Delhi: The year 2025 emerged as another severe stress test for Delhi’s fragile public health system, as environmental crises, climate pressures and long-standing systemic gaps converged to stretch hospitals, doctors and residents to their limits. From toxic winter air and extreme summer heat to recurring outbreaks of vector-borne diseases and a quieter rise in lifestyle disorders, the city’s health story was shaped not by a single emergency but by the relentlessness of many.
While government hospitals continued to function as Delhi’s primary safety net, doctors warned that the capital is now living in a “permanent state of health alert”, where one seasonal crisis barely recedes before the next arrives.
The smog that never let go
Air pollution once again dominated Delhi’s health narrative in 2025, particularly during the winter months, when the city endured prolonged spells of “severe” and “severe-plus” air quality.
Data from the Central Pollution Control Board (CPCB) showed that Delhi recorded multiple days with AQI levels crossing 400 and even breaching 450, placing air quality firmly in the hazardous category. In response, the Commission for Air Quality Management (CAQM) invoked Stage III and Stage IV of the Graded Response Action Plan (GRAP) on several occasions.
These measures triggered restrictions on construction activities, diesel vehicles, industrial operations and outdoor movement across the city.
Health officials said the impact on public health was immediate. Government hospitals reported a sharp rise in patients complaining of breathlessness, chest tightness, persistent cough, eye irritation and fatigue. Emergency departments at major facilities such as AIIMS, Safdarjung, RML and Lok Nayak Hospital witnessed seasonal surges that doctors now describe as “expected, but unmanageable”.
“Winter smog in North India is no longer a brief inconvenience but a prolonged toxic exposure. Fine particles like PM2.5 enter the bloodstream, silently increasing the risk of asthma, heart disease, strokes, and premature death. The real danger lies in cumulative damage over years, not just extreme pollution days,” said Dr Tushar Tayal, Associate Director Internal Medicine at CK Birla Hospital, Gurugram.
Dr Ravi Shekhar Jha, Director and Unit HOD Pulmonology at Fortis Escorts Hospital, Faridabad, said air pollution had shifted from a seasonal problem to a near-permanent health hazard, with winters being the most severe. Prolonged exposure, he said, led to a rise in pollution-induced bronchitis, asthma flare-ups and chronic cough, even among previously healthy individuals.
“The damage is cumulative—short periods of cleaner air no longer reverse months of exposure. The idea of ‘safe air days’ is steadily disappearing,” Jha said.
Hospitals under sustained pressure
The strain caused by poor air quality was reflected starkly in hospital data. According to figures shared by the Union Health Ministry in Parliament earlier this year, more than two lakh cases of acute respiratory illness (ARI) were recorded across six major government hospitals in Delhi over a three-year period.
Doctors said the numbers capture only part of the picture. Outpatient departments remained crowded with patients suffering from asthma, chronic obstructive pulmonary disease (COPD) and pollution-aggravated cardiac conditions. Many required repeated visits, inhaler therapy and long-term medication
“Every winter, hospitals witness a predictable surge of respiratory cases—from asthma flare-ups to pneumonia. High pollution days directly translate into higher emergency admissions, oxygen demand, and ICU pressure, pushing already stretched systems to the brink,” Tayal said.
Jha said respiratory caseloads remained consistently high throughout the year instead of peaking seasonally. Emergency rooms, he said, saw more asthma cases, COPD exacerbations and post-viral lung complications, particularly among the elderly.
“Alarmingly, younger patients with chronic respiratory symptoms are becoming more common, signalling serious long-term consequences,” he said.
“The growing disease burden in the national capital is the predictable outcome of treating pollution as an inconvenience rather than a health emergency. Delhi’s air is biologically aggressive. Daily exposure weakens lung defence, fuels chronic inflammation, and quietly damages immunity, leaving the body in a constant state of stress,” Dr Katiyar said.
“What makes this more dangerous is the normalisation of symptoms such as breathlessness, allergies, frequent infections, and poor sleep, which are now accepted as ‘city life problems.’ Pollution is amplifying existing lifestyle disorders and pushing even healthy individuals towards illness,” Dr Katiyar said.
“This is not limited to respiratory disease; we are seeing wider impacts on skin, immunity, and metabolic health. Medical treatment alone cannot offset this exposure. Unless pollution control is recognised and acted upon as a public health intervention, not just an environmental goal, disease trends in the capital will continue to rise despite advances in healthcare,” Dr Katiyar concluded.
Also Read: Crimes against women dip in Delhi, but serious concerns persist
Children and the elderly remained the most vulnerable, with paediatric wards reporting increased cases of bronchitis and wheezing during pollution peaks.
Children, schools and the health–education dilemma
As air quality deteriorated, authorities ordered schools to suspend physical classes or shift to hybrid learning modes multiple times in 2025. Outdoor sports and morning assemblies were banned during severe pollution spells.
While these measures were intended to protect children’s health, they exposed deeper challenges. Unequal access to digital education and the long-term effects of prolonged indoor confinement became increasingly visible.
Paediatricians noted a rise in childhood obesity, reduced physical activity, screen-related eye problems and anxiety among school-going children.
“Children are biologically more vulnerable to polluted air, yet families are forced to choose between schooling and health. School closures disrupt learning, while poorly ventilated classrooms continue exposure, widening both health and education inequalities,” Tayal said.
Jha said children were among the most vulnerable, as developing lungs are highly sensitive to polluted air. Families, he said, were forced to choose between health risks and educational disruption.
“While masks offered protection, prolonged use raised concerns during physical activity. The year exposed the absence of child-centric pollution policies and indoor air quality standards, with some schools continuing outdoor sports despite hazardous AQI levels,” he said.
