New Delhi is in the midst of a perfect storm of coronavirus infections, spiking pollution and crowded festivals
A deadly combination of surging coronavirus cases and toxic pollution has pushed intensive care units in the Indian capital to the brink, and major festivals may tip the scales, doctors warn.
Key points:
- While national coronavirus cases fall, New Delhi is in the midst of a third wave
- Experts say pollution appears to be to blame
- The country is now entering its festival season, with mass gatherings expected
Delhi is in the midst of a third wave of COVID-19, breaking a local daily record of 8,593 cases on November 12.
The increasing numbers are in stark contrast to most other parts of India, where case numbers are either holding steady or declining.
The recent surge has exposed yet again the inherent weaknesses of the Indian healthcare system, with several major public hospitals declaring they have run out of ICU beds with ventilator support.
Only about 170 ICU beds with ventilators are currently available in a city of more than 20 million people, according to a Government coronavirus app.
"Our ICUs are almost full," respiratory surgeon Doctor Arvind Kumar told the ABC.
"We don't have space for accommodating a spike in the number of cases."
The surge in cases comes as hazardous pollution blankets the city, a phenomenon that happens annually around November due to various factors such as wind patterns, cooler weather, the city's geographical position, and pollution from cars, heavy industry and stubble burning of farms in nearby states.
Delhi's poor air quality was considered "severe" for seven consecutive days, and a tiny pollutant known as PM2.5 was recorded at 14 times levels deemed "safe" by the World Health Organisation.
Studies have shown the coronavirus becomes attached to pollution particles, and the toxic air makes people more at risk of infection and experiencing harsher symptoms.
Dr Kumar said he was certain the recent surge was directly linked to the increase in pollution.
"It piggybacks on the pollution particles," Dr Kumar said.
"And it is known that an inflamed layer [of lung tissue] is a susceptible layer to all kinds of infections. Coronavirus would be no exception."
Around 13 per cent of the city's recent COVID-19 infections is due to pollution, the Indian Medical Association has said.
India is in the middle of its festival season
India has entered what is colloquially known as "festival season" due to the popular time for weddings and various festivals, including Diwali, which is the biggest on the Hindu calendar.
Large crowds have routinely been spotted at markets ahead of the festival, despite the surging number of cases, and families coming together for Diwali could prompt much further outbreak.
The Delhi High Court this week ordered authorities to take the coronavirus spread more seriously, due to lax social distancing and people ignoring masks.
The entire situation has left many Delhi residents exasperated.
"We are witnessing the highest ever peak but people are careless," Delhi resident Imran Khan told the ABC.
"You can see many people are not wearing mask. We are staring at a catastrophe after Diwali."
Several states, including New Delhi, have this year banned the sale of firecrackers in an effort to try and prevent pollution levels spiralling further out of control.
"Crackers are meant to enjoy, to celebrate," Dr Kumar said.
"But if celebration leads to loss of lives it cannot be called a celebration."
Many residents in the capital try to stay indoors in an attempt to reduce pollution exposure, while others with more money often try to leave the city or stock up on air purifiers.
Smog puts Delhi health workers' lives on the line
But teams of female frontline healthcare workers, known as Asha, or Accredited Social Health Activist, get no such reprieve, as they walk door to door in neighbourhoods to check on the most vulnerable.
The women are poorly paid and overworked.
"People are inhaling all harmful gases and suffering from headaches, vomiting, coughing, breathlessness and other health issues," Asha worker Usha Thakur said.
"Even medicines stop working. We're not able to provide any relief."
The Asha workers also distribute small medical devices that check oxygen saturation to coronavirus patients.
"We keep on asking people to stay home," Ms Thakur said.
"We are appealing to people to avoid going out and only go out if it is urgent. We strictly advise the elderly to stay indoors".
Surgeon Dr Kumar does not directly treat coronavirus, but the sheer spread of the infection means an increasing number of patients he treats for lung cancer or chest diseases are infected with coronavirus.
He said two weeks ago none of his patients were coronavirus positive, but this week around 20 per cent are.
"Even I'm exposed," he said.