Just how bad is the third wave of the coronavirus pandemic in Delhi? And how does it compare with what the US and Europe are going through right now?
The trajectory of Covid-19 in Delhi is different from that of any other Indian state or Union territory. No other Indian region has seen a clear second wave (many have just seen the end of the first). Delhi hasn’t just seen, but also seen off a second and is now in its third — although, as I’ve pointed out in this column, the peak of the curve of the first wave was too sharp (which is rare), and poor testing strategy may have been responsible for the optics of the entire second wave.
Still, on paper, Delhi is now seeing its third wave, and like the ongoing third wave in the US and the second wave in Europe, it is bad.
To return to the original question, how bad?
A measure of new cases per million — both daily and a seven-day average — provides the answer.
This number has steadily increased (barring blips caused by lower testing) as shown in the accompanying graphic. The first wave peaked in late June and then fell off sharply — too sharply, perhaps. The second wave started in late August, peaked in mid-September, and then fell off, and the third wave started in mid-October.
Since November 3, the number of daily cases per million of population in the Capital has been in excess of 300 (barring November 15, when it was low on account of a national holiday on Saturday). This column is being written before the day’s numbers are out but it is Monday’s too will be low, on account of low testing on Sunday. The 7-day average has been in excess of 300 since November 6 and was at 370.5 on November 14. It’s important to note that while many states and Union territories report their Covid numbers late in the day, Delhi reports its earlier — but its numbers are the previous day’s.
The Delhi cases-per-million number is comparable to that in Europe and the US. The latter’s is higher, in the mid-400s, but the former’s is currently just around where the Delhi number is. And their trajectory looks the same too. Delhi, then, is an outlier whose coronavirus disease trajectory is completely different from the national trend.
Some of Delhi’s current problems can be attributed to its botched approach to testing. In late June, as the first wave roared through it, Delhi decided to accelerate and expand its testing through the use of rapid antigen tests. These are unreliable, returning false negatives 50% of the time (this means they identify infected people as uninfected). Every region that uses such tests has seen an immediate improvement (a fall) in its positivity rate (proportion of people testing positive to those tested), which tells the story. Uttar Pradesh and Bihar have almost exclusively depended on such tests and their respective Covid dashboards, too, tell the same story.
Over the past month, Delhi has increased its testing capacity for the reliable RT-PCR test, but at a peak of around 20,000 a day last week, these still accounted for just a third of the total tests carried out in the Capital.
This has interfered with the accuracy and representativeness of Delhi’s positivity rate — Dispatch 156 on September 12 explained how rapid antigen tests, while useful in certain contexts, can do this when used indiscriminately, the way Delhi, UP and Bihar have done — presenting and perhaps amplifying a false sense of safety and security. In contrast, Tamil Nadu, used only RT-PCR tests and its positivity rate saw an extremely long plateau before dipping.
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And this misplaced sense of safety and security manifested itself in several ways. Checks at airports of incoming passengers became lax; containment zones were honoured more in the breach than in the observance; and citizens started behaving as if they had nothing to fear.
A final caveat: Delhi’s overall cases-to-date-per-million number is magnified by its lower population when compared to other states (it’s the same reason Goa tops the cases-to-date-per-million chart, and Ladakh comes second) but the number is bad by any measure. Delhi is seventh on the list of states and Union territories in terms of case numbers. And only Maharashtra and Kerala have more active cases than the Capital.