Tough but crucial lockdown decision enabled Delhi to tame deadliest wave

As cases reduce, HT looks at key policy interventions that helped the Capital overcome the surge When CM Kejriwal clamped a lockdown, no other state was officially fully locked. Six weeks on, the call has paid rich dividends

NEW DELHI: At 12.15pm on April 19, when Delhi chief minister Arvind Kejriwal announced a lockdown, the Capital was in dire straits.

The city had posted an average of 24,000 cases daily for the previous four days, every third person tested was turning out positive, hospitals were overrun, intensive care unit beds were scarce, and pharmacies were short of critical drugs and essentials. There was panic on the streets as infections mounted across India.

In the weeks leading up to the announcement, the government had imposed night curfews and restrictions to avoid the crushing economic impact and human suffering seen last year. Imposing a lockdown was a tough choice; at the time, there were “curfews” in some other states, but none had officially gone into complete “lockdown”.

Faced with a spiralling virus spread, the government decided to shut down the city and try to break the chain of transmission. “If we don’t impose a lockdown now, it will lead to a major tragedy,” Kejriwal said at the time.

The decision has paid dividends. In the six weeks that Delhi has remained locked, the city’s average daily case count plummeted from 23,686 to 2,108 on Wednesday, and the positivity rate dropped from 26.1% to 1.9%. The count of daily deaths, which usually shows a two-week lag from average infections, is also starting to fall with the city recording 130 deaths on Wednesday, the lowest in 41 days.

“It was time for decisive action and CM Kejriwal was clear that hard decisions had to be taken to control this wave. It’s because of his timely decision that Delhi was able to bring down its positivity rate from 35% to 2% within a month,” the chief minister’s office said in a statement.

Officials said that the lockdown was carefully planned. Prior to the announcement, Kejriwal announced a weekend curfew on April 17 and 18.

Special arrangements were made for migrant workers to avoid a repeat of last year’s humanitarian crisis and the government announced expanded ration distribution, and financial assistance to workers registered under the Delhi construction workers board and auto-taxi drivers, reopened hunger relief centres to help the poor and marginalised apart, from facilitating transportation of at least 800,000 workers to their villages.

Through the lockdown, the average daily tests didn’t drop below 60,000, even at the peak of the fourth wave.

“All of Delhi supported this decision wholeheartedly. A lot of lives have been saved because of this timely decision,” the CM’s office added.

The impact of the lockdown, which has been extended five times, gradually made itself apparent.

The seven-day average of new infections, which denotes a region’s Covid-19 case curve, peaked at 25,294 on April 23 – the highest ever recorded in the city till date – but then hovered at what appeared to be a week-long plateau before finally beginning to decline starting May 1.

By the time the third extension came into effect on May 10, the rate of new infections had dropped 30% from the April 23 peak – for the week ending May 10, there were 17,604 new cases in Delhi every day.

In another week, when the fourth extension was enforced, cases dropped 65% from peak levels – there were 8,882 new cases a day in the week ending May 17. For the week ending on May 24, this number has fallen to 2,861 – a drop of 89% from peak levels.

Public health experts attributed this easing of the city’s fourth wave largely to the lockdown.

“At such a time, the only other possible intervention is vaccination. But even if you do it in the last one month, it will take some time for the people to develop immunity. So, clearly, the numbers came down because the chain of transmission was broken by the lockdown. The decline in Delhi has been fast, which many modellers had predicted would be slower,” said Dr Amit Singh, associate professor, Centre for Infectious Disease Research, Indian Institute of Science, Bengaluru.

Due to a supply crunch, vaccination in the city has stagnated in recent weeks though the state has built a capacity of 214,150 doses a day.

Due to a shortage of vaccines, Delhi had no option but to shut all the 368 government vaccination centres for the 18-45 age group, while only around 450 instead of about 650 centres are operational for those above 45 years due to non-availability of Covaxin.

Strict enforcement of the lockdown played an important part in taming the virus curve, said Sanjeev Khirwar, Delhi’s divisional commissioner, to whom all the 11 district magistrates report.

“Without strict enforcement of Covid-appropriate behaviour and lockdown rules, it is impossible to bring contact between individuals to a bare minimum, which is essential to break the chain in this pandemic. From the day of the lockdown (April 19) till Monday (May 24), Delhi issued nearly 100,00 challans and registered about 1,800 FIRs. So, there has been no laxity from our district administrations during this period and the lockdown orders have been followed in letter and spirit,” said Khirwar. The figures of prosecutions and FIRs cited by him are combined data of actions taken by the DMs, police and local bodies.

A senior health official said for that Delhi created a record number of micro-containment zones during this wave.

Data analysed by HT showed that between April and May, Delhi saw a 1,648.7% jump in the number of its containment zones. The Capital had 3,291 containment zones on April 6. The number shot up to a staggering 57,550 by May 13.

Last week, Kejriwal announced that if the downward trend continued in cases and deaths, the lockdown may be eased in phases from May 31. Senior government officials said that lifting of the curbs may start once daily Covid-19 cases fall below 1,000-mark, and remain so for at least two days or more.

Delhi’s success on this front was in line with global trends where lockdowns have proved the most effective non-pharmaceutical intervention to curb infections. In a number of global studies last year, researchers attributed strict lockdown to effective disease control in China and south-east Asian countries.

Some experts suggested that Delhi should have imposed the lockdown even earlier, but admitted that the case spike was sharp, leaving the government with little time to think and act. “There has to be aggressive testing and the government has to be vigilant about which localities are seeing a surge,” Singh said.

Dr. Suneela Garg, Member Covid India Task Force of Lancet Commission, and National President of Indian Association of Preventive and Social Medicine, New Delhi, said while lockdowns cannot eliminate Covid-19, they can flatten the curve.

“Basically, a lockdown increases the duration of the pandemic which is always better than getting everyone infected in a single surge and attaining herd immunity. Lockdowns reduce the load on hospitals and help strengthen contact tracing and isolation.”