Delhi confirmed almost two million cases of the coronavirus (COVID-19) as of October 20, 2023, with over 26 thousand fatalities and over two million recoveries. The Delhi government, led by Arvind Kejriwal and the Aam Aadmi Party implemented a night and weekend curfew to curb infection numbers in late April 2021. The capital region faced acute shortage of oxygen and ICU beds during this time period.

COVID-19: As on Date: Number of Cured/Discharged/Migrated: Delhi data was reported at 2,017,021.000 Case in 05 May 2025. This records an increase from the previous number of 2,017,018.000 Case for 28 Apr 2025. COVID-19: As on Date: Number of Cured/Discharged/Migrated: Delhi data is updated daily, averaging 1,871,311.000 Case from Mar 2020 (Median) to 05 May 2025, with 1587 observations. The data reached an all-time high of 2,017,021.000 Case in 05 May 2025 and a record low of 2.000 Case in 18 Mar 2020. COVID-19: As on Date: Number of Cured/Discharged/Migrated: Delhi data remains active status in CEIC and is reported by Ministry of Health and Family Welfare. The data is categorized under High Frequency Database’s Disease Outbreaks – Table IN.HLF006: Disease Outbreaks: Coronavirus 2019: MOHFW.

India reported almost 45 million cases of the coronavirus (COVID-19) as of October 20, 2023, with more than 44 million recoveries and about 532 thousand fatalities. The number of cases in the country had a decreasing trend in the past months.

Burden on the healthcare system

With the world's second largest population in addition to an even worse second wave of the coronavirus pandemic seems to be crushing an already inadequate healthcare system. Despite vast numbers being vaccinated, a new variant seemed to be affecting younger age groups this time around. The lack of ICU beds, black market sales of oxygen cylinders and drugs needed to treat COVID-19, as well as overworked crematoriums resorting to mass burials added to the woes of the country. Foreign aid was promised from various countries including the United States, France, Germany and the United Kingdom. Additionally, funding from the central government was expected to boost vaccine production.

Situation overview
Even though days in April 2021 saw record-breaking numbers compared to any other country worldwide, a nation-wide lockdown has not been implemented. The largest religious gathering - the Kumbh Mela, sacred to the Hindus, along with election rallies in certain states continue to be held. Some states and union territories including Maharashtra, Delhi, and Karnataka had issued curfews and lockdowns to try to curb the spread of infections.

COVID-19: As on Date: Number of Confirmed Cases: Delhi data was reported at 2,043,723.000 Case in 05 May 2025. This records an increase from the previous number of 2,043,721.000 Case for 28 Apr 2025. COVID-19: As on Date: Number of Confirmed Cases: Delhi data is updated daily, averaging 1,900,735.000 Case from Mar 2020 (Median) to 05 May 2025, with 1587 observations. The data reached an all-time high of 2,043,723.000 Case in 05 May 2025 and a record low of 7.000 Case in 16 Mar 2020. COVID-19: As on Date: Number of Confirmed Cases: Delhi data remains active status in CEIC and is reported by Ministry of Health and Family Welfare. The data is categorized under High Frequency Database’s Disease Outbreaks – Table IN.HLF006: Disease Outbreaks: Coronavirus 2019: MOHFW.

COVID-19: As on Date: Number of Active Cases: Delhi data was reported at 1.000 Case in 05 May 2025. This records a decrease from the previous number of 2.000 Case for 28 Apr 2025. COVID-19: As on Date: Number of Active Cases: Delhi data is updated daily, averaging 505.000 Case from Mar 2020 (Median) to 05 May 2025, with 1587 observations. The data reached an all-time high of 103,424.000 Case in 29 Apr 2021 and a record low of 0.000 Case in 03 Mar 2025. COVID-19: As on Date: Number of Active Cases: Delhi data remains active status in CEIC and is reported by Ministry of Health and Family Welfare. The data is categorized under High Frequency Database’s Disease Outbreaks – Table IN.HLF006: Disease Outbreaks: Coronavirus 2019: MOHFW.

The Indian capital of Delhi had the highest share of districts, at about 27 percent, in the red zone as of April 19, 2020. Red zones marked districts having more than 100 confirmed cases of the coronavirus COVID-19.

Infections in Indian states

Maharashtra confirmed around 13 thousand cases of the coronavirus (COVID-19) as of May 4, 2020, with 548 fatalities and 2,115 recoveries. It was the leading state in terms of number of infections, followed by the states of Gujarat and Delhi. The first case, however, was reported in late January in the southern state of Kerala. Since then the spread of the virus has been consistent and the country is yet to see a drop in the number of infections.

