DELHI TO DOUBLE TESTS AS COVID SPIKE CONTINUES

NEWDELHI: Covid-19 cases in Delhi are increasing, chief minister Arvind Kejriwal acknowledged on Wednesday as the government took note of persistently rising numbers at an emergency meeting, where it decided to double the number of daily tests from current levels to around 40,000 per day in an effort to catch and isolate more infections.

With 1,693 new cases reported on Wednesday, the last seven days have seen an average of 1,375 cases every day. This is the highest since the seven-day period ending in July 15, when the Capital recorded 1,732 cases on an average – and a trend that HT highlighted in news reports on August 23, 25 and 26.

The increase has been preceded by a drop in testing and an increased focus on the relatively less reliable rapid test – also an issue that this paper highlighted in a news reports on August 15 and August 16.

“For nearly one and a half months now, the Covid-19 situation in Delhi is under control. But, since August 17, cases have been increasing again. In today’s health bulletin, which will be released in the evening, Delhi recorded 1,693 cases. Yesterday, 1,544 cases were recorded,” said the chief minister in a press briefing over video.

Experts warned that the Capital, which was the first Covid-19 hot spot to get some measure of control over the disease, stands at a critical juncture in the fight against the highly contagious

virus.

“Delhi is at the crux where the rise in the number of cases can be controlled, if it is not controlled now, we can enter a second wave in a few months. People are fed up and have become casual about using masks and maintaining social distancing, and we have to factor this in when planning a response to prevent resurgence,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences (AIIMS) Delhi.

In light of these trends, the rate of testing will be doubled over the next week, Kejriwal added, while assuring that the situation was still under control. “Other parameters are in good shape.

For instance, the death rate is low. For August, it is 1.4%, which is the best in the country. We have adequate hospital beds too. There are 14,130 total beds now, of which 10,448 beds are vacant. The recovery rate is good.

And, the home isolation model has worked well. Since July 15, there has been no death in home isolation,” he said.

Home isolation has been one of the centrepieces of Delhi’s Covid-19 mitigation strategy, as has been the testing programme that has covered the highest number of people in per capita terms among major states.

But, as reported on August 25, a slackening of testing coincided with a rise in positive rate – the proportion of samples confirming an infection – suggesting the city may have begun missing new infections.

In the 7-day period ending on Wednesday, the average positive rate for daily tests was 7.8%. The last time this number was this high was in the week ending July 18. Test positive rate can rise if there are fewer tests, but also if the outbreak is growing.

This is among five factors that data and circumstantial indicators suggest may be powering a spurt in cases in Delhi.

The others are behavioural fatigue that could be reducing mask discipline, the reopening of the city that is leading to more crowding, a lag in reporting that could be leading to a statistical build-up, and the possibility that the rise may be part of a cyclical wave trajectory that epidemic disease outbreaks follow.

In statements offered separately, the chief minister’s office said the increase in cases was a “momentary situation” that does not, at the moment, require putting curbs on the economic activities that have been allowed, and the government still believes the Delhi Metro must be restarted.

“Our stand on the Delhi Metro remains the same. Such decisions, including opening of other economic activities, were taken keeping in mind all possible parameters.

The prognosis of the current Covid-19 situation doesn’t call for any drastic or knee jerk decision. Going by the current infection rate, Delhi government is very well equipped to manage the case load and treat patients. We are certain that the situation will be brought further under control soon with the latest announcement of doubling tests and ensuring stricter enforcement of wearing masks and social distancing,” the chief minister’s office said.

According to the Kejriwal, tests will now be increased from “around 20,000 tests per day being conducted currently to 40,000 tests per day”. “Our strategy would remain the same – test and isolation,” he added, urging people to get themselves tested on feeling the slightest of influenza-like symptoms.

According to a government official, the announcement on testing reflects a reorientation in the chief minister’s approach to the outbreak.

“During the past few weeks when the cases were on a decline, the chief minister had shifted his entire focus on reducing the number of Covid deaths in the city.

The emphasis was on serious patients. Now, with Delhi recording more than 1,400 cases in a row, the CM has once again started reviewing the steps taken to control the infection rate in his daily meetings,” the official said, asking not to be named.

A second senior government who asked not to be named, said the increase in testing will be proportional for the two modes -through nucleic acid lab tests, known as RT-PCR tests, as well as the rapid antigen test kits, which offer quick results but run a higher risk of throwing up false negatives. A way to ensure this is being worked on, this person added.

The first official cited above said the government will prod labs to increase RT-PCR tests, which are at present the most reliable. “Directions will soon be issued to all hospitals and private testing labs to conduct RT-PCR to their full capacity. The health department has also been asked to explore if capacity for RT-PCR tests can be increased beyond the current level of 11,000,” this person said, while adding: “But, rapid antigen tests will continue to be more in numbers compared to RT-PCR as is the current format.”

Experts welcomed the planned steps. “Cases are going up. At this stage, the government must go for aggressive testing, isolate positive cases and strengthen surveillance. People should always wear masks, adhere to social distancing norms and follow respiratory etiquettes.

There is no room for complacency,” said Lalit Kant, the former head of epidemiology and communicable diseases department in the Indian Council of Medical Research (ICMR).

Wednesday’s meeting was attended by health minister Satyendar Jain, chief secretary Vijay Dev, and top officials of the health department.

Kejriwal said the administration has also taken note of people struggling with residual symptoms after recovering from the disease and the government will now provide them pulse oximeters (which measure oxygen concentration in blood and can identify severe breathing issues) and oxygen concentrators free of charge if required.

The chief minister said he has also directed authorities to strengthen enforcement of rules. “People should wear masks and maintain social distancing. Confidence is good but it should not lead to complacency at any cost. We hope nobody is penalised. In case one gets fined, one must understand that it is for a greater good,” said Kejriwal.