On Wednesday, Delhi recorded 8,593 Covid-19 cases, its biggest single-day jump till date, in what is being called the “worst wave of Covid-19 so far” in the national capital.
On Monday the national capital also overtook Maharashtra and Kerala to become the state contributing most to India’s daily Covid tally. The surge in Delhi’s cases began on 27 October when the national capital recorded 4,853 new cases. Delhi has consistently seen over 5,000 new cases since 28 October, with the spike crossing 6,000 cases last week.
The Delhi government has largely blamed the surge on the festive season, increase in air pollution and winter. Health Minister Satyendar Jain also said people were “fed up with Covid-19 and taking precautions over six to seven months”. He said on Wednesday that while the duration of the third peak of the spread of Covid in Delhi is longer than those of the previous peaks, it may subside in the next few days.
Experts told HuffPost India that while pollution and winter can be blamed for the number of cases, there are other reasons — an increase in commercial activities and slackening of guard on the part of the people.
“With respect to Delhi, pollution and early onset of winter have certainly contributed to the problem immensely, buttressed as they are by factors such as greater opening of the economy, slackening of guard on part of the people and the public health system, leading to decline in preventive health measures,” Vikas Bajpai, Assistant Professor at Centre for Social Medicine and Community Health, Jawaharlal Nehru University, told HuffPost India.
The new and fourth sero survey showed that around one in four of the 15,000 people tested in the capital showed prevalence of antibodies, the Delhi government told the high court on Wednesday. The latest report found that Covid-19 antibodies were present in 25% of the persons tested, according to PTI.
“This recent increase in Delhi is also because of an increase in commercial activities where factories, working places, buses, taxis and markets are full of people without protective measures,” Dr Jugal Kishore, head of community medicine at Safdarjung Hospital, told HuffPost India.
He explained that in winter, air becomes cooler and heavier and all pollutants tend to settle in the troposphere, making humans more susceptible to exposure to pollutants.
“It increases susceptibility of people getting infections because the respiratory tract gets injuries from the pollutants during winters and therefore, in winters we have more cases of respiratory infections. People also tend to huddle up with each other during winters, increases the chances of transmission of respiratory infections.”
Criticism of Delhi government
The Delhi government has come under severe criticism because of the sudden increase in Covid cases.
The Delhi Court on Wednesday pulled up the Arvind Kejriwal government for relaxing norms for public movement and gathering even as cases continue to rise. The court also sought to know what steps the government has taken to deal with the situation.
The court questioned the rationale behind allowing 200 people to attend public functions instead of reducing the number and permitting public transportation to be fully occupied, saying that these could turn into “super spreaders” of the infection when the city was “already tottering under the weight” of the rising Covid numbers, according to PTI.
The Congress also took a dig at AAP for its failure to stem the number of Covid cases in the capital.
All India Institute of Medical Sciences Director Dr Randeep Guleria said heavily crowded markets may have acted as “super-spreader spots”. “What happens is if in a crowd one does not wear mask, one person who may be asymptomatic and is highly infectious he can spread the disease to a large number of people in the crowd. If they get the disease, they will take it to the area they go to, their own family members, their relatives and they will again spread the disease. So you can have super spreading events, and it is likely that this has happened in Delhi,” he told ANI.
Number of tests
The Delhi government had said last month that one of the reasons for the spike was aggressive contact tracing and testing. On Wednesday, Jain said that three times more tests were being carried out now as compared to the last peak. However, experts have expressed concern over the high number of antigen tests being conducted.
“While Rapid Antigen Test can be expected to pick up a truly positive case, if it’s negative then it has to mandatorily be followed by the more definitive RT-PCR. This unfortunately has not been the case by and large,” said Bajpai.
Delhi on Wednesday conducted 64,121 tests, but out of these only 19,304 were RT-PCR tests. RT‐PCR is considered the gold standard in the diagnosis of Covid‐19.
Union health minister Harsh Vardhan last week directed the Delhi government to ensure mandatory testing for all those who have symptoms but test negative on a rapid antigen test.
Vardhan also pointed out that Delhi continues to have a highly skewed RAT to RT-PCR ratio with 77% of the tests being RAT, according to Hindustan Times. “The false negative results might give way to complacency among the Covid infected, hence mandatory testing of all RAT negative persons if they develop influenza-like or acute respiratory symptoms afterwards,” he was quoted as saying.
Hindustan Times said in an editorial earlier this month, as the cases were shooting up, Delhi’s reluctance to enforce restrictions on movement and activities or ban social, religious or cultural gatherings altogether is baffling.
Bajpai said that even if one concedes the government couldn’t do much regarding pollution (without active cooperation of the Central and the Punjab and Haryana governments) and with regard to the weather, but putting up a robust health care mechanism ought to have been done.
The Indian Express explained in its editorial that “Delhi checked the alarming proportions assumed by the disease in May and June through a combination of methods that included bolstering medical infrastructure, an effective home care system facilitated by government supplies of oximeters to Covid-affected families and a marked increase in the number of tests.”
The strategy of relying on antigen tests appeared reasonable given the pandemic situation of five months ago, it said, but added that Delhi government has not followed the advisory of a follow up test.