28-fold case rise, set to cross 4 lakh Covid high, but hospitalisation low; testing norms relaxed

A senior official said that while the daily case count in Delhi of about 20,000 last April matches the latest numbers, the level of hospitalisations is just about “one-fourth to one-fifth” of that month.

“With the equal number of cases which happened in Delhi, let’s say in April, and the number of cases which we have now, of around 20,000 cases per day, the level of hospitalisation is just about one-fourth to one-fifth. And the level of ICU admissions is even lower than that. So it is definitely one-fourth to one-fifth of what was there in the second wave,” the official said.

Last year, the daily count in Delhi crossed 20,000 cases on April 17, and was at 28,395 on April 20 and 22,933 on April 25. On Sunday, the capital’s case count was 22,751, dipping to 19,166 cases Monday. On December 27, 2021, India’s case count was 6,358, which surged to 1.79 lakh on January 9.

The Indian Council of Medical Research (ICMR), meanwhile, revised its testing norms to facilitate early detection of symptomatic cases. It recommended that asymptomatic individuals in community settings, individuals undertaking inter-state domestic travel and contacts of patients, unless identified as high-risk based on age or comorbidity, do not need Covid testing. It specified, however, that the advisory is “generic in nature and may be modified as per discretion of the state health authorities”.

According to Government officials, the case-count peak will cross the 4-lakh mark this time — it had hit a daily peak of 4.14 lakh on May 6, 2021 — but the Government is prepared to handle the rising numbers with increased hospital beds and oxygen supply.

As of January 8, infections appear to have spread rapidly across India. The number of districts reporting a weekly case positivity rate of more than 5 per cent has increased from 21 in the week ending December 25, 2021, to 202 in the week ending January 8 — a 10-fold increase in two weeks.

While Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Ahmedabad, Noida and Gurgaon are among the cities of concern, there are at least 40 districts across 13 states and UTs where positivity is more than 5 per cent and which have reported a 10-fold increase in positivity. These districts are in Jharkhand, Punjab, Haryana, Maharashtra, West Bengal, Odisha, Rajasthan, Tamil Nadu, Chhattisgarh, Delhi, Assam, MP and UP.

The ICMR, meanwhile, also recommended that patients discharged from a Covid facility as per policy don’t need to be tested. It said the new advisory is also for early detection of infection in the elderly and individuals with co-morbidities.

In a community setting, the ICMR recommended four categories to be tested: symptomatic individuals; at-risk contacts of lab-confirmed cases; individuals undertaking international travel; and international travellers arriving in India. It said that those who experience at least one of six symptoms — cough, fever, sore throat, loss of taste and/or smell, breathlessness, and/or other respiratory symptoms — should be tested.

The Council also listed at-risk contacts in two categories: more than 60 years of age, and those with comorbidity, such as diabetes, hypertension, chronic lung or kidney disease, malignancy and obesity.

In a hospital setting, it recommended testing according to the doctor’s advice with the three considerations: no emergency procedure should be delayed for lack of a test; patients should not be referred to other facilities for lack of a testing set-up; asymptomatic patients undergoing surgical or non-surgical invasive procedures, including pregnant women hospitalised for delivery, should not be tested unless warranted.

It further recommended that admitted patients may not be tested more than once a week.

A senior official from the Health Ministry said that “consistent evidence shows the Omicron variant has a growth advantage over the Delta variant with a doubling time of 2-3 days and rapid increases in the incidence of cases is seen in a number of countries”.

The official said WHO chief Tedros Adhanom Ghebreyesus has informed that the more infectious Omicron variant appears to produce less severe disease than the globally dominant Delta strain but should not be categorised as “mild”.

According to the data available, 28.79 lakh cases were recorded globally on January 7 this year, the highest ever since the onset of the pandemic in January 2020.

Approximately 62 per cent of the cases in the week ending January 7 — six out of 10 — were reported from the US (31.1%), France (10.3%), the UK (8.4%), Italy (6.4%) and Spain (5.8%), according to data collated by the Health ministry.

Officials said India has been monitoring Omicron since November 27, when Prime Minister Narendra Modi held a high-level review meeting. Since then, the ministries of Health, Home, Cil Aviation and Railways have been coordinating with states on the response, they said.

In India, there are 4,033 cases of Omicron, so far. Maharashtra leads the table with 1,216 cases followed by Rajasthan (529) and Delhi (513). There are 2,480 active Omicron cases, while 1,552 have been classified as recovered. There has been only one death, so far.

Officials said that while 67 per cent of the population have been fully vaccinated and 92 per cent have got a single dose, wearing N-95 masks is key. About 31 per cent of the adolescent age group between 15 and 18 years of age have been vaccinated in one week.

Officials also cited a study which showed that without wearing masks, a person can be infected within 15 minutes while with N-95 masks it may take about 25 hours.

The officials said the Government is fully prepared to deal with the situation, as it has invested over Rs 23,000 crore on upgrading medical infrastructure: ICU beds, oxygen supply, paediatric beds, ambulances, field hospitals, drugs and diagnostics, among other equipment.