Objectives: 

Following a surge in cases of coronavirus disease 2019 (COVID-19) in June

2020, India became the third-worst affected country worldwide. This study aims to
analyse the underlying epidemiological situation in India and explain possible impacts of
policy and technological changes.
Methods: Secondary data were utilized, including recently published literature from
government sources, the COVID-19 India website and local media reports. These data
were analysed, with a focus on the impact of policy and technological interventions.
Results: The spread of COVID-19 in India was initially characterized by fewer cases and
lower case fatality rates compared with numbers in many developed countries, primarily
due to a stringent lockdown and a demographic dividend. However, economic
constraints forced a staggered lockdown exit strategy, resulting in a spike in COVID-19
cases. This factor, coupled with low spending on health as a percentage of gross
domestic product (GDP), created mayhem because of inadequate numbers of hospital
beds and ventilators and a lack of medical personnel, especially in the public health
sector. Nevertheless, technological advances, supported by a strong research base,
helped contain the damage resulting from the pandemic.
Conclusions: Following nationwide lockdown, the Indian economy was hit hard by
unemployment and a steep decline in growth. The early implementation of lockdown
initially decreased the doubling rate of cases and allowed time to upscale critical
medical infrastructure. Measures such as asymptomatic testing, public-private
partnerships, and technological advances will be essential until a vaccine can be
developed and deployed in India.
Public interest summary: The spread of COVID-19 in India was initially characterized
by lower case numbers and fewer deaths compared with numbers in many developed
countries. This was mainly due to a stringent lockdown and demographic factors.
However, economic constraints forced a staggered lockdown exit strategy, resulting in a
spike in COVID-19 cases in June 2020. Subsequently, India became the third-worst
affected country worldwide. Low spending on health as a percentage of gross domestic
product (GDP) meant there was a shortage of hospital beds and ventilators and a lack of
medical personnel, especially in the public health sector. Nevertheless, technological
advances, supported by a strong research base, helped contain the health and economic
damage resulting from the pandemic. In the future, measures such as asymptomatic
testing, public-private partnerships, and technological advances will be essential until a
vaccine against COVID-19 can be developed.
Centre had said that Delhi government was well aware that the confluence of winter,
festival season and pollution were likely to witness a surge in cases and this
foreknowledge ought to have led to strict enforcement and Information, Education and
Communication (IEC) measures being instituted well in time but this was not done.
The affidavit filed by Delhi government was taken on record by a bench of Justices
Ashok Bhushan, R S Reddy and M R Shah, which said that it would hear on Thursday, the
matter related to treatment of COVID-19 patients in hospitals.

That since the start of the pandemic (COVID-19) in Delhi in the month of March, 2020,
the government of NCT of Delhi took all necessary proactive and preventive steps to
contain the spread of COVID-19 through institutional arrangements and interventions
(Lab and Hospital), interdepartmental co-ordination, the affidavit said.

It said that since June 1, there has been continuous effort to add more ICU beds in the
health facility of the government from the total 109 ICU beds to 1749 beds in
anticipation of a rise in cases.

ICU beds in hospitals under the aegis of the Central government have increased from 89
as on June 1 to 850 as on November 29, it added.

Further, the Delhi Government said in the private sector as well, the ICU beds have
increased from 111 in June 2020 to 2411 on November 29, appropriate steps have been
taken by the Delhi government to augment these private sector beds into the total
available tally for any person who requires medical attention.

Contrary to the claims of the Central government, the Delhi government further said
that in anticipation of the spike in cases due to the festival season in the city, with the
support, guidance and cooperation of the government of India, intensive efforts have
been made by it to increase ICU capacity in the last 15 days.

Detailing the steps, it said that an order for creation of 663 COVID ICU beds was issued
on November 18 in 11 Delhi government hospitals and order for reserving 80 per cent
COVID ICU beds in the remaining 42 private hospitals was issued on November 19,
which adds to 249 ICU beds in the private hospitals ICU beds.

It stated that an order for reservation of 60 per cent beds for COVID was issued on
November 19 for all the private hospitals (for 90 hospitals) which will add 2644 beds for
the COVID beds.

The Delhi government said that as on date the total number of COVID ICU beds
available in the National Capital Territory are 5010 and the cabinet has approved
procurement of 1200 of bilevel positive airway pressure (BiPAP) (a kind of ventilator)
from CSIR.

It said that 300 such BiPAP of the 1200 shall be delivered next week and remaining in
forthcoming weeks at a rate of 300BiPAP per week, which will enable creation of 1200
more ICU beds in Delhi government hospitals.
Regarding testing, Delhi government said that a detailed plan for testing through RT-
PCR and like modes has been rolled out by GNCTD and as a result sample collection has
started increasing substantially and has, in fact, saturated the ICMR declared self-
declared capacity of 38,000 in Delhi".

It added that extensive Information, Education and Communication (IEC) activities have
been launched wherein masks and hand sanitizers were distributed to generate
awareness in citizenry.

Regarding house to house survey, the affidavit said, The survey was started on
November 20 by all the districts and 80, 30, 979 number of persons have been surveyed
till November 29.

It said that the survey of the total population of the hotspots, vulnerable areas, crowded
marketplaces, super spreader areas, containment zones and colonies have been
completed and total 15,412 symptomatic and 27,740 contacts have been tested till
November 29.

