancelled with immediate effect.Earlier in the day, Sunil Prabhu had issued a letter asking all Sena MLAs to be present for a meeting in Mumbai. The letter warned that if anyone remained absent, it would be considered that the MLA had decided to quit the party voluntarily. The meeting did not, however, take place.In Guwahati, Shinde and the rebel MLAs were received at the airport by BJP MP Pallab Lochan Das and MLA Sushanta Borgohain.Speaking to reporters, Shinde said he and those with him were “committed” to Balasaheb Thackeray’s ideology of Hindutva. “We want to take it forward,” he said, “I have 40 Shiv Sena MLAs with me. I cannot comment on anybody.”Borgohain told reporters that he was at the airport to “receive friends”.“Two-three friends called me, so I came to receive them…They have not disclosed what programme they have,” he said.Assam Chief Minister Himanta Biswa Sarma told reporters that he was not privy to much information on the developments. “I am busy with flood relief work. Right now I am heading to Kampur (Nagaon)… tomorrow I will head to Silchar,” he said, adding that there were some “legislator friends” and he may meet them for “five to ten minutes”.Sarma said it was “positive” that people were visiting the state despite the floods. “Since we are inundated, all hotel rooms are empty and the state is facing financial difficulties. Now if tourists from across the country come and stay in a hotel, it will only benefit us,” he said.BJP Rajya Sabha MP Pabitra Margherita said “all people” were “welcome” in Assam.The rebel MLAs were taken to a luxury hotel in Guwahati in three buses amid heavy police protection.Sushmita Dev, TMC MP from Silchar which has been submerged in water for the last 72 hours, said the BJP government had its priorities wrong.“There is a crisis in Silchar — there is no drinking water, no electricity, no boats for rescue … people are living on roofs… in the middle of all this, the Chief Minister of Assam is busy poaching MLAs, and putting them up in five-star hotels. This is really bad,” she said.
MUMBAI: Soon after addressing people over social media in the wake of the rebellion led by Eknath Shinde, CM Uddhav Thackeray vacated the CM's official residence, Varsha, in south Mumbai and shifted to his private residence, Matoshree, in Bandra. "I am not hungry for power. I will resign if a Shiv Sena legislator comes and tells me to quit. I am vacating the Varsha bungalow right now and shifting to Matoshree,'' said Thackeray in his speech. Immediately afterwards, Thackeray set off for Bandra. As he reached Matoshree, hundreds of Shiv Sena activists welcomed him. Thackeray took the oath of office in November 2019, but shifted to Varsha almost a year later in October 2020 during Diwali. A week ago, when PM Narendra Modi was inaugurating Jal Bhushan, the official residence of the governor in Raj Bhavan, Thackeray remarked that the bungalow is huge and well decorated. "Your bungalow is tastefully decorated. Will you exchange it for Varsha?" Thackeray had said with a smile to governor Bhagat Singh Koshyari.
Uddhav Thackeray Facebook Live: Maharashtra Chief Minister Uddhav Thackeray on Wednesday addressed the state via Facebook Live. The address comes amid reports of Uddhav’s resignation as CM of Maharashtra. “Chief Minister Uddhav Balasaheb Thackeray will interact with the people through Facebook Live this evening at 5.00 pm and give his feedback on current affairs,” CMO Maharashtra tweeted earlier.Also Read - Maharashtra Political Crisis: Rebel Shiv Sena Leader Eknath Shinde to Address Media ShortlyThe Shiv Sena had earlier issued an ultimatum to all its MLAs, directing them to attend a meeting in Mumbai by 5 pm or face action. The letter also warned that if someone remains absent from the meeting without proper reason and prior information, they should keep in mind that action will be initiated to cancel their membership as per constitutional provisions. Also Read - Posts Will Come and Go: Uddhav Thackeray Drops Big Hint Amid Resignation Buzz | Top QuotesLive| Uddhav Thackeray Facebook Live: I am keeping my resignation letter ready, come and tell me if you don’t want me as chief minister: Uddhav ThackerayI am ready to resign as chief minister and Shiv Sena head, says Uddhav ThackerayAny of the rebel MLAs should come and tell me in the face that they don’t want me as chief minister. I will quit immediately, says CM UddhavIf NCP or Congress didn’t want me to be a CM, then it would have been okay. But with Shiv Sena leaders doing this is upsetting. I consider them as my own, it’s not likewise: