How Delhi Is Fighting COVID

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ARVIND KEJRIWAL In a special interview with  THE NAVHIND TIMES, the Chief Minister of Delhi speaks on the prevailing coronavirus pandemic situation in the capital city, the measures taken by his government to face the virus, the related Goan scenario, and other linked aspects

RAMNATH N PAI RAIKAR NT NETWORK

Q. How do you compare the COVID-19 situation in Delhi and Goa; Goa initially having a long record of no COVID-19 cases?

I have been observing the trend of coronavirus in various states in the country. The new cases in Goa are between 350 and 400 a day and rising. The positivity rate is over 20 per cent, which is quite high indicating that much more testing needs to be done. Delhi had hit a peak in the number of cases, during the first week of June. The situation was under control till the last week of May – the time till when the lockdown was in place. We had anticipated a rise in the number of coronavirus cases with the opening of the lockdown in Delhi, but the surge was more than expected. For a couple of weeks, there was a sense of panic but we never lost hope and kept addressing whatever challenges came ahead of us. We did many things that were never done in India like promoting home isolation of mild patients, distributing oximeters to home isolation patients, launching a corona app showing real-time availability of COVID beds in various hospitals, and aggressively scaling up testing using antigen tests.

Now, two months later, there has been a complete turnaround. Today we can say that coronavirus is fairly controlled in Delhi, although I won’t say we have defeated it. From a peak of over 4,000 new cases a day, today we see around 1,000 new cases a day, a positivity rate of six per cent and a recovery ratio of 90 per cent, the highest in the country. But we can’t afford to be complacent. Same holds for Goa. There is no room for complacency. What is needed is to study and learn from each other’s experiences, not just in India but from around the world.

Q. What in your opinion is the ideal way to handle COVID-19 containment zones?

When the lockdown had begun, the Centre had notified very strict guidelines for containment zones. According to the guidelines, if more than three people were found to be positive in a locality, the entire area or locality was contained. We strictly followed these guidelines. The guidelines also said that the area would be de-contained only if there was no new COVID-19 case for 28 days. But if a single new COVID-19 case emerged in the containment zone, then the area will remain under lockdown for another 28 days. Due to this, some containment zones in Delhi were under lockdown for three-four months. People in these zones were quite distressed because they were completely locked down in their houses for more than three months. We pursued this issue with the central government and I am glad that they issued new guidelines. According to the new guidelines, the area under containment zones has been re-defined – it can now be the street where a cluster of cases are found rather than the entire locality. In dense urban areas, this kind of re-thinking is necessary. Further, a containment zone can be de-contained in 14 days after the last COVID-19 patient in the area has recovered. This is another welcome change. Ultimately, we must see containment zones as a temporary strategy to curb the spread of the pandemic but not a long-term strategy by keeping entire areas in permanent lockdown for months by calling them containment zones.

Q. Delhi has started sero survey. Is it right for Goa to take the same measure?

One of the core tools in the fight against COVID is data. Sero surveys are extremely useful since they give health experts a very reliable estimate of the spread of COVID-19 in any state along with which geographic or socio-economic groups are most and least affected. In Delhi, two sero surveys have been conducted so far. The first survey was conducted with the help of the central government. We collected more than 21,387 samples and studied them. The results were eye-opening. We found that almost 23 per cent or approximately one fourth of Delhi’s population have antibodies. This has helped us in assessing the situation better and to know where exactly we stand. We have now decided that the Delhi government will conduct a sero survey in the first week of every month wherein around 20,000 samples will be collected. I think it is important for all states to study the spread of the disease. Goa being a small state can easily conduct sero surveys, frequently covering most of its population. This not only gives insight into the spread of coronavirus but will also help in preparation.

Q. You are a strong advocate of plasma therapy. Has this mode of treatment shown any reliable
success?

Coronavirus is a pandemic with no precedence. There is no known cure or vaccine for coronavirus at the moment. Many countries are doing their bit of research to develop a vaccine but till the time there is no breakthrough, we need to do everything that has the potential to save lives. We studied the experiences of many countries and found plasma therapy to be a promising option. I am not saying that plasma is the treatment for coronavirus but even if there is a small chance to save someone’s life, we should try it. Today, Delhi has shown the way as far as plasma therapy is concerned. Delhi was the first to initiate trials of convalescent plasma therapy in April at Lok Nayak Hospital, Delhi government’s largest COVID hospital, which showed encouraging results. Subsequently, we launched the country’s first two plasma banks in Delhi so that patients in need of plasma can get it free of cost and without any hassle. We are running large scale awareness campaigns to encourage recovered patients to donate their plasma, which was earlier an issue. All these efforts seem to have yielded results. So far, over 900 recovered patients have donated plasma and around 710 units of plasma have been used in recovery of patients across hospitals in Delhi. The recovery rate in Delhi has gone up to 90 per cent and it has been possible because of measures like plasma therapy.

Q. The tourists arriving in Goa, mainly by road and air, form one major source of coronavirus transmission. How do you think the Goa government, a tourist state, should handle this situation?

