Delhi should prepare for 15,000 daily Covid-19 cases during winter: Report

At its peak, the seven-day Covid-19 case average was 4,119, on September 19

Delhi is likely to report around 15,000 Covid-19 cases daily in winter because of the prevalence of respiratory illnesses during this season that worsen symptoms of the disease, the National Centre for Disease Control (NCDC) has warned. More patients with severe symptoms from other states are also expected to come to the national capital for treatment during this period, it has said.

At its peak, the seven-day Covid-19 case average was 4119, on September 19.

“Winter months that make respiratory illnesses severer...Patients may come from outside Delhi in large numbers… Patients coming from distant areas are likely to be more serious. In addition, with festival-related gatherings, there could be a sudden rise in cases. Therefore, it is recommended that Delhi should prepare for a daily surge of approximately 15,000 positive cases and make arrangements for inpatient admissions of patients with moderate and severe disease roughly amounting to 20% of this surge,” the NCDC said in a document related to the revised Covid-19 strategy for Delhi.

The document has been drafted on the basis of the recommendations of an expert group led by Dr V K Paul of Niti Aayog to help formulate a revised strategy for Covid-19 management in Delhi.

It has recommended that the Delhi government should engage with community leaders, organisers, etc, to ensure festivals like Durga Puja, Dussehra and Chhath are low key with little or no gathering.

The document said containment zones should be limited to places such as resettlement colonies and slums, and contact-tracing activities have to be rationalised and districts should follow leads provided by their own surveillance instead of just chasing targets when it comes to testing.

The Delhi Disaster Management Authority (DDMA) is relying on these recommendations for fresh Covid-19 management strategy for the Capital.

On September 18, lieutenant governor (L-G) Anil Baijal asked DDMA to draft a fresh strategy as Delhi witnessed too many ups and downs in the Covid-19 graph since June 26 when a plan was last drafted, said a senior government official who did not wish to be identified.

The DDMA is chaired by Baijal and its vice-chairperson is chief minister Arvind Kejriwal. Dr Paul leads separate advisory committees for both the central government and DDMA.

The DDMA is scheduled to draft its strategy and submit it to the L-G by Tuesday next when the next meeting of the authority is scheduled, the senior official said.

The official said these recommendations have been submitted to the offices of the L-G, chief minister and chief secretary Vijay Dev and discussed with district magistrates earlier this week.

Senior officials in the L-G office did not comment.

A Delhi government spokesperson refused to comment on the issue.

The document said cases are being reported from all areas of all the districts and hence existing containment zone strategy needs to be revised. “The formation of new containment zones could be restricted only for highly dense localities such as resettlement colonies and JJ clusters /slums areas...For planned colonies, big apartments, RWA (resident welfare association)-governed localities, the strategy of micro containment zones or home isolation may be continued,” it said.

“Proportion of active case under home isolation is to the extent of 50-60 %, which constitutes the major proportion of active cases in Delhi. Home isolation is observed in densely populated colonies as well. With the number of cases in thousands, the strict monitoring of movement restriction of all cases under home isolation, especially in densely populated areas, is challenging and maybe one of the reasons for the spread of infection.”

It has recommended that the guidelines for the selection of cases to be put under home isolation need to be strictly followed and all symptomatic positive cases reported from densely populated areas should be isolated only in Covid care centres to ensure optimal utilisation of these facilities.

It added that each home isolation case should be better monitored.

On contact tracing, the document suggested the government’s policy can be further “rationalised”. “The contact tracing could be restricted to forward contact tracing only -- immediate family contacts, neighbourhood contacts and close workplace contacts, should be traced and tested as per ICMR guidelines on a priority basis.”

It said the government’s current policy on testing was insufficient when it comes to containment zones, and recommended district-wise scaling up of tests and tests based on surveillance findings instead of chasing targets. “Criteria for scaling up of testing should be based on positivity in each district (preferably ward) vis-à-vis the total number of samples tested,” it said.