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Delhi braces for surge in Covid-19 cases, but says it’s ready for it
The crowding is likely to see a spike in cases in Delhi -- much like similar crowding in a vegetable market in Chennai caused the number of Covid-19 cases, on a downswing, to spike.
District health officials are expecting a sharp rise in Covid-19 cases next week, arising from the thousands of people who have been defying social distancing norms, especially outside liquor stores since Monday -- throngs that are threatening to become a logistical nightmare for staff working on contact tracing.
“The decision to open up the liquor stores was taken in haste. There was no proper planning or communication with government bodies and departments, leading to chaos and confusion on Monday. We were totally blank about which shops were being opened where— how were we to ensure adherence to social distancing norms? And, in the next two weeks, this will cause a lot of trouble because there is no way we will be able to trace who came in contact with whom at such stores,” a district administration official said on condition of anonymity.
To be sure, the crowds were not unique to Delhi. Similar scenes were witnessed in other states too.
Still, the crowding is likely to see a spike in cases in Delhi -- much like similar crowding in a vegetable market in Chennai caused the number of cases, on a downswing, to spike.
“There will be an increase in the number of cases, that is the natural course of the infection. We have to see whether the relaxation of the lockdown will exacerbate it. However, Delhi is reasonably well prepared for around 1,000 cases a day for about 15 days at a stretch. Even if we assume that for every 500 cases, 10 to 12 will need ventilators, we have enough in the city. The actual numbers are lower,” said Dr SK Sarin, chair of the five-member team advising chief minister Arvind Kejriwal on Covid-19 preparedness.
To market, to market
Marketplaces have emerged as the source of several clusters of infection across the country even before the relaxations of lockdown norms. In Tamil Nadu, 300 of the 527 fresh cases of Covid-19 on Monday were traced back to one of the country’s largest vegetable and fruit wholesale market in Chennai’s Koyambedu area.
In Delhi, 17 cases were reported from Azadpur Mandi, where the government has restricted the number of trucks coming in with goods, extended the market’s timings to ensure distancing, and has two teams of health care workers screening people.
“Now, vegetable vendors in the city have also started testing positive — customers could have infected them or someone from the mandi. However, one thing is for sure, the numbers will go up as the norms are relaxed,” the district administration official added.
Shortage of staff
The increase in cases expected over the next two weeks will pose a challenge for a team already fatigued by weeks of screening and contact tracing.
“We have hundreds of other things to do. We were already tracing the contacts of positive cases, ensuring people follow through with their quarantine, screening and testing people from the community. Now, with positive people being allowed to be in quarantine at home, our staff will have to keep a check on them for the progression of symptoms. There are also hundreds of migrant workers coming in and leaving Delhi, who have to be screened and given passes. With liquor shops and markets opening, our staff will also have to ensure social distancing everywhere. How can this be done? There is no additional manpower,” a second district administration official said on condition of anonymity.
“If 8-10 people test positive in each district and have come in contact with around 50 people, it is possible to trace them, but if suddenly there are 40-50 fresh cases in each district every day, this exercise will become impossible,” the first district official said.
The government is making provisions for private services to check on positive patients under home isolation, a third district official said.
“Currently, our teams call up everybody to check on them but we have been told that the government is in talks with some private agency to make the calls so that some of our staff is free for other work”..
Hospital-based care
Delhi has around 2,800 beds in government hospitals and another 420 in private hospitals for Covid-19 patients. Of the 3,572 people who are infected, 1,231 with moderate-to-severe symptoms are admitted to hospitals as on May 5. This means about 44% of the total bed capacity is being utilised.
Lok Nayak hospital, with the highest capacity for Covid-19 patients, will add 500 more beds in the next few days, increasing the number of beds in government hospitals to around 3,300. “Another 500 beds will be added in the next few days, taking the total number of beds dedicated to Covid-19 patients to 2,000. We can handle any surge in the number of cases. Besides, we have observed that 80% of the people are asymptomatic or mildly symptomatic and can remain in isolation in their homes. So there shouldn’t be too much pressure on the hospitals,” Dr JC Passey, medical director, Lok Nayak hospital said.
The Delhi government is also looking to purchase 500 more ventilators. There are 306 ventilators in government hospitals and around 800 in private ones in the city. There were 92 people in intensive care units and 17 on ventilators on Monday.
The Delhi government also has a stock of about 50,000 personal protective equipment kits, with more expected this week.
