• State preparedness to manage the possible third wave of Covid-19 .

• Provides a real time analysis of data – few
suggestions and strategies for effective management
Delhi Administration’s policy responses .

In January 2021 – first wave subsides – the need for hospitalisation of covid-19 patients fell drastically.
 Delhi administration was using less than 20% of its bed capacity.

• In February 2021 – Delhi Government reduced the bed capacity to the level of just above 5,000
• In March 2021 – health system collapsed – increase in the number of covid-19 cases hit by the second wave of pandemic.

In April 2021 – bed occupancy went from 33%
to over 90%
 Government – increased its bed capacity – could not keep pace with the rise in covid
cases .

In May 2021 – utilisation of government hospital beds went rapidly back to 30%
 Many other areas in the country were experiencing a rise in cases.


• COVID-19 waves require the health infrastructure to be elastic .

• Demand for COVID-19-specific health infrastructure is spatially varied – health
capacity at a fixed location will not be sufficient.

• Conveys the difficulty that several administrations in the country face
 Hard to increase the capacity in response to the kind of surge – in April 2021
 Key health infrastructures don’t exist in all areas in our country

Real time analysis of data .

• 145 districts – accounted for 75% of the cases during the 1st wave – Same accounted
for up to 80% of cases during the 2nd wave.
Permanently at risk Districts – districts that were hit by the 1st wave, affected in the 2nd wave to a greater extent
 Population size, density and mobility make them prone to rapid spread.
 Need reserve capacity and resources to be expanded – prevent any risk associated
with possible 3rd wave


• Mobility framework – capacity to move healthcare facilities from one area to another
 Identify what resources can be moved – based on mobility costs and supply elasticity.

• Policy innovations in three areas
 Personnel management – Inducting trained final year medicine and nursing students – Rehiring of retired medical personnel – use
paramedical workers
 Resources with high mobility costs need to be evenly distributed – ensure equity in access in poorly served areas
 Spatial equity
 Expanding the health infrastructure covering all regions
 Providing accessibility through enhanced regional and area connectivity .

• Leads to sharing of resources within the country – reduces inaccessibility and
• Efficiency of resource-sharing increases with the
area of coverage.
 States or districts – benefits of resource sharing is larger – coordinate and build trust
among themselves.

• Greater institutional coordination for a long run is
 Bodies such as the National Disaster Management Authority and the NITI Aayog could play a vital role.

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