Smoke from a funeral pyre stings Suresh’s (name changed) eyes as he cremates one more victim of the deadly coronavirus at the Punjabi Bagh Crematorium in the national capital on Sunday evening. But his job for the day is not over yet.
Soon, he has to cremate a few more bodies lined up at the crematorium. Such difficult, physically and emotionally, this month has been for Suresh and several of his colleagues
working at the crematory.
After a lull of two months, the sudden spike in coronavirus deaths in New Delhi in November, amid the festive season and rising pollution level, has once again put extra pressure on the staff working cremation and burial grounds.
Despite working longer hours, the staff, at times, can’t clear the backlog. In just one month, the city witnessed 3,462 Covid-19 fatalities.
And on November 19, the national capital logged 131 Covid-19 deaths, the highest single-day fatality count till date.
“Beech mein ekdum kam ho gaye the bodies aana. August-September mein aise bhi din the jab ek bhi body nahi aaya (August-September saw very fewer bodies at the crematorium. There had been days when no dead body was brought here). Usually, most bodies are sent to the Nigambodh Ghat. We thought the toll was under control. Little did we know that it was a temporary relief,” Suresh says.
According to the official data, the Nigambodh Ghat — Delhi’s largest and one of the oldest crematoriums — alone cremated a total of 210 bodies between November 10 and 20.
However, the scene at the ITO burial ground was better compared to the earlier Covid-19 waves.
Haji Miyan Faiyazuddin, the in-charge of the burial ground, says though there has been an increase in the number of deaths in the third wave, the burial ground has received fewer bodies.
“During the earlier waves, we even witnessed 12 bodies in a day. But now, the number has come down to 2-3, and at times, a maximum of five in 24 hours,” says Faiyazuddin.
He, however, is concerned about the lack of space at the ground.
“Since March, more than 750 bodies have been buried here, and we don’t see any end to it sooner. Where will we take the bodies in the coming days? The Delhi government has been callous when it comes to us. They never spoke to us to know the situation,” says Faiyazuddin.
The city had recorded its highest single-day spike of 8,593 cases on November 11. But unlike the previous waves — when patients had to run nook and corner looking for beds, ventilators and oxygen, while many were turned down by hospitals citing a shortage of beds — the city hospitals, according to the Delhi government, are better prepared and equipped to tackle the situation this time.
Measures taken
The Directorate General of Health Services (DGHS) of the Delhi government has enhanced the percentage of ICU and non-ICU beds at many private hospitals given the rising number of Covid-19 cases in the city.
The Delhi government has ordered 90 private hospitals to reserve 60 per cent of their total bed capacity for the treatment of Covid-19 patients, increasing 2,644 beds.
It has also ordered 42 private hospitals to reserve 80 per cent of their total ICU bed capacity, thus enhancing 260 ICU beds for treatment of Covid-19 patients.
The new hospitals such as the one in Burari also has received around 50 more ventilators for critical patients.
The Arvind Kejriwal-led government also held a meeting with Union Home Minister Amit Shah, Union Health Minister Harsh Vardhan and Lieutenant Governor Anil Baijal to tackle the crisis.
At the meeting, the Centre promised 750 more ICU beds at the facility set up by the Defence Research and Development Organisation (DRDO) to treat coronavirus patients.
A door-to-door survey was also conducted in the containment zones to identify the residents having Covid-19 symptoms but have not been tested yet. Shah also announced that the number of RT-PCR tests will be doubled in Delhi.
“Mobile testing vans of the ICMR and the Health Ministry will be deployed at vulnerable spots. Few MCD hospitals to be converted into Covid dedicated hospitals for treatment of Covid patients with mild symptoms,” Shah had said.
It was also decided that additional doctors from CAPFs and paramedical staff will be airlifted to Delhi, given the shortage of healthcare workers, dedicated multi-department teams will visit all private hospitals for inspection of availability of Covid-19 medical infrastructure, admission of patients and availability of beds.
And the Centre will provide more oxygen cylinders, high flow Nasal Cannula and other necessary equipment to the Delhi government.
