As coronavirus sweeps through India's capital, experts say plans to stop it are "a waste of time"
New Delhi — India's jam-packed capital has become the country's hardest-hit city amid a raging coronavirus epidemic. Officials in Delhi have confirmed more than 73,000 COVID-19 cases and blamed at least 2,500 deaths on the disease.
The rate of infections in the city, where almost all businesses were allowed to reopen earlier this month, has continued to increase steadily. Government data provided on Friday showed that 3,390 new infections were confirmed over the past 24 hours alone.
Amid fears the outbreak is set to get much worse before it gets better, officials in the capital — home to some 30 million people, more than all of Texas — have been racing to prepare for an expected tidal wave of patients.
But prominent infectious disease and public health experts say new government plans to try to avert that tidal wave, "don't make any sense."
A ballooning outbreak
A third of Delhi's roughly 70,000 coronavirus cases have been recorded in the past week alone, and the number has doubled in just 13 days. That's a significantly faster spread than the rest of India is seeing; nationally the case load has been doubling approximately every 20 days.
The Delhi government's own estimates project more than 500,000 COVID-19 cases in the city by the end of July, requiring more than 150,000 hospital beds for patients suffering significant symptoms. There are only about 15,000 hospital beds in Delhi right now, so the government has been scrambling to ramp up its health infrastructure, converting dozens of train cars, hotels, and banquet halls into makeshift hospitals.
Work is also under way to convert a spiritual center into a 10,000-bed makeshift hospital on the outskirts of the capital. Last week, Delhi government spokesperson Aswathi Muralidharan told CBS News that the administration was confident there would not be a shortage of doctors or other medical staff for all the makeshift facilities.
Prevention, or wasted time?
With the rate of new infections spiking, Delhi officials have also announced a plan to send medical workers door-to-door, with the aim of screening the entire city of almost 30 million people for COVID-19 symptoms by July 7.
The government insists it will help detect infections early and prevent the spread of the virus. Officials had not responded to CBS News' request for details on how many health workers will be deployed, or how they hope to use the data gathered, as of Friday afternoon. Similar mass-screening efforts in South Africa, for instance, lead to on-the-spot testing for the disease in any suspected cases, but it's unclear if India will implement such testing as part of its plan.
"The only way to put a lid on infections is early diagnosis and quarantine," Dr. Sundeep Salvi, director of the Pulmocare Research and Education Foundation, told CBS News. "The door-to-door screening would be helpful in achieving that if they test suspected cases during the screening. Otherwise screening people just for symptoms won't serve any purpose as 80% of the cases are asymptomatic."
Another health expert agreed, telling CBS News the screening plan, "doesn't make any sense."
"This is going to be a waste of time," said Dr. Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, Economics and Policy (CDDEP). He also noted that the vast majority of cases remain asymptomatic; "How will they detect such cases through screening?"
"There is also a risk to the door-to-door health workers and them being the infection carriers themselves," added Laxminarayan, who first warned in March that India was facing a likely surge in COVID-19 cases.
Laxminarayan told CBS News a more effective option for the Delhi government would have been "serosurveillance," which involves testing people's blood for antibodies indicating a past infection. It's a tool ofen used to estimate a population's expected immunity to a virus, but it also helps in epidemic surveillance by showing how many people have carried a pathogen.
"This allows for targeting of efforts much better than door-to-door visits," Laxminarayan told CBS News. "It should have been done since March as a matter of routine."
Delhi's government also plans to deploy drones and install cameras to monitor designated "containment zones" around the city, where there are particularly high concentrations of COVID-19 cases and residents are under police orders to remain indoors.
Low testing numbers
Last week, Delhi was testing only about 7,000 people per day for COVID-19, but the pace has increased. The plan is to test 20,000 random samples from across the city per day. On Thursday the number was up to 17,000.
While numbers are rising, Delhi has still only tested 23,000 people per million inhabitants. That's much higher than the national rate of 5,636 tests per million people, but still far lower than some other countries with major epidemics, including the U.S. (92,858 tests per million population, Russia (126,103 tests per million), and the U.K. (128,317 per million), according to data compiled by the Worldometers website.
Epidemiologists have stressed since the early days of the pandemic the importance of widespread and rapid testing for the virus. The countries that have managed to control it fastest, and clamp down on subsequent outbreaks, have done so largely through efficient testing and tracing efforts.
India is now the world's fourth worst affected country, with nearly half a million coronavirus cases and 15,000 deaths.