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United Nations, Apr 16: WHO chief Tedros Adhanom Ghebreyesus has welcomed the world health body's cooperation with India to leverage strategies that helped the country win its war against polio into the response to COVID-19 outbreak, saying such joint efforts will help defeat the pandemic.

The World Health Organization (WHO) has said it will work with India's Ministry of Health and Family Welfare to leverage the strategies that helped the country eradicate polio to fight the pandemic.

Migrants who returned to UP and Bihar were hurriedly housed in schools and panchayat buildings, which were turned into quarantine centres. However, unhygienic conditions and people running away have proved to be a problem

The WHO's national polio surveillance network will be engaged to strengthen COVID-19 surveillance and its field staff will continue to support immunization and elimination of tuberculosis and other diseases.

“Great news: @MoHFW_INDIA & @WHOSEARO initiated a systematic engagement of @WHO's national polio surveillance network, and other field staff, for India's #COVID19 response, tapping into the best practices & resources that helped win its war against polio,” the WHO director-general tweeted, referring to India's Ministry of Health and Family Welfare and World Health Organization Regional Office for South-East Asia.

According to the Johns Hopkins University data, over 2 million people are infected by the virus and more than 136,000 people have died of the disease globally.

Ghebreyesus expressed gratitude to Health and Family Welfare Minister Harsh Vardhan “for his leadership and collaboration” with WHO. “Through these joint efforts we can defeat the #coronavirus and save lives. Together!”

India eliminated polio in 2014.
According to a WHO press release, Vardhan said in New Delhi that “time and again the Government of India and WHO together have shown our ability, competence and prowess to the whole world. With our combined meticulous work, done with full sincerity and dedication, we were able to get rid of polio.”

“All of you in the field – IDSP (Integrated Disease Surveillance Project), state rapid response teams and WHO - are our ‘surveillance corona warriors'. With your joint efforts we can defeat the coronavirus and save lives,” Vardhan added.

WHO South-East Asia Regional Director Poonam Khetrapal Singh said the National Polio Surveillance Project (WHO-NPSP) played a critical role in strengthening surveillance for polio that generated useful, timely and accurate data to guide policies, strategies and interventions until transmission of the poliovirus was interrupted in the country,” adding that the other WHO field staff involved with elimination of tuberculosis and neglected tropical diseases and hypertension control initiative were also significant resources.

Singh added that “it is now time to use all your experience, knowledge and skills, with the same rigor and discipline that you showed while monitoring polio activities, to support districts with surveillance, contact tracing and containment activities.”

The WHO release said strengths of the NPSP team – surveillance, data management, monitoring and supervision, and responding to local situations and challenges – will be utilized to supplement efforts of National Centre for Disease Control, IDSP and Indian Council of Medical Research to strengthen COVID-19 surveillance.

The NPSP team will also support in sharing information and best practices and help states and districts calibrate their response based on transmission scenarios and local capacities.

The WHO field staff will continue to support immunization and surveillance and elimination of Tuberculosis and Neglected Tropical Diseases, Singh said, adding, “disease outbreaks can negatively impact progress in a range of areas, from maternal and child mortality to vaccine-preventable diseases and other treatable conditions. India had been making stupendous progress in these areas and we cannot afford for India's remarkable progress to be set back or reversed.”

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

Mumbai, Jan 3: The Shiv Sena on Friday targeted the Centre by questioning the "efficacy" of the 2016 surgical strike and said the perception that it would demoralise Pakistani terrorists remained an "illusion" as Indian soldiers continue to get killed in terror attacks in Kashmir.

Accusing the Modi government of boasting about how Pakistan was straightened out after the surgical strike, the Sena sought to know whether it has really happened.

It also observed that troubled borders were not good for the country's well-being.

The Sena's remarks come in the wake of the death of an Army soldier from Maharashtra, Naik Sandip Raghunath Sawant, who was killed during a counter-insurgency operation in Jammu and Kashmir on Wednesday.

"The New Year did not begin on a positive note in Kashmir. Our jawan from Satara, Sandip Sawant, attained martyrdom in Kashmir along with two other soldiers. In the last one month, seven to eight jawans from Maharashtra were killed in the line of duty. The Maha Vikas Aghadi government in Maharashtra is not responsible for this," the Sena said in an editorial in party mouthpiece 'Saamana'.

The party also questioned whether the situation in Kashmir has improved after the surgical strike and abrogation of Article 370 provisions.

The party, however, maintained that scrapping Article 370 was a good move.

India had conducted the surgical strike on September 29, 2016, across the Line of Control (LoC) as a response to a terrorist attack on an Indian Army base in Uri sector of Jammu and Kashmir earlier that month.

Without naming the Centre, the Sena alleged, "Circulating news that only the Pakistanis were getting killed in Kashmir will not change the reality as tricolour-draped bodies of Indian soldiers, like Sawant, are reaching their respective villages."

"There is a bloodshed along the Kashmir border and mounting anger among the families of martyred jawans. The perception that surgical strike will demoralise Pakistani terrorists has turned out to be an illusion. In fact, the (terror) attacks have increased," it added.

The Uddhav Thackeray-led party accused the ruling BJP of boasting about straightening out Pakistan after the surgical strike.

"But has Pakistan been really straightened out? Rather Pakistan has been indulging in ceasefire violations along the LoC every day," it added.

The Shiv Sena also questioned the government's claim that the situation in Kashmir was under control after the nullification of Article 370.

"It is good that Article 370 was scrapped. Before that, surgical strike was carried out in Pakistan. But has the situation in Kashmir improved? The terror attacks continue. It's only that there is a control in reporting (these incidents)," it said.

The Sena also alleged that there was no clarity as to what was transpiring in Kashmir after the scrapping of Article 370 and only the media reports of soldiers sacrificing their lives have been coming out from that state

In a veiled attack on the BJP, its erstwhile ally, the Sena, also accused it of exploiting the surgical strike for political gains.