A report prepared by the National Control for Disease Control (NCDC) has cautioned that the national Capital needs to gear up to tackle the surge of 15,000 COVID-19 cases per day in upcoming winters and festivals.
The report has highlighted three reasons to worry that may cause excessive pressure on healthcare services. (i) winter months that make respiratory illnesses severer; (ii) patients may come from outside Delhi in large numbers; (iii) patients coming from distant areas are likely to be more serious. In addition, with festival-related gatherings, there could be a sudden rise in cases.
The report has been drafted by the NCDC under the supervision of Dr VK Paul, Chairman of NITI Aayog Member (Health).
The report has recommended that the Delhi government should get prepared for a daily surge of about 15,000 positive coronavirus cases and make arrangements for inpatient admissions of patients with moderate and severe disease roughly amounting to 20 percent of this surge.
"The guidelines for relative proportion for ICU, non-ICU beds, COVID care isolation beds should be according to the guidelines provided in the 3rd report of Empowered Group I," the report has said.
The report has talked about the prevention of infection among health care workers.
"Till date about 2324 of healthcare workers have been affected due to Covid19 in Delhi of which 23 percent are doctors, 34 percent are nurses, 15 percent are paramedics, 18 percent are group D staff and 10 percent others. A total of 75 deaths are reported in healthcare workers of which 14 are of doctors which may be under-reported. The increasing mortality in HCW and doctors is detrimental to maintaining the morale of these COVID warriors. Hence all efforts should be undertaken, to prevent the Health Care-associated infection in all the hospitals, labs and field workers engaged in an active survey in the containment zone." it reads.
The report has highlighted to implement non-pharmaceutical measures and COVID appropriate behaviour like focus on masks, physical distancing and hygiene. Launch a massive campaign for 100 per cent compliance with masks. This would be the single most important measure to prevent the spread of the virus going forward. A two-fold strategy, persuasion and enforcement - should be followed, it said.
The NCDC in its 'Revised Strategy for control of COVID-19 version 3.0' has noted that contact tracing strategy needs to be more rationalized.
According to the report, Delhi has reported a total of 5,401 deaths till date. It has mentioned that the average daily mortality reported ranges between 30 to 40 from 15 September onwards. The higher mortality in the co-morbid (66.6 per cent) and elderly is inevitable and reported all over states and globally.
The NCDC has pointed out that Delhi needs to reduce mortality to the extent possible should be one of the key objectives of managing the pandemic as the overall COVID-19 case fatality rate in Delhi is 1.9 per cent which is higher than the national average of 1.5 per cent.
The report has recommended taking measures to minimize gatherings during coming festivals.
"Large gatherings are super-spreading events. These must be avoided. Coming festivals (Chhat, Puja, Dussehra, Deepavali, Id, Xmas, New year) pose a huge challenge in pandemic control. It has been seen that Onam in Kerala and Ganesh Chaturthi in Maharashtra escalated the pandemic seriously. This must not be allowed to happen in Delhi. Our emerging gains in reduction in cases will be reversed because of these festivities and the rush in markets/localities. Such a setback that is potentially avoidable will dent the image of the capital and the country," it said adding that the next 3 months are crucial in our battle with coronavirus.
The NCDC report has recommended that the Delhi government to make awareness among people to develop a consensus to have these festivals with little / no gatherings.
The NCDC's report has also recommended conducting a sero-survey which can be tentatively planned during the 1st week of November.
The NCDC has opined the Delhi government to focus on vulnerable populations that are elderly, co-morbid patients and recommended a periodic review of the triage facilities and training need assessment for medical staff to triage the patients as per the severity of illness and risk assessment for selection of facility.
