Delta variant still driving hospitalisations amid Omicron surge
A little more than one-fifth, or 2371, of Mumbai’s 11,360 active Covid-19 cases up until December 30 were admitted to hospitals and jumbo centres, BMC records show
MUMBAI: A little more than one-fifth, or 2371, of Mumbai’s 11,360 active Covid-19 cases up until December 30 were admitted to hospitals and jumbo centres, BMC records show. ‘Active cases’ is when you subtract the discharged and deceased Covid-19 patients from the cumulative Covid-positive cases.
Of those admitted to various facilities, 751 (31.67%) are on oxygen support, 222 (9.36%) are on ventilator support and 171 (7.21%) are critical, the civic body said.
Health experts and the state’s Covid-19 task force members said the hospitalisation pattern indicated that the Delta variant (which was primarily responsible for the second wave between February and June 2021) is still in circulation, along with the fast-spreading and highly-mutated Omicron variant.
On December 31, the city’s active caseload jumped to 16,441; however, the civic body had not completed its analysis for the day at the time of going to print.
“Clinically, our observations suggest that hospitalisations are being caused by both Delta and Omicron,” said Dr Om Srivastav, an infectious disease specialist and a member of the state’s Covid-19 task force. “Since Omicron is known to cause mild disease, patients admitted with milder symptoms could be infected with this variant. But there is a small percentage of patients that require oxygen support and intensive care unit (ICU) admissions. These admissions could be driven by Delta,” he said.
According to Dr Srivastava, all those admitted under him in the last week were fully vaccinated. “We are seeing admissions in the younger age group between 35 to 50 years, and more women than men,” he said, adding that, another striking trend he has observed in some patients is rapidly-progressing pneumonia.
The presence of variants is detected with the help of genome sequencing. As soon as the Omicron scare began, samples of international travellers and their contacts were sent for genome sequencing. In addition, the civic body has also started community surveillance by randomly sending samples from all wards. However, not all positive samples undergo genome sequencing, which makes it difficult to understand the exact circulation of the variants.
The latest genome sequencing results released by the civic body on Friday, however, showed that Omicron was the highest in circulation with 55% of the 282 samples detected with the variant. Delta was present in 13% of the samples, while 32% were Delta derivatives.
“Most patients I consulted over the past several days have been in the mild category, but I have five patients hospitalised and on oxygen support,” said infectious disease expert Dr Tanu Singhal from Kokilaben Dhirubhai Ambani Hospital. “They could be infected with the Delta variant as we have had Delta in circulation before Omicron came in,” she said.
Civic officials said hospitals are informed of genome sequencing results so that they can corroborate the symptoms and severity of patients with the variant. The next few weeks will make it clear if Omicron is also responsible for some number of ICU admissions and patients on oxygen.
“The footfall in our hospital has definitely increased, but we try not to hospitalise mildly symptomatic patients,” said Dr Anita Mathew, an internal medicine consultant at Fortis Hospital, Mulund. She added that they were also checking the S-gene dropout factor for some clarity on the variant.
Among the many other genes, the SARS-CoV-2 also has a Spike (S) gene. A specific deletion in the S gene results in an S-gene dropout also referred to as an S-gene target failure (SGTF), which is an indirect way of indicating the presence of Omicron. However, not all Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) test kits look into the S-gene, and the ones that do look into it are expensive.
A doctor said that deploying the S-gene kits will not make much of a difference as Omicron is already spreading in the community. “We need to detect the Covid-19 infection and break the chain before clusters are formed. Instead, we need to send more samples for genome sequencing to get a fair idea about which variant is in circulation,” he said.
A deeper look at BMC data indicates that between December 23 and 29, the city’s overall caseload jumped from 752,816 to 759,523. The highest increase was reported in the age 20-29 age group (1,474 cases), followed 30-39 years (1,397 cases) and 40-49 years (1,137 cases). The lowest number (33) was reported in the 90+ age group, followed by 105 in the 80 to 89 age group, and 111 in the 0 to 9 age group. BMC officials said 80% of the city’s cases are from high-rises and 20% are from slums.
“Even though there has been a rise in the number of positive cases, there is no heavy demand for hospital beds in the city at present,” said Covid-19 task force member Dr Rahul Pandit. “However, we shouldn’t get complacent and need to wait for up to 10 days more before concluding anything. Meanwhile everyone should strictly follow rules and Covid-19 appropriate behaviour.”
Dr Gautam Bhansali from Bombay Hospital, who is also the coordinator of all the private hospitals in Mumbai, said 92 percent of beds are empty in Mumbai. “Most patients that are getting admitted are senior citizens with comorbidities. They are coming to get the antibody cocktail dose, while the rest of the patients are being treated at home,” he said.
Dr Bhansali said his hospital had admitted 16 Omicron positive patients out of which 11 were discharged. “These patients didn’t need any medication or oxygen support as they were asymptomatic. The remaining five patients are also doing fine and don’t require any serious medication,” Dr Bhansali added.
To be sure, the weekly average growth rate of Covid-19 cases in the city is 0.14%. However, there are several wards with a higher growth rate, including H-West (0.31%), A (0.30%), D (0.24%), K-West (0.22%) and G-South (0.20%). These wards include Bandra West, Khar West, Santacruz West, Andheri West, Jogeshwari West, Vile Parle West, Churchgate, Colaba, Malabar Hill, Peddar Road, Worli and Prabhadevi.
BOX:
MUMBAI
Active cases in Mumbai: 11,360 (as of December 30, 2021)
Patients in Covid Care Centres and hospitals: 2,371
Critical patients: 171
Patients on ventilator support: 222
Patients on oxygen support: 751
(With inputs from Eeshanpriya MS, Mehul Thakkar and Pratip Acharya)