Has Delhi flattened COVID-19 curve? Widespread testing, improved health infrastructure major boost in easing situation

The BJP and AAP called a truce as they joined hands to deal with the COVID-19 crisis in Delhi, and encouraging results are now being seen

Vijaya Pushkarna /CitizenMatters.in August 13, 2020 19:22:32 IST
Has Delhi flattened COVID-19 curve? Widespread testing, improved health infrastructure major boost in easing situation

Delhi had become the centre of attention in the fight against COVID-19 when on 9 June, Deputy Chief Minister Manish Sisodia estimated that the city, groaning under an acute shortage of hospital beds, would need over 5.5 lakh beds by the end of July.

A shocked public, the city administration, hospitals and even Union Home Minister Amit Shah stepped in. The BJP at the Centre and AAP in the Delhi government called a truce as they joined hands to deal with what was becoming a crisis in the capital. Their crisis management efforts appear to have finally yielded some positive results.

At 10.25 am on 7 August, the Corona Dashboard of the Delhi government showed a total availability of 13,557 COVID-19 beds. The numbers were as follows:

Total number of beds: 13, 557
Vacant: 10,491 (3066 were occupied)

ICU beds with ventilators: 1214
Vacant: 829 were vacant, and of the 956

ICU beds without ventilators: 956
Vacant: 668

Just ten days earlier, the situation had been thus:

Total COVID-19 beds: 15,921
Vacant: 12,963 (2958 occupied)

ICU beds with ventilators: 1207
Vacany: 811

ICU beds without ventilators: 958
Vacant: 651

On 29 July, the Delhi government issued an order discontinuing the scheme of creating healthcare facilities by private hospitals at hotels. The scheme had been put in place through an order exactly two months earlier, on 29 May.

The number of COVID-19 deaths too has come down significantly. On 6 August, 15 deaths were registered while 1,008 patients were discharged. The next day, the Government of India’s COVID-19 portal put Delhi’s total confirmed cases at 1,41,531, active cases at 10,348, the number of people discharged at 1,27,124, and total deaths at 4,059.

The same day, the coronavirus-designated crematorium at Punjabi Bagh in West Delhi was given the green signal to reopen for non-coronavirus cremations too. The number of bodies of people who died due to COVID-19 had reduced to an average of 3 or 4 for some days — down from 60 to 70 a day all through June!

Has Delhi flattened COVID19 curve Widespread testing improved health infrastructure major boost in easing situation

The first plasma bank set up by the Delhi government. Vijaya Pushkarna/Citizen Matters

The Delhi model

Several statistics showed that by the end of July, Delhi had “flattened” the COVID-19 curve. “The Delhi Model” is what Union home minister Amit Shah later cited to the other states battling with rising figures.

The Delhi government has also managed to successfully implement the cap on treatment charges by private hospitals that have reserved 60 percent of their beds for COVID-19 patients.

Steps taken

On 14 June, several measures were announced after a meeting between Chief Minister Arvind Kejriwal and Shah. These included a huge ramping up of testing and treatment capacities.

This was at a time when patients with symptoms were facing a nightmare to get themselves tested. There were some instances of patients desperately going from one hospital to another to find a bed, only to be turned away everywhere.

Testing was doubled over the next two days and trebled in the next three days. From 6 June to 13 June, an average of 5,193 tests were conducted. But between 14 June and 21 June, the number shot up to 10,846.

How did this happen?

The government decided to include the far quicker rapid antigen tests from 18 June, following approval by the Centre. Only those who tested negative were then sent for the RT-PCR testing to confirm the negative result.

The Centre had also on 17 June capped the testing price in Delhi to Rs 2,400.

Simultaneously, infrastructure was beefed up. Sleeper coaches of ordinary, non-airconditioned trains, three, four and five star hotels and banquet halls were converted into COVID-19 care centres and were attached to hospitals in the neighbourhood.

Hospitals treating COVID-19 patients received a checklist from the Delhi government on 16 July. While the government has not made this list public, sources say they are “basically ICMR guidelines to hospitals across the country.”

Willingness to experiment

The Delhi government explored several lines of treatment that held promise. For example, hardly had plasma therapy been mentioned as promising that the Delhi government began to promote it vigorously. “We got permission for plasma therapy trial in the Lok Nayak Jaiprakash Narayan Hospital,” said Kejriwal on 2 May. “The first patient given the therapy was in the ICU and has since been discharged”.

Exactly two months later, a plasma bank was set up at the Institute of Liver and Biliary Sciences, and the government regularly urges recovered patients to donate plasma.

Citizens of Delhi also by and large followed the guidelines laid down by the Indian Council of Medical Research, which was another reason for the reduction in COVID-19 cases.

Serological survey

Authorities in Delhi also conducted a serological survey. Blood samples of 21,387 people at random were taken from densely-populated localities between 27 June and 10 July, and tested for antibodies.

According to the health ministry, the survey results showed that 22.86 percent of the surveyed people had developed antibodies, indicating that they had been exposed to the novel coronavirus. The health ministry also said that citizens’ compliance had yielded benefits. On 25 July, the capital’s COVID recovery rate crossed 87 percent, the best among all states.

According to Kejriwal, the Delhi model was about “testing, home isolation, transparent data, hospital beds and plasma therapy. But to achieve these five things, we followed three principles—team work, acknowledging constructive criticism and fixing what is wrong, and not giving up as a government, no matter how bad the situation got”.

Reducing mortality

On 30 July, four committees were set up to inspect about a dozen private and government hospitals with the highest coronavirus mortality rate. They were directed to give hospital-wise recommendations on following standard operating procedures and protocols, specifically to recommend measures for the betterment of coronavirus patient care services and reducing mortality of corona patients.

These hospitals included Lok Nayak Hospital, GTB Hospital, Safdarjung Hospital, Max East & West, Sir Ganga Ram Hospital, RML Hospital, Jaipur Golden Hospital, Sir Balaji Action Medical Institute, Escorts, and St. Stephen’s Hospital. They were also given a checklist to follow.

One recommendations made by all the four committees was that high-risk cases must be transferred to ICU/HDU at the earliest sign of deterioration.

Officially, OPD and other non-COVID-19 services have not yet resumed in COVID-19-designated hospitals. But as the number of coronavirus admissions are dropping, some, like the Hindu Rao Hospital under the North Delhi Municipal Corporation, are considering reopening OPDs.

Hotels and gyms have not presently been allowed to open in Delhi. The city’s many Thursday, Friday, Saturday and Sunday bazaars were told to open on an odd-even basis.

Bishamber Kumar who used to be a permanent fixture selling dry snacks at these bazaars says his income has been hit. “But even if the government allows us to open the bazaar, there may not be too many customers as the fear of the disease is still there,” says Bishamber.

AIIMS director Randeep Guleria, who also heads the Clinical Research Group of the National COVID Task Force, believes that Delhi may have gone over the peak and is now heading downwards.

Kejriwal has asked the health department and hospitals to work towards a zero COVID death count in the capital.

On the whole, it appears that Delhi has now succeeded to an extent in curbing coronavirus cases — without having to go into a second lockdown.

This article was first published in Citizen Matters, a civic media website and is republished here with permission. (c) Oorvani Foundation/Open Media Initiative.

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