Health minister Jain puts spike on better tracing, but numbers don’t really add up
As Delhi set a new record for the highest single-day infections for the third day in a row pushing the outbreak in the city to worse levels yet, health minister Satyendar Jain on Thursday attributed the surge in cases to the festive season, and a “change” in the administration’s contact tracing strategy that was helping identify more patients.
Cases in Delhi have been soaring to unprecedented highs over the past week. For the third day in a row, the Capital set a new daily case record with 5,739 new Covid cases taking the city’s tally to 375,753, including 338,378 recoveries and 6,423 deaths.
What is alarming is that the positivity rate has risen from 5.3% on October 8 to 9.55% on Thursday, indicating that the Capital is not testing adequately. This rise appears too sharp to be attributed to better contact tracing, experts said.
An expert committee headed by NITI Ayog member (health) VK Paul has warned that the number of cases in Delhi could go up to 15,000 a day during the winter months. But the Delhi health minister refuted the figure, and said cases would not rise to that level. Jain also insisted that Delhi was “well-prepared” to tackle a winter surge.
“We have changed our strategy by strengthening our contact tracing system now. We are seeing a surge in daily Covid-19 cases not only because more people are coming out owing to the festivities, but also because of this change in strategy,” Jain said.
Jain added that until last week, the government used to test contacts of people who tested positive for Covid-19 only if they exhibited symptoms. “Now directions have been issued to test every person who came in close contact with the Covid-19 positive case, even if they are not showing symptoms. This is why the positivity rate is increasing. So, now we are trying to test 5-7 contacts per Covid case to break the cycle of infection,” he said.
Even at this rate, however, Delhi’s contact tracing target would be half of what Central experts say is ideal. At the Union ministry’s health briefing on Tuesday, Dr VK Paul said that “contact tracing can only be considered successful if at least 10 contacts” of every positive case are traced and tested by the local governments.
Though cases in Delhi are increasing in what appears to be the third wave of infections, a senior government official ruled out the possibility of re-imposing any form of restrictions that were put in place during the lockdown. Many European nations, such as Germany and France, which are seeing a second wave of cases, have all announced restrictions over the past week, especially keeping in mind the festive season.
RT-PCR tests scaled up
The number of cases in the city started increasing in October as the government scaled up reverse transcriptase-polymerase chain reaction (RT-PCR) test, known as the gold standard. On Wednesday, over 17,000 RT-PCR tests were conducted in the city for the first time.
On Thursday, one in every 10 samples tested (9.55%) positive, and the average positivity rate rose more than two percentage points in the past two weeks. The positivity rate should drop to 5% or below for two weeks if a region’s testing programme is adequate and is keeping the outbreak in control, according to the World Health Organization.
HT reported on Monday that the data showed the tests need to be scaled up now irrespective of the daily volume since the positivity rate was well over the acceptable 5%-7% level, and rising.
Dr Lalit Kant, former head of epidemiology and infectious disease at the Indian Council of Medical Research (ICMR), said the true impact of the festive season, which started with the Navratras on October 22, is likely to be seen from mid-November.
“It is from mid-November that the daily cases may see a further uptick because and the trend is likely to continue till December because Diwali is on November 14 and it takes around 1-2 weeks for the symptoms to show. Contact tracing and containment zones should be the focus in such a scenario. Wherever contact tracing is not possible, the areas should be turned into mini containment zones so that there are no spreaders of the infection,” said Kant.
The Delhi health minister, meanwhile, also said that there would only be more clarity next week on whether cases had entered a third wave. “It is a bit early to say that Delhi is experiencing the third wave. We must wait for another week in order to definitively say that. But it is also possible that we’re already in that phase or are headed towards it,” he said.
Delhi saw its first peak in mid June, which was followed by another spike in the number of cases around September 17, and cases have been rising at a fast clip again over the past two weeks again.
While Jain said the city administration is “well-prepared” for the coming days, senior health department officials said the number of hospital beds, especially intensive care unit (ICU) beds, will be increased on a “need basis”.
Jain said that more than 10,000 beds were vacant in the city hospitals for Covid patients.
“If 5,600 persons are testing positive in a day, it does not mean that all would need a hospital bed. Going by previous data, only around 10% of the daily cases need a hospital bed. Sometimes it is even less. In any case, the Delhi government is preparing for all scenarios,” the minister said.