From panic to belief: How Delhi turned things around in fight against coronavirus

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In a public health emergency, assuaging public fears is as important as medical interventions, since public behaviour affects the process of pandemic management. As cases began to rise in Unlock 1.0, there began a spread of panic, especially through social media. Several measures were taken to reduce this panic and build public confidence.

Rapidly increasing hospital beds

Till early June, there were only 8 private hospitals that were treating Corona patients and these had a sum total of 700 beds available. This was in addition to 2500 beds in Delhi Government hospitals. When the cases started rising in the first week of June, the aforementioned 8 private hospitals reached their capacity and when patients reached some of these hospitals they found no beds available.

Some patients even went to 2-3 of these private hospitals and did not find beds. While more than a 1000 beds continued to be available in government hospitals during this period, many people preferred private hospitals. The process of going from hospital to hospital began to create panic amongst patients; and via social media in the public-at-large. Bed capacity was immediately expanded in private hospitals. An order was passed by the Kejriwal government whereby all private hospitals with more than 50 beds had to reserve 40% of beds for treating COVID patients. 

Not only did this mean that the number of COVID beds in private hospitals increased from 700 to 5000, it also meant that COVID facilities were now available in all parts of the city. In addition to this, hotels were linked to private hospitals thereby increasing bed capacity of hospitals. With this hotel linkage, the number of beds in private hospitals went up from 5000 to 7000. Today, there are over 15,000 COVID beds in Delhi. While much of this increased capacity is still vacant - with only 38% of 15000+ COVID beds being occupied - it has meant that the people of Delhi feel a sense of confidence that if they need a hospital bed, it would be easily available in a hospital of their choice.

Accessible information on bed availability

When several cases came to light of patients going from one hospital to another, the government realised that the problem was also the availability of information. More than a 1000 beds were available even in the first week of June, but the patients and their families did not know which were the hospitals where these beds were available. It was then that the Kejriwal government became the first in the country to launch ‘Delhi Corona App’ that displayed real-time availability of beds in every hospital of the city.

Yes, there were hiccups in the first few days of App launch with some disparities in the numbers that hospital staff keyed in to the App, and the actual number of available beds. But as hospitals got into the rhythm of using the App, bed availability started being displayed on a real time basis. So now every Delhi-ite had the information about the nearest hospital, how many beds they had available as well as a 24x7 dedicated helpline number for each hospital. And it was this transparency of information that ended the panic of patients running from one hospital to another.

Counselling of Corona patients by doctors

The list of COVID positive patients is provided by the testing labs to ICMR who give it to the Delhi Government Health Dept; and from the Health Department to the District Surveillance teams who reach out to patients and assign them to Home Isolation Quarantine centres or move them to hospitals depending upon their condition. However, this transfer of information and reaching out to the increasing number of patients meant that there was a gap of 24-36 hours between when the patient received their COVID report from the lab and when they received a communication from the government about next steps. And it was in these 24-36 hours that patients, their families and neighbourhoods often panicked. Many of them rushed to hospitals, even though their symptoms were mild and they did not need hospitalisation. In response to this, Delhi Govt collaborated with a network of NGOs and Doctor-volunteers who started real-time calling and counselling of COVID-positive patients, as soon as their lab reports got uploaded. 

This meant that a COVID-positive patient was able to get medical advice and counselling within hours of getting their lab reports. When doctors counselled them and explained how most Corona patients do not need hospitalisation, patients were able to cope with the psychological and emotional trauma of their COVID-positive status, without panicking.

REDUCING DEATHS

COVID-19 has a 2-5% mortality rate across the world. In the absence of a vaccine for this virus, it may not be possible to bring the mortality rate down to zero, but proper patient and facility management can lead to reduction of mortality and this is exactly the strategy that has been followed in Delhi. The focus of the Delhi Government was on ensuring that the patients who had mild symptoms could recover at home, so that

hospital facilities remained available for serious and critical patients. Close watch was also kept on patients to ensure a swift transition to hospitals in case of escalating symptoms. The objective was to reduce deaths by preventing mild and moderate patients from becoming severe and preventing severe patients from getting into critical condition.