As temperature drops and air pollution increases to critical levels, Delhi has seen a sharp spike in daily cases putting pressure on hospitals. Chief Minister Arvind Kejriwal has written to the central government requesting for more beds at government as more than a half available beds are already occupied.
With 8.6 million cases, India currently has the world's second-highest caseload but there has been a decline in active cases since mid of September. But cases in recent weeks have been increasing at an alarming rate in Delhi than any other states in the country.
Experts suggest that as winter approaches in the northern parts of the country and severely high levels of air pollution are two factors that could worsen the virus situation in the city.
Festival season resulting in crowd thronging markets for shopping is another reason for growing numbers in the city. And these markets, authorities suggest, can become hotspots.
Doctors say that city hospitals are burning with patients and free beds are also getting filled by every minute. The scene is worse in private hospitals as there are no beds vacant whereas beds are available in government hospitals. But people who can afford private healthcare will not choose for public hospitals citing the poor quality.
Dr Randeep Guleria, director at All India Institute of Medical Sciences, one of India's biggest public hospitals said that the spike in cases indicates patients requiring admission into hospitals will also increase. He added, "Additionally, there is an increase in the number of patients coming to the emergency [room] with acute respiratory problems because of air pollution and respiratory viral infections.”
Air quality monitors show that pollution levels of Delhi are 14 times greater than the safe levels told by the World Health Organization's (WHO).
General immunity in cooler climates gets reduced regardless of one’s age or comorbidities. Doctors say that viruses can survive for long times in dry and cool air in cold weather.
According to Prof K Srinath Reddy, president of the Public Health Foundation of India, Delhi, "Cold air is heavier and less mobile, which means viral clouds or viral particles will hover closer to the ground, making it easier to get into one's lungs."
Add pollution to this situation, and it's "a double whammy", he added, as cooler air means that pollutants will stick around longer.
Studies around the world have found that COVID-19 cases and related deaths can increase with air pollution. A Harvard University study has explained that the addition of only one microgram per cubic metre in PM 2.5 - dangerous tiny pollutants in the air - is associated with an 8% increase in the coronavirus death rate.
Cambridge University has discovered a connection between the severity of Covid-19 infection and long-term exposure to air pollutants, including nitrogen oxides, car exhaust fumes or burning of fossil fuels.
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Prof Reddy said, "We have to keep our fingers crossed," citing Delhi felt the pressure when cases exploded in April during the initial outbreak of the virus. "It started to come back down in June when we had warmer weather and much better air. This is the first time we will have to deal with the virus under a winter season so we can't go by what happened in the summer. We will certainly be more vulnerable."
He added that European countries like France and Italy had seen rising cases at the beginning of the pandemic. Those nations were hit hard in January and February under a harsh winter.