The AAP government, on the other hand, increased the penalty for wearing masks in public places to Rs 2,000 from the earlier Rs 500. The same amount is being charged from the people found spitting or consuming tobacco.
It has also reduced the guests limit at marriage ceremonies from 200 to only 50.
The Delhi government also passed an order announcing that fourth and fifth-year MBBS and BDS students can assist doctors in the treatment of covid-19 patients. The decision was taken to meet the manpower shortage in the national capital.
Besides, the Delhi government said the fourth and fifth-year MBBS students and dental doctors will assist on-duty doctors at the honorarium of ₹1,000 for an eight-hour shift and ₹2,000 for a 12-hour shift per day.
The government, in its order, also said the interns will give the honorarium over and above their stipend.
The order, however, did not go down well with many healthcare workers.
The Federation of Residents Doctors Association (FORDA) has moved a letter to the Delhi Health Minister, expressing anguish over the order, and sought to reconsider its decision.
The association said the undergraduate students do not have the necessary skills to clinically manage the medical care of the Covid patients and hence, are also at the risk of contracting the infection.
“UG students are not skilled enough. They are yet to undergo basic training and internship. Engaging such students is like deploying an army without weapons. How would they fight or even manage the lethal pandemic?” asks Shivaji Dev Barman, president of the FORDA.
Tackling the pandemic
“The initial fear of contracting the virus is minimal now. Now, we know what drug to use in what dose and at what time of the disease. We were aware that there could be a surge during the festive seasons and there could be another one during Christmas and New Year. We are still under pressure, as more and more patients are reporting to us many with multiple co-morbidities. At this time, we need to keep the morale of our healthcare workers high. The contribution of nurses, sanitation workers and technical staffs is equally important,” says Dr Anjan Trikha, professor of anaesthesiology, pain and critical care at AIIMS.
Deaths and critical cases
The sudden surge in fatality rates can be attributed to several factors. According to Dr Ajeet Jain, nodal officer for Rajiv Gandhi Super Specialty Hospital, the virus is more infectious among senior citizens, especially those who are above 80 years.
“Many patients are those who have comorbidities, almost 70 per cent of the critical cases have such conditions. Also, many patients are coming to hospitals when their conditions deteriorate and therefore, becomes tough to recover them,” Jain says.
The doctor also underlines that the season of stubble burning and pollution also made patients with respiratory complications more severe.
A study by Sir Ganga Ram Hospital has found that of late, the hospital has been receiving patients exhibiting serious medical conditions, mainly because of ignoring testing when the Covid symptoms first appeared.
“In the last month, we have treated close to 30 patients of Covid-induced moderate to major complications with no test being done. Antibody tests in all these patients were found to be positive. Many patients who had lung involvement required oxygen term supplementation and a few special medications,” says Dr Atul Kakar, vice-chairperson of the department of internal medicine, Sir Ganga Ram Hospital.
Arrangements at crematoriums
The North MCD has made elaborate arrangements for cremation the at Nigambodh Ghat. It has earmarked 52 wooden pyres out of a total of 104 and three CNG furnaces for of Covid deaths.
The MCDs have also attached the crematoriums and burial grounds with hospitals.
The medical superintendents of Covid dedicated hospitals have also been asked to release bodies at intervals so that there is no rush at cremation grounds.
The North MCD has also urged people to come in less number with bodies for last rites to maintain social distancing.
Besides, six furnaces will be available for last rites. There are 13 pyre platforms at the bank of Yamuna which would be used in case of an increase in the number of bodies arriving at the Nigambodh Ghat.
‘No need to worry about storage of vaccines’
Health Minister Satyendar Jain said Delhi has sufficient infrastructure and equipment to vaccinate its entire population in a few weeks once a Covid-19 vaccine is available.
“There is no need to worry about storage of vaccines. We have a large number of health care facilities, such as mohalla clinics, poly clinics, and hospitals etc, where a vaccine can be administered to people,” Jain said.