Despite having adequate warning, the Delhi government failed to create enough hospital infrastructure for Covid
The Delhi government, however, did little and even as the number of active cases rose 40% in the last two months, the number of hospital beds in the city rose by just a tenth or so.
How fast the Covid-19 situation has changed in Delhi is evident from the fact that until two weeks ago, one of the largest government hospitals had just five of its 200 ventilator beds occupied. With the city recording over 7,000 infections daily for the last few days—infection dipped to 5,000 on Tuesday because of reduced testing—Rajiv Gandhi Super Speciality Hospital (RGSSH) has only 71 ventilator beds free. If we exclude RGSSH, just 58 of the 597 ventilator beds are unoccupied in the rest of the government hospitals. If you look at all hospitals, including the private ones, less than a fifth of ICU or ventilator beds are available. While just private hospitals were facing a capacity crunch earlier, as a result of the sharp jump in cases—Delhi had 3,229 cases two months ago—even government hospitals are stretched thin; on Tuesday, 84% of ventilators in the government sector were occupied as compared to barely 50% two months ago.
This is the reason why the government is now in a mad scramble to get private hospitals to reserve 80% of their capacity for Covid-19. While the Delhi High Court had stayed the government order, the authorities are now pinning their hopes on the HC reversing its earlier order. What is especially frightening is that none of this should have come as a surprise. The fact that the government was relying heavily on rapid antigen tests (RAT) that are not as good as RT-PCR ones when it comes to detecting infections should have made it clear that, over time, this would mean a surge in infections as those left undetected would infect others. Add to this, the careless attitude of people who are now thronging the markets for Diwali shopping, the massive increase in pollution levels—higher pollution levels are associated with higher infection-spread—and the onset of winter that allows the virus to remain in the air for longer. Indeed, a central government panel had, early last month, warned that infections could rise dramatically and had advised the state to prepare for the possibility of daily infections rising to as much as 15,000.
The Delhi government, however, did little and even as the number of active cases rose 40% in the last two months, the number of hospital beds in the city rose by just a tenth or so. While the ICU capacity was almost doubled, keep in mind that the occupancy of ICUs rose 121% as the number of severe cases rose much faster.
In the case of ventilators, just four percent more were added in the last two months while the number of those requiring ventilation rose 44%. While the government is hoping to add more beds to existing hospitals, if this does not happen in time, Delhi could soon run out of critical infrastructure. As compared to September 15, 2.7% of active cases needed ventilators and 4.3% needed ICUs on October 31; this was 2.6% and 2.7% respectively in mid-September. Do the math, and this means that if active infections rise to even 50,000, Delhi will run out of ICU beds.
Relying on private hospitals to release more capacity for Covid patients is all very well, but ideally, the government should have been focused on creating jumbo facilities that could have been wound up after the pandemic was under control. Nor is Delhi, sadly, the only city where the proportion of serious cases requiring ventilators and ICUs is rising. Despite a fall in active infections in Mumbai and Pune, the number of serious cases as a percentage of active infections have increased. States must create additional infrastructure quickly if they don’t wish to go the Delhi way.