Pollution, Fatigue, Population Density, Unplanned Development: Why Delhi is Struggling to Contain Covid

Delhi had done very well in controlling the Covid-19 pandemic if one goes by the numbers from the first week of August. By then, India’s national capital had seen the number of active cases coming down below the level of 10,000 cases from a high of over 28,000 by the end of June this year. 80-90% beds in government’s dedicated Covid-19 hospitals were empty and on June 29 chief minister Arvind Kejriwal decided to delink the state capital hotels from hospitals as there was no need for additional beds.

Delhi, in fact, was another success story like other successful Covid-19 control models such as Bhilwara (Rajasthan), Agra (Uttar Pradesh) and Pathanamthitta (Kerala).

“I am proud of you, Delhiites,” Kejriwal had tweeted then. Your “Delhi model” is being discussed everywhere, he had said.

“Delhi had almost become a success story because of the way containment of different zones and segregations were done,” says Shailaja Chandra, former health secretary and ex-chief secretary of Delhi. “The strictness with which it was enforced was laudable and few states have done it with that kind of vigour.”

Chandra adds that “the way information about Covid-19 was shared by the government through its district magistrates and other authorities to different colonies and RWAs was commendable”. It really helped people get an idea of how dangerous it was for individuals to unnecessarily get out of their homes.

And this success, even though it was short-lived, could not have been possible without public participation. “People’s participation was the key element of Delhi’s initial success,” says Chandra.

But Delhi doesn’t look like a Covid-19 success story anymore. The initial triumph in almost winning the fight against the pandemic has been lost with the city seeing a third wave of coronavirus cases.

On August 1, there were just 539 containment zones in the city, but now the surge in Covid-19 cases has seen their number rise to 4,444. On an average 1,018 new cases were registered in the first week of August vs over 6,150 average new cases being registered daily in the past one week. 17 deaths on an average were recorded between August 1 and 7 while in the past week, on an average 102 people have succumbed to Covid-19 daily. In fact, on Wednesday the city recorded 131 new fatalities, the highest single-day count till date.

“Corona ko sambhal liya hai, ab kuch nahi hoga (Corona has been taken care of and nothing much will happen now)” was the widely shared sentiment in Delhi by the end of October, Chandra says, and this feeling that “all is now well” brought in a certain sense of complacency. Alongside came the opening up of the city’s economic activities which was much needed but it aggravated the spread of the virus as human contact increased manifold.

“And remember, Delhi is a very educated part of the country,” says the former bureaucrat who was also the executive director of the National Population Stabilisation Fund. “Most of the people living in Delhi are more health conscious about everything but once the numbers came down and treatment appeared possible, they just took the pandemic very lightly. Wearing a mask, washing hands and maintaining some distancing was considered sufficient to prevent infection. But that has been proved insufficient.”

Chandra gets the backing of Dr Anant Mohan, head of pulmonary medicine at AIIMS. “Probably a little bit of fatigue set in over time and the same level of alertness regarding masks and social distancing wasn’t maintained,” he says.

Can we link it to the Delhi government’s decision to unlock? Last Thursday, the Delhi High Court, while expressing concern over the rise in Covid-19 cases in the national capital, had said that the AAP government was “doing everything under the sun to ‘unlock’ things”.

“Not sure, but obviously at one point of time one has to open up. One cannot keep the lockdown indefinitely,” Dr Mohan adds. “Arrangements were made to take care of all these things. A lot of healthcare systems were ramped up and a lot of arrangements were made, no doubt.”

“The problem became much bigger because of the festive season. Once normal activity was allowed, people who had pent up energy, the wish to shop, meet friends and socialise, rushed out in droves to restaurants and shopping centres,” says Chandra. “We saw those pictures of Sarojini Nagar and Lajpat Nagar markets and it was something which even at the best of times was clearly avoidable.”

Delhi is a very big and highly congested city too, explains Dr Anant Mohan, and whatever arrangements are done to some extent they sometimes fall short. “It is difficult to maintain social distancing and other precautions because a lot of people are living in crowded places and slums,” he says.

“Whether one believes it or not there is a strong link between high levels of congestion, pollution and the spread of Covid. There is this receptivity to get Covid because your lungs are already susceptible due to bad air and this is something that the public has clearly not understood,” Chandra says.

Explaining the congestion issue, she says, “Delhi’s population of around 20 million could be broadly broken into four groups. Organised colonies comprising some 8-9 million people. Another 7 million people stay in unauthorised colonies (regularised but still terribly congested) like Seelampur, Sangam Vihar, etc. Houses in these unsanctioned, unplanned colonies lack even a modicum of hygiene and basic civic infrastructure including drainage facilities, roads, sewage systems and proper ventilation. Almost 2 million people are slum dwellers with 4-6 people sharing a tiny space, making social distancing or self-quarantine totally unfeasible.”

Delhi also has 135 urban villages like Katwaria Sarai, Ber Sarai, Khirki, Munirka, Masjid Moth, etc. These localities lack municipal planning of any kind and are not just congested but there are no municipal bylaws which require sanitation and hygiene to be maintained. A sizable part of the population lives in such urban villages.

This leaves around 80-90 lakh people in organised colonies and they are serviced by the adjacent poor and intermingling is a necessity. “Over time families have multiplied and where you once had a single unit house, now there are four-storeyed buildings with four to five families living there, bringing their own entourage of house helps, drivers, guards and vendors. In Covid times it becomes very difficult to enforce any restrictions on human movement,” says Chandra. “This kind of congestion is bound to result in anything but social distancing.”

According to Census data of 2011, Delhi has 11,297 people living in per square kilometre of land, i.e., over ten times that of Bihar which with 1,102 persons per sq km is the most densely populated state. This number must have risen since then.

And what about the prevailing environmental condition in the capital? Is pollution adding new Covid-19 cases?

“Of course, one important reason for surge in cases is the environmental condition,” says Dr Mohan, who as a specialist from AIIMS has been guiding and providing knowledge support on Covid-19 to doctors managing ICUs in state hospitals. “The fact is that viral infection otherwise is also very common in this season and to add to it there is the deterioration in air quality in the last two weeks or so. This has further contributed to respiratory illnesses.”

Further explaining the recurring infection waves he says, “We are seeing a cyclical trend so far. There is a surge and then there is a decline. So we do expect the same in this case as well, a surge followed by decline.” However, he warns against attributing the new surge to any single cause.

Shailaja Chandra too warns against blaming a single reason for the surges. “No doubt the city’s population is congested, added to that is the sense of complacency and lastly the kind of rigour or the kind of work that was done in the month of July, in August and some days in September, which really had a very good effect on the public, has been given up totally,” she says.

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