Vector-borne diseases and monsoon risks
Vector-borne diseases remained one of Delhi’s most persistent public health challenges in 2025. Unlike years dominated by a single illness, the city saw mixed trends across dengue, malaria and chikungunya.
According to data from the Municipal Corporation of Delhi (MCD), the city reported 1,136 dengue cases in 2025, with two deaths confirmed as of early November. This marked a decline from the previous two years, when Delhi recorded 3,581 cases in 2024 and 4,826 cases in 2023.
Health officials cautioned, however, that dengue remains a recurring seasonal threat.
In contrast, malaria and chikungunya cases rose. Malaria cases reached 604 during the same reporting period, compared with 671 in 2024 and 280 in 2023, indicating persistently high transmission linked to stagnant water and lingering humidity.
Chikungunya cases climbed to 133, up from 127 in 2024 and just 16 in 2023, suggesting a possible expansion of the Aedes mosquito population
Medical officers said the rise in malaria and chikungunya was particularly concerning in neighbourhoods with poor drainage and waterlogging. Cases surged after monsoon rains created favourable breeding conditions.
Municipal teams conducted more than 3.2 crore household inspections, sprayed insecticide at over 30 lakh homes and issued more than 1.4 lakh notices for mosquito-breeding conditions across the city in 2025.
“Erratic monsoons and rising temperatures have extended the breeding season for mosquitoes, making dengue and other vector-borne diseases more frequent and prolonged. Control measures remain largely reactive instead of preventive,” Tayal said.
“The steady rise in malaria and chikungunya cases in Delhi is not surprising. What is concerning is that we continue to treat it as a seasonal problem. Our cities are being built faster than they are being planned for health. Water now accumulates invisibly in basements, overhead tanks, construction pits, and poorly sealed drains, creating permanent mosquito habitats that municipal spraying alone cannot address,” said Dr Deeksha Katiyar, Co-founder & Managing Director, WeClinic Homeopathy.
“Climate variability has only amplified this by extending mosquito survival cycles. Equally important is the gradual decline in urban immunity. Chronic stress, sleep deprivation, pollution exposure, and metabolic disorders are reducing the body’s ability to fight infections effectively,” Dr Katiyar said.
“Vector-borne diseases today are a symptom of how urban living is overwhelming both infrastructure and human resilience. Unless prevention strategies expand beyond fogging to include lifestyle-linked health resilience and early intervention, these trends will continue to worsen,” Dr Katiyar added.
Viral fevers and seasonal illness
Beyond mosquito-borne diseases, Delhi recorded a steady rise in viral fevers, flu-like symptoms and respiratory infections, particularly during periods of weather fluctuation.
Health surveys indicated that more than half of households in Delhi-NCR reported at least one member experiencing flu-like symptoms during certain periods of the year. Recovery times were longer among children and senior citizens.
Jha said erratic monsoons, rising temperatures and stagnant water created ideal breeding conditions for mosquitoes, causing dengue, chikungunya and malaria to appear earlier and last longer.
“Healthcare systems struggled with overlapping symptoms of viral fevers and respiratory infections, highlighting the need for climate-informed disease planning rather than reactive control measures,” he said.
Doctors linked these trends to pollution-weakened immunity, climate variability and crowded living conditions.
The silent epidemic of lifestyle diseases
Even as visible crises dominated attention, Delhi continued to face a quieter surge in non-communicable diseases such as diabetes, hypertension, obesity and heart disease.
Government clinics and mohalla clinics reported rising numbers of patients in their 30s and 40s requiring long-term medication. Doctors attributed this trend to sedentary lifestyles, stress, poor diet and environmental exposure.
“Seasonal viral illnesses now circulate almost year-round. Delayed care, self-medication, and low vaccination coverage allow mild infections to escalate into serious complications, adding sustained pressure on healthcare facilities,” Tayal said.
Jha said poor air quality limited outdoor activity, worsening sedentary lifestyles and accelerating obesity, diabetes, hypertension and heart disease. Mental health issues such as anxiety and sleep disturbances, he added, were increasingly linked to environmental stress.
“These chronic conditions further increased vulnerability to acute illness,” he said.
Public hospitals: backbone under strain
Delhi’s public hospitals once again served as the backbone of healthcare delivery, handling pollution-related emergencies alongside routine care for chronic illnesses.
Doctors highlighted persistent challenges, including staff shortages, overcrowding and infrastructure gaps. Long waiting times and delayed procedures remained common complaints.
Despite these constraints, hospitals continued to deliver emergency interventions, complex surgeries and life-saving treatments.
“Public hospitals continued to serve as the primary healthcare backbone for disadvantaged populations. However, persistent underfunding, staff shortages, and infrastructure gaps became more visible under sustained pressure,” Jha said.
“Healthcare worker burnout underscored that resilience cannot depend on individual effort alone,” he added.
Lessons from 2025
As the year draws to a close, health experts agreed that Delhi’s challenges demand long-term planning rather than reactive responses. Pollution control, climate-resilient healthcare, stronger primary care and investment in mental health emerged as urgent priorities.
“The lesson from 2025 is clear—health cannot be separated from environment and urban planning. Cleaner air, climate-resilient cities, preventive care, and stronger public hospitals must form the foundation of public health policy,” Tayal said.
Jha said environmental health must be treated as a core pillar of healthcare policy. Early warning systems, stronger primary care, school-focused protections and sustained investment in public hospitals, he said, were no longer optional.
“Without coordinated action, preventable environmental harm will continue to translate into avoidable disease and suffering,” he said.
Delhi enters the new year still breathing through its problems — resilient, but undeniably strained.
