Ex-CJI Ranjan Gogoi takes oath as Rajya Sabha MP

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, May 24: New rules for domestic travel during the lockdown were released by the government today, including advising passengers to download the Aarogya Setu application on their mobile devices and asking states to ensure thermal screening at departure point of airports, railway stations and bus terminals. The guidelines were shared by Civil Aviation Minister Hardeep Singh Puri, who also shared new rules for international travel.

The minister had recently said that international flight operations may start by mid-June or end-July if the COVID-19 virus "behaves in a predictable manner".

"Prescribed clinical protocol will be followed in case any domestic or international traveller shows symptoms of COVID-19. States can also develop their own protocol for quarantine and isolation as per their own assessment," Mr Puri said.

The guidelines come a day before the resumption of air travel after nearly two-months hiatus following lockdown to prevent the spread of coronavirus.

The Indian Railways has also issued a list of 100 pairs of trains that it will operate from June 1, putting in operation popular trains such as Durontos, Sampark Krantis, Jan Shatabdis and Poorva Express.

Dos and Don'ts shall be provided along with tickets to travellers by agencies concerned, said the Health Ministry's guidelines for domestic travel (air/train/inter-state bus travel).

Latest guidelines on domestic & international travel have been issued by @MoHFW_INDIA.

I hope travellers strictly follow these self-regulatory norms & strengthen India's hands in this fight against COVID19. Remember, each one of us is a soldier against the pandemic.@MoCA_GoIpic.twitter.com/xVbTG1K44n

— Hardeep Singh Puri (@HardeepSPuri) May 24, 2020
Travellers shall give 14-day quarantine undertaking before boarding

The states and Union Territories shall ensure that all passengers undergo thermal screening at the point of departure and only asymptomatic passengers are allowed to board the flight, train or bus. Asymptomatic passengers, however, will be permitted to travel after they give an undertaking to self-monitor for 14 days, the ministry said.

Those having moderate or severe symptoms will be admitted to dedicated COVID health facilities and managed accordingly, the guidelines said.

Those having mild symptoms will be given the option of home isolation or isolated in the COVID Care Centre (both public and private facilities) as appropriate and tested as per ICMR protocol, they said.

"If positive, they will continue in COVID Care Centre and will be managed as per clinical protocol. If negative, the passenger may be allowed to go home, isolate himself/herself and self-monitor his/her health for further 7 days," the health ministry said.

In case, any symptoms develop they shall inform the district surveillance officer or the state or the national call centre (1075), it said.

Use of face covers, following respiratory hygine during travel

During boarding and travel, all passengers shall use face covers or masks and will also follow hand hygiene, respiratory hygiene and maintain environmental hygiene, the ministry said in its guidelines.

At airports, railway stations and bus terminals, required measures to ensure social distancing shall be taken, the guidelines said.

Airports, railway stations and bus terminals to be regularly sanitised

Airports, railway stations and bus terminals should be regularly sanitised or disinfected and the availability of soaps and sanitisers shall be ensured, the health ministry said.

The ministry said that states can also develop their own protocol with regards to quarantine and isolation as per their assessment.

Guidelines for International Travel

The guidelines for international travel include mandatory undertaking for quarrantine for 14 days. "Only for exceptional and compelling reasons such as cases of human distress, pregnancy, death in family, serious illness and parent(s) accompanied by children below 10 yrs, as assessed by the receiving states, home quarantine may be permitted for international travellers for 14 days," the Civil Aviation minister said.

Asymptomatic travelers will be allowed to board flight/ship

At the time of boarding the flight or ship, only asymptomatic travellers will be allowed to board after thermal screening, the health ministry said.. Passengers arriving through land borders will also have to undergo the same procedure, it said.

"Self-declaration form in duplicate shall be filled by the person in the flight/ship and a copy of the same will be given to Health and immigration officials present at the airport/seaport/landport. The form will be made available through the Aarogya Setu app," the new order said.

Passengers found to be symtomatic during screening shall be immediately isolated and taken to medical facility as per health protocol. "These passengers will be kept under institutional quarrantine for a minimum period of 7 days and should undergo necessary tests as per ICMR protocol," the guidelines said.

Sanitisation and disinfection must inside flights

Authorities must take adequate measures to such as environmental sanitation and disinfection at the airports as well as within the flights, the guideline said.Suitable announcement about COVID-19 including precautionary measures to be followed shall be made at airports/ports, it added.

While on board flight, ships, passengers and crew required precautions such as wearing of masks, environmental hygiene, respiratory hygiene, hand hygiene, the ministry said.

This morning, India registered the biggest-single day jump in the number of coronavirus cases as 6,767 new patients were reported in the last 24 hours. This is the third consecutive day that India has reported more than 6,000 COVID-19 cases with a record number of new patients each day. The county has officially logged 1,31,868 cases, 3,867 deaths linked to the highly infectious illness since the pandemic began. Of these, 147 patients died in the last 24 hours. The global number of novel coronavirus cases has passed 5.25 million with more than 339,000 deaths. Since the outbreak first emerged in China in December, 5,260,970 cases have been recorded across 196 countries and territories, with 339,758 deaths attributed to the virus.

Prime Minister Narendra Modi, who had maintained silence on Chinese aggression and massacre of Indian in eastern Ladakh, now issued a statement saying ‘India wants peace’. He added that India is capable of giving a befitting reply if provoked. 

The prime minister started his meeting with chief ministers on the Covid-19 with a two-minute silence as a tribute to the 20 soldiers who were killed in action in Galwan Valley this week. As he spoke, it became clear that the message was aimed not just at reassuring the nation but also delivering a sharp message to Beijing.

“I would like to assure the nation that the sacrifice of our jawans will not be in vain. For us, the unity and sovereignty of the country is the most important,” PM Modi said. Home minister Amit Shah and defence minister Rajnath Singh were also present in the meeting.

Over twenty Indian soldiers were killed in the violent face-off which took place in Eastern Ladakh on Monday. The troops fought each other with fists and rocks. After the clash, the two sides “disengaged” from the area where the fighting happened, the Indian army statement said. A news agency quoting sources said four Indian soldiers are in critical condition after the face-off.

Defence minister Rajnath Singh mourned the death of 20 Indian soldiers. “The loss of soldiers in Galwan is deeply disturbing and painful. Our soldiers displayed exemplary courage and valour in the line of duty and sacrificed their lives in the highest traditions of the Indian Army,” he said in a statement.

“The Nation will never forget their bravery and sacrifice. My heart goes out to the families of the fallen soldiers. The nation stand shoulder to shoulder with them in this difficult hour. We are proud of the bravery and courage of India’s bravehearts,” the minister further said in the statement posted on Twitter.

These are the first Indian casualties in a border skirmish with PLA since October 1975 when Chinese troops ambushed an Indian patrol in Arunachal Pradesh’s Tulung La sector and shot four soldiers dead.