With a severe heatwave sweeping vast swathes of the country, the National Capital has seen a huge upsurge in mortalities caused by sunstrokes and other heat-related ailments. As more than 210 people have so far succumbed to the heat fury not seen in decades in Delhi or elsewhere in the country.

Of the 210 dead in Delhi, 192 were homeless people who have been bearing the brunt of the extreme heat in the city. A total of 22 fatalities caused by suspected heat-related illnesses have been recorded at the Ram Manohar Lohia and Safdarjung hospitals in the last 24 hours.

The Centre for Holistic Development (CHD), an NGO working for the homeless, claimed that deaths of 192 homeless people due to extreme heat were recorded in Delhi between June 11 and June 19, marking a sharp increase of 156 per cent over the last year's figure when 75 people sleeping rough were found to be dead.

Though Delhiites have got some relief from the searing heat thanks to a mild dust storm and light rainfall causing a slight fall in the maximum temperature, the heatwave conditions may intensify in the coming days as the minimum temperature showing a rising trend.

The maximum temperature in the city was recorded at 40 degrees Celsius, one notch above the normal, while the minimum temperature settled at 29.6 degrees Celsius.

However, the feel like temperature or heat index is 48.5 degrees celsius.

According to officials at the Safdarjung Hospital, 33 patients suffering from heat-related illnesses were admitted there. Of them, 13 died in the last 24 hours. The RML Hospital received 22 patients, victims of suspected heatstroke, in the last 24 hours, four of them have died, a hospital source said. Meanwhile, at Nigambodh Ghat, the city's main crematorium, there has been a spike in the number of cremations. Officials, however, could not confirm if the deaths were related to heatstrokes.

On Wednesday, 142 corpses were brought to the Nigambodh Ghat for cremation, which is nearly 136 percentage points higher than the daily average of 50-60 bodies, Suman Gupta, general secretary of the Nigambodh Ghat Sanchalan Samiti, which manages operations at the crematorium, said.

The number was higher on Tuesday as well when 97 bodies were brought to the city's oldest and largest crematorium for cremation. "Usually, around 50-60 bodies are brought in here daily for cremation. The number has gone up in the last few days. Today, 35 cremations have taken place since morning and the number may go up by the end of the day," Gupta said.

Further, the bodies of 50 people from underprivileged class were recovered from around Delhi during the past 48 hours, police said. Police and health officials, however, have not confirmed if all of them died of heat-related causes.

Taking cognisance of the matter, Ashish Kundra, Principal Secretary to Delhi Lieutenant Governor Vinai Kumar Saxena expressed to the Chief Secretary about Saxena's anguish over such unfortunate incidents in the National Capital.

Saxena directed that a meeting be convened with concerned officers of Social Welfare department, DUSIB and Health, to ensure that adequate measures are in place for providing water and other facilities to destitutes, homeless and the poor. "District Magistrates may also be advised to visit the shelter homes and hospitals in their jurisdiction to ensure adequate arrangements are in place for relief and emergency response where warranted," the letter stated.

Sunil Aledia, Executive Director of CHD stated that heatstroke, dehydration and skin problems are a major reason why such high numbers of mortality among the homeless people is being reported. "The constant exposure to scorching sun puts them at high risk of heatstroke, a life-threatening condition. Symptoms include dizziness, confusion, high body temperature, and seizures. Access to clean drinking water might be limited, leading to dehydration which can worsen heatstroke risk and cause fatigue, headaches, and dizziness. Sunburn, rashes, and heat boils are common due to relentless sun exposure," he said.

Keeping in view of the situation, the Delhi government has directed officials to rescue the homeless from footpaths, parks and send them to shelter homes. In an order issued to Delhi Urban Shelter Improvement Board (DUSIB) by Delhi Minister Saurabh Bharadwaj on Wednesday, he said, "With the summer season at its peak in Delhi and various advisories issued by concerned Government Departments (NDMA, NPCCHH, NCDC, State Health Departments, etc.), it has been directed to carry out rescue drives in Delhi."

Appropriate medical assistance to people in distress due to the heat should be prioritised and Centralised Accident and Trauma Services (CATS) ambulance can also be used to send sick persons to hospital, it said, adding that a report on the drive should be sent daily and any laxity on it will be viewed seriously, the order added.

The Centre-run RML Hospital received 22 patients in the last two days. There have been five deaths and 12 to 13 patients are on ventilator support. "The victims did not have any comorbidities. When such people come to the hospital, their core body temperature is recorded and, if it is found to be more than 105 degrees Fahrenheit and there is no other cause, they are declared as heatstroke patients," a senior hospital official said, adding that those who succumb to heatstroke are declared as 'suspected heatstroke' and there is a committee of the Delhi government that later confirms the deaths.

The Safdarjung Hospital received 60 patients with suspected heatstroke, including 42 who were admitted. The hospital has reported six casualties, including a 60-year-old woman and a 50-year-old man. At LNJP Hospital, four patients have died due to suspected heatstroke in the last two days.

The Sir Ganga Ram Hospital in Delhi is reporting 30 to 35 heatstroke cases at its outpatient department daily. "These include conditions such as heat cramp and heat exhaustion," said Dr Atul Kakar, chairperson of the hospital's Department of Internal Medicine.

The heat wave is causing an increase in the prevalence of lupus that affects the skin, joints and kidneys, among other organs. People who have lupus frequently experience flare-ups and aggravated symptoms as the temperature rises.

Six to 10 cases of lupus were detected due to the prolonged heat wave. SLE (systemic lupus erythematosus) or lupus is an autoimmune disease in which the body's own system is targeted, leading to multiple-organ affection and damage. It primarily affects women and that too in their child-bearing age between 15 and 45, said Dr Lalit Duggal, a senior consultant of rheumatology and clinical immunology at Sir Ganga Ram Hospital.

These numbers can be more as AIIMS hospital has yet not make its data public.