COVID-19 in India

India reported around 42.7 thousand cases of the coronavirus (COVID-19) as of May 4, 2020. The country went into lockdown on March 25, the largest in the world, restricting 1.3 billion people and extended until May 3, 2020. The lockdown had been until May 17, 2020.

Executive summary: Studying the spread and epidemiological characteristics of COVID-19 virus specially in household settings are needed to prepare our self-better in preventing and controlling this epidemic. In this study we proposed a conceptual framework of four level of determinates and tried to understand the transmission dynamics of COVID-19 among household contacts along with clinical, epidemiological and virologic characteristics of the infection.

Aims & Objectives:

the proportion of asymptomatic cases and symptomatic cases;

the incubation period of COVID-19 and the duration of infectiousness and of detectable shedding;

the serial interval of COVID-19 infection;

clinical risk factors for COVID-19, and the clinical course and severity of disease;

high-risk population subgroups;

the secondary infection rate and secondary clinical attack rate of COVID-19 infection among household contacts; and

the associations of various factors across four dimensions interaction associated with risk of transmission

Methodology: This was a case-ascertained study where all susceptible contacts of a laboratory confirmed COVID-19 case were studied prospective for four weeks after their enrolment. It was done in New Delhi, during the end of first wave as well as whole second wave from December 2020 to July 2021. The study team collected the key information by questionnaire along with blood and oro-nasal swab during the household visits. Follow-up was done on day 7, 14 and 28 for observing the disease characteristic and symptomatology along with confirmation by serum and oro-nasal swab testing. Daily characteristics of the infection were noted by the participants on symptoms diary.

Results: We enrolled 99 households, each having one laboratory-confirmed COVID-19 index case along with their 318 susceptible contacts. By the end of the follow-up, secondary infection rate was seen at 55.5%, while seroconversion in 46.6%. Hospitalization and case fatality rate was 3.83% and 1.7% respectively. Among epidemiological characteristics we observed serial interval of 8.0 ± 6.7 days, generation time 3.8 ± 6.4, while secondary attack rate was 54.9%. The predictors of secondary infection among individual contact level were being female (OR:2.13, 95% CI:1.27 - 3.57), age of the household contact (1.01;1.00 - 1.03), symptoms at baseline (3.39; 1.61- 7.12) and during follow-up (3.18; 1.64 - 6.19), while only symptoms during follow-up (3.81: 1.43 - 10.14) and being RT-PCR positive (8.32; 3.22 -21.54) was significantly and independently associated with seroconversion among household contacts. Among index case-level age of the primary case (1.03; 1.01 -1.04) and any symptoms during follow-up (6.29; 1.83-21.63) significantly and independently associated with secondary infection while any symptoms during follow-up was associated with seroconversion among household contacts. Among household-level characteristics having more rooms (4.44; 2.16 - 9.13) independently associated with secondary infection, while more rooms (3.98; 1.23 -12.90) along with overcrowding (0.37; 0.16 - 0.82) associated with seroconversion. Among contact pattern only taking care of the index case (2.02;1.21- 3.38) was significantly and independently associated with secondary infection, while none was associated with seroconversion.

Conclusion: A high secondary cases and secondary attack rate was seen in our study. This highlights the need to adopts strict measure and advocate COVID appropriate behaviours in order to break the transmission chain at household level. The targeted approach at household contacts with higher risk would be efficient in limiting the development of infection among susceptible contacts.

Executive summary

The novel coronavirus SARS-CoV2 (COVID-19), first detected by Wuhan Municipal Health Commission, China, in Wuhan, Hubei Province in December 2020 and eventually the disease became pandemic. It was declared as Public Health Emergency of International Concern (PHEIC) by WHO in January 2020. The COVID-19 disease primarily spreads through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. People infected with the COVID-19 virus experiences mild, moderate or serious respiratory illness.

Health workers play a critical role in the clinical management of patients with COVID-19 and hence are likely to be the most vulnerable for contracting the disease. Therefore, investigating the extent of infection in health care settings and identifying risk factors for infection among health workers along with follow-up within a facility in which a confirmed case of COVID-19 infection is receiving care can provide useful information on virus transmissibility and routes of transmission, and will bear important step in limiting amplification events in health care facilities.

