1,450 fresh infections in Capital: Are cases on the up once more?

Delhi on Sunday recorded 1,450 new cases of Covid-19, the highest single-day jump in over a month, amid concerns that infections could be on the rise in the Capital, which became the first major hot spot in the country to largely control the outbreak last month.

With the new-case trajectory at a month’s high, clinicians and public health experts said violations of recommended protection protocols such as social distancing and wearing masks in public places, and further relaxation of movement could be reasons behind the rise in cases.

On Thursday, the results of Delhi’s second serological survey found that 29.1% of the city’s population may have developed antibodies against Covid-19. Epidemiologists say that this means over 70% of Delhi’s population remains susceptible to infections and the Capital cannot afford to lower its guard.

Sunday’s new cases took the total positive cases recorded till date to 161,466. With 16 fresh deaths, the death toll climbed to 4,300. More than 145,000 people have recovered from the disease, the Delhi government said in its health bulletin.

“Delhi has done quite well in terms of testing, surveillance, containment measures, contact tracing, and scaling up health infrastructure that led to the drop in overall numbers, but people’s lack of caution is preventing a further drop in cases. There’s laxity in people’s behaviour as far as adopting preventive measures is concerned, which is extremely important along with surveillance and other epidemiological measures, to bring down the rate of infection,” said Dr VK Paul, member (health), Niti Aayog.

In the last week, 1,269 new cases have been reported every day on an average. This is the highest this number has touched since July 22, when it was 1,333 – when cases were dropping from the peak so far (see chart).

“There is still at least 1.38 crore population that’s susceptible going by Delhi’s sero survey results, and there is direct correlation between vulnerable population and rate of infection. The disease transmission is still there, so cases will not stop being reported completely. No matter how much you increase testing, it is just a supportive measures, what will work eventually is non-pharmacological measures such as physical distancing, cough etiquette, wearing mask/face covers, etc. There is a need to be careful for at least four-five months,” said Dr Sujeet K Singh, director, National Centre for Disease Control (NCDC). NCDC had supported the Delhi government in conducting the first sero-survey around late June and early July.

Delhi’s health minister Satyendar Jain told HT: “The numbers have witnessed fluctuations but it is not sufficient to conclude that there is a change in trend. As of now, the situation of Covid-19 in Delhi is under control. The number of cases recorded every day should not be seen in isolation. One should also consider the increasing recovery rate, reducing positivity rate and decreasing rate of deaths.”

 

Testing, meanwhile, appears to have dropped from its peak levels. Delhi conducted 21,660 daily tests on average for the week ending July 10, the city’s highest recorded rate of testing till date. Since then, this number has dropped to 17,494 in the past week — down by about 15%.

Experts have also raised questions about Delhi’s heavy reliance on antigen tests, which they say are not as reliable as gold-standard RT-PCR tests. Over the past month, around seven of every 10 tests conducted in Delhi have been an antigen test (on Sunday, 66% of the total tests were antigen). A high dependence on antigen tests, which throw up more false negatives, can lead to under-detection of cases and tilting crucial data metrics such as positivity rate and case distribution, experts said.

With daily tests hitting a plateau, the average positivity rate — the fraction of tests that return positive — has started inching up as well. The number, which had dropped from a peak of 31.4% in mid-June to 5.7% at the end of July, was at 6.8% in the past week.

 

“Unlike how it was in the beginning of the pandemic, our health care infrastructure is comfortably placed to handle the current patient load. We have enough ICU beds, and ventilators, as the number of critically ill patients is low. As I see it, the rate of rise has decreased and the recoveries have gone up,” said Dr Yatin Mehta, chairman, critical care department, Medanta Hospital, Gurugram.

Dr Sandeep Budhiraja, clinical director, Max Healthcare, said: “The numbers aren’t as bad as they were a couple of months ago. A total of about 1,000-1,200 new cases that we see these days will keep hovering around that number because the disease obviously is not going to go away overnight.”

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