The death toll in Delhi due to the coronavirus disease (Covid-19) soared past the 1,000 mark on Thursday as the city recorded 1,877 new infections and 101 new fatalities, a new record for single-day numbers that reinforce fears about the outbreak worsening and the need to rapidly ramp up health care infrastructure.

According to the Delhi government’s daily health bulletin that accounts for cases and deaths from the day before, the Capital’s total tally of Covid-19 cases stands at 34,687 and of these, 1,085 have died.

The latest figures push the city’s case fatality rate – the proportion of infected persons who succumb to the illness – to 3.13%, the highest it has been since March 25, when a single death had taken place from among 35 infections.

“We are planning to double the number of beds needed; there will be around 15,000 beds in another 10 days or so. This is the biggest disaster of the century,” said Delhi health minister Satyendar Jain in a virtual press conference on Thursday.

The 1,877 new cases came from testing 5,360 samples, translating to a test confirmation rate of over 35%. This number has steadily grown from about 21% at the beginning of June, a trend that experts say could indicate the outbreak is larger than detected, particularly due to the limited reach of testing, although the inherent bias in testing of largely symptomatic cases may also have something to do with this.

According to the health bulletin, the number of active infections is 20,871, of which nearly 78% are in home isolation that is available as a treatment option for those with mild or asymptomatic illness. The current rate at which infections double in the city — taken as a trajectory seen over the last week — is 14.8 days.

“The lockdown has been lifted, people are moving around and interacting with each other. The number of cases will go up. That is the natural course of the disease,” said Dr Shobha Broor, former head of microbiology at the All India Institute of Medical Sciences.

Officials in the administration have been divided over whether the rise in cases justifies the reimposing of the lockdown. “A lockdown would help but now that it has been lifted, we cannot ask them not to. They are not wearing masks and going to markets which will lead to increase in the number of cases. As it is, it has become difficult to trace contacts,” said a senior district-level health official, asking not to be named.

A senior health department official clarified on condition of anonymity that “Delhi is not considering another lockdown for now.

“If we impose lockdown again, there will be no logic as the cases will increase from around 2.5 lakh to 25 lakh despite the lockdown,” Jain had said in a statement on Wednesday.

Delhi, as well as most parts of the country, began what has been called Unlock 1.0 this week, allowing malls, salons and religious places to open in addition to several other types of activity that were approved last month.

Officials at the Union and the state level said it is now crucial to learn to live with the virus, a process that will involve new etiquettes such as always wearing a mask when away from home and keeping a distance of 2 metre from others.

“We went into a lockdown a little early and even the relaxation of restrictions happened a little early. Other countries lifted their lockdown when their curve started to come down, but we did it when the curve is going up exponentially. However, economic considerations have to be kept in mind. The only strategy that the government can now adopt is aggressively test and isolate those with the infection or close areas where they think the infection is circulating in the community,” said Amit Singh, associate professor at the Centre for Infectious Disease Research, Indian Institute of Science, Bengaluru.

The spike in cases comes in a week when the government begun preparations to add over a 100,000 beds, an exercise described as “an unprecedented challenge” by chief minister Arvind Kejriwal, after initially attempting to restrict access to its facilities only to people who live in the national capital. On Wednesday, the CM said Delhi would need 65,000 beds by mid-July and 150,000 by the end of the month.

On the basis of the current doubling rate of 12.6 days, the Delhi health department has projected that the number of active cases in Delhi will touch 60,004 by June 30; 134,722 by July 15 and 319,237 by July 31. According to documents reviewed by HT and comments by officials aware of the preparations, the administration has earmarked space for close to 25,000 hospital beds in banquet halls, a religious centre and two stadiums in the city.

Officials are going over the experiences of their counterparts in Mumbai, where the civic agency converted some of the city’s most prominent sport complexes into health care facilities. “Our challenge will be bigger because we are turning all these spaces into makeshift hospitals while theirs were observation centres and Covid care centres,” said a senior government official, who was aware of discussions at a late-night meeting chaired by health minister Satyender Jain on Wednesday.

Mumbai crossed the 1,000 deaths mark on May 26, when it had close to 32,000 cases – a scenario similar to what Delhi is staring at now. The Maharashtra capital then had a doubling rate of 13.1 days but has not brought it down to 24.6 days.

Wednesday’s discussions in Delhi were described as the first round of scouting for space. It included a covered space that belongs to a religious group in Bhati area, where 10,000 hospitals beds can be accommodated.

The exercise will require a mammoth logistical mobilization comprising medical and paramedical staff, crucial medical equipment such as oxygen cylinders and general infrastructure resources such as beds and electricity connections.

Authorities in central China’s Wuhan, where the coronavirus is believed to have first emerged last year, built a 1,000-bed hospital in 12 days at the peak of the outbreak in February. It was among 16 makeshift hospitals the city built, the last of which were closed by mid-March after the region controlled the outbreak.

(With inputs from Sweta Goswami)

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