Even as Mumbai recorded 20,971 cases on Friday, data from the Brihanmumbai Corporation (BMC) showed that a large majority of Covid-positive patients requiring oxygen support are those who have not taken a single dose of the anti-Covid vaccine.
Mumbai has 22,222 active beds for Covid patients (including oxygen, ICU and ventilator beds) in 186 private and public hospital facilities. As of January 6, of the 11,912 oxygen beds, only 16.6% or 1,983 beds, are occupied. According to municipal commissioner Iqbal Chahal, till Thursday, 96% of the oxygen bed occupants were unvaccinated and had not taken even a single dose of the vaccine. The remaining were partially or fully vaccinated.
“Out of the around 1,900 Covid patients who were on oxygenated beds, around 96% are unvaccinated and only 4% are vaccinated,” Chahal said.
The age group and co-morbidity status of these patients occupying oxygen beds is not yet know. However, separately doctors said that the age group of such patients is above 40 to 50 years.
As of January 6, the city also had 2,636 ICU beds of which 671 were occupied and 1,407 ventilator beds, of which 421 were occupied. The vaccination status of these patients is not known.
According to BMC officials, trends from the past experience of the pandemic indicates that comorbidities and old age increases the chances of death. In the past 16 days, the city has recorded a death a day on average, officials said.
In Mumbai, the BMC has vaccinated 108% of the population with at least one dose (the number exceeds 100% because it includes floating population; the target adult population is 9.2 million), while 89% have been given two doses. However, the civic body is in the process of compiling data on exactly how many have taken a single dose to compute the ratio of residents to floating population. Since January 03, the civic body started vaccinating 0.9 million teenagers in 15 to 18 years age category was started.
“We may even have 100,000 Covid active patients in Mumbai. Our oxygen consumption is only 10 tonnes. Our (production) capacity is up to 200 tonnes (a day). We have another 400 tonnes of oxygen in storage. In the third wave, we have to understand that positivity rate or cases will not be parameter with which to gauge the situation but hospitalisation rate. The occupation of oxygen and ICU beds along with the overall bed occupancy rate is to be gauged.”
Chahal said 80% of the city’s Covid beds were as yet unoccupied and the situation will be reviewed if occupancy reached 50% in the coming days.
“Our experts from the Covid Taskforce have told me that in Mumbai may even go up to say 40,000 cases daily. This may or may not happen but we will come out comfortably out of this considering the cooperation from citizens,” he said.
According to BMC officials, going by the trend in South Africa, the cases of Omicron variant started going down in a time span of five weeks. A recent round of BMC’s genome sequencing revealed that 55% of the samples were of the Omicron variant, but experts said that Delta and Delta derivatives could also be driving some number of hospitalisations.Officials said that the Omicron variant could likely be the dominant strain in circulation in the coming days.
Dr Gautam Bhansali of the Bombay Hospital who is also coordinator of all private Covid hospitals in the city said, “In case of hospital beds, both vaccinated and unvaccinated citizens are occupants, but on oxygen beds, the majority of patients are unvaccinated. The age group of such patients is normally above 40 to 50 years. This shows that vaccination is very important for each and every citizen.”
An analysis carried out by the civic-run Seven Hills Hospital in Marol showed that of the 4,054 Covid patients admitted between October 1, 2021 and January 5, about 11% or 443 were unvaccinated and about 12% or 477 had taken only one shot of the vaccine. While the hospital has not analysed the vaccination status of those on oxygen support and in ICU separately, they said that anywhere between 10%-20% of the patients who are on oxygen or in the ICU are unvaccinated or have taken only a single dose. “We are in the process of collating more specific data,” said Dr Smita Chavan, deputy dean of the hospital.
Infectious disease expert Dr Om Srivastava, who is also a member of the Covid-19 task force said that there is a definite increase in the number of unvaccinated and partially vaccinated people who were being hospitalised with Covid-19. “Many of these patients seem to have rushed to take the vaccine after the surge in cases started, perhaps battling the initial hesitancy towards vaccination,” said Srivastava. “We have not conducted a thorough analysis, but the uptick in such patients, even on oxygen support and ICUs is visible,” he said.
According to Srivastava, Omicron is largely affecting the upper respiratory area and patients suspected with Omicron may not require oxygen. While the presence of Omicron is confirmed by genome sequencing, some hospitals have started using the S-gene dropout parameter in the RT-PCR tests to indirectly indicate the variant causing the disease in the patient.
“Recent data from Bostwana and other parts of Africa have also shown similar trends wherein Omicron is not causing any lower respiratory distress that might need intensive care or oxygen support. My worry is about the possibility of joint infections with both Delta and Omicron variants due to repeated exposure that could be driving some number of patients towards severe disease. We don’t have genome sequencing data to establish this, but it definitely needs to be looked at,” he said.
(With inputs from Jyoti Shelar)
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