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COVID Cases on the Rise in Delhi: Are Hospitalisations Going up Too?

As COVID cases once again go up in India, FIT asks doctors what the situation is like in hospitals.

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On 16 August, Delhi reported 917 new COVID cases and a positivity rate of 19.20 percent. What this means is that nearly 20 percent of all the people who were tested for COVID ended up testing positive.

"The numbers are still low, although they have gone up in the last few weeks," Dr Soumya Swaminathan, Chief scientist of the World Health Organisation (WHO) told NDTV on Wednesday, 17 August.

Speaking of whether the reason for this spike is a new Omicron subvariant in Delhi, Dr Swaminathan said, "All these numbers basically indicate a combination of different mutations."

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"In India and about 15 to 20 other countries, BA.2 (Omicron sub-variant) has further evolved and we have BA 2.75 and also BA 2.74, BA 2.76. and by studying the mutations, scientists have a very good idea of what each variant is doing. BA 2.75 has certainly become more efficient at transmitting itself, and is able to evade the immune response."
Dr Soumya Swaminathan, Chief Scientist, WHO, quoted by NDTV

The BA.2.75 subvariant was first detected in Delhi in June, and experts think it might have something to do with the rise in cases in the city since then.

But it's not just Delhi, cases of COVID have been on the rise in other parts of the country as well. India reported 8,813 new cases of COVID in 24 hours on 16 August.

These numbers aren't totally out of the blue though, the daily caseload of new COVID cases have been in the five digits for the close to a month now. In fact this is actually the first time India's daily casecount has been lower than ten thousand in almost a month.

Does the recent spike in cases also mean that severe cases and hospitalisations have also gone up? What about ICUs and ventilator requirements?

FIT spoke to doctors across Delhi, and other parts of the country to get a glimpse into the situation in hospitals.

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Inside Hospitals In Delhi

Speaking to FIT, Dr Suranjeet Chatterjee, Senior Consultant, Internal Medicine, at Indraprastha Apollo Hospital, Delhi, says "there is a definite uptick in COVID cases, no doubt about that."

Speaking of hospitalisations and severe illnesses he adds, "admissions have also gone up slightly, but not majorly."

Dr Sumit Ray, Head of critical Care at Delhi's Holy Family Hospital also says something along the same lines. "Hospital admissions have gone up steadily in the past few weeks, but not dramatically."

Breaking down the categories of COVID patients being hospitalised, Dr Ray explains, "There are three subsets of COVID patients being admitted right now."

  • The first category is patients, he says, are those who require oxygen support and ventilator support.

"These are mostly people who are either unvaccinated or partially vaccinated, elderly, on immunosuppressants."
Dr Sumit Ray, Head of Critical Care, Holy Family Hospital
  • The second subgroup is that of younger people, but those with significant comorbidities like chronic kidney disease, who were incidentally found to have COVID during routine check-ups.

  • The third, and largest subgroup of hospital admissions in Dr Ray's hospital, he explains, are patients wanting to get admitted as a precautionary measure.

"These patients don't have severe illness, but are choosing to be admitted because they or their family members feel anxious, and would like to keep them in the hospital for observation in case they require immediate attention at any point."
Dr Sumit Ray, Head of Critical Care, Holy Family Hospital
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FIT also spoke to Dr Vinay Kumar, Senior resident, at All India Institute of Medical Sciences, Delhi who said, "we have a COVID designated ICU in the trauma centre. This has been closed for a few months but we had to open it a few weeks ago."

He goes on to explain that while COVID admissions have started, it isn't exactly 'high'.

"In the last few weeks, though cases have gone up, we haven’t had any patient who has aggressive respiratory symptoms like low oxygen saturation, severe breathlessness."
Dr Vinay Kumar, Senior resident, at AIIMS Delhi

Right now, he says, they have 1 COVID patient admitted to the ICU, "but his vitals and parameters are stable."

As far as the resident doctors are concerned, however, Dr Kumar says the hospital has been seeing a rise in positive cases, especially in the anaesthesia and consultant critical care departments.

"Some of them are experiencing breathlessness, but saturation is maintained, and as of now, they don’t have severe illnesses."

The Situation in Other Parts of the Country

Speaking to FIT, Dr Ashwin Rajenesh, Senior Consultant Physician and Chief of Emergency Medicine, N.S. Memorial Institute of Medical Sciences, Kollam, explained the situation in his hospital in Kerala.

The COVID ward at the hospital is "functioning at full capacity most of the time," says Dr Rajenesh.

This, he explains, doesn't mean that hospitalisations are out of control. The number of beds dedicated to COVID were cut down when the requirement for them subsided.

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"During the peak, we had a much higher strength of COVID ICU beds (around 24). Right now, there are 6 beds in the COVID ward there, and they are all occupied."
Dr Ashwin Rajenesh, Senior Consultant Physician and Chief of Emergency Medicine, N.S. Memorial Institute of Medical Sciences, Kollam, Kerala

"The patients admitted here are mostly those with multiple systemic issues, elderly patients with comorbidities, serious issues such as underlying airway diseases like asthma, lung disease, or those who have hypoxia because of COVID itself," he explains.

"Cases and admissions have suddenly gone up in the last two weeks," says Dr Priyanka Nadkarni Consultant in General Medicine at Dr L.H.Hiranandani hospital Powai Mumbai.

Many of these cases, she adds, " are coincidentally diagnosed. "They are admitted for some other illness, and then they test positive for COVID."

Like all the other doctors we spoke to, Dr Nadkarni also says that most of the patients who have severe illness are elderly patients, or those with other serious comorbidities. "That is why they need ICU, not purely because of COVID complications."

'Things Are Under Control'

Although cases are going up, the virus is still behaving predictably, causing typical symptoms associated with COVID.

However, Dr Ray says that in his hospital, "while the usual suspects of cough, fever and breathlessness persist, more patients are coming in with gastrointestinal symptoms like diarrhoea and vomiting."

In Kerala, Dr Rajenesh says "We have been seeing a spike in respiratory illnesses over the last month or so. We still have quite a bit of COVID cases, but now we are seeing more of other respiratory illnesses coming in."

He also adds that even these are mostly suspected cases because because testing is limited owing to how costly it can get.

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To sum it up, yes cases are going up, and yes, hospitalisations have also been going up, but not at a rate which is especially concerning.

"We are not in a situation where we lack beds or anything. Even with the beds that are available, there are still beds that are vacant," says Dr Suranjeet Chatterjee.

"It hasn't reached a point where it hampers the functioning of the non COVID services," adds Dr Vinay Kumar, Senior resident, at AIIMS Delhi.

Get Boosted!

To make sure the situation remains under control, Dr Swaminathan, on Wednesday, said that it's important for people to get the precautionary shot, or the booster shot as many of those who are hospitalised were observed to have received two doses of the COVID vaccine, but not a third dose.

"This is important for people to understand, that a third dose is really needed to get a strong and durable immune response against Omicron, but also against other variants. It's really important, especially for vulnerable people to get that third dose if they have not done so."
Dr Soumya Swaminathan, Chief Scientist, WHO quoted by NDTV

(Written with inputs from NDTV.)

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