How Delhi managed to curb its Covid-19 spike: All you need to know

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Delhi’s Covid-19 count crossed the 1 lakh mark earlier this week with a continuing surge in new cases since the end of June. A ray of hope, however, shone through the health crisis in the capital as the recovery rate from the infection increased and nearly 80,000 patients recovered from the disease, according to state health department data.

With the number of tests increasing, the death toll too has indicated a slight dip while the projections for July have not yet happened. These positive signs have raised hopes that the national capital may well be able to flatten the coronavirus curve if things go according to plan. Experts, have however, cautioned about the need to sustain the dip in cases. They have emphasised on the urgent need to continue with social distancing guidelines, mandatory wearing of masks, hand hygiene and other dos and don’ts to ward off the infection. Neglecting any of the health guidelines could once again lead to coronavirus cases soaring in the national capital, health experts have said.

Although Covid-19 cases surged and crossed the one lakh mark on July 6, the active cases and positivity rate declined and the recovery rate increased in Delhi. On July 5, the recovery rate was 71.74 per cent, up from 63.32 per cent the week before . This was higher than the national recovery rate which at that time was 60.7 per cent.

The Delhi government has adopted aggressive containment plans to curb the spread of Covid-19 in the city. Here are some of the measures that have helped Delhi to fight the viral infection and bring about a dip in Covid-19 cases:

1. Home Isolation and an awareness drive:

The Delhi government has aggressively promoted the concept of home isolation of Covid-19 positive patients who were asymptomatic or even had mild symptoms. These patients made up almost 80% of all Covid-19 positive cases. The government ensured visits of a medical team to their homes explaining home isolation. Regular monitoring was done and guidance given via daily phone calls from healthcare workers. This meant that patients could recover in the comfort and security of their homes. Their family members were also quarantined in the same house for 2 weeks and this ensured that they did not spread the disease. The accompanying awareness campaign helped reduce the stigma around being Covid-19-positive for most people.

2. Aggressive testing and Isolation of patients:

Delhi had been following a strategy of high testing from the beginning of the pandemic. Even before the end of June, the capital city was testing more than any other state in India at 10,500 tests per million on May 31. From the first week of June, a strategy of aggressive testing was adopted by the Delhi government with a focus on areas that were becoming coronavirus hotspots. In the first week of June, the Delhi government carried out 5,500 tests per day. With the Centre’s help in providing antigen test kits, by mid-June, this figure stood at 11,000 tests per day and by the first week of July at 21,000 tests per day.

Obviously increased testing hiked the number of cases. Covid-19 positive patients were traced and isolated in a timely manner. With thousands of patients and their families isolated every day, within a fortnight the success of this strategy became apparent.

So the number of active coronavirus cases began to plateau despite high testing, from June 16 onwards and fresh cases began to sharply decline from June 23.

3. Increasing hospital beds in Delhi:

Till early June, there were only 8 private hospitals that were treating Covid-19 patients and these had a total of 700 beds available. This was in addition to 2,500 beds in Delhi government hospitals. When the cases started rising in the first week of June, the 8 private hospitals filled their capacity and when patients reached some of these hospitals they found no beds available. The government started expanding bed capacity in private hospitals. According to a government order, all private hospitals with more than 50 beds had to reserve 40% of beds for treating Covid-19 patients. Not only did this mean that the number of Covid-19 beds in private hospitals increased from 700 to 5000, it also meant that Covid-19 facilities were now available in all parts of the city.

4. Roping in large hotels and banquet halls:

A few hotels were linked to private hospitals thereby increasing bed capacity of hospitals. With this hotel linkage, the number of beds in private hospitals went up from 5000 to 7000. Currently, there are over 15,000 Covid-19 beds in Delhi. While much of this increased capacity is still vacant - with only 38% of 15,000+ beds are occupied.

5. Counselling of coronavirus patients by doctors:

Many suspected patients rushed to hospitals, even though their symptoms were mild and they did not need hospitalization. In response to this, the Delhi government collaborated with a network of NGOs and doctor-volunteers who started real-time calling and counselling of Covid-19 positive patients, as soon as their lab reports got uploaded. A patient was able to get medical advice and counselling within hours of getting their lab reports. When doctors counselled them and explained how most coronavirus patients did not need hospitalization, patients were able to cope with the psychological and trauma of the disease.

6. Plasma Therapy:

Convalescent plasma showed encouraging results across countries in preventing mortality amongst critical patients, as it provides the patient with antibodies to fight the virus. Delhi was one of the first cities to start an experimental trial of plasma therapy in LNJP, the largest Delhi government Covid-19 facility. Trial results were encouraging. So Plasma Therapy could save some lives in Delhi. The government also set up a ‘Plasma Bank’ so that patients could easily access convalescent plasma. An aggressive awareness campaign for plasma donation has been led by Chief Minister Arvind Kejriwal to encourage recovered patients to come forward and donate their plasma for treating others.

7. Oximeters and Oxygen Concentrators:

One of the causes of deaths due to coronavirus is reduction in oxygen levels in the blood, hypoxia. Unlike other ailments where this hypoxia is accompanied with breathlessness, in Covid-19 a phenomenon of ‘Happy Hypoxia’, wherein a patient may have dangerously low levels of oxygen but may not be aware about it is visible. Monitoring oxygen levels and having accessible supply of oxygen was crucial to prevent mortality of patients in Home Isolation.

The Delhi Govt provided oximeters to all patients recovering in home isolation so they could monitor their oxygen levels to prevent any sudden dip. The government purchased 59,600 oximeters and 58,974 are in use by patients in home isolation. Oxygen Concentrators were provided to local dispensaries that could immediately take these to a patient’s home and provide oxygen support, if their oxygen levels began to dip. The Delhi government purchased 2,750 oxygen concentrators. Most beds in Delhi government hospitals have oxygen facility.

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