Is the third wave finally starting to ebb in Mumbai and Delhi?
The earliest urban hot spots of India’s third wave of Covid-19 – Mumbai and Delhi, which were among the first regions in the country to reflect a rising trend in infections – appear to be exhibiting early signs that their infections curves may be flattening, data shows
The earliest urban hot spots of India’s third wave of Covid-19 – Mumbai and Delhi, which were among the first regions in the country to reflect a rising trend in infections – appear to be exhibiting early signs that their infections curves may be flattening, data shows.
While key data indicators in Mumbai suggest that numbers in the city have already started peaking, Delhi is experiencing what could be the first indication that the rise of cases has slowed down.
In Mumbai, the positivity rate has started dropping. Positivity rate (the proportion of daily tests returning positive for Covid-19) is one of the first statistical measures that indicate a reversal in trend. This number has now fallen for five days in a row – the figure was 29.9% last Thursday, 29% on Friday, 28.6% on Saturday, 28.5% on Sunday, 23% on Monday, and touched 18.8% on Tuesday.
As expected, this trend was closely followed by a drop in daily infections, which have now fallen for four consecutive days – there were 20,971 cases on Friday, 20,318 on Saturday, 19,474 on Sunday, 13,648 on Monday, and finally 11,647 on Tuesday.
In Delhi, while cases and positivity rate have not yet started declining, the rapid rise seen over the past two weeks appears to have slowed , hinting that the peak may be approaching – a factor that has been pointed out by several health experts, both government and independent.
While daily cases in the Capital more than doubled in four days from 10,665 on Wednesday to 22,751 on Sunday, cases have stayed below Sunday’s level over the two following days – there were 19,166 new cases on Monday (when fewer tests were conducted), and 21,259 on Tuesday. The rapid rise in positivity rate in Delhi has also slowed . While daily positivity rate jumped more than 11 percentage points between Wednesday (11.9%) and Sunday (23.5%), it has only increased two percentage points between Sunday and Tuesday (25.6%).
If this trend continues, these numbers may be headed to a peak in a few days, something that Delhi health officials have suspected may happen based on an analysis by a team of medical experts along with an assessment of Sutra – a mathematical model developed by scientists at IIT-Kanpur and IIT-Hyderabad to assess the peak in Covid-19 cases in India – that says that Delhi could see a peak in Covid-19 infections around January 15.
“We are expecting a peak in cases in the next day or two. But we are prepared to handle the spike in cases,” Delhi health minister Satyendar Jain said on Tuesday.
To be sure, doctors and health experts said that numbers on the ground may be higher as a lot of people have resorted to using home test kits due to milder symptoms occurring with the Omicron variant, and do not necessarily follow up with a RT-PCR test if they are positive, thereby staying off the radar.There is, however, no way to map these cases since most mild patients are recovering in home isolation.
Infectious disease expert Dr Om Srivastava, who is also a member of Maharashtra’s Covid-19 task force, said that the wide use of self-testing kits is a matter of convenience but when looked at from a public health perspective, it could present a skewed picture of the spread of infection. “The authorities should consider devising a mechanism through which reports of all self-tests are recorded,” he said.
Experts, however, said that so far the waves in Mumbai and Delhi appear to be following trends seen in Omicron waves the world over – a very rapid rise in infections that peaks just as fast, coupled with a relatively higher share of mild cases, causing fewer hospitalisations.
To be sure, they also warned that the marginal improvement in numbers witnessed over the past few days needs to become a sustained trend, and that keeping in mind the high transmissibility of the Omicron variant, the focus remains on keeping hospitalisations low.
In Mumbai, authorities said they were optimistic, but wanted to remain cautious. Suresh Kakani, additional municipal commissioner of the Brihanmumbai Municipal Corporation (BMC) said, “It looks like the cases are stabilising but we will have to wait for this week before commenting on whether we have reached the peak .”
Experts also expressed optimism about the reduced number of hospitalisations and comparatively fewer deaths so far.
Delhi government numbers show that as of Tuesday, despite a consistent rise in the cases, less than 15% of hospital beds designated for Covid-19 patients were occupied. In Mumbai, this number was under 20%. A tally of data compiled by HT from 16 regions in India showed that fewer 15% of hospital beds are occupied across the country as of Tuesday night.
And even among those hospitalised and those dying, the numbers are dominated by those who are unvaccinated. On Monday, HT reported a Delhi government analysis of deaths among Covid-19 patients in Delhi between January 5 and 9 that showed that 35 out of 46, or 76%, of the fatalities were in unvaccinated people.
“We are in comfortable situation during the third wave and are handling all symptomatic patients or those from high-risk groups. This time the demand for oxygen and ICU beds is low due to which we are in a much better situation. However, we are on alert if cases increase drastically we will have to further ensure every patient gets a bed,” BMC’s Kakani said.
Maharashtra’s health minister Rajesh Tope said that so far Oxygen requirement has not been an issue like it was in the country’s brutal second wave. “The need for oxygen has not risen a great deal. The bed occupancy has not shot up to a concerning level. However, we need to remain cautious and follow Covid-appropriate behaviour... Out of the active cases, only 2% are on oxygen support and 1% are in ICU in the state. The numbers are not such that would burden the medical infrastructure,” he said.
And like in Delhi, an overwhelming majority of medical resources such as Oxygen beds in Mumbai were currently deployed towards the unvaccinated. On Saturday, HT reported that 96% of Covid-19 patients requiring oxygen support in Mumbai’s hospitals are unvaccinated.
Doctors and health experts have repeatedly said that considering the high transmissibility of the Omicron variant, it would be better to look beyond reported infections and towards hospitalisations instead.
“Infection-wise the on-ground reality could be 10-100 times also because a lot of people are taking home tests. But what is important is to see the hospitalisations, the requirement of oxygen and ventilators because that is a very small percentage. There is no point now looking at just case numbers because a majority of the infections are mild. If we see the trends in other countries, the rise in cases is steep because this variant is definitely more transmissible but since the infection period is also shorter, the fall is also equally fast. But we will have to wait and watch how the trends are here because taking a definitive stand,” said Dr Sumit Ray, head (department of critical care), Holy Family Hospital.
With inputs from Soumya Pillai in Delhi, and Swapnil Rawal, Mehul Thakkar and Jyoti Shelar in Mumbai