Objectives:

1. To find out the extent of human-to-human transmission of the SARS-CoV-2 infection among health workers
2. To study the clinical presentations of COVID-19 infection and the risk factors for infection among health workers.
3 To evaluate the effectiveness of infection prevention and control measures among health workers in protecting against COVID-19.
4. To evaluate the effectiveness of infection prevention and control programmes at health facility level
5. To determine the serological response of health workers with symptomatic and possibly asymptomatic COVID-19 infection.

Materials and Methods:

This was a prospective cohort study conducted over a period of seven months, from December 2020 to June 2021, the period covering India’s deadly second wave of COVID-19 pandemic. This was done among the health care workers working in HIMSR & HAHC hospital, a tertiary health care setting (Dedicated COVID-19 Hospital) providing care to patients with a laboratory-confirmed COVID-19 infection. This hospital located in South East Delhi has 200 bedded COVID-19 Care Hospital and 1050 registered healthcare workers who come in contact with COVID-19-infected persons. The study population (sampling frame) included all the health personnel like doctors, nurses, paramedical staff, housekeeping staff, security staff, students of medical, nursing and paramedical sciences and other front office staff who come in contact with the patients. In this study, the first visit / interview (Baseline) was done when the staff came in contact with a confirmed COVID-19 case. The second visit / interview (Endline) was done between 22-28 days. During each of these two visits, biological sample in the form of serum was collected to check the presence of anti-COVID-19 antibodies

Results:

A total of 192 HCW were recruited in this study. All of them were interviewed and blood was collected for serology at the baseline visit as well as at endline. Out of 192 participants, 119 (61.97%) were detected with SARS-CoV2 antibodies at baseline whereas 73 (38.02%) were seronegative. Again, on22-28 days of follow-up, the seropositivity was 77.7% at the endline. We found that seropositivity was significantly and negatively associated with doctor as profession [OR:0.353, CI:0.176-0.710], COVID-19 symptoms [OR:0.210, CI:0.054-0.820], comorbidities [OR:0.139 , CI: 0.029 - 0.674], recent IPC Training [OR:0.250, CI:0.072 -0.864] , while positively associated with Partially [OR:3.303,CI: 1.256-8.685], as well as fully Vaccinated for COVID-19 [OR:2.428, CI:1.118-5.271]. We also observed seroconversion among 36.7% while 64.0% had increase in titre of antibodies during our follow-up period. The seroconversion was 63.2% in doctors, 42.9% in nurses and 13.0% in paramedics staff. Seroconversion was positively associated with doctor as profession [OR:11.43, CI:2.47 - 52.79] and with partially, as well as fully vaccinated for COVID-19 [OR: 32.63, CI: 5.11 - 208.49]. None of the HCW who were smokers and with any comorbidity did not found to have been seroconversion. We observe a negative and significant relationship of increase in titre of antibodies with recent any ILI symptoms [OR:0.17, 0.13 - 0.94], smokers[OR: 0.35, 95%CI: 0.13 - 0.94], HCW with comorbidities [OR:0.08,95CI: 0.01 - 0.71],, recent full IPC Training [OR:0.07, CI:0.01 -0.63] , while positively associated with partially [OR: 7.87, 95CI: 2.18 - 28.40)], as well as fully Vaccinated for COVID-19 [OR: 3.59, 95CI: 1.46 - 8.87]. Majority of the health care worker enrolled in our study had close contact exposure with COVID-19 patients while 5 had indirect exposure. It was observed that almost all (100% in both) doctors and nurses as well as almost all paramedical staff (99%) were wearing some kind of personal protective equipment (PPE) when they were exposed to a COVID-19 patient. We did not found adherences to any of the infection prevention measure adopted by the enrolled HCW during the recent contact with COVID-19 patients to be significantly associated with seroconversion.

Conclusion:

Majority of the health care worker (67% doctor, 80% nurses & 55% paramedics) enrolled in our study had close contact exposure with COVID-19 patient. The results show that among 192 HCW enrolled, 62% were seropositive at the baseline. At end line the seropositivity was increased to 77.7%. The seroconversion rate was also studied. It was found to be 36.7% in our study population (63.2% in doctors, 42.9% in nurses and 13.0% in paramedic’s staff.). Adherence to the recommended IPC measures was reported by most participants. About two third (63%) of the HCW in our study were not vaccinated against COVID-19; nurses and paramedics were higher in proportion among those who were unvaccinated. Fifteen percentage were partially vaccinated and 22% were fully vaccinated against COVID-19, with doctors comprising majority among them. We also found that vaccination had the strongest association with seropositivity, seroconversion as well as serial rise of titre.