At no point since cases of Covid-19 began surging in the Capital this year has the hospital bed occupancy rate been beyond 20% of capacity, data released by the Delhi government every day shows. At its peak, the city recorded 43 deaths in a day on Thursday – of these, only three could be directly linked to Covid-19 alone, the city’s health minister Satyendar Jain said on Friday.
Another other way to look at Delhi’s current outbreak is to consider diagnosis and the predicted spike in admissions, which typically take place a week later. In Delhi, the peak of recorded cases came on January 12, and that of the test positivity on January 14. Since then, the number of people in the hospital have remained in the 2,600-2,700 range, even in fact dipping slightly in the last three days. And cases too have fallen sharply to 10,765 on Friday, from this wave’s peak of 28,867.
Whichever way the data is sliced, the import is clear: Delhi’s health care infrastructure has been far from a crisis. And this prompts questions on the Delhi Disaster Management Authority’s (DDMA) response, including a decision by Anil Baijal, who as the Union territory’s lieutenant governor heads the body, to not lift the weekend curfew or allow shops in markets to return to business as usual (instead of opening on alternate days).
There’s also no talk of reopening schools, which Maharashtra (and Mumbai) have already indicated that they will do as early as next week.
Looking at Delhi’s restrictions from the perspective of guidance by World Health Organization (WHO) and conversations among experts from the fields of epidemiology, public health and economics, it is clear that it is following a paradigm set in 2020, when the world faced an unknown threat. That is out of place in 2022, when there is high vaccination coverage, effective treatment protocols, and wider understanding of early clinical risks.
If restrictions and lockdowns were meant to “flatten the curve” of cases to under a level that the health care infrastructure could manage, Delhi, with over 80% of its beds still vacant in the third week of its outbreak, may have actually flattened it too much.
“The availability of effective vaccines provides an additional, potent tool to exit the pandemic, allowing the progressive reduction of non-pharmaceutical interventions while maintaining low incidence…” jointly wrote a group of experts in medical sciences, public health and economics in the Lancet Global Health’s January, 2022 issue.
Among themselves, they came to several conclusions. “First, strict public health interventions such as school closures, curfews, or lockdowns might no longer be justified as the risk attached to contracting Covid-19 has been starkly reduced by vaccines”.
“Second, countries’ persistent efforts to control the virus have led to an increasing fatigue among the population…”
And, most of all, if there is no wide-reaching coordination on what the correct strategies should be, “we might face years of increased morbidity and mortality due to not only Sars-CoV-2 itself, but also the resulting economic instability and increased inequalities”.
In other words, eliminating the virus – essentially what curbs like those in Delhi are meant to do – has no place at a time when vaccination has largely eliminated the risk of death.
In the Capital, 80% of the adult population has been fully vaccinated.
The administration needs to merely look back at WHO’s guidance on approaching public health measures during Covid: “Any decision to introduce, adapt or lift” them should be based “primarily on a situational assessment of the intensity of transmission and the capacity of the health system to respond”, but, crucially, “must also be considered in light of the effects these measures may have on the general welfare of society and individuals”.
On this yardstick, as the numbers demonstrate, Delhi’s restrictions are an overkill, prolonging not just deep economic losses, but also posing little epidemiological benefit.
“Since this variant is so transmissible, restrictions are only delaying the decline in infections,” Dr Jugal Kishore, head of department of community medicine at the Safdarjung Hospital, told HT on Thursday.
Kishore pointed out that prolonging the epidemic also poses another risk: “The longer we allow the virus to stay in the community, the greater are its chances of mutating.”