Late hospital admissions, paucity of ICU beds behind surge in COVID-19 deaths in Delhi, say experts

Dr Samiran Panda, the head of Epidemiology and Communicable Diseases (ECD) Division at the Indian Council of Medical Research (ICMR), said not following home isolation guidelines, late reporting to hospital despite a deterioration in symptoms are some of the factors playing a major role in patients landing up at hospitals in severe conditions. "People who test COVID-19 positive and are advised home isolation should monitor their oxygen saturation levels and seek medical help if the symptoms keep deteriorating.

Late hospital admissions leading to COVID-19 cases turning critical, shortage of ICU beds, unfavourable weather and rising pollution are among the factors experts attribute to the spike in COVID-19 deaths in Delhi. The national capital's COVID-19 fatality rate has increased to 1.89 per cent as against a national average of 1.46 per cent. The city has been reporting the highest number of coronavirus cases and fatalities for the last few days.

Going by the epidemiological trend, the severity of the disease is more in this phase of the pandemic compared to the last one and several factors, including weather and pollution, are contributing to it, a health ministry official said. Dr Samiran Panda, the head of Epidemiology and Communicable Diseases (ECD) Division at the Indian Council of Medical Research (ICMR), said not following home isolation guidelines, late reporting to hospital despite a deterioration in symptoms are some of the factors playing a major role in patients landing up at hospitals in severe conditions.

"People who test COVID-19 positive and are advised home isolation should monitor their oxygen saturation levels and seek medical help if the symptoms keep deteriorating. Seeking help early would ensure timely treatment," he said. Medical Superintendent of Ram Manohar Lohia Hospital Rana A K Singh said change in weather and rising pollution are compounding the problems.

"People are more prone to flu, cold and cough in this season. Those suffering from respiratory diseases are facing exacerbation of the symptoms. On the top of that, if timely help is not sought, that leads to adverse outcomes," Dr Rana stressed. Considering the increased burden on ICU beds in the national capital, the RML Hospital medical superintendent said the Union Health Ministry has asked the three Centre-run hospitals -- Safdarjung Hospital, RML Hospital and Lady Hardinge Hospital -- to increase the number of ICU beds.

"And we are trying to do that," he said. Dr D S Rana, chairman of board, Sir Ganga Ram Hospital, said patients are reaching hospitals when oxygen saturation levels fall below 90 per cent and their condition becomes severe.

"Further, ICUs in many hospitals are full. As a result of which, a patient whose condition has already deteriorated has to wait in a ward for a longer duration which increases complexities. This is where seeking medical help on time helps," he underlined. Dr Atul Kakar, Vice-Chairperson, Department of Internal Medicine at Sir Ganga Ram Hospital said the hospital has been receiving patients who did not pay attention to mild symptoms of COVID-19 and did not get themselves tested.  They rushed to the hospital when they started having moderate to major complications, he said.

"In last month alone we have treated close to 30 patients of COVID-19-induced moderate to major complications. They had not undergone COVID-19 tests earlier... Severity of the disease could have been limited had there been early testing and treatment," Dr Kakar said. "People with any of the mild symptoms of COVID-19 should not take it lightly. They should get tested immediately and should be under medical supervision. Any persistence or deterioration should be reported on an urgent basis," he added.   Delhi recorded over 100 daily deaths in seven of the last 13 days. A total of 109 fatalities were recorded on Tuesday, as against 121 each on Monday and Sunday, 111 on Saturday, 118 on Friday, 131 on November 18 -- the highest till date -- and 104 fatalities on November 12.

A senior doctor at a Delhi government hospital attributed the high number of daily COVID-19 deaths to a large number of "critical" non-resident patients coming to the city for treatment. Also, easing of restrictions has exposed the vulnerable population -- the elderly and those with comorbidities -- to the deadly virus, the doctor said.

Delhi Lt Governor Anil Baijal directed officers to ensure timely hospitalisation of COVID-19 patients under home isolation in case of emergency to reduce the mortality rate in the national capital which has recorded over 100 daily deaths in seven of the last 13 days. Chief Minister Arvind Kejriwal on Tuesday appealed to Prime Minister Narendra Modi to reserve 1,000 ICU beds for Delhiites in Centre-run hospitals like AIIMS and Safdarjung Hospital as he underlined that the high severity of the third wave of COVID-19 cases in the national capital was due to many factors with pollution being a significant one.

During a COVID-19 review meeting convened by the prime minister, Kejriwal said if the Centre reserves these ICU beds in its hospitals in the city for the people of Delhi amid a surge in coronavirus cases, "it will be a great support to us". Delhi recorded 5,246 fresh COVID-19 cases in a day as the positivity rate declined to 8.49 per cent, the lowest since October 28, while 99 more fatalities pushed the city's death toll to 8,720 on Wednesday.

The national capital had recorded its highest single-day spike of 8,593 cases on November 11 when 85 fatalities linked to the disease were also registered..

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)