Bodies of all four Nirbhaya convicts taken to hospital for post mortem

New Delhi, Apr 24: The trajectory of COVID-19 cases could have plateaued and might even fall for some weeks after the lockdown is lifted but India is likely to see a second wave in late July or August with a surge in the number of cases during the monsoon, say scientists.

The timing of the peak will depend on how India is able to control physical distancing and on the level of infection spreads after restrictions are relaxed, they said.

It looks apparent that the trajectory of daily new cases has reached a plateau and eventually it will take a downward fall, maybe for some weeks or even months, Samit Bhattacharya, associate professor at the Department of Mathematics, Shiv Nadar University, said.

Still, we may get a surge of new cases of the same coronavirus and this will be considered a second wave, Bhattacharya explained.

The second epidemic may come back in late July or August in the monsoon, although the peak timing will depend on how we control social distancing during that time, he said.

Rajesh Sundaresan, professor at Bengaluru's Indian Institute of Science (IISc), agreed.

“Once we return to normal activity levels, there is a chance that infection may begin to rise again. China is seeing this to some extent post easing of some restrictions on travel,” Sundaresan, corresponding author of a working paper by researchers at IISc and the Tata Institute of Fundamental Research (TIFR) in Mumbai, said.

On March 25, when the number of coronavirus cases was 618 with 13 deaths, the government announced a nationwide lockdown that was later extended to May 3.

On Friday, the death toll due to COVID-19 rose to 718 and the number of cases to 23,077, according to the Union Health Ministry.

In good news, officials said this week that the doubling rate of cases has slowed down in the period, going from 3.4 days before lockdown to 7.5 days, with 18 states doing better than the national average. The recovery rate has also almost doubled in the last 10 days.

"Looking at the new cases in the past few days, it seems the growth of new daily infection is much slower than earlier. This apparently indicates that we might have reached at the plateau of the growth curve, Bhattacharya said.

He noted that recent studies in China and Europe observed that the infection might relapse in those people who have already recovered from earlier phases.

So, there is no evidence that the earlier infection may help acquire immunity against the second infection. And in that way, the entire population may be vulnerable to the second wave to some extent, said the scientist.

In their study unveiled this week, IISc and TIFR researchers analysed the impact of strategies such as case isolation, home quarantine, social distancing and various post-lockdown restrictions on COVID-19 that might remain in force for some time.

The study modelled on Bengaluru and Mumbai suggests the infection is likely to have a second wave and the public health threat will remain, unless steps are taken to aggressively trace, localise, isolate the cases, and prevent influx of new infections.

The new levels and the peaking times for healthcare demand depend on the levels of infection spreads in each city at the time of relaxation of restrictions, they said.

The lockdown is currently upon us. It has given us valuable time. Let us test, trace, quarantine, isolate, practice better hygiene, search for a vaccine, etc. We should do these anyway, and these are being done. When and how to lift the lockdown is going to be a difficult decision to make, said Sundaresan.

It's clear that it's going to be phased. What our team is focusing on is to come up with tools to help the decision makers assess the public health impact of various choices, he said.

According to the experts, infectious diseases spread via contact between infectious and susceptible people. In the absence of any control measures, an outbreak will grow as long as the average number of people infected by each infectious person is more than one.

Once enough people are immune there will be fewer people susceptible to the infection and the outbreak will die.

However, when an outbreak is brought under control by social distancing and other interventions, it is possible only a small proportion of the population will have been infected and gained immunity, they said.

This means enough susceptible people may remain to fuel a second wave if controls are relaxed and infection is reintroduced.

Until the vaccine comes on the market, we have to remain alert Once sporadic cases occur here and there in the country, we immediately need to implement quarantine or social distancing locally for the people in that region, and also need to perform tests to identify positive cases irrespective of showing symptoms, Bhattacharya explained.

Note that these monsoon months are also flu season in many places of India. So, we should not ignore the early signs of the flu symptoms. Irrespective of symptoms, we need to increase tests in the hotspots to identify people and contain the surge, he said.

Sundaresan added that the timeline for a second wave will depend on a lot of circumstances which may change as the time passes.

Significant testing may have been underway, there may be behavioural changes with people becoming more careful about their hygiene, wearing masks may become more common, etc. All these responses may help restrict the second wave, he said.

A study published in The Lancet journal earlier this month modelled the potential adverse consequences of premature relaxation of interventions, and found it might lead to a second wave of infections.

The finding is critical to governments globally, because it warns against premature relaxation of strict interventions, the researchers said.

