Delhi in battle mode to rein in Covid-19 wave

The meeting was chaired by Union home minister Shah and attendees included chief minister Kejriwal, health ministers of Centre as well as the state, Delhi’s lieutenant governor and top officials from Niti Aayog, ICMR and AIIMS.

Delhi will get hundreds of more intensive care unit (ICU) beds for Covid-19 patients, testing for the coronavirus will be doubled, and doctors from central paramilitary forces will be flown in, the government announced following a high-level meeting that on Sunday underscored what numbers have been indicating of late: the Capital is in the grip of an unprecedented wave of infections.

Kejriwal described the lack of ICU beds as the “biggest challenge”. (Sanchit Khanna/ Hindustan Times)

The meeting was chaired by Union home minister Amit Shah and attendees included chief minister Arvind Kejriwal, the health ministers of the Centre as well as the state, Delhi’s lieutenant governor and top officials from Niti Aayog, Indian Council of Medical Research and All India Institute of Medical Sciences (AIIMS).

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The meeting began with a presentation from Niti Aayog’s VK Paul, who described Delhi’s situation as “unprecedented” and “ likely to become worse”, according to an official familiar with the discussions, who spoke on condition of anonymity. Among the worrying details presented was this: on November 11, a day when it reported 48,355 new cases, Delhi recorded 361 cases per million of population, a level not seen before in India, not even in Maharashtra during its worst days.

“First, it was decided that the testing capacity for RT-PCR tests would be doubled in Delhi. Labs in Delhi will be utilised to their maximum capacity and wherever the risk of an outbreak is high, mobile testing vans from health ministry and ICMR will be deployed,” Shah said in a series of tweets. ICMR is expected to decide how this can be done by Monday afternoon.

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Experts said that while the decision to increase testing was welcome, authorities will need to focus on speeding up results since people are likely to continue spreading the infection in the time it takes between when their samples are collected and the reporting of results.

The minister also said that a decision had been taken to strengthen hospital infrastructure. “It was decided that 250-300 additional beds with ICUs would be added to the existing medical facility of DRDO at Dhaula Kuan... The 10,000-bed Covid Care Centre established at Chhattarpur would also be strengthened with enhanced availability of beds with oxygen capacity,” the home ministry said in a statement.

Officials also are believed to have briefly considered the idea of additional restrictions, although no decision on this was taken. “There was nothing discussed on more restrictions, although the home ministry may hold a meeting on the matter,” chief minister Arvind Kejriwal said following the meeting.

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Kejriwal described the lack of ICU beds as the “biggest challenge”. “We have seen that after October 20, cases have really started rising. Hospital beds are in adequate number but ICU beds have been dwindling. The Centre has assured that 500 ICU beds will be added at the DRDO hospital followed by another 250,” he said, adding: “Second big decision was to increase daily tests to over 100,000. ICMR has assured us they will extend facilities. Delhi government’s facilities are at capacity”.

As on Sunday evening, of the total 3,524 ICU beds for Covid-19 patients across more than 100 hospitals in Delhi, 3,099 were occupied. Hospitals have particularly been swamped this month, with active cases having risen from a little over 22,000 in mid-October to close to 40,000 on Sunday. HT also learns that a team of senior government officials from the Centre and the state may visit private hospitals to ensure that every available bed is being utilised.

The spike has been particularly pronounced due to the festive season. In the week ending October 25, when the city held Dussehra celebrations, there was an average of 3,663 cases every day. As on the middle of last week, this number rose to 7,196. In comparison, the number was 2,627 in the first week of October.

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“It was pointed out that the number of active cases per day has increased substantially. While the Case Fatality Rate (CFR) continues to remain in control, the health and medical infrastructure, such as dedicated Covid-19 beds, beds with ventilators, and ICUs, is already showing signs of strain,” the home ministry statement said.

The ministry added that house-to-house surveys will be carried out across Delhi by teams of AIIMS, Delhi government and municipal corporations after which all symptomatic persons people would be tested and provided necessary treatment. People familiar with the development said Union home secretary Ajay Kumar Bhalla, health secretary Rajesh Bhushan and Delhi chief secretary Vijay Kumar Dev will meet on Monday to discuss a strategy on containment zones.

“With the positivity rate on the rise, there is no other option but to scale up testing to contain the spread of the infection. And, in an ideal world, all the tests would be conducted using RT PCR, which is more sensitive and can pick-up more cases,” said Dr Rajinder K Dhamija, professor of medicine and head of the department of neurology at Lady Hardinge Medical College.

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“If there is a delay, it has to be ensured that anyone who undergoes the test -- and you undergo the test only if there is some suspicion -- remains in quarantine till they get the results to limit transmission of the infection. And, it is the responsibility of the government and the people,” Dr Dhamija added.

The Centre also decided to rush additional doctors and para-medical staff from central paramilitary forces, who will be airlifted to Delhi from other parts of the country. The Union government also directed some hospitals of the three municipal corporations of Delhi – which do not fall under the Delhi government -- will be turned into dedicated Covid-19 hospitals to treat patients with mild symptoms.

Subsequently, teams comprising officials from various departments will visit the private hospitals across Delhi to inspect the availability of medical infrastructure, beds, admission of patients and to assess if the decisions taken earlier are being implemented or not.

There will also be new protocols prepared for plasma donation and providing plasma to critical patients. A high level committee with Niti Aayog’s Paul, AIIMS director Randeep Guleria and ICMR’s head Balram Bhargava will soon submit a report in this regard. “The containment measures taken previously like establishment of containment zones, contract tracing and quarantine and screening will also be reassessed,” Shah said in his tweets, before adding: “Prevention is the only solution to coronavirus; hence Delhi needs to have a robust communication awareness program to inform people about Covid-19 behaviour and negative aspects of the pandemic,” Shah tweeted.

The home minister also suggested that the Delhi CM consult the three mayors in the city for better Covid management.

Later in the day, Kejriwal tweeted: “Delhi has shown before that we can overcome corona when we all work together. Centre, state government, DRDO, ICMR will double their efforts n work together but we need support from all delhites. We can’t afford to be careless. We need all citizens to help by taking all precautions.”