CM Uddhav ThackerayWe opposed NCP and Congress for 25-30 years; Sharad Pawar insisted I should come on board, says Maharashtra CM Uddhav ThackerayMaharashtra CM Uddhav Thackeray said that he had no experience of administration, but worked hard and got good result. He said because of state work, he was selected as top chief minister in country.Shiv Sena and Hindutva are synonymous. They cannot be separated. Aaditya Thackeray, Eknath Shinde and several ministers visited Ayodhya: Uddhav ThackerayWe have 63 MLAs in Maharashtra, says Uddhav ThackerayShiv Sena can’t be separated from Hindutva, says Uddhav Thackeray“I’ve tested positive for COVID. I was one of the top 5 Chief Ministers in the country to deal with the COVID wave”: Uddhav Thackeray
MUMBAI: On a politically charged day, Maharashtra governor Bhagat Singh Koshyari and chief minister Uddhav Thackeray tested positive for Covid-19. Eighty-year-old Koshyari, who announced his diagnosis on Twitter early on Wednesday, is in hospital as a precautionary measure. “I have been tested positive for COVID-19 with mild symptoms. However I have been admitted to a hospital as a precautionary measure,” he tweeted. Meanwhile, Thackeray’s Covid-positive status was announced by the All-India Congress Committee (AICC)’s appointed observer in the state, Kamal Nath. He told reporters that he had been unable to meet Thackeray who had tested positive for the infection. Koshyari is admitted to Sir H N Reliance Hospital, Girgaum. Senior hospital officials said the governor is stable but refused to make further comments, citing patient confidentiality. A statement from Raj Bhavan said the governor could be contacted via video-conferencing. "Governor has Covid symptoms. Which is why he is admitted to the hospital. He is stable and there are no such talks of handing over his charge to the other Governor. If anyone wants to get in contact with the Governor, can do it via video-conference," said the statement.
Maharashtra Governor Bhagat Singh Koshyari tested positive for Covid-19 on Wednesday, and was admitted to the HN Reliance Foundation Hospital in south Mumbai for treatment. The 80-year-old, who has been seen wearing a face mask at public events, said his symptoms were mild and he has been admitted in hospital as a precautionary measure.“I have been tested positive for Covid-19. There are only mild symptoms. However I have been admitted to a Hospital as a precautionary measure,” he tweeted.Koshyari’s illness comes at a time when the state is in the midst of a political crisis. The ruling Maha Vikas Aghadi government is facing the threat of being toppled after Shiv Sena leader Eknath Khadse and 40 other rebel MLAs have left the state, and are currently camping in Assam’s Guwahati.Shinde and his loyalists went missing after reports claimed that cross-voting in the MLC polls benefited the BJP, which ultimately registered a victory. Shinde and the other MLAs stayed at a luxury hotel in Surat yesterday and flew to Guwahati this morning.The Governor’s role comes to the fore at the times of political crises, when decisions pertaining to convening emergency sessions of the Assembly, conducting floor tests and taking decisions about forming and dissolving governments are to be taken.
Amid the political storm facing the Maha Vikas Agadhi (MVA) government in Maharashtra, Shiv Sena leader and Chief Minister Uddhav Thackeray Wednesday tested positive for Covid-19.This comes shortly after Maharashtra Governor Bhagat Singh Koshyari was admitted to the HN Reliance Foundation Hospital in south Mumbai as he tested positive for the infection.The All India Congress Committee (AICC)’s appointed observer in the state, Kamal Nath, told reporters that he could not meet with Thackeray as the CM had tested positive for the infection. He also stated that of the 44 Congress MLAs in the House, 41 had attended the party meeting, while three were on their way. Nath is scheduled to hold a meeting with NCP leader Sharad Pawar next, he said.#WATCH | Mumbai: “Maharashtra CM Uddhav Thackeray has tested positive for #COVID19,” says Congress Observer for the state, Kamal Nath. pic.twitter.com/wl22yJkXXt— ANI (@ANI) June 22, 2022The future of the MVA alliance-led government in Maharashtra hangs in the balance with Shiv Sena leader Eknath Shinde along with at least 40 MLAs, as he claims, camping in Guwahati, after they were shifted from a resort in Surat early Wednesday morning.On Tuesday afternoon, Thackeray hosted a meeting of Sena MLAs at his official residence, Varsha, where only 18 of his party’s 55 MLAs showed up.
