New Delhi: As Delhi’s Covid-19 cases surge — it has a total of 73,780 cases as of Friday — its neighbouring districts of Ghaziabad and Gautam Buddh Nagar, which are part of the National Capital Region (NCR), are also seeing their infection rates rise.
As on 25 June, Gautam Buddh Nagar, home to Noida, has reported a total of 1,811 cases, while Ghaziabad has 1,175 cases. As part of the NCR region, both GB Nagar and Ghaziabad have an equal stake in the region’s plan to fight Covid-19.
On 18 June, Home Minister Amit Shah had ordered the NCR to come together to mitigate the effects of Covid-19 in the region after his meeting with Delhi Chief Minister Arvind Kejriwal and senior officials of the UP and Haryana governments.
On the ground, however, this order has meant little as the districts have limited their strategies and focus to within their borders.
“The essence of the plan was that all members (of NCR) do their best to reduce the spread of the virus in their own areas and save lives,” GB Nagar District Magistrate, Suhas L.Y., told ThePrint.
Dr G.K. Mishra, Ghaziabad’s district malaria officer (DMO), said if the Uttar Pradesh government or the Centre made further orders regarding the plan, they “will obey”, but for now, their focus is on making sure that the district isn’t overwhelmed by Covid-19.
In light of this, ThePrint spoke to various stakeholders from both districts to learn more about their testing and containment strategies.
Mortality rate low but GB Nagar faces some questions
GB Nagar, which includes Noida and Greater Noida, accounts for a chunk of the cases in Uttar Pradesh, which has recorded a total of 20,193 cases as of 25 June.
DM Suhas told ThePrint that it’s high case count and low mortality rate of less than 2 per cent is testament to the district’s apt testing efforts. The district has seen only 20 deaths so far.
“We are not shy of identifying cases, which is why we have the highest number of infections in the state,” he said. “We have managed to keep our death rate low by testing and surveillance of symptoms.”
While it’s true that Noida’s testing is among the most impressive in Uttar Pradesh, the administration has raised eyebrows due to its opacity with regard to data.
For one, it has stopped publishing its district bulletin with testing data entirely, and since 20 June has gone with the state bulletin for numbers of fresh cases, deaths, and discharges. The state bulletin doesn’t mention the cumulative number of cases or number of tests done and samples collected. It only mentions active cases, fresh cases, deaths, and discharges.
“There are definitely not enough tests being done in Noida — and patients are suffering because of it,” Dr Mohita Sharma, secretary, Indian Medical Association, Noida, told ThePrint. “If patients are not tested or don’t receive their results on time, those who are critical are less likely to get the treatment they need and will deteriorate quickly and die.”
The RT-PCR testing process in the district has been marred by delays and changes in orders — something Dr Sharma says has left private labs confused and hesitant to collect samples. “The administration has said they will correct the order and allow some private labs to tie up with hospitals to keep them accountable, which is a good thing,” she said.
But the delay in test results from labs has led to further delays in treatment for several patients.
Take the case of Neelu Bhatia, who lives in Sector 173. She said she developed a fever on 1 June, and when it didn’t subside on the fifth day, decided to get a test done at the privately-run Jaypee Hospital.
“After giving me an appointment, my test was abruptly cancelled the evening before I was to get it done,” she said. “I then went to Sharda Hospital, another private institution offering the test, but I didn’t get my report for another three days.” By the time her positive report came, Bhatia said her symptoms had subsided and she felt fit again.
She was, however, sent to hospital on 12 June for mandatory quarantine. After seven days, once a second test came back negative, Bhatia was discharged. “Because of the delayed test result, the treatment was delayed too. All of it should have happened a week earlier. Thankfully, I recovered before the treatment but what if I was critical?” Bhatia asked.
District Magistrate Suhas denied suggestions that private labs were prevented from collecting samples or results were delayed, and said there would be no issues as long as all labs strictly followed ICMR guidelines.
The district is also preparing to run 15,000 rapid antigen tests, of which it has received 8,000 so far. Suhas said the nature of the test could stop any delays in services for Covid patients.
“We want to increase all levels of testing now, and we’re increasing our containment efforts too — 800 teams will now go to our 280 containment zones for door-to-door surveillance,” Suhas said. “We will begin our antigen testing from 25 June itself, but the first few tests will be like a pilot. These tests are extremely sensitive to temperature and time, so our technicians need time to adjust.”
Noida has also prepared 1,050 beds across public and private facilities for Covid-19 patients and will increase bed capacity by roping in other institutions, like college hostels, when the need arises.
A similar tale in Ghaziabad
Until last week, Ghaziabad, with a population of at least 46.8 lakh, was among the districts with the lowest testing rate and highest positivity rate in the country, which indicates the infection is spreading but testing is inadequate.
“We have to enhance our surveillance activities because ultimately that is the best way to control the spread,” said DMO Dr. Mishra. “We have deployed 441 teams, and we gradually hope to increase the number of teams per day.”
Like GB Nagar, Ghaziabad too has stopped publishing its testing data due to “disparities” and “instructions from the state government”, Mishra told ThePrint.
According to Mishra, there were 175 new cases on 23 June and “200 or more” on 24 June in Ghaziabad. But the state bulletin on the two days put the figures at 121 and 114, respectively.
Asked about the gap in figures, he however, said, “We agree with the state bulletin.”
According to the bulletin, the district has 1,175 cases in total as of 25 June.
The Ghaziabad administration is now due to receive 30,000 rapid antigen tests, which it will use in its hotspot areas, and is currently doing around 500 RT-PCR tests a day, according to Mishra.
The district plans to ramp up its RT-PCR testing to 1,000 tests a day, but there is no clear timeline to do so.
But problems persist. There are allegations that the administration hasn’t been screening the district properly.
A resident of Indirapuram, who did not wish to be named, said despite a high number of positive cases, no surveillance or contact-tracing had been done in the area since March.
“The last time they came to sanitise was in March, when one person was found positive in my complex. But since then, no one has come even though one person died recently and we have 13 cases here,” the resident said. “I tried getting in touch with the chief medical officer about this but there was no response. There is also no repository of data or any guide for patients regarding the number of beds and testing centres. This is a failure on the part of the administration.”
Repeated calls and messages to Dr Narendra Kumar Gupta, the chief medical officer, went unanswered.
For its enormous population, Ghaziabad has only one government testing facility, which is at the I.M.S. College. The rest of its tests are managed through a mobile vehicle lab or through door-to-door surveillance for contacts and those displaying influenza-like symptoms. Yashoda Hospital is the only private lab offering tests for those willing to pay.
As part of its surveillance strategy, the district is going above and beyond the ICMR’s guidelines and isolating asymptomatic cases as well, said Additional Chief Medical Officer Dr Munshi Lal.
“Once the result is positive, we evaluate the patient and send them to L1, L2, and L3 facilities accordingly. L1 is for asymptomatic, L2 is for those with mild to moderate symptoms, and L3 centres are for crucial patients,” explained Dr Lal, who is in charge of L2 hospitals that deal with moderately symptomatic cases.
Dr Mishra said he was confident the district would be successful in its attempt to control the virus’ spread, and that bed capacity would increase on a daily basis from the current 1,000. “Our testing is enough for now, because we are testing strategically. I can’t comment on Delhi but we will be able to manage the cases,” he said.