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India has jumped past 4.5 lakh coronavirus cases and 14,476 people have succumbed to the viral infection so far. In this backdrop, speaking to IANS in an exclusive interview, AIIMS Director Randeep Guleria said India is also vulnerable to second wave of coronavirus and people should continue to follow social distancing, wearing mask and other precautions, after cases begin to decline.

He added that in order to contain the outbreak of Covid-19, a limited lockdown in hotspots, where volume of cases is very high, may be considered along with a micro-plan to prevent leakage of cases from these areas to other non-containment areas. Excerpts of the interview are below:

Q: Reports say China and South Korea are witnessing a second wave of coronavirus infection, what is this second wave, is India also vulnerable to this?

A: When cases come down significantly, people tend to drop their guard against the viral infection, and this leads to the second wave (which means a sudden increase in the number of cases). After cases begin to decline, people should continue to follow the precautions -- continue to maintain social distancing and wear masks regularly. See what happened in Singapore, it was struck by a second wave of coronavirus. Look, what happened in the 1918 pandemic, people dropped their guard and the second wave of viral infection struck back. If people do not follow social distancing then the spike in cases is apparent. We need to take these precautions at least for one year. India is also vulnerable to this second wave.

Q: If Covid-19 cases continue to rise rapidly, do you think we need another lockdown in areas where volume of cases are very high?

A: A large volume of cases is concentrated in specific areas like hotspots, and in order to maintain things in order, we may need a limited lockdown in these areas. This should be followed by a micro-plan which entails extensive testing of people and also extensive contact tracing of people who have got in touch with positive people. Need to ensure there is no leakage of cases from these areas. People from these areas should not mix with others in non-containment areas. This will aid in containing the outbreak of the virus. People who have developed symptoms should get themselves tested, especially in the containment areas.

Q: With more than 4.5 lakh cases and close to 14,500 deaths, do you think India has reached its peak and a decline in cases is prominent?

A: The cases will continue to increase for some time. The doubling time of cases has also increased. But, the cases will also begin to flatten. Though, it is difficult to give an exact time period in this viral infection, it seems, the growth in cases will flatten in the end of July or beginning of August. A decline will come to this viral infection, but it does not mean that people should drop their guard. As a measure, we need to decrease community participation and citizens should continue to follow social distancing. People should get themselves tested. All these efforts will help in preventing people from contracting this virus. These precautions will also prevent us from the second wave, and we must continue to take precautions. The virus has not gone away, it is still lurking.

Q: India has crossed the 4.5 lakh coronavirus cases so far, although our recovery rate is good, but still 10,000 to 15,000 cases are reported daily. Why do cases continue to spiral, what is the reason?

A: We have to remember a few things -- the bulk of cases are in 10 cities, nearly 70 per cent, and if we take into account cases per million population, the number is not very high, as compared with countries including countries in Europe. Many European countries put together still do not add up to the Indian population. Do not compare India to countries like Italy, Spain etc. We need to focus on hotspots, which contribute to between 70 -80 per cent of cases, and we have to identify cases in these areas at an early stage. The population density is very high in these cities. People in lower socio-economic status are highly vulnerable to the viral infection, as many live together in small spaces and there is a lot of mixing of people happening there. Look at the market places, people are not following social distancing and not wearing masks. In fact, many are in close vicinity of each other.

Thiruvananthapuram, Jun 24: Kerala on Tuesday was among those honoured for tackling the Covid-19 pandemic when the United Nations celebrated the Public Service Day.

The function, held on a virtual platform, saw the participation of UN Secretary General Antonio Guterres and other top UN dignitaries who applauded all the leaders which included state Health Minister K.K. Shailaja for effectively tackling Covid-19.

Speaking on the occasion, Shailaja noted that the experiences of tackling Nipah virus and the two floods - 2018 and 2019 - where the health sector played a crucial role, all helped in tackling Covid-19 timely.

"Right from the time when Covid cases got reported in Wuhan, Kerala got into the track of the WHO and followed every standard operating protocols and international norms and hence, we have been able to keep the contact spread rate to below 12.5 per cent and the mortality rate to 0.6 per cent," she said.