MUMBAI: Maharashtra chief minister Uddhav Thackeray on Wednesday tested positive for Covid-19. The development comes amid ongoing crisis in Maha Vikas Aghadi due to the rebellion by senior party leader and minister Eknath Shinde. Maharashtra Congress' Observer for the state Kamal Nath and party leader Nana Patole informed about Thackeray testing positive for the virus. Meanwhile, Maharashtra governor Bhagat Singh Koshyari was admitted to a private hospital in south Mumbai after testing Coronavirus positive, an official said. "I have been tested positive for COVID -19. There are only mild symptoms. However I have been admitted to a Hospital as a precautionary measure," Koshyari tweeted. Koshyari (80) has been admitted to the Reliance Foundation Hospital, the official said.
Mumbai: Maharashtra governor Bhagat Singh Koshyari tested positive for Covid-19 on Wednesday. According to news agency ANI, he is admitted to HN Reliance Foundation hospital, Mumbai today for COVID19 treatment. Taking to his official twitter handle, the governor said, “I have been tested positive for COVID -19. There are only mild symptoms. However I have been admitted to a Hospital as a precautionary measure.” The news comes amid Shiv Sena rebel minister Eknath Shinde was expected to meet Governor Koshyari with a claim that there are 40 party legislators with him.Also Read - Two Shiv Sena MLAs Return From Eknath Shinde Camp, To Support Uddhav: ReportsI have been tested positive for COVID -19. There are only mild symptoms. However I have been admitted to a Hospital as a precautionary measure.— Governor of Maharashtra (@maha_governor) June 22, 2022 Also Read - Uddhav Thackeray to Quit? Here's What's at Stake & How Numbers Stack Up in Maharashtra Assembly | EXPLAINEDMaharashtra is currently witnessing political turmoil as rebel Shiv Sena leader and Maharashtra Cabinet Minister Eknath Shinde, along with several other MLAs went incommunicado on Wednesday and appeared to have rebelled against the party. Also Read - As Shinde Ditches Uddhav, MVA Looks Upto Sharad Pawar-Kamal Nath Meet | LIVE Updates33 Shiv Sena and 7 independent MLAs, led by Eknath Shinde arrived at a luxury hotel in Guwahati in BJP-ruled Assam on Wednesday. The revolt in the Shiv Sena has given rise to speculations that Shinde along with other MLAs might join the BJP in a bid to topple the Maha Vikas Aghadi (MVA) government.The Shiv Sena MLAs are now staying at Radisson Blu Hotel in the city.“A total of 40 MLAs are present here. We will carry Balasaheb Thackeray’s Hindutva,” said Shinde after arriving in Guwahati. The Shiv Sena MLAs were received by BJP MLA Sushanta Borgohain and BJP MP Pallab Lochan Das at Guwahati airport.
MUMBAI: Maharashtra governor Bhagat Singh Koshyari tested positive for Covid-19 on Wednesday. "He was admitted to a private hospital in south Mumbai after testing positive for the virus," said an official. The official added that Koshyari (80), who was always seen wearing face masks at public events, has been admitted to the Reliance Foundation Hospital in Mumbai. (With inputs from PTI)
India’s financial capital Mumbai witnessed a six-fold rise in deaths related to heart attack in the first six month of 2021 when the city was under the grip of the second wave of Covid-19.In the period between January-June 2021, nearly 3,000 people lost their lives to heart attacks every month which was around 500 in 2020.Nearly 23.8 per cent (17,880) of the total 75,165 deaths recorded till June last year in Mumbai were attributed to heart attacks. This information was revealed through an RTI filed by an activist Chetan Kothari.The figures have raised several questions about the sudden, unprecedented surge in deaths related to heart attacks. Medical officials have attributed several factors behind the staggering spike – post-Covid development of thrombosis, delay in diagnosis in heart-related ailment amid the second wave, better recording of heart-attack cases, major lifestyle changes and additional distress noticed in the second wave.Data provided by the Brihanmumbai Municipal Corporation (BMC) showed that in 2019, a total of 5,849 patients lost their lives to heart attack in Mumbai. This dropped slightly by 3.6 per cent when in 2020, 5,633 patients succumbed to the disease. But, to everyone’s surprise, in the the period between Jan-June 2021, a total of 17,880 succumbed to heart attacks in Mumbai with a surge of 217 per cent, compared to the previous year, as per the RTI.Dr Avinash Supe, in-charge of the Covid-19 death committee, sees three major reasons for the surge in deaths related to heart attack – possibility of development of thrombosis among the Covid-19 recovered patients, delay in diagnosis of patients amid the pandemic and better recording of data.