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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, Apr 20: With 1,553 more COVID-19 cases, India's total number of coronavirus cases has reached 17,265, the Ministry of Health and Family Welfare said on Monday.

Out of the total cases, 14,175 cases are active, while 2,547 people have been cured/discharged/migrated and 543 deaths have been reported, as per the ministry.

As many as 36 deaths have been reported in the last 24 hours.

According to the Ministry of Health and Family Welfare, Maharashtra continues to be the worst-affected state with a total of 4,203 cases. While 507 patients have recovered, 223 deaths have been reported.

Delhi comes next with 2,003 cases, out of which 72 patients have recovered while 45 patients have died.

Rajasthan has confirmed 1,478 cases, out of which 183 people have recovered while 14 patients are dead.

Tamil Nadu has reported 1,477 cases, out of which 411 have recovered and 15 have succumbed to the virus.

Madhya Pradesh has reported 1,407 cases, including 127 patients recovered and 70 patients dead. On the other hand, Uttar Pradesh has 1,084 COVID-19 positive cases.

In Kerala, which reported the country's first COVID-19 case, 402 people have been detected positive for coronavirus.

New Delhi, Feb 4: Four-month-old Mohammed Jahaan accompanied his mother almost every day to the Shaheen Bagh demonstration where he was a favourite with the protesters who would take turns to hold him and often draw the tricolour on his cheeks.

Jahaan will not be seen at Shaheen Bagh anymore. He died last week after acquiring a severe cold and congestion following exposure to the winter chill at the outdoor demonstration. His mother is, however, undeterred and determined to participate in the protests, saying it is "for the future of my children".

The infant's shattered parents, Mohammed Arif and Nazia, live in a tiny shanty put together with plastic sheets and cloth in Batla House area and have two other children -- a five-year-old daughter and a one-year-old son.

Hailing from Bareilly in UP, the couple is barely able to make ends meet. Arif is an embroidery worker and also drives an e-rickshaw. His wife helps him in his embroidery work.

"I haven't been able to earn enough in the last month despite driving the battery rickshaw in addition to my embroidery work. Now with our baby's demise, we have lost everything," he said, showing a picture of little Jahaan wearing a woolen cap that read 'I Love My India'.

A visibly disturbed Nazia said Jahaan passed away in his sleep on night of January 30 after returning from the protests.

"I had returned from Shaheen Baag at around 1 AM. After putting him and other kids to sleep, even I went to sleep. In the morning, I suddenly found him motionless. He was gone in his sleep," she said.

The couple said they took their motionless baby to the nearby Alshifa Hospital on the morning of January 31 where he was declared dead on arrival.

Nazia, who had been visiting the Shaheen Bagh demonstration everyday with Jahaan since December 18, says that he died after catching a cold that turned lethal.

She said she didn't realise that his congestion was so severe. However, the baby's death certificate issued by the hospital does not mention any specific reason for the death.

Shazia, a neighbour who was present at the couple's home, said Nazia had fought with her mother and husband to visit Shaheen Bagh everyday. Nazia would gather all women in the bylane outside her house so that they could together walk to the demonstration, around 2 km away. Sometimes, Arif would drop some of them to Shaheen Bagh on his e-rickshaw.

Nazia said she strongly feels that the CAA and NRC are against the welfare of all communities and will join the Shaheen Bagh protests, but this time without her children.

"Why was I doing this? For my children and the children of all us who need a bright future in this country," she told PTI.

"The CAA divides us on religion and should never be accepted. I don't know if there is politics involved but I know that I must question what is against the future of my children."

Arif, however, blamed the NRC and CAA for his child's death.

"Had the government not brought CAA and NRC, people would not have protested and my wife would not have joined them, my son would have been alive," he said.