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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 7: The death toll due to novel coronavirus rose to 114 and the number of cases in the country climbed to 4,421 on Tuesday, according to the Union Health Ministry.

While the number of active COVID-19 cases stood at 3,981, as many as 325 people were cured and discharged, and one had migrated, it stated. The total number of cases include 66 foreign nationals.

According to the ministry's data updated at 9 am, three new deaths were reported from Rajasthan, while Tripura recorded its first coronavirus case.

Maharashtra has reported the most coronavirus deaths at 45, followed by Gujarat at 12, Madhya Pradesh nine, Telangana and Delhi seven each, Punjab six and Tamil Nadu five fatalities.

Karnataka registered four deaths, while West Bengal, Uttar Pradesh, Andhra Pradesh and Rajasthan have recorded three fatalities each. Two deaths each have been reported from Jammu and Kashmir and Kerala. Bihar, Himachal Pradesh and Haryana have reported one fatality each, according to the health ministry data.

However, a PTI tally based on figures reported by states directly on Monday night showed at least 138 deaths across the country, while the confirmed cases reached 4,683. Of them, 359 have been cured and discharged.

There has been a lag in the Union Health Ministry figures, compared to the numbers announced by different states, which officials attribute to procedural delays in assigning the cases to individual states.

The highest number of confirmed cases are from Maharashtra at 748, followed by Tamil Nadu at 621 and Delhi with 523 cases. Kerala reported 327 COVID-19 cases, Telangana 321, Uttar Pradesh 305 and Rajasthan 288 cases. Andhra Pradesh reported 226 coronavirus cases.

Novel coronavirus cases have risen to 165 in Madhya Pradesh, 151 in Karnataka and 144 in Gujarat. Jammu and Kashmir has 109 cases, West Bengal has 91, Haryana 90 and Punjab 76 cases of the infection.

Thirty-two people were infected with the virus in Bihar while Uttarakhand has 31 patients and Assam 26. Odisha reported 21 coronavirus cases, Chandigarh 18, Ladakh 14 and Himachal Pradesh 13 cases.

Ten cases each have been reported from the Andaman and Nicobar Islands and Chhattisgarh. Goa has reported seven COVID-19 infections, followed by Puducherry with five cases. Jharkhand has reported four cases and Manipur two. Tripura, Mizoram and Arunachal Pradesh have reported one case of the infection each.

"State-wise distribution is subject to further verification and reconciliation," the ministry said on its website.

Chennai, Jan 19: Amid ongoing nationwide protests against Citizenship (Amendment) Act, 2019, finance minister Nirmala Sitharaman on Sunday said that as many as 2838 people from Pakistan were given citizenship during the last six years.

"In the last six years, as many as 2838 Pakistani refugees, 914 Afghan refugees, 172 Bangladeshi refugees including Muslims have been given Indian citizenship. From 1964 to 2008, more than 4,00,000 Tamils (from Sri Lanka) have been given Indian citizenship," Sitharaman said at 'Programme on Citizenship (Amendment) Act, 2019' event here.

She added, "Till 2014, over 566 Muslims from Pakistan, Bangladesh and Afghanistan were given Indian citizenship. During 2016-18 under Modi government, around 1595 Pakistani migrants and 391 Afghanistani Muslims were given Indian citizenship."

The minister, further, said, "It was also during the same period in 2016, that Adnan Sami was given Indian citizenship, this is an example."    

Sitharaman added that people who came from East Pakistan have been settled at various camps in the country.

"They are still there and it's been 50-60 years now. If you visit these camps, your heart will cry. The situation is the same with Sri Lankan refugees who continue to live in camps. They're barred from getting basic facilities," she said.

Asserting that the government is not snatching away anyone's citizenship, the BJP leader said: "This Citizenship (Amendment) Act is an attempt to provide people with a better life. We are not snatching away anyone's citizenship, we are only providing them that."

"The National Population Register (NPR) will be updated every 10 years and is not involved with the National Register of Citizens (NRC). Some are involved in raising false allegations and triggering people unnecessarily without any base," she added.