‘Warning signs for another spike’: Caution, vaccines key, say experts

The Covid-19 outbreak in Delhi may now be at a crucial stage when urgent steps could help fend off a full-fledged new wave of infections, experts have said, underscoring the need for people to stay cautious and for the vaccination drive to be accelerated.

The city added 409 new cases, according to the state health bulletin on Thursday, the highest since January 9. The current seven day average positivity rate of 0.50% is an increase over the 0.37% recorded the week before and 0.28% recorded the week before that

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“These are the warning signs for another surge in the number of infections in Delhi; there is no doubt about that. This is the natural cycle of any virus, add to that the complacency on part of the people in following Covid-19 appropriate behaviour since the decline in the number of cases over the last three months,” said Dr GC Khilnani, former head of the department of pulmonary medicine at the All India Institute of Medical Sciences (AIIMS).

Delhi has experienced three distinct wave of infections, with the last peaking around Diwali in the first half of November last year. “The situation is exactly like it was during Diwali when people were out and about, leading to a lot of asymptomatic spread of the infection. Delhi is currently a ticking time bomb,” Khilnani added.

The pulmonologist added that there are also concerns that people who were infected previously may now be at risk since immunity is believed to wane after several months. “One, there are still questions about the life span of the immunity against the infection – is it three months? Five? Seven? Nobody can say for sure. Second, the latest seroprevalence in Delhi was found to be 56%, which means true herd immunity – of at least 70% population being protected against the infection – hasn’t happened yet,” he said.

Additionally, the city could face a threat from mutated variants that could be more infective or cheat previous immunity.

The Union government on Thursday said Delhi and the National Capital Region (NCR) was emerging as an area of concern, in addition to Maharashtra. “We are very worried about Maharashtra. We are reaching a stage where all those measures (lockdown) are being brought back; it is a matter of serious concern. A word of caution for Delhi and neighbourhood as well. There is a rise in positivity rate in Delhi, Gurgaon, Faridabad, Gautam Budh Nagar, and Ghaziabad. Be careful and be watchful. We still have a huge proportion of vulnerable population,” said VK Paul, member (Health), Niti Aayog.

Officials said they are working on aggressive contact tracing and testing. “Strong surveillance, testing of suspects, identifying cases, educating people for covid appropriate behaviour, vaccination of identified and vulnerable group as per guidelines is being done with greater intensity. District health teams are working hard to trace the contacts,” a Delhi government spokesperson said.

Revenue officials said all district magistrates have directed their health teams to continue with aggressive testing. A second revenue official, who asked not to be named, said focus is also being directed on improving turnout at vaccination centres.

Although number of tests conducted in Delhi has increased over the last one week, it is still not near capacity. On average, nearly 65,600 tests were done each day during the last seven days in comparison to 61,377 the week before. In mid-December – just after the November surge – there were over 82,000 tests being done a day.

“The government should ramp up testing to capacity now as that will help us in quickly identifying more people with the infection. If they are isolated and all their contacts are traced and tested, then we can contain the spread of the infection. I believe that there is a need to trace as many as 15 to 20 contacts for each positive case, who have to be tested. The government also has to ensure that the quarantine and isolation are actually followed,” said Dr Lalit Kant, former head of the department of epidemiology at the Indian Council of Medical Research.

Experts also called for faster pace of vaccination as well as vaccinating everyone over the age of 18 in regions witnessing a surge in infections.

“When there is a fire somewhere, should we throw all the water we have at it or distribute it equally. What are the vaccines for? The government should vaccinate everyone over the age of 18 in the six states that have started seeing an increase in the number of cases. All the vaccines from other states should be diverted; the others can wait for it,” said Dr T Jacob John, former head of the department of virology at Christian Medical College, Vellore.

Dr Khilnani said, “The solution to Covid-19 remains vaccination along with masking social distancing and other Covid-19 norms. There is no dearth of vaccine and although the vaccination drive is picking up it is not commensurate with the Indian population.”