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New Delhi, May 26: With India now in the bracket of top 10 nations worst hit by the novel coronavirus, experts have attributed the surge in cases to easing of travel restrictions and movement of migrants besides enhanced testing capacity.

According to AIIMS Director, Randeep Guleria, the present rise in cases has been reported predominantly from hotspot areas but there is a possibility of further rise in the number of COVID-19 cases in the coming few days due to increased travel.

"Those who are asymptomatic or are in presymptomatic stage will pass through screening mechanisms and may reach areas where there have been minimal or less cases," Guleria said.

He said there was a need for more intense surveillance and monitoring in areas where migrants have returned to contain the spread of the disease.

If proper social distancing and hand hygiene is not maintained at a time when people are out on roads, the coronavirus infection will transmit much faster, he said.

Guleria also noted that testing capacity has been significantly ramped up which is reflecting in the increasing number of cases being detected.

Commenting on the partial resumption of rail and road transport services and migrants returning to their native places, Dr Chandrakant S Pandav, former president of the Indian Public Health Association and Indian Association of Preventive and social medicine, said the floodgates have been opened.

"This is a classic case of creating an enabling environment for coronavirus to spread like wildfire. In the coming few days, the number will rise dramatically. While it is true that lockdown cannot go on forever, the opening up should have been in a measured, calibrated and informed manner," he said.

"Travelling leads to spread of the infection. Now, the government will have to ensure even stronger surveillance to curb the infection but if that will be done is something to be observed," he said.

The death toll due to COVID-19 rose to 4,167 and the number of cases climbed to 1, 45,380 in the country, registering an increase of 146 deaths and 6,535 cases since Monday 8 am, according to the Union Health Ministry.

Dr K K Aggarwal, President of the Confederation of Medical Association of Asia and Oceania (CMAAO), and former IMA President, said there will be a further surge in cases in the coming days if migration continues without any proper social distancing.

"Within the next ten days, the cases will cross two lakh. The very fact that number of cases was rising before the end of the third lockdown and continuing during the fourth lockdown means that people are not following physical distancing as required," he said.

"Even in the last week of May when the temperature is very high, the rising number of cases would mean that human-to-human transmission is more important than surface-to-human transmission. Normally in heat the surface-to-human transmission should have reduced the new cases by half which has not happened," Aggarwal said.

However, Professor K Srinath Reddy, president of the Public Health Foundation of India, said an increase in the number of cases reflects both an increase in testing rates and an increase in spread.

"What we need to see is the number of new tests performed per day and the number of new cases that were identified from them. That gives a better idea of the rate of spread than the total number of new cases alone.

"We also have to see if the testing criteria has remained the same between the two periods of comparison.We may open up gradually but will have to continue case detection, contact tracing and follow personal protection measures as vigorously as possible," he added.

A total of 31,26,119 samples have been tested as on May 26, 9 am and 92,528 samples have been tested in the last 24 hours, ICMR officials said.

India is the tenth most affected nation by the pandemic after the US, Russia, UK, Spain, Italy, Brazil, Germany, Turkey and France, as per the John Hopkins University data.

The country has recorded 6,088, 6,654, 6,767 and 6977 cases on May 22, 23, 24 and 25 respectively. Also, the number of RT-PCR tests for detection of COVID-19 in the country crossed the 30-lakh mark on Monday.

The first two phases of the lockdown led to 14-29 lakh COVID-19 cases being averted, while the number of lives saved in that period was between 37,000 and 78,000, the government said last Friday, citing various studies, and asserted that the unprecedented shutdown has paid "rich dividends" in the fight against the pandemic.

Muzaffarpur, Mar 18: Prisoners in the central jail here are working overtime to produce facemasks to prevent the deadly COVID-19 striking. In addition to providing protection to fellow inmates and prison staff, the produce will be shared with nine district and sub jails falling under Muzaffarpur Central Prison as well, Deputy Superintendent of the jail Sunil Kumar Maurya said. From supplications at places of worship to hectic activities at the biggest hospital, this north Bihar district is witnessing invocation of all powers, human and otherwise, to prevent novel coronavirus hitting them.

Although nobody has so far tested positive for the dreaded virus in Bihar, where the state government has imposed a semi-lockdown as a preventive measure, Muzaffarpur which hit the headlines last year for losing close to 200 children to an outbreak of brain fever seems determined not to fall prey to yet another virulent affliction.

On making of facemasks by about 50 prisoners, the Deputy Superintendent of the jail said, "We have had a tradition of producing fabric at the Muzaffarpur Central Jail. An idea was floated why not use the skills acquired for producing masks which are in great demand but in short supply.

The local administration seems impressed with the endeavour of the social outcasts to rise to a global challenge.

"It is a welcome step. Despite all precautions, we never know who is going to catch the infection at which place. The efforts by prisoners to protect themselves and the staff manning their premises is laudable. "Full assistance will be provided to Central Jail authorities in supply of the masks to other prisons," Sub Divisional Magistrate (East) Kundan Kumar said.

A conservative town inhabited by a deeply religious citizenry, Muzaffarpur is also witnessing prayer congregations at temples and mosques in keeping with the tradition here of people of all faiths coming together when faced with a major challenge.

The Garib Nath temple, a renowned shrine devoted to Lord Shiva which attracts devotees from far and wide, is witness to the power of faith trumping the biggest fears as the footfall seems to have increased since the outbreak.

The temples mahant Vinay Pathak says, "faith can move mountains. People come here in search of strength to face a crisis which has caused worldwide scare. We advise the visitors to conduct regular 'havans' at their houses just like we have been performing here. "The smoke emitted by burning of purified offerings cleanses the air and, who knows, could be an antidote as well," Pathak added.

Chanting of 'Mahamrityunjay mantra', which the faith believe to be potent enough to dispel illness and untimely death, is taking place round the clock at the shrine in addition to 'havans', the mahant said.

Just a few yards away stands the Chhata Chowk mosque where large number of devotees appear in skull-caps to offer namaz.

"It is a pandemic threatening to engulf the entire world and dua (prayers) are needed as much as dawa (medicines). May God, who is one, listen to the common wish expressed by humanity in myriad ways," says Imtiaz Ahmed, a devout local resident.

Meanwhile, the health authorities are busy with their own efforts, not leaving prevention and cure to divine intervention.

District Medical Officer Shailesh Kumar Singh says a total of 42 people here who have come from abroad, have been tested but their results have been negative.

"Nonetheless, a five-bed special ward has been set up at the Sadar Hospital, manned by medical staff armed with a special kit comprising medicines and other logistics required for primary care of those with suspected symptoms," he said.

The SKMCH referral hospital, which bore the brunt of last years brain fever epidemic accounting for over 120 deaths is fully geared up to meet the latest challenge.

SKMCH superintendent Sunil Shahi says "we have a 30- ward insulation ward ready. Samples of patients with suspected symptoms are being routinely sent to RMRI, Patna. We appeal to all to remain alert, but avoid panic."