While interventions to control the spread of SARS-CoV-2 are in place, countries will need to work toward returning to normalcy; thus, knowledge of the effect of each intervention is urgently required, they said in the study.

According to a recent analysis by the Harvard Chan School of Public Health, the best strategy to ease the critical care burden and loss of life from COVID-19 might be on-again, off-again social distancing.

In the absence of such interventions, surveillance and intermittent distancing may need to be maintained into 2022, which would present a substantial social and economic burden, the researchers wrote.p

New Delhi, Mar 25: The Congress said on Wednesday that it stood with Prime Minister Narendra Modi on his appeal for 21-day lockdown but was "deeply disappointed by the lack of coherent strategy" and demanded that Rs 7,500 should be transferred to every Jan Dhan, PM Kisan and pension account to tide over the nutrition needs for 21-days.
It also demanded that the Public Distribution System (PDS) ration should be given free.
In a series of tweets, Congress Communications in-charge Randeep Singh Surejwala said that the need of the hour was to implement 'Minimum Income Guarantee Scheme' (Nyay) mooted by the Congress and party leader Rahul Gandhi.
"Please transfer Rs 7,500 to every Jan Dhan, PM Kisan, and every pension account to tide over nutrition needs of 21 days and give free PDS ration. We will rise together as a nation and defeat COVID-19. We stand with lockdown but are deeply disappointed by the lack of coherent strategy or a clear 'way ahead' on your part," he said.
Surjewala asked what steps the government took despite an early warning about COVID-19 and sought details about isolation beds and ventilators available to people.
"Dear PM, India will adhere to the lockdown but what steps did the govt take to tackle the corona pandemic despite early warnings in Feb? When will doctors, nurses and health workers have adequate protection? How many 'isolation beds' and ventilators are available and where?" he said.
He asked how daily wagers and labourers will sustain during the 21-day lockdown.
"What's your plan to address the huge issue of bread and butter and livelihood for millions? How will daily wagers, labourers, MGNREGA workers, factory workers, unorganised workers, fishermen, farmers and farm labour sustain for 21 days?" he asked.
Surjewala said the crying need is to arm doctors, nurses and health workers with personal protection equipment and asked: "why are N-95 masks, Hazmat suits not available?"
"In March itself, India needs 7.25 lakh bodysuits, 60 lakh N-95 masks, 1 crore 3 ply masks? When will they be available?" he asked.
Surjewala said that the government banned the export of ventilators, respiratory devices and sanitisers only yesterday on March 24, "84 days after the spread of COVID-19."
"Is this your government's 'Modus operandi' to fight coronavirus? Too little, Too late!," he said.
Noting that two-thirds of the country's population is engaged in agriculture, he said that Prime Minister Modi did not refer to farmers during his address to the nation and demanded a moratorium on farmers' loans.
"Crop is ready for harvest in March itself. How will it be harvested and sold and who will buy at fair price? Indebtedness relief to farmers is the only way forward in these testing times. Please put a moratorium on farmers' loans and recoveries. Please ensure the procurement of crops at MSP. Let's not forget that farmers are the backbone of India's economy," he said.
Surjewala said the Prime Minister gave only four hours to prepare for 21-day lockdown.
"Did you think of over 5 lakh truck drivers, who are now stranded on roads? Did you think of millions of workers, who are stranded in cities away from home without food or money? What should they do," he asked.

May 14: Customs officials on Wednesday intercepted China-bound consignments of raw material for masks, misdeclared as packing materials for pouches, in large quantities, a senior official said.

It has also seized multiple shipments containing 5.08 lakh masks, 57 litres of sanitiser and 952 PPE kits bound for the US, the UK and the UAE, the official said.

The export of such goods is prohibited by the government in the wake of the COVID-19 pandemic.

"On the basis of specific intelligence, 2,480 kg of raw material for masks was intercepted by air cargo export, Delhi Customs. The goods were misdeclared as packing materials for pouches and were being illegally attempted to be smuggled/ exported to China," he said. 

These goods are prohibited for export as per the latest guidelines issued by the Directorate General of Foreign trade (DGFT), he said, adding that investigation into the case is under progress.

In another catch, the air cargo officers intercepted multiple shipments containing 5.08 lakh masks, 57 litres of sanitiser in 950 bottles and 952 PPE kits at the courier terminal in New Delhi. These were attempted to be smuggled or exported out of the country, the official said.

"These goods are also prohibited for export," he added. 

These items were being illegally exported to the United States, United Kingdom and the United Arab Emirates. "No arrests have been made so far," the official said.