Delhi broke its record for the highest number of Covid-19 cases to be added on a weekend, data released on Monday showed, as alarm grows over the scale of the outbreak in the Capital, forcing top officials from the Union and the Delhi governments to meet on Monday and discuss a recalibration of testing, treating and surveillance strategies.
In a meeting of top bureaucrats from the Union home ministry, Union health ministry, Niti Aayog, the Delhi government, and Delhi Police, to review the situation, the central officials stressed on the need to make testing more pinpointed, and called new awareness campaigns targeted at people in the 20-40 age bracket at a time when people have started moving about more freely and “pandemic fatigue” has started to set in.
Several indicators now reinforce the fact that Delhi is in the grip of its third and worst wave of infections yet. In the past week, there were 5,269 cases on average every day, the highest this number has been since the first case was recorded on March 2. Peak seven-day average was at 4,174 at the height of the second wave on September 17 and 3,446 at the height of the first, which was on June 26.
Similarly, the proportion of tests that turned positive was at 10.91%, according to Monday’s data. Taken as an average over the week, the test positivity rate is 10.3% – a jump of 5 percentage points in less than a month (it was 5.3% on October 8) as the proportion of more accurate molecular RT-PCR tests has increased.
The trend is well reflected in Sunday numbers – from 1,947 new cases in the 24 hours ending October 4, this number grew to more than double for the corresponding period on November 1 to 4,001. Sundays follow a distinct pattern from other days of the week since there are fewer tests done, and though the total case load is suppressed, offer a good yardstick of the growth of the disease.
Delhi’s chief secretary Vijay Dev, who was a part of Monday’s meeting headed by Union home secretary Ajay Kumar Bhalla, said a revised strategy was now being devised to handle the spread of the deadly pathogen.
“The recent surge in the number of active cases was attributed to the festival season, which has witnessed greater movement of people, accompanied by laxity in adhering to the basic principles of safe Covid behaviour,” the Union home ministry said in a statement following the meeting on Monday.
“Testing, tracing, surveillance, hospital management and IEC-cum-enforcement of Covid-appropriate behaviour will be the crux of the revised strategy. Inputs of the expert panel headed by Dr (VK) Paul will also be included,” said Dev said, adding that the Delhi administration will now work on the new road map with the Union home and health ministries.
People familiar with the matter said the Delhi administration was advised to launch targeted RT-PCR testing to cover sensitive, high-risk locations such as railway stations, interstate bus terminuses, marketplaces, restaurants and salons.
“Targeted testing is already being carried out, but a revised strategy will be prepared by the MoHFW (ministry of health and family welfare), Delhi government, National Centre for Disease Control and Indian Council of Medical Research soon with suggestions from the expert panel. Delhi government officials informed in the meeting that targeted testing is being carried out at some level by setting camps at ISBTs, railway stations, markets and containment zones,” a Delhi government official said, asking not to be named.
Delhi government spokespersons did not comment on the matter.
The surge in cases is not unexpected. In early October, a report by the expert committee on Covid-19 headed by Niti Aayog’s VK Paul cautioned that the Capital could face as many as 15,000 Covid-19 cases per day due to festival crowding and winter conditions.
That perfect storm of factors now appears to be here: More people are crowding markets for festival shopping, winter conditions have set in and the air has become more polluted. The Sars-Cov-2 virus that causes Covid-19 is known to survive better in the cold, and pollution is a known risk factor, often also causing symptoms similar to a coronavirus infection, making people less likely to pay attention on time.
This comes at a time when imposing another lockdown is being seen as highly unlikely given the economic damage done by the summer shutdown, although experts say there may be little else that authorities can do at this point.
“A lockdown now might be effective in bringing down cases, but it will not be well accepted by people. The only way now to protect against infection is to ensure 100% mask wearing in public. We haven’t been able to do it so far and that is because people are just told they should wear mask. I believe they will be more willing to follow through if they are explained why it is necessary to wear mask and how it would protect them and their families,” said Dr T Jacob John, former head of clinical virology at Christian Medical College, Vellore.
A second expert said the authorities must consider the option of bringing back some curbs like it has been done in other countries.
“A study recently published in the Lancet that looks at such interventions found that shutting down schools and offices can effectively control infection. So, we need to keep schools and colleges closed. We should also close non-essential services such as cinema hall, restaurants and pubs. I would say even the metro because people are not following preventive measures in there too,” said Dr Shobha Broor, former head of the department of microbiology at the All India Institute of Medical Sciences (Aiims).
According to an official who asked not to be named, home secretary Bhalla and Union health secretary Rajesh Bhushan on Monday stressed on the need for the Delhi government to “substantially augment” bed and hospital facilities. “Different hospitals earlier showed variation in death rates. We told them to identify hospitals with higher death rates and take appropriate steps. It would be more helpful,” said the official. They also pointed to Prime Minister Narendra Modi’s IEC (inform-educate-communicate) campaign, asking Delhi officials to target people in the 20-40 age bracket since they seemed to be the ones stepping out most often.