“Globally, it has been witnessed that heart attack related deaths increased in the pandemic, so it is not a new phenomenon that has only been observed in Mumbai. Secondly, since the start of the pandemic, the medical practitioners are more conscious in segregation and bifurcation of types of deaths, so it has possibly helped to maintain better data related to heart attacks,” said Dr Supe.Also, during the second wave, many patients avoided hospitals due to fear of contracting Covid-19, which further delayed life-saving treatment.Dr Prafulla Kerkar, interventional cardiologist and chairman of Guidelines Committee of Cardiological Society of India (CSI), said, “The pandemic has been blamed for people with heart attack symptoms reaching hospital late, which pushed up the mortality rate. Reperfusion therapies like Thrombolytic therapy (that dissolve clots) and timely interventions like angioplasty were delayed.”He also said there is a possibility that patients who died of pre-existing heart conditions like decompensated heart disease or heart failure (the heart doesn’t pump blood as well as it should) were categorised as heart attacks without necessary investigation at a time the health system was overwhelmed with Covid-19.“A patient with heart failure is not identified as having a heart attack until it is shown in the ECG and cardiac enzyme levels are elevated. So, there is a possibility that the data also includes cases of heart failure,” he said.Covid restrictions led to a more sedentary lifestyle. Can this lifestyle change have a correlation with heart attacks?Other than the critical risk factors, the prolonged lifestyle changes in the pandemic added to the risk of developing heart attacks.“Life has become more sedentary with less options of socialisation and physical activities. The sugar and cholesterol levels are going haywire along with weight gain. Along with that, during the second wave, a lot of people were under stress – all these can also be contributing to the rise in heart attacks,” said Dr Supe.Doctors have witnessed an increase in the prevalence of diabetes, hypertension, smoking, alcohol use and an unhealthy lifestyle in the last two years.“Besides the rise in these risk factors, Indians have a genetic predisposition, smaller coronary arteries, a diet pattern with excessive consumption of trans fats and a sedentary lifestyle that puts them in a high-risk category for heart attacks,” said Dr Sanjith Saseedharan, consultant and head of Critical Care, SL Raheja Hospital, Mahim.Is there a clinical explanation behind linking Covid-19 with higher risk of heart attacks?Since the start of the pandemic, it has been observed that SARS-Cov-2 damages the heart and blood vessels in infected patients which leads to the development of clots, heart inflammation, arrhythmias, and heart failure. The Lancet – a science journal in August 2021 published that in the week after a diagnosis with Covid-19, the risk of a first heart attack increased by three to eight times.Dr Kedar Todaskar, Director of Critical Care at Wockhardt Hospital and member of Maharashtra Covid-19 task force, said that though no clear-cut cause and effect relationship has been proven, data does suggest that Covid-19 infection was a risk factor for thrombosis – not only arterial but venous thrombosis which included deep vein thrombosis and pulmonary thromboembolism too apart from acute coronary syndromes.“This is related to the virus interacting with the ACE2 receptors in the host body. So, all the organs with a predominance of ACE2 receptors are involved which includes the endothelium. The endothelium is the inner lining of all the vascular structures in the body which includes the arterial & the venous system. Covid-19 typically causes inflammation of the endothelium which is termed as Covid Endotheliitis. This endotheliitis is the cause of increased thrombotic events thereby leading to the increase in the cardiac mortality and morbidity seen in the second wave,” he said.Dr Saseedharan further explained that Covid-19 is an inflammatory disease which has the potential to destabilize plaques in the coronaries, which can lead to myocardial infarction. The severe affection of the lungs can also cause oxygen supply and demand mismatch, which also causes increased heart attacks. “This means that Covid-19 can also cause microvascular damages, which may have also contributed to heart ailments,” he added.Some medical experts also raised voices about unscientifically certifying deaths without proper post-mortem or other apparent methods like an angiography proven coronary occlusion in the second wave.“There is a distinct possibility that many of these patients died at home and thus ‘certified’ like heart attacks by the local general practitioner. Many of them might have not even visited the hospital due to the fear of relatives contracting Covid,” said Dr Saseedharan.Do we need better multi-centred studies in India for more scientific analysis of this trend?Dr Abdul Samad Ansari, Director, Critical Care Services, Nanavati Max Hospital, said that many patients have suffered from Acute Cardiac Events during the pandemic due to the thrombotic state created by the infection.But he also raised the need for better investigation by involving population dynamic or demographic statistics, past history of Covid-19 infection, vaccination status and existing medication routine.“If these patients had no history of past or present Covid infection and died purely due to cardiac complications then the causes could be major lifestyle changes, additional distress or any new clinical anomaly, yet to be analysed. It’s advisable to read the data in conjunction with associated risk factors for cardiac complications,” he said.Dr Shashank Joshi, member of the state Covid-19 task force, also laid emphasis on proper audit and scientific analysis.