The initial surge of cases in Delhi was also due to the fact that Delhi has the busiest international airport and majority of the people, who arrived from all over the world in February and March landed in Delhi. That didn’t deter us from welcoming these people. We ensured mandatory checks for all passengers on arrival, prepared good quality public quarantine facilities and also gave the option of private hotels for quarantine facilities on payment basis. Ultimately, all of us have to learn to live with coronavirus. The country has been under lockdown for almost three months which has been very hard for all the sectors, especially tourism. Even though the country is being unlocked, domestic flights and the hotel industry still remain the worst affected. The economy of Goa mainly thrives on tourism. A significant Goan population is dependent on tourism and allied sectors for survival. Many people have lost their life savings due to coronavirus. The lockdown has served its purpose by and large, which is to give time to various governments to ramp up their facilities, be it testing, PPE kits, hospital beds etc. The focus should now be on slowly opening up the economy with all safeguards in place, while at the same time ensuring that there is no shortage of medical facilities, especially for critical patients. We are taking several steps in Delhi too to ensure the economy and the livelihoods of people get back on track. For example, after we started unlocking, we faced a unique situation that while many people lost their jobs during lockdown, businesses willing to open up were finding it difficult to find labour. The Delhi government came up with a very innovative solution by starting ‘Rozgaar Bazaar’, an online platform to connect job givers with job seekers. The response we have received is overwhelming. In just three weeks, over 10 lakh job seekers have registered, while 8,400 companies have registered, offering 8.5 lakh jobs.

Q. You have de-linked hotels from hospitals in Delhi, not allowing them to accommodate patients in the capacity of COVID care centres…

The decision to link hotels with COVID hospitals was taken in early June when we saw a sudden surge in coronavirus cases and wanted to plan for adequate bed capacity had that surge continued. Thankfully, from June end, the number of active cases in Delhi has seen a steep decline and the new cases are also coming down steadily. As on date, of the 14,000 beds available for the treatment of COVID-19 patients in Delhi’s hospitals, only 3,500 patients, which is around one-fourth of the capacity of beds in Delhi are being hospitalised. More than 80 per cent of the patients in Delhi have recovered under home isolation, which has been very successful. Considering the adequate availability of beds in COVID hospitals and the need to get the hotel industry back to functioning normally for the overall economy of Delhi to improve, we took the decision to de-link hotels from hospitals.

Q. What do you propose for Delhi-based schools and colleges as far as education during the academic year 2020-21 is concerned?

There are several things, which coronavirus has given us that are not entirely desirable but necessary. Online education is one such thing. I don’t think anything can replace the experience of learning by sitting in a classroom or playing with your friends in a playground. But the risks are far too high. The responsibility of all the children of Delhi is not just that of their parents but also mine. Till the time the COVID situation is completely brought within control, we are not going to open schools and colleges. But we have learned to adapt and especially our government schools are working hard to meet the demands of online education, while at the same time catering to the needs of those children who may not have the facility.

Q. Co-morbidity is often cited as a reason for the death of COVID-19 patients. How is the Delhi government handling this aspect?

Co-morbidity is a major contributing factor in corona-related deaths. If a person has any co-morbidity like high blood pressure, diabetes, breathing issues, kidney problem, etc, and contracts coronavirus, it leads to severe complications. Since most of these co-morbidities are seen in elderly patients, we are advising senior citizens to strictly remain indoors. We have also ensured that every treatment option that holds promise for critical patients, like plasma therapy, is made available to them in a timely manner and without facing any hassle. Finally, such patients need to be monitored in ICUs and by teams of doctors specialised in critical care. In the last three months, we have increased the capacity of ICUs in COVID hospitals by 400 per cent and ensured adequate availability of BIPAP and ventilator machines. We have also enforced a checklist for management of COVID-19 patients in all our hospitals to ensure standardised care, and treatment options are made available everywhere. All these steps have cumulatively led to a steep decline in COVID fatalities in Delhi. From a peak of 120-130 deaths daily, today we are seeing 10-15 deaths every day. But we are not satisfied and we won’t rest until deaths due to COVID-19 become zero in Delhi. We are working on several additional measures to further reduce the death rate. We recently constituted four committees of doctors to study how the number of deaths can be further reduced in the 11 hospitals where the COVID-19 deaths remain on the higher side. I am personally monitoring the status of every single critical patient and deaths due to COVID-19 every day.

Q. Can Goa adopt the Delhi model to fight the coronavirus pandemic?

It’s not correct for me to say if Goa or any other state should adopt the Delhi model to fight coronavirus. I am sure the Goan government is trying to do its best. Every state is facing unique circumstances and it must learn from the experiences of other states, just as we learned from experiences of others in India and around the world. But I am glad that today the Delhi model is being discussed as a case study in India and around the world.

The first principle and foundation of the Delhi model is teamwork. The government cannot fight the pandemic without support from various stakeholders and interest groups. So we reached out to everyone and asked for their cooperation. The second principle of the Delhi model was acknowledging, appreciating and encouraging constructive criticism from stakeholders, and responding to these by working towards fixing the problems highlighted by others. The third principle is that no matter how bad the situation gets, you as a government cannot give up. In terms of specific actions too, we pioneered many interventions like home isolation, a dedicated corona app and plasma therapy. In particular, Delhi’s home isolation model has proven to be extremely successful in treating patients with mild symptoms, which in turn freed up hospital beds for critical patients.