Delhi: 82 times jump in Covid-19 cases, 3 times rise in hospitalisation
As per the January 3 health bulletin released by the Delhi government, out of the 9,029 hospital beds available in the city for Covid-19 patients, only 420 were occupied.
The number of people hospitalised in the national capital on account of Covid-19 has increased by only around 3 times from the lowest point number of hospitalisations after the end of India’s second wave, even as the rate of new infections in the city has increased more than 82 times from the post-second wave low, an analysis by HT shows.
This indicates that Delhi is seeing a very marginal rise in patients needing medical care despite a spike in new infections – both in keeping with the trend in regions across the world that have seen strong case surges due to the highly transmissible Omicron variant.
The current number of people in the city who need hospitalisation is, in fact, much lower, and the figures given by the Delhi government is artificially boosted by two factors – the number of Omicron patients who may not need immediate medical attention (majority are asymptomatic, as per government officials), but were hospitalised for isolation; as well as those whom the Delhi health bulletin classifies as “suspect patients”.
As per the January 3 health bulletin released by the Delhi government, out of the 9,029 hospital beds available in the city for Covid-19 patients, only 420 were occupied. After the peak of India’s second wave (and Delhi’s fourth), the number of occupied beds in Delhi dropped to a low of 128 for the week ended November 28, 2021, according to government data. This means that there are around 3.3 times as many hospital beds occupied right now as there were at the lowest point since the second wave.
An important caveat while looking at current hospitalisation numbers from Delhi is that the bed occupancy number includes “Covid-19 suspect patients” as well as asymptomatic Omicron cases. Senior government officials explained that currently several Omicron patients are under mandatory institutional isolation because a policy for home isolation for these patients is yet to be formulated given the high transmissibility rate of infections caused by the variant.
This implies that the number of hospital beds occupied right now may be inflated by these policy decisions as a large proportion of patients in hospitals may be either asymptomatic or mildly symptomatic (as a major proportion of Omicron infections have been across countries), and, as such, may not require hospitalisation at all.
According to the government health bulletin, 168 patients required oxygen support, and 14 were on ventilator – both a small fraction of the availability of the two medical resources.
Dr JA Jayalal, former president of the Indian Medical Association, said that even though trends in other countries show milder symptoms in the Omicron variant, people need to be cautious and follow all Covid-appropriate behaviour. “The global trend is that among vaccinated people, the chances of hospitalisation is less compared to those who are unvaccinated. So, we should not lower our guards and the governments should push for maximum vaccinations so that the load on the health care system is less as the cases peak,” he said.
On the cases front, the seven-day average of new infections in the city bottomed out after India’s second wave at 25 daily cases for the week ended October 21, 2021. For the week ended January 3, this number – which denotes a region’s case curve – stands at 2,077. This means that there are currently 82.1 times as many new infections as there were at recent lows.
“Eventually, when cases rise further, we will have to hospitalise only severe cases and patients that are from the high-risk groups. Because this variant is so infectious, home isolation will require strict guidelines so that other members of the family and neighbourhood are not infected,” said a senior Delhi government official who did not wish to be identified.
The Delhi government is also holding a meeting on Wednesday to assess the home isolation policy for Omicron policy so that asymptomatic and mild cases can be isolated at home instead of being placed in institutional isolation. “It will not be possible to continue shifting all Omicron patients to hospitals and care centres because these infections rising so rapidly, we will need to reserve hospitalisation only for severe cases or for high-risk cases. Otherwise, the health care system will collapse,” the official quoted above said.
The hospitalisation trends exhibited in Delhi appear to fall much in line with what has been witnessed by countries seeing massive Omicron surges.
While the case curve (the seven-day average of daily cases) is currently soaring at record highs in countries such as the US, UK, France, Spain, and Italy, the number of hospitalisations seen in all these countries remains a fraction (70% in the US, 30% in UK, 60% in France, 40% in Spain, and 36% in Italy) of their respective peaks in previous waves, data shows. This has further meant that their respective death numbers are an even a smaller fraction — the US is currently seeing deaths at 46% of peak levels in previous wave, in UK it is 10% of peak, in France, Spain, and Italy deaths are 19%, 7% and 18% of their past worst, data shows.
Furthermore, an overwhelming majority of people dying even in these countries are those suffering from the Delta variant. The UK, which has seen the highest such fatalities, has seen 14 Omicron patients die. In the US, only a single Omicron patient has so far died.
Dr KK Talwar, former head of the Medical Council of India, said, “Even if the symptoms are mild, we have to ensure that we give out the message to exercise utmost caution. Even though in other countries we are seeing that the symptoms are less serious, that cannot be a sure shot consolation. The governments need to ensure that the message that they are sending out to the public is one to take maximum precaution and care.”