Revamped action plan for Delhi to fight Covid-19

Shah has held a series of meetings with Baijal, Kejriwal and senior officials over the past week over the strategy to augment Delhi’s health care infrastructure amid the Covid-19 outbreak.
A health worker in PPE prepares COVID-19 Ag rapid antigen test kits at a tesing centre in SKV Government Girls Senior Secondary School, in Chandni Chowk, New Delhi.(Amal KS/HT PHOTO)
A health worker in PPE prepares COVID-19 Ag rapid antigen test kits at a tesing centre in SKV Government Girls Senior Secondary School, in Chandni Chowk, New Delhi.(Amal KS/HT PHOTO)
Updated on Jun 22, 2020 12:23 AM IST
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Hindustan Times, New Delhi | BySaubhadra Chatterji and Neeraj Chauhan

The Centre and the Delhi government agreed on Sunday to revamp the action plan to control the spread of the coronavirus disease (Covid-19) in the national capital, laying emphasis on the need for more effective containment and tracing efforts, widening the scope of detecting infections and intensifying social distancing and surveillance at the ground level to tackle the outbreak at a time when the case count has risen to 59,746.

Union home minister Amit Shah chaired a meeting attended by Delhi chief minister Arvind Kejriwal, deputy CM Manish Sisodia, lieutenant governor Anil Baijal, Union health minister Harsh Vardhan and other senior officials to discuss the action plan. The strategy has been prepared in consultation with AIIMS director Dr Randeep Guleria, Indian Council of Medical Research (ICMR) director general Dr Balram Bhargava and Niti Aayog member Dr VK Paul, according to people aware of the developments.

An official, who spoke on condition of anonymity, said five key recommendations were: an improved containment tactic; wider tracing of a patient’s contacts; rapid antibody testing to gauge the prevalence of the disease; close involvement of the police to enforce social distancing norms; and inclusion of epidemiologists at the district level to augment the health care efforts. The Delhi Police commissioner will spearhead efforts to impose fines on people violating norms on social distancing and wearing face masks.

“The detailed discussions were needed as there is a need to have a foolproof implementation of this plan. Various layers of the government machinery will be involved in the implementation stage. We need smooth coordination as well as good management,” the official said.

Shah has held a series of meetings with Baijal, Kejriwal and senior officials over the past week over the strategy to augment Delhi’s health care infrastructure amid the Covid-19 outbreak. The infectious disease has so far killed 2,175 people in Delhi, with 31% of the total cases in the Capital being reported over the last week.

The central government official said at the meeting that Delhi accounted for 24% of all new cases and 25% of the Covid-19 deaths reported in the country in the last two days, adding that there was a need to overhaul the strategy in the Capital.

As part of the action plan, the Delhi government will revamp the way it decides containment zones and sets their boundaries, a second official present at the meeting said, asking not to be named.

A high-level committee led by Dr Paul has given a timeline under which the Delhi government will prepare a strategy by Monday and form district-level teams by Tuesday to revise the strategy by June 26. The committee said that there should be 100% survey of all containment zones by June 30, and by July 6, there should be an extensive survey of the entire Capital, according to a statement by the home ministry.

As of Sunday night, there were 261 containment zones in Delhi. Strict perimeter control is maintained in the containment zones, with restrictions on the movement of people.

While the discussions acknowledged that Delhi’s contact-tracing efforts showed good results in early days of the outbreak, a decision was taken to expand the tracing beyond family members of an infected person, the official said. “So, both contact-tracing and surveillance has to improve and for this purpose, the faculty and 3rd and 4th year students of Delhi hospitals will be engaged,” said the official.

Another senior official, who asked not to be named, underlined the urgent need for a push to contact tracing. “We have noticed that in Delhi, 60% of Covid-19-related deaths occur within three days of admission in hospital. This clearly shows that we are lacking in surveillance,” the official said.

At the meeting, both Shah and Kejriwal approved the plan prepared by the experts. After the first meeting ended, Union home secretary Ajay Bhalla held another meeting with senior officials of both Union and Delhi governments to chalk out the finer points to roll out the plan.

Shortly after the meeting, which was attended by Kejriwal and Sisodia via video-conferencing, the Aam Aadmi Party (AAP) said: “Chief Minister Arvind Kejriwal and Deputy Chief Minister Manish Sisodia discussed key strategies with Union home minister Amit Shah on making contact tracing more robust and further strengthening of medical services in severely impacted areas.”

The document on the strategy said that while the case doubling rate at the national level improved to 20.7 days, cases in Delhi were doubling in 14.4 days.

It has been observed that 57% of Delhi’s Covid-19 cases are coming from either clusters or containment zones, the second official said. “This indicates a serious problem in the current strategy,” the official added.

The third point of the fresh plan said that rapid antibody tests – also referred to as serological surveillance because the diagnosis involves blood samples – will be conducted in the Capital at a wider scale from the middle of next week to find out the prevalence of the disease.

It was decided that the serological survey will be conducted between June 27 and July 10, and 20,000 samples will be collected to analyse the scale of the spread of Covid-19. The rapid tests show the presence of antibodies in an individual’s bloodstream, showing whether the person may have been infected by the Sars-CoV-2 virus at some point.

Under the fourth point, punitive action will be taken strictly against people not wearing masks and not following social distancing norms. This will be led by the Delhi Police commissioner. Fines will be imposed if anyone is found violating these rules and a renewed drive will be conducted by district administrations to spread awareness, the second official said.

“As Delhi entered Unlock 1.0, we have noticed that in many cases, the strict social distancing norms are not being maintained. The plan says that the campaign must go on asking people to adhere to Covid appropriate behaviour. And if they don’t follow the norms, punitive action will be taken,” the official added.

The fifth point involves district-level governance structures and their engagement in the fight against Covid-19. “There are 11 epidemiologists with the Delhi government and they will be pressed into action. The district commissioners will also play a larger role,” said the first official.

Shah, according to the official statement, said that there should be an analysis pertaining to every Covid-19 death in the Capital, including the number of days a person was in hospital. The analysis will also assess if the deceased was in home isolation.

The remarks come a day after the Delhi Disaster Management Authority, chaired by Baijal, withdrew its order directing that all Covid-19 cases, including asymptomatic and mild cases, be admitted to hospitals.

Shah said that all positive cases will have to go to Covid Care Centres for an assessment before a decision on home isolation is taken.

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