The survey is going to be continued for another more month by GNCT of Delhi to cover
all the senior citizens, vulnerable population and persons with co-morbidities. GNCT of
Delhi is committed to chasing the virus and intervening to break the chain of
transmission at the first instance, it said.

The Delhi government claimed that due to its consistent efforts, the spread of COVID-19
has started showing a declining trend from last week in terms of positive cases, number
of admission/discharge from hospitals, number of ICU beds occupancy and active cases
in the national capital.

On March 8, with three cases of COVID-19 in the state, the Department of Health and
Family Welfare decided to carry out an awareness drive at various crowded places
during Holi.  Along with it, the government also took several other steps for mitigating
the spread of COVID-19 in the state.  Some of these measures are summarised below.

Health Measures
Disinfecting the vehicles: On March 11 and 12, the government ordered to
disinfect minibuses, school buses and school cabs daily.
The Delhi Epidemic Diseases, COVID-19 Regulations, 2020: On March 12, with six cases
of COVID-19, the Delhi government notified The Delhi Epidemic Diseases, COVID-19
Regulations, 2020.  These regulations are valid for a year.  Key provisions include:
(i)  All government and private hospitals should have dedicated flu corners.
(ii) home quarantine for people who have travelled through the affected areas, and

(iii) Certain persons authorised under the Regulations, with the approval of the State
Task Force, can take necessary measures to contain the spread of COVID-19, such as: (i)
sealing a geographical area, (ii) restricting the movement of vehicles and people, and (iii)
initiating active and passive surveillance of COVID-19 cases.

Movement Restrictions
Educational institutions: On March 12, the government ordered the closure of all
educational institutions up to March 31.  The students writing examinations were
allowed to attend them along with the staff.   However, on March 19, the
government ordered the postponement of exams until March 31.
Public gatherings:
 On March 13, the government issued an order prohibiting the gatherings of over 200
people such as seminars, conferences, and Indian Premier League cricket matches.   This
was further restricted to 50 people on March 16, and to 20 people on March 19 when the
number of cases rose to 12.
 Between March 12 and March 16, the government ordered the closure of cinema
halls, public swimming pools, gyms, and night clubs until March 31.   On March 19 and
20, sports complexes and shopping malls were also ordered to be shut down. 
Restaurants and private establishments: On March 19, all restaurants were ordered to
discontinue sitting arrangements until March 31.  Private establishments
were ordered to allow their employees to work from home till March 31. 
Delhi-Kathmandu bus service: On March 20, the government suspended the Delhi-
Kathmandu bus service, officially known as the Maitri Bus Sewa.
During the lockdown
On March 22, when the number of cases rose to 29, the Delhi
government announced the lockdown in the state until March 31.  The lockdown
involved: (i) suspending the public transport services, (ii) sealing borders with Haryana
and Uttar Pradesh, (iii) suspending all domestic and international flights arriving in Delhi,
and (iv) banning the congregation of more than five persons at any public place.  This
was followed by a nation-wide lockdown enforced by the central government between
March 25 and April 14, now extended till May 3. 
Starting from April 20, the central government allowed certain activities in less-affected
districts of the country.  

Welfare Measures
The Delhi government announced several welfare measures to address the difficulties
being faced by people during the lockdown.  Key measures include:

Night shelters: The Delhi Urban Shelter Improvement Board is providing free meals to

the homeless people staying in the night shelters.  On March 25, a hunger helpline was
set up which directs the needy people to the nearest night shelter for food.
Hunger Relief Centers: On March 26, the government directed the District Magistrates
to set up at least two hunger relief centres in every municipal ward for providing 500
meals twice (lunch and dinner) every day at each centre. 
Financial assistance: The government is providing one-time financial assistance of Rs
5,000 to drivers of vehicles such as autos, taxis, and e-rickshaws.
Compensation to family members: The Delhi government will be
giving compensation of one crore rupees to the family members of the employees who
may die due to COVID-19.
Health Measures
Additional manpower: On March 24, the government ordered the hospitals and
institutions under the Department of Health and Family Welfare to engage up to 25%
additional manpower in outsourced services such as sanitation, security, and nursing
assistants. 
Wearing masks made compulsory: On April 8, the government made it compulsory for
all people to wear masks in public places, offices, gatherings, meetings, and personal
vehicles.
Identification of paid quarantine facilities: On April 13, the government ordered all
district magistrates to identify paid quarantine facilities in their respective districts for
housing the people who would like to use private facilities on payment basis.   
Creation of a multi-sectoral dedicated team: On April 13, the government ordered for
the creation of the Corona Foot Warriors and Containment Team at every booth.  The
government aims to enhance ground level intervention through them. 
Setting up Helpline: On April 17, the Department of Health and Family Welfare set up
a dedicated 24x7 Whatsapp number for receiving complaints and requests from the
people related to COVID-19.
Measures related to Media
The government took the following steps to control the spread of fake news related to
COVID-19:

 On April 1, the government ordered the Director, Directorate of Information and

Publicity to regularly monitor the fake news across print and electronic media.  He was
appointed as the nodal officer of Delhi’s fact check unit on April 3.    
 On April 20, the Department of Health and Family Welfare ordered all government
hospitals to create a media cell for monitoring the fake news about the functioning of
hospitals on social and news media.
In conclusion the Delhi government has dealt in all aspects from labour welfare to
lockdown in order to contain the effect of Corona virus in capital.