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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, Jun 7: India registered its highest single-day spike of COVID-19 cases for the fifth consecutive day on Sunday, with 9,971 new infections taking the country's tally to 2,46,628, while the death toll rose to 6,929, according to the Union Health Ministry.

India registered 287 deaths in the 24 hours since Saturday morning.

India had raced past Spain on Saturday to become the fifth worst-hit nation by the COVID-19 pandemic. Now, only the US, Brazil, Russia and the UK are ahead of it.

The number of active COVID-19 cases stands at 1,20,406, according to the Health Ministry.

A total of 1,19,292 people have recovered and one patient has migrated, the Ministry said.

During the last 24 hours, a total of 5,220 COVID-19 patients have been cured, the ministry said.

"Thus, around 48.37 per cent patients have recovered so far," a senior ministry official said.

The tally of confirmed cases includes foreigners.

The Indian Council of Medical Research has further ramped up the testing capacity for detecting the novel coronavirus in infected persons.

The number of government labs has been increased to 531 and private labs to 228, taking the total number of labs to 759.

As many as 1,42,069 samples were tested in the last 24 hours, taking the total number of samples tested till now to 46,66,386.

Deaths in India per lakh population (0.49) are much lower than the world average of 5.17 and are the lowest among countries that have eased lockdown such as Germany (10.35), Italy (55.78), the UK (59.62) and Spain (58.06), as per a WHO situation report cited by the Health Ministry.

Cases in India per lakh population (17.32) are much lower than the world average of 87.74 and are the lowest among countries that have eased lockdown such as Germany (219.93), Italy (387.33), the UK (419.54) and Spain (515.61).

Of the 287 deaths reported since Saturday morning, 120 were from Maharashtra, 53 from Delhi, 29 from Gujarat, 19 from Tamil Nadu, 17 from West Bengal, 15 from Madhya Pradesh, 13 from Rajasthan, 10 from Telangana, three from Jammu and Kashmir, two each from Karnataka, Punjab and Chhattisgarh and one each from Kerala and Bihar.

Of the total 6,929 fatalities, Maharashtra tops the tally with 2,969 deaths, followed by Gujarat with 1,219 deaths, Delhi with 761, Madhya Pradesh with 399, West Bengal with 383, Uttar Pradesh with 257, Tamil Nadu with 251, Rajasthan with 231, Telangana with 123 and Andhra Pradesh with 73 deaths.

The death toll reached 59 in Karnataka and 50 in Punjab.

Jammu and Kashmir has reported 39 fatalities due to the disease, Bihar has 30, Haryana has 24 deaths, Kerala has 15, Uttarakhand has 11, Odisha has eight and Jharkhand has reported seven deaths so far.

Himachal Pradesh and Chandigarh have registered five COVID-19 fatalities each. Assam and Chhattisgarh have recorded four deaths each.

Meghalaya and Ladakh have reported one COVID-19 fatality each, according to the Health Ministry data.

According to the Ministry's website, more than 70 per cent of the deaths are due to comorbidities.

The highest number of confirmed cases in the country are from Maharashtra at 82,968, followed by Tamil Nadu at 30,152, Delhi at 27,654, Gujarat at 19,592, Rajasthan at 10,331, Uttar Pradesh at 9,733 and Madhya Pradesh at 9,228, according to the Health Ministry data updated in the morning.

The number of COVID-19 cases has gone up to 7,738 in West Bengal, 5,213 in Karnataka, 4,915 in Bihar and 4,510 in Andhra Pradesh.

It has risen to 3,952 in Haryana, 3,496 in Telangana, 3,467 in Jammu and Kashmir and 2,781 in Odisha.

Punjab has reported 2,515 coronavirus infections so far, while Assam has 2,397 cases. A total of 1,807 people have been infected with the virus in Kerala and 1,303 in Uttarakhand.

Jharkhand has registered 1,000 cases, Chhattisgarh has 923, Tripura has 747, Himachal Pradesh has 400, Chandigarh has 309 cases, Goa has 267, Manipur has 157, Nagaland has 107, and Puducherry and Ladakh have 99 cases.

Arunachal Pradesh has 47 COVID-19 cases, while Andaman and Nicobar Islands and Meghalaya have registered 33 infections each.

Mizoram has reported 24 cases and Dadar and Nagar Haveli has 19 cases, while Sikkim has reported seven cases till now.

"8,605 cases are being reassigned to states," the Ministry said on its website adding, "our figures are being reconciled with the ICMR."

State-wise distribution is subject to further verification and reconciliation, it added.

New Delhi, Jul 3: In a significant step, ICMR has partnered with Bharat Biotech International Limited (BBIL) to fast-track clinical trials of the indigenous COVID-19 vaccine (BBV152 COVID Vaccine). It is the first indigenous vaccine being developed by India and is one of the top priority projects which is being monitored at the topmost level of the Government, says ICMR in a statement.

The vaccine is derived from a strain of SARS-CoV-z isolated by ICMR-National Institute of Virology, Pune. ICMR and BBIL are jointly working for the preclinical as well as clinical development of this vaccine.

In a letter to the institutes that will be involved in the trails of the vaccine, ICMR has said

"It is envisaged to launch the vaccine for public health use latest by 15th August 2020 after completion of all clinical trials. BBIL is working expeditiously to meet the target. However, final outcome will depend on the cooperation of all clinical trial sites involved in this project. you have been chosen as a clinical trial site of the BBV152 COVID vaccine. ln view of the public health emergency due to COVID-19 pandemic and urgency to launch the vaccine, you are strictly advised to fast track all approvals related to initiation of the clinical trial and ensure that the subject enrollment is initiated no later than 7th July 2020."

The ICMR also asked the institutes to comply with the order, "Kindly note that non-compliance will be viewed very seriously. Therefore, you are advised to treat this project on the highest priority and meet the given timelines without any lapse."

The ICMR has selected 12 institutes, including one from Odisha, for the clinical trial of the country's first indigenous COVID-19 vaccine.