New Delhi – The crowded capital of India has become the most affected city in the country amid a fury coronavirus epidemic. Officials in Delhi have confirmed more than 73,000 cases of COVID-19 and have attributed at least 2,500 deaths to the disease.
The infection rate in the city, where almost all businesses were allowed to reopen earlier this month, has continued to rise steadily. Government data provided on Friday showed that 3,390 new infections were confirmed in the last 24 hours alone.
Amid fears that the outbreak will worsen long before it improves, officials in the capital, home to some 30 million people, more than all of Texas, have been competing to prepare for an expected wave of patients.
But leading infectious disease and public health experts say the government’s new plans to try to avoid the tidal wave “don’t make any sense.”
A balloon outbreak
A third of the approximately 70,000 Delhi coronavirus cases have been reported in the past week alone, and the number has doubled in just 13 days. That is a significantly faster extension than the rest of India is seeing; Nationwide, the case load has doubled approximately every 20 days.
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The Delhi government’s own estimates project more than 500,000 cases of COVID-19 in the city at the end of July, requiring more than 150,000 hospital beds for patients suffering from significant symptoms. Right now, there are only around 15,000 hospital beds in Delhi, so the government has been fighting to increase its health infrastructure, turning dozens of train cars, hotels and banquet halls into makeshift hospitals.
Work is also underway to convert a spiritual center into a makeshift 10,000-bed hospital on the outskirts of the capital. Last week, Delhi government spokesman Aswathi Muralidharan told CBS News that the administration was confident that there would be no shortage of doctors or other medical personnel for all makeshift facilities.
Prevention or lost time?
With the rate of new infections increasing, Delhi officials also announced a plan to send medical workers door-to-door, aiming to screen the entire city of nearly 30 million people for symptoms of COVID- 19 before July 7.
The government insists that it will help detect infections early and prevent the spread of the virus. Authorities had not responded to CBS News’ request for details on how many health workers will be deployed, or how they hope to use the collected data, as of Friday afternoon. Similar mass detection efforts in South Africa, for example, lead to on-site tests for the disease in any suspected case, but it is unclear whether India will implement such tests as part of its plan.
“The only way to control infections is early diagnosis and quarantine,” Dr. Sundeep Salvi, director of the Pulmocare Research and Education Foundation, told CBS News. “The door-to-door examination would be useful to achieve this if they analyze suspicious cases during the examination. Otherwise, examining people only for symptoms will not do any good, since 80% of cases are asymptomatic.”
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Another health expert agreed, telling CBS News that the screening plan “doesn’t make any sense.”
“This will be a waste of time,” said Dr. Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, Economics and Policy (CDDEP). He also noted that the vast majority of cases remain asymptomatic; “How are you going to detect these cases through detection?”
“There is also a risk for door-to-door health workers and for themselves as carriers of infections,” added Laxminarayan, who first warned in March that India was facing a likely increase in COVID-19 cases.
Laxminarayan told CBS News that a more effective option for the Delhi government would have been “serological surveillance,” which is to test people’s blood for antibodies that indicate a previous infection. It is a tool that is often used to estimate a population’s expected immunity to a virus, but it also helps in epidemic surveillance by showing how many people have carried a pathogen.
“This allows efforts to be focused much better than door-to-door visits,” Laxminarayan told CBS News. “It should have been done since March as a matter of course.”
The Delhi government also plans to deploy drones and install cameras to monitor designated “containment zones” around the city, where there are particularly high concentrations of COVID-19 cases and residents have police orders to remain inside.
Low test numbers
Last week, Delhi was testing only around 7,000 people per day for COVID-19, but the pace has increased. The plan is to analyze 20,000 random samples from across the city per day. On Thursday the number was as high as 17,000.
While the numbers are increasing, Delhi has only evaluated 23,000 people per million inhabitants. That’s much higher than the national rate of 5,636 tests per million people, but still much lower than some other countries with major epidemics, including the US (92,858 tests per million population, Russia (126,103 tests per million ) and the United Kingdom (128,317 per million), according to data collected by the Worldometers website.
Epidemiologists have stressed from the earliest days of the pandemic the importance of conducting rapid and comprehensive tests to detect the virus. Countries that have managed to control it faster, and curb subsequent outbreaks, have done so largely through efficient testing and tracking efforts.
India is now the fourth most affected country in the world, with almost half a million coronavirus cases and 15,000 deaths.
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