India on Thursday recorded over 20,000 new Covid-19 cases for the first time in two months amid Maharashtra’s second wave, Punjab’s third wave, and increasing counts in three other states, but continued declines elsewhere.

However, health experts believe a second nationwide wave is unlikely without concurrent surges in many more large states.

Health authorities recorded 22,854 new Covid-19 cases nationwide — the highest since 20,346 on January 6 — after a near-steady increase in the counts of Covid patients over the past month from 135,000 on February 12 to over 189,000 on March 10.

Maharashtra and Punjab are largely driving the epidemic’s current growth. In Maharashtra, the seven-day average daily new cases have increased four-fold — from 2,500 to 10,000 — over the past month. In Punjab, counts have increased six-fold from 200 to over 1,300.

“We’re very worried about several districts in Maharashtra. There are lessons for us — don’t take the virus for granted,” said Vinod Paul, a senior pediatrician, chair of the national expert group on Covid-19 vaccines and member of Niti Aayog, the government’s apex think tank.

Paul said the surge in Maharashtra and other states underlines the importance of personal precautions such as masks and avoiding crowds and the need for rigorous implementation of standard public health measures such as testing, containment and health system preparedness.

“It will also be our suggestion that vaccinations should be intensified and prioritised in districts where cases are on a significant rise,” Paul said.

Maharashtra on Thursday recorded 13,659 new Covid-19 cases, more than halfway to its peak count of 24,886 on September 10 during the state’s first epidemic wave. Experts said the current rise represents a second wave in the state and appears driven by laxity in both precautions and public health measures.

Punjab’s current rise marks a third wave, after the first in mid-September and a second peak in November. Health officials said Gujarat, Haryana and Madhya Pradesh have also shown a steady rise in counts over the past month.

“We think Madhya Pradesh, Gujarat and Haryana are at a tipping point close to a surge,” Union health secretary Rajesh Bhushan said.

The daily new cases have more than doubled in the three states since early February.

“The states have been told that they need to pull up their socks — increase their tests, increase their surveillance, increase their containment areas. Basically whatever we’ve been doing so far. More of the same but in a more efficient manner,” Bhushan said.

Epidemiologists said while the surge in Maharashtra is surprising because the state had consistently reported large numbers of cases since the start of the epidemic in 2020, a nationwide second wave is unlikely without similar surges in other states with large populations.

Kerala, Uttar Pradesh and Bengal are among the states that have continued to show a decline in the counts of active patients over the past month. In Kerala, the number fell from 64,000 in early February to around 35,000 this week. In Bengal, patient counts decreased from 4,300 to 3,100, while in Uttar Pradesh, the counts declined from 3,200 to 1,600.

Community medicine specialists say the key to avoiding a second nationwide wave would be to ensure that surges like the one in Maharashtra do not occur in other states with large populations such as Uttar Pradesh, Bihar, Andhra Pradesh or Tamil Nadu.