Is Delhi the New Covid-19 Hotspot?

NEW DELHI: As covid-19 cases in India show a downward trend over the last few weeks (from a peak of 97,894 cases on September 17 to 45,576 cases on November 19), the capital of New Delhi is an exception to this overall decline, with cases hitting record highs over the last few weeks.

“The third wave of corona is going on in Delhi,” Chief Minister Arvind Kejriwal admitted at an all-party meet on Thursday, as cases in the last few weeks crossed 8000 a day. The numbers had started climbing at the end of October. On November 3, Delhi recorded 6725 covid-19 cases. Three days later, the 7000 mark was crossed. And on November 11, Delhi logged 8593 cases -- an all time high. The situation hasn’t yet improved - for the last three consecutive days, numbers have been over 7000. Delhi also has the highest positivity rate in the country, with almost 13 percent of those tested testing positive for covid-19.

At the time of writing, the total number of covid-19 fatalities have crossed 8000 in Delhi. On Wednesday evening 131 deaths were reported, the highest single day tally in the national capital. In the last week alone, Delhi added 43,109 new cases (an 11% rise), taking its case tally to over 500,000. 21% of India’s covid-19 deaths in the last week were in Delhi.

The rising cases come even as Delhi continues to depend on rapid antigen tests - far less accurate than the RT-PCR tests. As on November 12, 19,752 RT-PCR and 40,477 rapid antigen tests were conducted. Official guidelines state that rapid antigen tests should be followed by an RT-PCR test, and various bodies, including courts, have asked the Delhi government to increase the percentage of RT-PCR tests so as to obtain more accurate results.

The Delhi government -- whilst negating the possibility of another lockdown -- sought to implement measures such as increasing the fine imposed on those caught without masks, from Rs. 500 to Rs. 2000; limiting guests at weddings to 50 people (this had been relaxed to 200 people earlier); increasing ICU beds; and moving to close down markets in covid hot spots. "If we see that social distancing and mask-wearing is not being followed in any market, and there's a possibility of those areas becoming a hotspot, we should be allowed to close them down for a few days," Kejriwl said, adding that his government had sought permission to impose the above restrictions.

The measures came after the Delhi High Court pulled up the Kejriwal government for failing to respond adequately to rising cases. “It has been noticed that even in such a critical situation, the Delhi Government has continued to relax the norms relating to movement of the public. This is apparent from the fact that as against an order capping 100 guests at marriage ceremonies, the number of guests has been permitted to be increased to 200,” the court said.

Government officials blamed the spike on a combination of things -- including the festive season of Diwali and rising pollution levels. Over the last few weeks, Delhi's air quality index - on several occasions - has been 12 to 14 times greater than the World Health Organisation’s safe levels.

The rising cases, however, had been predicted - most notably in a report released early October by a government expert group led by Dr VK Paul of Niti Ayog. The report said that Delhi should brace itself for upto 15,000 cases a day during the festive season - unless restrictions and measures are immediately put in place.

But even as the festive season draws to a close and wind speed provides some relief to pollution-choked Delhi residents, the covid-19 numbers remain high. A slew of measures were announced on Wednesday in the hope to tackle the crisis, including ramping up RT-PCR tests to 60,000 a day by November-end, increasing ICU beds at hospitals, and flying in doctors and paramedics to the capital.

The Delhi government ordered 42 private hospitals to reserve 80% of their total ICU beds for covid-19 patients, adding 249 ICU beds to the present strength of 3,700. In another order, 90 private hospitals were instructed to reserve 60%, instead of 50%, of their total beds for Covid-19, adding 2,644 beds to the nearly 17,000 beds earmarked for Covid-19 treatment. 11 Delhi government hospitals were ordered to increase ICU capacity by 663.

Kejriwal also instructed hospitals to delay all non-critical surgeries and procedures so as to free up beds. “Last week, after the court allowed us, 80% ICU beds were reserved in 33 private hospitals. Now, this will be implemented across all hospitals in Delhi to increase the number of ICU beds further by 300-400. Along with that, we had asked private hospitals to reserve 50% beds, which will be increased to 60% for some days,” Kejriwal said.

The increase in beds will be essential as, at the time of writing, the Delhi corona app shows that 88% of ICU beds in the city’s hospitals are occupied. About 55% of non-ICU beds are also occupied. According to the online Corona dashboard of the Delhi government at 1230 pm on November 19, only 131 covid-19 ICU beds were available out of 1362 such beds at various hospitals and facilities in Delhi.

The available beds are shrinking fast, as data shows that no beds with ventilators are available at nearly 60 Delhi hospitals. The hospitals with no vacancy for such beds include Rajiv Gandhi Super Speciality Hospital, Max hospital at Saket, Patparganj and Shalimar Bagh, Batra hospital, Fortis hospital at Shalimar Bagh and Vasant Kunj, Fortis Escorts Heart Institute, amongst others.

The data shows that the national capital isn’t just the new hotspot, it is also on the brink of a medical and healthcare disaster.