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India has jumped past 4.5 lakh coronavirus cases and 14,476 people have succumbed to the viral infection so far. In this backdrop, speaking to IANS in an exclusive interview, AIIMS Director Randeep Guleria said India is also vulnerable to second wave of coronavirus and people should continue to follow social distancing, wearing mask and other precautions, after cases begin to decline.

He added that in order to contain the outbreak of Covid-19, a limited lockdown in hotspots, where volume of cases is very high, may be considered along with a micro-plan to prevent leakage of cases from these areas to other non-containment areas. Excerpts of the interview are below:

Q: Reports say China and South Korea are witnessing a second wave of coronavirus infection, what is this second wave, is India also vulnerable to this?

A: When cases come down significantly, people tend to drop their guard against the viral infection, and this leads to the second wave (which means a sudden increase in the number of cases). After cases begin to decline, people should continue to follow the precautions -- continue to maintain social distancing and wear masks regularly. See what happened in Singapore, it was struck by a second wave of coronavirus. Look, what happened in the 1918 pandemic, people dropped their guard and the second wave of viral infection struck back. If people do not follow social distancing then the spike in cases is apparent. We need to take these precautions at least for one year. India is also vulnerable to this second wave.

Q: If Covid-19 cases continue to rise rapidly, do you think we need another lockdown in areas where volume of cases are very high?

A: A large volume of cases is concentrated in specific areas like hotspots, and in order to maintain things in order, we may need a limited lockdown in these areas. This should be followed by a micro-plan which entails extensive testing of people and also extensive contact tracing of people who have got in touch with positive people. Need to ensure there is no leakage of cases from these areas. People from these areas should not mix with others in non-containment areas. This will aid in containing the outbreak of the virus. People who have developed symptoms should get themselves tested, especially in the containment areas.

Q: With more than 4.5 lakh cases and close to 14,500 deaths, do you think India has reached its peak and a decline in cases is prominent?

A: The cases will continue to increase for some time. The doubling time of cases has also increased. But, the cases will also begin to flatten. Though, it is difficult to give an exact time period in this viral infection, it seems, the growth in cases will flatten in the end of July or beginning of August. A decline will come to this viral infection, but it does not mean that people should drop their guard. As a measure, we need to decrease community participation and citizens should continue to follow social distancing. People should get themselves tested. All these efforts will help in preventing people from contracting this virus. These precautions will also prevent us from the second wave, and we must continue to take precautions. The virus has not gone away, it is still lurking.

Q: India has crossed the 4.5 lakh coronavirus cases so far, although our recovery rate is good, but still 10,000 to 15,000 cases are reported daily. Why do cases continue to spiral, what is the reason?

A: We have to remember a few things -- the bulk of cases are in 10 cities, nearly 70 per cent, and if we take into account cases per million population, the number is not very high, as compared with countries including countries in Europe. Many European countries put together still do not add up to the Indian population. Do not compare India to countries like Italy, Spain etc. We need to focus on hotspots, which contribute to between 70 -80 per cent of cases, and we have to identify cases in these areas at an early stage. The population density is very high in these cities. People in lower socio-economic status are highly vulnerable to the viral infection, as many live together in small spaces and there is a lot of mixing of people happening there. Look at the market places, people are not following social distancing and not wearing masks. In fact, many are in close vicinity of each other.

New Delhi, May 14: India may witness the death of additional 1.2-6 lakh children over the next one year from preventable causes as a consequence to the disruption in regular health services due to the COVID-19 pandemic, UNICEF has warned.

The warning comes from a new study that brackets India with nine other nations from Asia and Africa that could potentially have the largest number of additional child deaths as a consequence to the pandemic.

These potential child deaths will be in addition to the 2.5 million children who already die before their fifth birthday every six months in the 118 countries included in the study.

The estimate is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health published in the Lancet.  

This means the global mortality rate of children dying before their fifth birthday, one of the key progress indicators in all of the global development, could potentially increase for the first time since 1960 when the data was first collected.

There were 1.04 million under-5 deaths in India in 2017, of which nearly 50% (0.57 million) were neonatal deaths. The highest number of under-5 deaths was in Uttar Pradesh (312,800 which included 165,800 neonatal deaths) and Bihar (141,500 which included 75,300 neonatal deaths).

The researchers looked at three scenarios, factoring in parameters like reduction in workforce, supplies and access to healthcare for services like family planning, antenatal care, childbirth care, postnatal care, vaccination and preventive care for early childhood. The effects are modelled for a period of three months, six months and 12 months.  

In scenario-1 marked by 10-18% reduction of coverage of all the services, the number of additional children deaths could be in the range of 30,000 plus over three months, more than 60,000 over six months and above 120,000 over the next 12 months.

Coronavirus India update: State-wise total number of confirmed cases, deaths on May 13

The numbers sharply rose to nearly 55,000; 109,000 and 219,000 respectively for scenario-2, which was associated with an 18-28% drop in all the regular services.

But in the worst-case scenario in which 40-50% of the services are not available, the number of additional deaths ballooned to 1.5 lakhs in the three months in the short-range to nearly six lakhs over a year.

The ten countries that could potentially have the largest number of additional child deaths are Bangladesh, Brazil, Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and Tanzania.

In countries with already weak health systems, COVID-19 is causing disruptions in medical supply chains and straining financial and human resources.

Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and due to the fear of infection among the communities. Such disruptions could result in potentially devastating increases in maternal and child deaths, the UN agency warned.

Thiruvananthapuram, Apr 20:  Kerala Chief Minister Pinarayi Vijayan on Monday said that the government would revoke the order, which allowed the opening of barbershops and restaurants in the State.

The development comes after the Ministry of Home Affairs (MHA) objected to the move.
When asked about the letter issued by the MHA terming certain decisions as to the dilution of guidelines, Chief Minister Vijayan said: "There is no confrontation between the State government and the Centre."

"Kerala is following all directions issued by the Centre. Barbershops will not be opened and restaurants will only provide online delivery," he told the reporters, adding that public transport would not be allowed.

"There was a decision to open barbershops but many experts have pointed out against the decision. So the Kerala government is withdrawing the decision," he said.

Earlier, Chief Secretary Tom Jose said that if needed, then the State government will make necessary modifications to the lockdown guidelines in the wake of a communication received from the Central government.

The MHA had objected to the decision of Kerala government to allow services like barbershops, local workshops, restaurants, etc., and had urged the State government to revise its lockdown guidelines.

The Government of India had said that violation to lockdown measures reported posed a serious health hazard to the public and risk the spread of COVID-19.

Union Home Secretary Ajay Bhalla wrote to all Chief Secretaries and a separate letter had been sent to the Kerala Chief Secretary asking them not to dilute lockdown guidelines in any manner.

In his letter to the Kerala Chief Secretary, Bhalla had stated that the consolidated revised guidelines on the measures to be taken by the Ministries/Departments of the Government of India has been circulated on April 15 for containment of COVID-19.

Kerala Minister Kadakampally Surendran had said that relaxations have been given abiding by the direction issued by the Central government. He had added that the Centre may have asked for an explanation due to some misunderstanding.

India is under a nation-wide lockdown that came into force on March 25 to contain the spread of coronavirus, which has claimed 559 lives in the country. Last week, Prime Minister Narendra Modi announced the extension of lockdown till May 3.