Lives could have been saved if the disease protocol was executed in letter and spirit. We can’t afford to go the New York way

In a major firefighting exercise, the Centre and the Delhi Government have decided to bury the hatchet, work together to curtail the spread of COVID-19 and keep the fatalities in the national Capital down. For the success of any clinical protocol can only be assessed when the death rate is ascertained and under control. And as far as Delhi is concerned, the number of deaths is more worrisome than the number of positive cases. Of course, now the city’s medical infrastructure is being ramped up on a war footing, with Union Home Minister Amit Shah announcing another 10,000-bed facility near Chhatarpur, which is supposed to be bigger than anything China had built during the contagion. But then, Delhi’s caseload has now far surpassed that of Wuhan’s and the priority should be to ensure that no patient is allowed to deteriorate unattended, without a bed or oxygen, or turned away. Some lives could have been saved if the management protocol was executed in letter and spirit. For example, although the Delhi Government ordered that 20 per cent of beds in 117 private hospitals/nursing homes in the city would be reserved for Coronavirus patients, the latter are not being cared for. There have been far too many complaints about patients, once they were admitted to the hospital, being simply left alone. Forget about treatment for Covid, patients are also finding it difficult to get treated for their co-morbidities with doctors staying away. And this despite being charged the moon. This could be one of the reasons why the fatality rate has spiked. If the city has to see a fall in the number of deaths, then it is not enough to frame strategies and action plans. They have to be implemented on the ground. There must be a collective will, too.

Significantly, the renewed efforts to beat the pandemic will include more stringent regulations in the city’s 261 containment zones, stricter contact tracing, rapid antibody testing to gauge the spread of the virus in the community, close involvement of the police to enforce social distancing norms and inclusion of the Delhi Government’s 11 epidemiologists to play a larger role at the district level. So grim is the situation that Delhi saw a 31 per cent spike in infections last week and has overtaken Tamil Nadu to be the second-worst hit State in the country. With Delhi accounting for 24 per cent of all new cases and 25 per cent of the Covid-19 deaths reported in the country in the last two days, there has to be war room efficiency. Following the example of Karnataka, it can even get communities involved in contact tracing and accelerate the process of early detection. The lack of contact tracing in containment zones and slackened policing there have led to people interacting with each other normally and multiplying the incidence of the disease. The State should draft in more medical workers and volunteers for better data collection and on-site reports. Experts are now pushing for a 100 per cent survey of all containment zones by June 30 and an extensive one of Delhi by July 6. There is also talk of a serological study being planned between June 27 and July 10, and 20,000 samples being collected to analyse the scale of the spread of the virus. For this is not the time to fly blind or go by assumptions but to map the reality as is to prevent deaths. There are also plans to expand contact tracing beyond family members of Corona patients as 60 per cent of deaths occurred within three days of admission in hospital, showing a worrying lack of surveillance. While encouragingly, the doubling rate in the country improved to 20.7 days, cases in Delhi are doubling in 14.4 days and 57 per cent of them are coming from either clusters or containment zones, indicating a serious problem in the current strategy. It is no wonder then that the Centre also wants to analyse every COVID-19 death in the city, including the number of days a person was in hospital and if they were in home isolation. Plus, in a slight variation of the diktat issued by the L-G, from now on positive cases will have to go to Covid care centres for an assessment before a decision on home isolation is taken. New Delhi is dangerously similar to New York where all the initial emphasis was on capacity creation and no attention was paid to contact-tracing or mapping the disease. A clinical protocol can work only when we know what we are dealing with. So let’s not ask questions of who did a good or bad job or who has the upper hand politically and administratively. Suffice it to say that this coordinated effort should deliver in the end.