A report prepared by the National Centre for Disease Control (NCDC) has alerted the Delhi government to get ready to witness a surge as high as about 15,000 cases of Covid-19 per day due to upcoming festivals and winter season.
As per the report, three reasons that may cause excessive pressure on healthcare services are:
1. Winter months that make respiratory illnesses severer 2. Patients may come from outside Delhi in large numbers 3. Patients coming from distant areas are likely to be more serious
In addition, with festival-related gatherings, there could be a sudden surge in coronavirus cases. "Delhi should prepare for a daily surge of 15,000 positive cases and make arrangements for inpatient admissions of patients with moderate and severe disease roughly amounting to 20 per cent of this surge," the report highlighted.
On testing, the NCDC observed, "Till September 24, more than 80 per cent tests are conducted by Rapid Antigen Tests. Majority of testing has been conducted in the camp settings (like railway stations, bus stand, crowded localities) and hence majority of people tested are asymptomatic. Test Positivity is 4.3 per cent by Rapid Antigen Tests and 20.33 per cent by RTPCR as on September 24."
The report also raised concerns over limited Covid-19 testing in containments zone and the trace-testing of people who had come in contact with positive patients. It said testing of symptomatic patients - being only 20 per cent of the total - had not been sufficient, as well.
The NCDC pointed out that in and around 6/8 districts positivity ratio is high, but samples collected are quite low. "Testing should not be target driven rather it should be guided by the surveillance in containment zones, number of positive and their symptomatic contacts identified and number of symptomatic persons identified at screening sites," it reads. The NCDC further said that increase in the number of tests should be reflected in increased case finding.
"Merely increasing the number of tests to reduce the positivity rate would not be appropriate," the report said and advised the district authorities to maximally encourage to report positive cases.
The report further said that the average daily mortality reported ranges between 30 to 40 from September 15 onwards. "The higher mortality in the co-morbid (66.6 per cent) and elderly is inevitable and reported all over states and globally, however, the concern is reported mortality in under 15 (1.5 per cent approximately) and young age groups 16-44 years of age group (17 per cent)."
The mortality is this age group could be prevented with promoting early recognition of symptoms, timely testing and increased awareness in younger population to adopt Covid-19 Appropriate Behavior.
Furthermore, the NCDC has advised that all workplace contacts in offices or other workplaces being run in closed setting, to be enlisted and districts should keep a data base of coronavirus positive cases reported from these workplaces. Social gathering must be minimised. "Large gatherings are super-spreading events. These must be avoided," the report suggested.
WARNING FOR FESTIVE SEASON
"Coming festivals (Chhat Puja, Dussehra, Deepavali, Eid, Christmas, New year) will pose a huge challenge to control pandemic. It has been seen that Onam in Kerala and Ganesh Chaturthi in Maharashtra escalated the pandemic seriously. This must not be allowed to happen in Delhi," it reads.
The emerging gains in reduction in cases will be reversed because of these festivities and the rush in markets/ localities. It is very important to take a rational view to make these events very low-key, and essentially centered around family celebration, the report suggested.
This report was prepared by the expert group including Dr Vinod Paul, Member NITI Aayog and NCDC officials for New Delhi, where the main aspects of future strategy were discussed. The focus was on distribution of active cases and containment strategies, management of isolated cases i.e cases under home isolation, contact tracing activities and number of contacts traced per case, testing strategy: current numbers and focus areas, review of mortality and implementation of non-pharmaceutical measures and Covid-19 Appropriate Behavior.