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New Delhi, May 18: With the highest-ever spike of 5,242 new cases in last 24 hours, the total number of positive COVID-19 cases in India reached 96,169 on Monday, according to the Ministry of Health and Family Welfare.

With 157 deaths reported in the last 24 hours, the death toll has risen to 3,029, as per the latest update by the ministry.

Out of the total number of cases, 36,824 have been cured/discharged/migrated.

This comes a day after the nationwide lockdown, imposed as a precautionary measure to contain the spread of COVID-19, was extended till May 31.

Maharashtra remains the worst-affected state due to the virus with 33,053 cases, including 1,198 deaths. It is followed by Gujarat (11,379), Tamil Nadu (11,224) and Delhi (10,054).

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

Jan 13: India lost more than $1.33 billion to internet restrictions in 2019 as Prime Minister Narendra Modi’s government pushed ahead with his party’s Hindu nationalist agenda, raising tensions and sparking nationwide protests.

The worst shutdown has been in Kashmir, where after intermittent closures in the first half of the year, the internet has been cut off since Aug. 5 following the government’s decision to revoke the special autonomous status of the country’s only Muslim-majority state, a study said. The prologued closure was criticized by India’s highest court, which ruled Friday that the “limitless” internet shutdown enforced by the government for the last five months was illegal and asked that it be reviewed.

India imposed more internet restrictions than any other large democracy, according to the Cost of Internet Shutdowns 2019 report released by Top10VPN, a U.K.-based digital privacy and security research group. The South Asian nation recorded the third-highest losses after Iraq and Sudan, which lost $2.31 billion and $1.86 billion respectively to disruptions. Worldwide internet restrictions caused losses worth $8.05 billion, the report said.

The cost of internet blackouts was calculated using indicators from groups including the World Bank, International Telecommunication Union, and the Delhi-based Software Freedom Law Center. It includes social media shutdowns in its calculations.

India’s ministry of information and technology didn’t respond to an email seeking a response to the report’s findings.

‘Conservative Estimates’

Through 2019, India shut access to the internet for over 4,000 hours. The report added shutdowns in India were often narrowly targeted, down to the level of blocking city districts for a few hours to allow security forces to restore order. Many of these incidents were not included in the report.

“These are conservative estimates,” said Simon Migliano, head of research at U.K.-based Top10VPN. “Internet shutdowns are increasing and it shows a damaging trend.”

India’s other major internet disruptions coincided with two moves by the government that affect India’s Muslim minority. The first disruption took place in November in the states of Uttar Pradesh and Rajasthan after the Supreme Court handed a victory to Hindu groups over Muslim petitioners in a long-simmering dispute over a plot of land.

There were further disruptions in December when protests erupted against the introduction of a religion-based law that allows undocumented migrants of all faiths except Islam from neighbouring countries to seek Indian citizenship. The government enforced shutdowns across Uttar Pradesh and some Northeastern states in order to quell the protests, the report said.