United Nations, Jun 30: India accounts for 45.8 million of the world's 142.6 million "missing females" over the past 50 years, a report by the United Nations said on Tuesday, noting that the country along with China form the majority of such women globally.

The State of World Population 2020 report released on Tuesday by the United Nations Population Fund (UNFPA), the world organisation's sexual and reproductive health agency, said that the number of missing women has more than doubled over the past 50 years - from 61 million in 1970 to a cumulative 142.6 million in 2020.

Of this global figure, India accounted for 45.8 million missing females as of 2020 and China accounted for 72.3 million.

Missing females are women missing from the population at given dates due to the cumulative effect of postnatal and prenatal sex selection in the past, the agency said.

Between 2013 and 2017, about 460,000 girls in India were missing' at birth each year. According to one analysis, gender-biased sex selection accounts for about two-thirds of the total missing girls, and post-birth female mortality accounts for about one-third, the report said.

Citing data by experts, it said that China and India together account for about 90-95 per cent of the estimated 1.2 million to 1.5 million missing female births annually worldwide due to gender-biased (prenatal) sex selection.

The two countries also account for the largest number of births each year, it said.

The report cites data by Alkema, Leontine and others, 2014 National, Regional, and Global Sex Ratios of Infant, Child, and under-5 Mortality and Identification of Countries with Outlying Ratios: A Systematic Assessment' from The Lancet Global Health.

According to their analysis, India has the highest rate of excess female deaths, 13.5 per 1,000 female births, which suggests that an estimated one in nine deaths of females below the age of 5 may be attributed to postnatal sex selection.

The report notes that governments have also taken action to address the root causes of sex selection. India and Vietnam have included campaigns that target gender stereotypes to change attitudes and open the door to new norms and behaviours.

They spotlight the importance of daughters and highlight how girls and women have changed society for the better. Campaigns that celebrate women's progress and achievements may resonate more where daughter-only families can be shown to be prospering, it said.

The report said that successful education-related interventions include the provision of cash transfers conditional on school attendance; or support to cover the costs of school fees, books, uniforms and supplies, taking note of successful cash-transfer initiatives such as Apni Beti Apna Dhan' in India.

It said that preference for a male child manifested in sex selection has led to dramatic, long-term shifts in the proportions of women and men in the populations of some countries.

This demographic imbalance will have an inevitable impact on marriage systems. In countries where marriage is nearly universal, many men may need to delay or forego marriage because they will be unable to find a spouse, the report said.

This so-called "marriage squeeze", where prospective grooms outnumber prospective brides, has already been observed in some countries and affects mostly young men from lower economic strata.

"At the same time, the marriage squeeze could result in more child marriages, the report said citing experts.

Some studies suggest that the marriage squeeze will peak in India in 2055. The proportion of men who are still single at the age of 50 is forecast to rise after 2050 in India to 10 per cent, it said.

The UN report said that every year, millions of girls globally are subjected to practices that harm them physically and emotionally, with the full knowledge and consent of their families, friends and communities.

At least 19 harmful practices, ranging from breast ironing to virginity testing, are considered human rights violations, according to the UNFPA report, which focuses on the three most prevalent ones: female genital mutilation, child marriage, and extreme bias against daughters in favour of sons.

Harmful practices against girls cause profound and lasting trauma, robbing them of their right to reach their full potential, says UNFPA Executive Director Dr. Natalia Kanem.

This year, an estimated 4.1 million girls will be subjected to female genital mutilation. Today, 33,000 girls under age 18 will be forced into marriages, usually to much older men and an extreme preference for sons over daughters in some countries has fuelled gender-biased sex selection or extreme neglect that leads to their death as children, resulting in the 140 million missing females.

The report said that ending child marriage and female genital mutilation worldwide is possible within 10 years by scaling up efforts to keep girls in school longer and teach them life skills and to engage men and boys in social change.

Investments totalling USD 3.4 billion a year through 2030 would end these two harmful practices and end the suffering of an estimated 84 million girls, it said.

A recent analysis revealed that if services and programmes remain shuttered for six months due to the COVID-19 pandemic, an additional 13 million girls may be forced into marriage and 2 million more girls may be subjected to female genital mutilation between now and 2030.

The pandemic both makes our job harder and more urgent as so many more girls are now at risk, Kanem said.