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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

Kolkata, May 20: Cyclone 'Amphan' lay centred about 240 km south of Digha in West Bengal on Wednesday morning as an extremely severe cyclonic storm, the Met department said here.

The intensity near the centre of the storm was 170 to 180 kmph gusting to 200 kmph, the Met said.

'Amphan' is very likely to move north-northeastwards and cross West Bengal-Bangladesh coast between Digha and Hatiya, close to the Sunderbans during the afternoon to evening of Wednesday with a wind speed of 155 to 165 kmph gusting to 185 kmph as a 'very severe cyclonic storm', the Met department said.

West Bengal has evacuated more than three lakh people to safer places as the cyclonic storm 'Amphan' roared towards the coastal areas of the state, officials said.

The Met department, which has issued an "orange message" for West Bengal, warned of extensive damage in Kolkata, Hooghly, Howrah, South and North 24 Parganas and East Midnapore districts.

The Met department has advised that all establishments and markets remain closed in Kolkata and adjoining areas and movement of people be restricted on May 20.

There is likely to be disruption of rail and road link at several places, uprooting of communication and power poles, extensive damage to all types of 'kutcha' houses and some damage to "old badly managed pucca" structures and potential threat from flying objects, the weatherman warned.

There is also likelihood of extensive damage to standing crops, plantations and orchards and blowing down of palm and coconut trees, the Met said.

The weatherman has advised diversion or suspension of rail and road traffic in the districts which are likely to be affected.

The Eastern Railway (ER) has cancelled the departure of Howrah-New Delhi AC Special Express for Wednesday.

The departure of 02301 Howrah-New Delhi AC Special Express on Wednesday and 02302 New Delhi-Howrah AC Special Express on May 21 would remain cancelled, the ER said.

Wind speed along and off the coastal areas of West Bengal will reach 75 to 85 kmph with gusts up to 95 kmph from Wednesday morning along and off districts of North and South 24 Parganas, East and West Midnapore, Kolkata, Howrah and Hooghly, Regional Met director G K Das said.

"It will gradually increase thereafter becoming 110 to 120 kmph gusting to 130 kmph over West Midnapore, Howrah, Hooghly, Kolkata and wind speed of 155 to 165 kmph gusting to 185 kmph over the districts of North and South 24 Parganas and East Midnapore of West Bengal from the afternoon to night of May 20," he said.

Under its impact rainfall will occur in most places over the districts of Gangetic West Bengal on Wednesday, with heavy to very heavy downpour with extremely heavy rain at a few places in Kolkata, Howrah, East Midnapore, North and South 24 Parganas and Hooghly districts, he said.

"Storm surge of 4 to 5 metres above astronomical tide is likely to inundate low lying areas of South and North 24 Parganas and about 3 to 4 metres over low lying areas of East Midnapore district of West Bengal during the time of landfall," he said.

The Indian Navy has dispatched a diving team for providing assistance to the West Bengal government in relief operations, a Defence official said.

The diving team from Vishakhapatnam has brought specialised equipment along with them which can be used for rescue in case of flooding and have been positioned at the Naval Service Selection Board at Diamond Harbour in South 24 Parganas district, the official said.

Mar 5: The fourteen Italians, who have tested positive for coronavirus, have been shifted to the Medanta Hospital in Gurgaon from an ITBP quarantine centre.

The hospital issued a statement on Thursday morning, saying these patients are housed on a completely separate floor, which has been quarantined and has no contact with the rest of the hospital.

There is a dedicated medical team wearing protective gear looking after these patients.All items used on the floor are isolated to that floor.

The isolated floor will completely contain the disease even with these asymptomatic persons. All other hospital operations are operating as normal, and there is no increased risk to patients, visitors or staff, the statement said.

Twenty-one Italian tourists and their three Indian tour operators were shifted out from an ITBP quarantine centre here on Wednesday as they were exposed to novel coronavirus.

An affected Italian couple is being treated at Jaipur's SMS medical college.

Officials on Tuesday said the foreigners have been sent to a private hospital in Gurgaon and a centre in the national capital while the Indians have been transferred to the Safdarjung Hospital.

Fourteen Italians and an Indian (driver), who were in the same group as the affected Italian couple, tested positive for the virus as per information provided by the Health Ministry.

The Italian tourists and three Indians were admitted to the Indo-Tibetan Border Police (ITBP) force centre in Chhawla on Tuesday.

The Centre already has 112 people, 76 Indians and 36 foreigners, since February 27 after they were evacuated by an Indian Air Force (IAF) plane from China's Wuhan, the epicentre of the deadly coronavirus.

The first samples of these 112 people had tested negative when reports came in last week.