The year 2021 dawned with hopes of a resurrection. Its predecessor had shown the world how unprepared we were to face the novel coronavirus. Learning quick lessons, governments and researchers across the world worked overtime to create a fix — vaccines.
In January India rolled out a massive vaccination-drive against Covid-19 and in the same month we announced, rather prematurely, victory over the fatal virus.
Fast forward two months, funeral pyres were burning non-stop across the country, especially in Delhi, thanks to the Delta variant of the virus which caught everyone off guard. The virus came, it conquered and then, it went for a short slumber.
As the eventful year draws to a conclusion the virus has again risen, this time in the form of Omicron, a mutant first spotted in South Africa.
With the number of Omicron cases going up every passing day, both central and state governments are preparing for another round of battle, albeit with abundant caution and more ammunition. Facing all-round flak for its unpreparedness during the second wave of the pandemic, the Delhi government, too, is leaving no stone unturned to ramp up the healthcare infrastructure. It has approved a budget of Rs 1,544 crore to make the national capital’s fight against the pandemic stronger.
The government aims to spend this whopping amount on short-and-long-term activities.
A break-up of the amount shows that Rs 415 crore alone will be used to strengthen laboratories and another Rs 445 crore to procure supplies.
The government will also spent Rs 280 crore to bolster healthcare facilities and another Rs 125 crore to manage the Covid Care Centres.
However, a big budget may not be enough to ensure a smooth sail through the next year.
The government has to ensure that arrangements can match up to the ground situation considering the past experiences of medicines and oxygen cylinders running out of stock and patients running pillar to post for a hospital bed.
More beds, ICU facility
Delhi Chief Minister Arvind Kejriwal has set a contingency plan of preparing 65,000 beds across hospitals in the city, if the situation worsens.
According to him, this will be done by adding 100 oxygen-assisted beds in every ward within two weeks.
Dr Suresh Kumar, director of Lok Nayak Hospital, a dedicated Covid care facility in the city, says his hospital is prepared to face all adverse situations and there are sufficient beds available.
“There are 150 ICU beds for children and 950 beds for adults in total at Lok Nayak Hospital and the Ram Lila Ground Covid Care Centre,” says Kumar.
As per state government data, around 37,000 Covid beds and 10,594 Covid ICU beds have been prepared in the hospitals and care centres run by it.
However, these numbers are not reflected in the Delhi Corona app launched by the government, which shows that around 13,500 Covid beds are available in both government and private hospitals in the city, out of which only 249 are occupied.
Also, the app shows 2,786 ICU beds in city hospitals, out of which just 34 are occupied.
One of the reasons behind this discrepancy could be the hospitals not updating the data on the app, says Dr Jugal Kishore, professor and head of community medicine department, Safdarjung Hospital. He says the government needs to prepare a strategy to allot these beds to patients.
“Beds should not be given to those with mild symptoms but to those who are in a severe health condition,” Dr Kishore says.
Focus on oxygen storage
Learning a bitter lesson from the oxygen crisis during the second wave, which led to the death of many severely-ill Covid patients, the Delhi government has been ramping up infrastructure to prevent a repeat of the tragedy.
At present, the state has a capacity of 1,363.73 metric tonnes of medical liquid oxygen, including storage, buffer and PSA plants.
The government is also bringing in 15 tankers in the next three weeks to ensure timely delivery of the life-saving gas.
As per the state government, the oxygen cylinders with medical institutions can now provide 217 MT in total. Additionally, 6,000 D-type cylinders have been placed in reserve for emergency use.
Previously, the oxygen refilling capacity of Delhi was limited to 1,500 cylinders a day. Now, two cryogenic plants with an installed capacity of 12.5 MT each will be able to refill an additional 1,400 jumbo cylinders every day.
The government has also issued a tender for 4,640 D-type cylinders and the technical bid evaluation is under process.
Delhi government is also providing free oximeters to patients recovering from Covid at home isolation. On an average, 2.6 oximeters have been provided to patients between December 1 and 17, and from December 18, nearly 10 oximeters are being distributed every day.
