We will begin pool testing trials to speed up diagnosis: Satyendar Jain
Delhi’s health minister Satyendar Jain spoke to Sweta Goswami about enhanced tests, new testing methods, the PPE challenge, hospital infrastructure, and community transmission, among other issues. Edited excerpts:
The Delhi government has ordered 100,000 rapid test kits to detect more Covid-19 cases and take containment measures accordingly. What is the plan for conducting these tests?
Till date, 9,035 tests have been conducted in Delhi. The 1 lakh (100,000) rapid antibody test kits will be used in three ways. First is the area around the Nizamuddin Markaz, second will be in and around north-east Delhi’s Nand Nagri area. The third will be on our health workers, who are the front-line workers in our fight against coronavirus.
After the 18 fresh positive cases that emerged among health workers, we have decided that random rapid tests will be conducted on them. We have nearly 3,000 medical staff on Covid-19 duty.
What about labs? Will they be able to take the load?
We are trying a new thing -- pool testing. It is currently being done in Germany. We will begin trial runs on this in a week. Two hospitals -- Institute of Liver and Biliary Sciences (ILBS) and Rajiv Gandhi Super Speciality hospital -- have been asked to start the trial.
Once this starts, Delhi’s testing capacity will go up by about eight times with the same manpower, the number of kits and other resources. These confirmatory tests will then be run parallel to the rapid tests (non-confirmatory) for detection at a massive scale.
Under pool testing, people are divided into teams of about 15. If a team tests negative, that is good. If the result is positive, they are divided into groups of three, for another round of tests.
At present, we have the ILBS lab under us which is processing 250-300 tests daily. Apart from pool testing, we are working on increasing the normal testing at this institute to 500-600 a day.
Do you have enough personal protective equipment (PPE) kits now?
Stocking up on PPEs is one of our top priorities now as we have to keep the virus from spreading among our health workers. But the truth is that at present, we have stocks for only about five days. The Centre is giving us 27,000 kits, but that will not be enough.
We need minimum 50,000 PPE kits as buffer stock at any given point of time, in addition to the kits that are being used on a daily basis. Right now, we hardly have 5,000 kits as a buffer. If an incident like Nizamuddin Markaz recurs, our five-day stock would last only for about three days.
On our own, we have ordered more than 1.2 lakh (120,000) kits by now, but the problem is there are only 3-4 vendors who have been able to meet government standards and their daily delivery is merely 500-1,000 kits per company per day.
Can you explain the government’s plan to tackle a sudden surge in Covid-19 cases, if such a scenario arises?
Our action plan is based on projections of daily active cases. At present, the number of active cases and the rate of growth are slightly lower than our projection, which we feel is because of the lockdown. But, we have a road map ready to treat 30,000 active cases in the city.
At present, we have 2,500 beds ready in three of our hospitals. Then 500 beds are available in Central government hospitals such as Safdarjung and AIIMS. Then we have beds in Max Hospital, Saket, Sir Gangaram Hospital and Apollo Hospital.
Our existing quarantine capacity is also eight times the present occupancy.
Do you have enough ventilators?
At present, we have nearly 300 Covid-19 dedicated ventilators sourced from Delhi government and private hospitals. The number goes up to around 400 if we add the ventilators in central government hospitals.
We have asked for 300 more ventilators from the central government; hope they agree to it.
However, let me point out that at present there are only eight Covid-19 patients in Delhi who are on the ventilator. Even the number of cases in ICUs is as low as 35 in the city.
Has community transmission begun in Delhi or at least in some parts of the city?
No. I am saying this because we have analysed this by creating a heat map of Covid-19 cases in Delhi. No area other than the Nizamuddin Markaz has so far thrown up an exploding number of positive cases to conclude that community transmission has begun.
Those in Markaz were living in confined premises, so the virus spread rapidly among them. If we see the data, of the total 550 positive cases in Delhi, only 219 are non-Markaz cases, that too over a period of about a month.
In the Markaz case, apart from the first information report, which the police has registered, hasn’t the Delhi government found any lapses of its own officials?
I know there could have been some lapses, but this is not the time for that. This is a crisis. If we order an inquiry against the officials who are key to a district, who will do the work?
So, let us keep the inquiry for a time when we are free from coronavirus. But action will be taken.
How is contact tracing is being done in the area and other places?
We formed 11 core teams for aggressive contact tracing - one in each district. Each team has a minimum 60 people from different agencies such as medical staff, police, district administration and so on.
Out of the 550-odd cases, there are about 49 cases in which we are still tracing contact history.