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Is Delhi Prepared to Reopen As New COVID-19 Cases Rise Sharply?

Is Delhi Prepared to Reopen As New COVID-19 Cases Rise Sharply?

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Fit
5 min read
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How does the National Capital of India fare in the battle against coronavirus? We spoke to experts to understand what lies ahead for Delhi and whether or not the city is ready for the post lockdown phase.

The number of positive coronavirus cases in the national capital crossed the 5000-mark on Tuesday, 5 May. At the end of 6 May, the case tally stood at 5,532.

With a population of around 19 million, Delhi is the third worst-hit state in the country, after Maharashtra and Gujarat. It is also the second most affected city after Mumbai.

According to the health ministry's data on Thursday morning, 1,542 people have recovered from the deadly coronavirus and 65 have died in the capital.

Is Delhi Prepared to Reopen As New COVID-19 Cases Rise Sharply?
The number of positive cases in Delhi since 2 March.
Even though the case fatality rate in Delhi (1.17%) is lower than that of the country’s (3.3%), the danger looms over the city as all 11 districts fall under the red zone. Chief Minister, Arvind Kejriwal has spoken about living with coronavirus now and reopening Delhi.

The city witnessed its first coronavirus positive case on 2 March. In another 40 days, on 11 April, it crossed the 1000-mark. However, in the next 8 days, the number doubled to reach 2,003. It took another 12 days for the number to reach 4,122 but only 2 days after that for it to cross the 5000-mark. The doubling rate seems to have improved and stands at 11 days currently.

Experts believe that the doubling rate is improving due to self-isolation measures put in place during the lockdown, however, as soon as the lockdown is lifted, these cases are likely to surge.

"The flattening of the curve has not happened. The rise may have been slow but when we lift the lockdown, there will be increase in number of cases", said Dr Sumit Ray, Critical Care Specialist in conversation with FIT.

Is Delhi Prepared to Reopen As New COVID-19 Cases Rise Sharply?
Number of containment zones in the 11 districts of Delhi as of 3 May.

As of 3 May, Delhi had 96 containment zones housing a population of 5,37,175 according to the numbers shared by the state government. Around 1,071 were positive in these 96 zones. South-east Delhi and South Delhi have the maximum number of containment zones followed by West Delhi. Around 8 of these zones have been de-contained recently without any new additions. B Blocks of Paschim Vihar and Hari Nagar in the West district were removed from the list on 5 May.

Some of the cramped and congested areas that fall under these containment zones are Chandni Mahal, Jahangirpuri, Nabi Karim, Sadar Bazaar, Nawab Ganj and Tughlaqabad. The idea of social distancing in these areas is far-fetched and mostly just imaginary. High population density remains a challenge here - very similar to Mumbai - reported by FIT earlier.

As of 21 April, Central Delhi and South-East Delhi were worst affected, followed by West Delhi and South Delhi, as per a report by Live Mint. The district-wise data of the number of positive cases in May is not available.

Last week Arvind Kejriwal had suggested that only containment zones should be declared red zone by the central government and not the entire district. But according to the numbers shared by the government, over 3,000 cases were from outside the containment zones.

The state government is also planning to map the cases ward-wise instead of district wise. The city has 272 wards in total and the authorities are detailing out the plan for ward-wise mapping of red, orange and green zones.
Is Delhi Prepared to Reopen As New COVID-19 Cases Rise Sharply?
Number of tests done in Delhi so far.

As the state government ramps up isolation beds and measures for containment zones, testing numbers have also improved since March. On 1 April, the number of tests conducted in the city was at 2,621 and by 11 April, this rose up to 11,709. By 5 May, these have further increased to 67,852.

The city is testing around 3,000 people per million which is less than Mumbai's over 5,000 per million.

The government is also identifying private hospitals in case of "shortage of isolation beds".

According to a Hindustan Times report, the city has around 1,106 ventilators and only 306 out of them are in government hospitals, rest 800 are in private space.

The data for the number of isolation beds in the city is not yet available. Experts tell us that in absence of proper quarantine facility, people will continue to fear getting tested.

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What Can Be the Exit Plan for Delhi?

While it's not clear what the government plans to do next and what the strategy is but experts believe that apart from advising personal hygiene, restricting unessential movement and transport, the government should also ensure that most asymptomatic and mild cases are home quarantined.

Dr Mathew Varghese, Veteran Orthopaedic Surgeon, known for his contribution in eradicating polio hinted at possible larger transmission in the city and told FIT, "The disease is possibly in community and that is why the number of cases is more. Patients are coming positive even when there is no known contact with COVID-19 patients. This explains the increasing number of cases".

He further added,

Dr Sumit Ray believes Delhi is better prepared than many other cities in the country but a secondary plan is necessary for the future.

"How do we isolate asymptomatic and mild cases, we need to decide. We can't overburden hospitals with those cases. Another crucial part is to protect the more vulnerable. How will the government do it is most important", he told FIT.

He suggests that as COVID-19 spreads, we must take care of mild cases at home and severe ones at the hospital.

Dr Varghese is of the same opinion.

"Isolation areas in hotels etc are very distressing for the patient who is anyway petrified of dying of this disease so there are emotional and psychological stresses. They can be nursed at home provided there is no vulnerable people at home", Dr Varghese said.

The guidelines should be clearly laid out by the government and should be simple, he added.

Dr Suranjeet Chatterjee, Senior Consultant, Internal Medicine, at Apollo Hospital in Delhi told FIT, "When the lockdown is lifted, we have to follow stringent measures for the next few months. We have to maintain all the things we have been maintaining during the lockdown especially the social distancing."

"If we don't follow these basic things, this lockdown will become a failure. If there is exponential escalation, then we are doomed", he added.

About the isolation facilities, he said, "If the isolation facilities are not improved, people will be scared to get tested. So facilities in isolation centers should be improved. Basic amenities have to be provided so people don't feel scared. The stigma has to go."

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