Mumbai witnessed an over six-fold rise in monthly deaths related to heart attack in the first six months of 2021 compared to previous years. Between January and June 2021, as many as 3,000 people lost their lives to heart attacks every month in the city, compared to 500 in 2020.According to data provided by the Brihanmumbai Municipal Corporation (BMC), a total of 5,849 patients lost their lives to heart attacks in Mumbai in 2019. This dropped by 3.6 per cent when 5,633 patients succumbed to the disease in 2020. But between January and June 2021, a total of 17,880 succumbed to heart attacks in the city — a surge of 217 per cent over the previous year, according to a reply to an RTI request filed by activist Chetan Kothari.“Pre-pandemic, cancer was the biggest killer. But last year, although deaths due to cancer subsided, heart attacks surged significantly,” said a civic official.Dr Avinash Supe, in-charge of the Covid-19 death committee, said there are three major reasons for the surge in deaths related to heart attack — possibility of development of thrombosis among recovered Covid-19 patients, delay in diagnosis of patients during the pandemic and better recording of data.“Globally it has been witnessed that heart attack-related deaths increased during the pandemic, so it is not a new phenomenon that has only been observed in Mumbai. Secondly, since the start of the pandemic, medical practitioners are more conscious of segregation and bifurcation of types of deaths, so it has possibly helped maintain better data pertaining to heart attacks,” said Supe.It has been observed that SARS-Cov-2 injures the heart and blood vessels in infected patients, which leads to the development of clots, heart inflammation, arrhythmias and heart failure. In August 2021, The Lancet reported that the risk of a first heart attack increased by three to eight times in the week after a Covid-19 diagnosis.Dr Kedar Todaskar, director of critical care at Wockhardt Hospital and member of Maharashtra Covid-19 Task Force, said though there is no proven cause and effect relationship, the data suggests that Covid-19 infection was a risk factor for thrombosis, not only arterial but venous thrombosis, which included deep vein thrombosis and pulmonary thromboembolism, too, apart from acute coronary syndromes.“This is related to the virus interacting with the ACE2 receptors in the host body. So, all the organs with a predominance of ACE2 receptors are involved, which includes the endothelium. The endothelium is the inner lining of all vascular structures in the body, which includes the arterial and venous system. Covid-19 typically causes inflammation of the endothelium, which is coined as Covid endotheliitis. This endotheliitis is the cause of increased thrombotic events, thereby leading to increase in the cardiac mortality and morbidity seen in the second wave,” he said.Also during the second wave, many patients avoided hospitals due to fear of contracting Covid-19, which further delayed life-saving treatment. Dr Prafulla Kerkar, interventional cardiologist, chairman of Guidelines Committee of Cardiological Society of India (CSI), said, “It has been blamed on the pandemic when people with heart attack symptoms reached hospital late, which pushed up the mortality rate. reperfusion therapies like Thrombolytic therapy (that dissolve clots) and timely interventions like angioplasty.”He also said there is a possibility that patients who died of preexisting heart conditions like decompensated heart disease or heart failure (the heart doesn’t pump blood as well as it should) were categorised as heart attacks without necessary investigation at a time the health system was overwhelmed with Covid-19. “A patient with heart failure is not identified as having a heart attack until it is shown in the ECG and and cardiac enzyme levels are elevated. So, there is a possibility that the data also includes cases of heart failure,” he said.To better understand the trend, doctors say there is a need for better investigation into the deaths and verbal autopsy of the deceased patients. “But if these patients had no history of past or present Covid-19 infection and died of cardiac complications, then the causes could be major lifestyle changes, additional distress or any new clinical anomaly yet to be analysed. So, it’s advisable to read the data in conjunction with associated risk factors for cardiac complications,” said Dr Abdul Samad Ansari, director, Critical Care Services, Nanavati Hospital.
