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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

Visakhapatnam, May 7: Andhra Pradesh Chief Minister Y S Jagan Mohan Reddy on Thursday announced an ex- gratia payment of Rs one crore each to the kin of those killed in the styrene gas leak incident at LG Polymers Limited near here.

The NDRF had put the death toll from the leak at 11.

The chief minister announced a committee to probe into the mishap and also said the government would talk to the LG Polymers management seeking job for the kin of the deceased in any of its businesses.

Speaking to reporters after conducting a review meeting, Reddy also announced Rs 10 lakh each to those undergoing treatment on ventilator support and Rs 25,000 to those who took treatment as out-patients after developing health complications due to inhalation of the styrene vapour.

Earlier, he held a review meeting at the Andhra Medical College with District Collector Vinay Chand and others.

The gas leak victims undergoing treatment in various hospitals would be paid Rs one lakh each. The 15,000-odd population in the five villages that were affected by the gas leak would be paid Rs 10,000 each, the chief minister added.

Reddy further announced constitution of a high-level committee, headed by the Special Chief Secretary (Environment and Forests), to probe into the mishap and make recommendations to prevent such tragedies in the future.

Earlier, he visited the King George Hospital and consoled the victims of the gas leak.

Accompanied by his Deputy holding the health portfolio A K K Srinivas and Chief Secretary Nilam Sawhney, Reddy flew down to the port city and went straight to the KGH.

He met the gas leak victims undergoing treatment and enquired about their well-being.

At the review meeting, the Collector informed the Chief Minister that the gas spread was limited to a 1.5 to 2 km area from the epicentre of the leak and that the locals were evacuated to safety.

Of the two styrene tanks in the plant, the leak occurred from one that was holding about 1,800 kilo litres of the chemical.

Jan 28: China said on Tuesday that 106 people had died from a new coronavirus that is spreading across the country, up from the previous toll of 81.

The number of total confirmed cases in China rose to 4,515 as of Jan. 27, the National Health Commission said in a statement, up from 2,835 reported a day earlier.

The United States warned against travel to China on Monday and Canada issued a more narrow travel warning as the death toll from the spreading coronavirus passed 100, with tens of millions stranded during the biggest holiday of the year and global markets rattled.

Global stocks fell, oil prices hit three-month lows, and China's yuan dipped to its weakest level in 2020 as investors fretted about damage to the world's second-biggest economy from travel bans and the Lunar New Year holiday, which China extended in a bid to keep people at home.

The health commission of China's Hubei province said on Tuesday that 100 people had died from the virus as of Jan. 27, according to an online statement, up from the previous toll of 76, with the number of confirmed cases in the province rose to 2,714.

Other fatalities have been reported elsewhere in China, including the first in Beijing, bringing the deal toll to 106 so far, according to the People's Daily. The state newspaper put the total number of confirmed cases in China at 4,193, though some experts suspect a much higher number.

On Monday, US President Donald Trump offered China whatever help it needed, while the State Department said Americans should "reconsider" visiting all of China due to the virus.

Canada, which has two confirmed cases of the virus and is investigating 19 more potential cases, warned its citizens to avoid travel to China's Hubei province, at the heart of the outbreak.

Authorities in Hubei province are taking increasing flak from the public over their initial response to the virus. Chinese Premier Li Keqiang visited the city of Wuhan, epicentre of the outbreak, to encourage medical workers and promise reinforcements.

Visiting Wuhan in blue protective suit and mask, Li praised medics, said 2,500 more workers would join them in the next two days, and visited the site of a new hospital to be built in days.

The most senior leader to visit Wuhan since the outbreak, Li was shown on state TV leading medical workers in chants of "Wuhan jiayou!" - an exhortation to keep their strength up.

China's ambassador to the United Nations, following a meeting with UN Secretary-General António Guterres on Monday, said "the Chinese government attaches paramount importance to prevention and control of the epidemic, and President Xi Jinping has given important instructions. ...

"China has been working with the international community in the spirit of openness, transparency and scientific coordination," he said.

Guterres said in a statement, "The UN appreciates China's effort, has full confidence in China's ability of controlling the outbreak, and stands ready to provide any support and assistance."

MOUNTING ANGER

On China's heavily censored social media, officials have faced mounting anger over the virus, which is thought to have originated from a market where wildlife was sold illegally.

Some criticised the governor of Hubei province, of which Wuhan is the capital, after he corrected himself twice during a news conference over the number of face masks being produced.

"If he can mess up the data multiple times, no wonder the disease has spread so severely," said one user of the Weibo social media platform.

In rare public self-criticism, Wuhan Mayor Zhou Xianwang said the city's management of the crisis was "not good enough" and indicated he was willing to resign.

The central Chinese city of 11 million people is in virtual lockdown and much of Hubei, home to nearly 60 million people, is under travel curbs.

Elsewhere in China, people from the region faced questioning about their movements. "Hubei people are getting discriminated against," a Wuhan resident complained on Weibo.

Cases linked to people who travelled from Wuhan have been confirmed in a dozen countries, from Japan to the United States, where authorities said they had 110 people under investigation in 26 states. Sri Lanka was the latest to confirm a case.

INVESTORS WORRIED

Investors are worried about the impact. The consensus is that in the short term, economic output will be hit as authorities limit travel and extend the week-long New Year holiday — when millions traditionally travel by rail, road and plane - by three days to limit spread of the virus.

Asian and European shares tumbled, with Japan's Nikkei average sliding 2%, its biggest one-day fall in five months. Demand spiked for safe-haven assets such as the Japanese yen and Treasury notes. European stocks fell more than 2%.

The US S&P 500 closed down nearly 1.6%.

"China is the biggest driver of global growth so this couldn't have started in a worse place," said Alec Young, FTSE Russell's managing director of global markets research.

During the 2002-2003 outbreak of Severe Acute Respiratory Syndrome (SARS), which originated in China and killed nearly 800 people globally, air passenger demand in Asia plunged 45%. The travel industry is more reliant on Chinese travellers now.

Chinese-ruled Hong Kong, which has had eight cases, banned entry to people who had visited Hubei recently.

Some European tour operators cancelled trips to China, while governments around the world worked on repatriating nationals.

Officially known as 2019-nCoV, the newly identified coronavirus can cause pneumonia, but it is still too early to know just how dangerous it is and how easily it spreads.

"What we know about this virus it that transmission occurs through human contact but we are speaking of close contact, i.e. less than a meter," said Jerome Salomon, a senior official with France's health ministry.

"Crossing someone (infected) in the street poses no threat," he said. "The risk is low when you spend a little time near that person and becomes higher when you spend a lot of time near that person."