Besides, the government is installing telemetry equipment on all large and small oxygen tanks to provide real-time data on oxygen availability.
Boosting home isolation
On the positive side, compared to the Delta variant, Omicron is giving only mild illness to patients, many of whom have received both shots of anti-Covid vaccines.
Besides, some of the Omicron patients are asymptomatic.
This has reduced the need for hospitalisation of the patients and instead, they are being advised to isolate themselves at home. In the ten days from December 16 to 25, the number of Covid patients undergoing home isolation has more than doubled from 202 to 464.
This has, however, brought up a new challenge to the health officials — managing the patients at home.
The chief minister has already stated that his government is planning to upscale the home-isolation programme to an unprecedented level, so that the government can handle even one lakh cases a day.
At present the home-visit capacity of health department is a mere 1,100 cases per day and the plans are to raise it to one lakh cases, said Kejriwal on Thursday.
The government claims it has put in place a strong system. The teams of auxiliary nurse midwives (ANM), ASHA workers, paramedics and civil defence volunteers have been directed to visit the patients undergoing home isolation as soon as the case is detected and inform the patients of necessary precautions.
The visiting team will assess the patient’s health and provide a home isolation kit with an oximeter.
Following this, tele-caller teams will continue to contact the patient in mornings and evenings to obtain their health information.
If the patient’s condition is critical, he/she will be admitted to hospital right away. To ensure smooth functioning of the tele-caller service, the city government has hired private operators.
More testing to detect more cases
There are 317 government and private testing labs in the city, which are conducting 40,000 to 50,000 tests per day, including RT-PCR and rapid antigen test.
Kejriwal recently said testing facilities will be further upgraded to a capacity of three lakh tests per day.
Meanwhile, the Delhi airport has set up 20 dedicated counters for the passengers arriving from ‘at risk’ countries who have pre-booked their mandatory Covid-19 test.
Additional health staff on the rolls
Amid the ongoing strike of resident doctors over delay in NEET PG counselling, the Delhi government has told its hospitals to increase the sanctioned strength of doctors, nurses, and paramedics as required.
“Hospitals can add 25% more doctors and 40% more nurses and paramedics to their approved staffing levels. At present, these additional doctors, nurses, and paramedics will be hired till March 31, 2022. Instructions have been issued to extend the appointments of additional staff in both Covid and non-Covid hospitals until March 31, 2022,” says an order issued by the Delhi government.
According to health officials, the government has given special training in Covid management to medical students, nurses and paramedical staff along with specialist doctors to ensure their health and well-being.
No panic, but maintain caution
Health experts feel that apart from restrictions and guidelines, the government needs to ensure that panic is not created and the policy makers should strengthen arrangements for severe cases and its management.
“Most people are vulnerable to Covid and its variants but we need to ensure that the impact is not severe and only in mild form,” says Dr Kishore. On the brighter side, doctors feel that a third wave, if it materialises, will not be as intense as the second one.
“Any state which has faced an intense second wave, 80% of the population has presence of antibodies. The third will not be severe,” says Dr Samiran Panda of ICMR.
He, however, cautions that we should focus on preventive measures because the predominant variant is still Delta.
“Omicron might replace Delta but we don’t know how it will behave in elderly patients,” says Panda.
Keeping medicine Buffer
Officials in the drug control department say 32 medicines have been identified by the committee constituted by the Delhi government and it has been mandated to maintain the buffer stock of these medicines for 60 days.
In addition, eight drugs have been identified by the Central government and as per its recommendations the procurement process has started.
Besides, technical bid evaluation is under process to procure 67 ECG machines, suction machines, defibrillators, pharmaceutical refrigerators, portable X-ray machines, USG machines, CPAP (Continuous positive airway pressure) machines, and DVT pumps, says a Delhi government health department official.
Help through 1031
The state government has issued helpline number 1031, to help Covid patients. This number works 24x7 and has employees who can attend 600 to 700 calls.
If there is an increase in the calls, the number of employees will be increased.
By calling the helpline number, one can get oxygen cylinders, tele-consultation, pulse oximeters, medicine kits, information on vaccination, hospital beds, home isolation, ambulance services and tests.
