As Delhi takes stock of COVID preparedness, doctors say city is “battle-ready”

Delhi, which was among the worst-affected cities in India during the outbreak of the deathly second wave of COVID-19, is gearing up deal with a possible crisis anticipated in the wake of a spurt in cases in several countries, with the government assuring that the national capital is “battle ready”.

On Monday, the government took stock of its health infrastructure and conducted mock drills across government-run hospitals including the

Lok Nayak Jai Prakash Narayan (LNJP) Hospital, the nodal hospital for COVID infections.

During the peak of the second wave of COVID-19 between April and May, 2021, the national capital reported over 20,000 cases a day, which was among the highest in the world.

The question is what has changed in the city, whose medical infrastructure was in a shambles just 20 months ago with patients being turned away for the lack of beds and medical oxygen and if the government can avoid a similar recurrence this time around.

Also read: No need to panic, India armed with “hybrid immunity” to fight COVID: NTAGI chief  

What led to the surge in 2021?

Dr Shipra Anand, pulmonologist and assistant professor at LNJP attributed the critical shortage in medicines, medical oxygen and beds including ICU beds during the second wave to high patient load and critical COVID cases requiring undisrupted medical intervention. ‘Burden of disease’ or comorbidity indicated that Delhi had a significant load of non-communicable diseases, which complicated the COVID fight, she said.

“What made the second wave even more challenging was the sheer number of patients requiring medical assistance at hospitals. The number just overwhelmed the medical infrastructure,” the pulmonologist recalled.

“As cases surged in Delhi, hospitals ran out of ICU beds with ventilators. But the underlying cause was the sheer number of people requiring hospitalisation. The medical fraternity and even the government couldn’t foresee such a scenario. So, the overload resulted in severe shortage in medical oxygen,” she said.

The Delta variant which spread rapidly in the second wave led to severe cases and even deaths in younger patients under 45 years of age.

Also read: COVID nasal vaccine to cost Rs 800 in pvt hospitals, Rs 325 in govt clinics

The way forward

Doctors say even though the virus is not going anytime soon, the pandemic will reach endemicity after a certain point which in turn would make its management easier. This besides the fact that this time around, doctors and scientists have more information about the virus and how it will respond to a particular line of treatment

“We may need to start a new ward named ‘COVID ward’ going ahead. One thing is for sure, the virus will not go away and there is scientific evidence to support my submission. The pandemic will reach endemicity with its ever-evolving strains and variants. Population groups in such an endemic situation are manageable,” Dr Anand said.

Summing up the current level of preparedness of Delhi health facilities, a group of doctors said even though they encountered immense difficulty during the first three waves of the pandemic due an overwhelming number of patients and a trial-and-error-approach in treatment due to the evolving nature of the virus, now they have more grasp on the nature of the virus.

The doctors say now they are also equipped with an established treatment protocol and all the factors together put them at a great advantage in case there is a fresh wave of the pandemic.

Also read: Active Covid cases in country rise to 3,468

‘Beds on standby, govt ready for any crisis’

“At LNJP, there are 2,000 beds and 450 of them are dedicated to COVID-19. If a need arises, we can dedicate all 2,000 beds for COVID-19,” said deputy chief minister Manish Sisodia addressing the press on Tuesday. Sisodia, who also holds the health portfolio, visited the state government-run LNJP Hospital around noon to assess the drill.

A senior official in the Department of Health and Family welfare, Delhi government, said that the government has ensured the best COVID preparation and is ready to handle any eventualities. However, he appeared confident that India will not see anything like the previous waves with the current level of vaccination.

LNJP Hospital was Delhi’s nerve centre in the city’s fight against COVID-19 pandemic since its outbreak in March 2020.

‘Better preparation, more-efficient public outreach’

Speaking to The Federal, Suresh Kumar, LNJP Hospital’s medical director said, “Compared to previous times, oxygen availability has increased 10 times, beds have been increased five-fold with adequate stock of ventilators. Since this is a nodal hospital, we have ensured that the preparations are more than adequate this time.”

Also proper monitoring of bed availability and arrangements for public information by displaying the number of beds available and a functioning information centre with multiple helplines and COVID helpdesk number have made the entire mechanism more public-friendly this time, said Kumar.

Real-time data on the availability of beds, oxygen cylinders and ventilators will be available for the public on a Delhi government portal from Tuesday, assured Suresh Kumar.

Also read: Covid: Delhi authorities take stock of arrangements in govt hospitals

A senior medical officer said in the absence of a high volume of COVID-19 patients in the last few months, the oxygen levels were adjusted and also diverted to non-COVID departments. This was being done to ensure that the equipment did not become obsolete and non-functional at the time of need. The officer, however, said that when the need arises, the oxygen will be diverted specifically for COVID treatment.

Mock drill not necessary now: public health specialist

Epidemiologist and public health specialist, Chandrakant Lahariya, said that it is unlikely that India will see an uptick in COVID-19 cases matching the magnitude and severity of those seen in April-May 2021.

He also questioned the very idea of ‘mock drills’ saying that a pandemic or an epidemic calls for calm and composed response that should be a blend of public health intervention and hospital readiness. Mock drills are more common in an emergency situation where there is an immediate and excessive surge in patient load. “Such a surge will not happen in India due to high vaccination coverage and also the efficacy of our vaccines,” he said.

Also read: Delhi to dismantle last three Covid care centres as cases decline

Transmissibility of BF.7 and importance of masks

Speaking to The Federal, senior consultant, Internal Medicine and Infectious Diseases at Nanavati Max Super Speciality Hospital, Mumbai said masks are very useful, especially for older people and those with co-morbidities whose immunity may be low.

“BF.7 is a variant of Omicron and is highly contagious. It is possibly around five to 10 times more contagious than the other variants. However the virulence is not quite as high as the Delta just like the other Omicron variants,” the doctor said.

Delhi currently has 8,200 beds dedicated for COVID-19 patients and if needed, this can be increased to 25,000 and further, to 36,000 beds.