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New Delhi, May 26: With India now in the bracket of top 10 nations worst hit by the novel coronavirus, experts have attributed the surge in cases to easing of travel restrictions and movement of migrants besides enhanced testing capacity.

According to AIIMS Director, Randeep Guleria, the present rise in cases has been reported predominantly from hotspot areas but there is a possibility of further rise in the number of COVID-19 cases in the coming few days due to increased travel.

"Those who are asymptomatic or are in presymptomatic stage will pass through screening mechanisms and may reach areas where there have been minimal or less cases," Guleria said.

He said there was a need for more intense surveillance and monitoring in areas where migrants have returned to contain the spread of the disease.

If proper social distancing and hand hygiene is not maintained at a time when people are out on roads, the coronavirus infection will transmit much faster, he said.

Guleria also noted that testing capacity has been significantly ramped up which is reflecting in the increasing number of cases being detected.

Commenting on the partial resumption of rail and road transport services and migrants returning to their native places, Dr Chandrakant S Pandav, former president of the Indian Public Health Association and Indian Association of Preventive and social medicine, said the floodgates have been opened.

"This is a classic case of creating an enabling environment for coronavirus to spread like wildfire. In the coming few days, the number will rise dramatically. While it is true that lockdown cannot go on forever, the opening up should have been in a measured, calibrated and informed manner," he said.

"Travelling leads to spread of the infection. Now, the government will have to ensure even stronger surveillance to curb the infection but if that will be done is something to be observed," he said.

The death toll due to COVID-19 rose to 4,167 and the number of cases climbed to 1, 45,380 in the country, registering an increase of 146 deaths and 6,535 cases since Monday 8 am, according to the Union Health Ministry.

Dr K K Aggarwal, President of the Confederation of Medical Association of Asia and Oceania (CMAAO), and former IMA President, said there will be a further surge in cases in the coming days if migration continues without any proper social distancing.

"Within the next ten days, the cases will cross two lakh. The very fact that number of cases was rising before the end of the third lockdown and continuing during the fourth lockdown means that people are not following physical distancing as required," he said.

"Even in the last week of May when the temperature is very high, the rising number of cases would mean that human-to-human transmission is more important than surface-to-human transmission. Normally in heat the surface-to-human transmission should have reduced the new cases by half which has not happened," Aggarwal said.

However, Professor K Srinath Reddy, president of the Public Health Foundation of India, said an increase in the number of cases reflects both an increase in testing rates and an increase in spread.

"What we need to see is the number of new tests performed per day and the number of new cases that were identified from them. That gives a better idea of the rate of spread than the total number of new cases alone.

"We also have to see if the testing criteria has remained the same between the two periods of comparison.We may open up gradually but will have to continue case detection, contact tracing and follow personal protection measures as vigorously as possible," he added.

A total of 31,26,119 samples have been tested as on May 26, 9 am and 92,528 samples have been tested in the last 24 hours, ICMR officials said.

India is the tenth most affected nation by the pandemic after the US, Russia, UK, Spain, Italy, Brazil, Germany, Turkey and France, as per the John Hopkins University data.

The country has recorded 6,088, 6,654, 6,767 and 6977 cases on May 22, 23, 24 and 25 respectively. Also, the number of RT-PCR tests for detection of COVID-19 in the country crossed the 30-lakh mark on Monday.

The first two phases of the lockdown led to 14-29 lakh COVID-19 cases being averted, while the number of lives saved in that period was between 37,000 and 78,000, the government said last Friday, citing various studies, and asserted that the unprecedented shutdown has paid "rich dividends" in the fight against the pandemic.

New Delhi, Apr 23: The nationwide lockdown in India which started about a month ago has impacted nearly 40 million internal migrants, the World Bank has said.

The lockdown in India has impacted the livelihoods of a large proportion of the country's nearly 40 million internal migrants. Around 50,000 60,000 moved from urban centers to rural areas of origin in the span of a few days, the bank said in a report released on Wednesday.

According to the report -- 'COVID-19 Crisis Through a Migration Lens' -- the magnitude of internal migration is about two-and-a-half times that of international migration.

Lockdowns, loss of employment, and social distancing prompted a chaotic and painful process of mass return for internal migrants in India and many countries in Latin America, it said.

Thus, the COVID-19 containment measures might have contributed to spreading the epidemic, the report said.

Governments need to address the challenges facing internal migrants by including them in health services and cash transfer and other social programmes, and protecting them from discrimination, it said.

World Bank said that coronavirus crisis has affected both international and internal migration in the South Asia region.

As the early phases of the crisis unfolded, many international migrants, especially from the Gulf countries, returned to countries such as India, Pakistan, and Bangladesh until travel restrictions halted these flows.

Some migrants had to be evacuated by governments, such as those of China and Iran, it said.

Before the coronavirus crisis, migrant outflows from the region were robust, the report said.

The number of recorded, primarily low-skilled emigrants from India and Pakistan rose in 2019 relative to the prior year but is expected to decline in 2020 due to the pandemic and oil price declines impacting the Gulf countries.

In India, the number of low-skilled emigrants seeking mandatory clearance for emigration rose slightly by eight percent to 368,048 in 2019.

In Pakistan, the number of emigrants jumped 63 per cent to 6,25,203 in 2019, largely due to a doubling of emigration to Saudi Arabia, it said.

According to the bank, migration flows are likely to fall, but the stock of international migrants may not decrease immediately, since migrants cannot return to their countries due to travel bans and disruption to transportation services.

In 2019, there were around 272 million international migrants.

The rate of voluntary return migration is likely to fall, except in the case of a few cross-border migration corridors in the South (such as Venezuela-Colombia, Nepal-India, Zimbabwe South Africa, Myanmar-Thailand), it said.

Migrant workers tend to be vulnerable to the loss of employment and wages during an economic crisis in their host country, more so than native-born workers.

Lockdowns in labour camps and dormitories can also increase the risk of contagion among migrant workers.

Many migrants have been stranded due to the suspension of transport services. Some host countries have granted visa extensions and temporary amnesty to migrant workers, and some have suspended the involuntary return of migrants, it said.

Observing that government policy responses to the COVID-19 crisis have largely excluded migrants and their families back home, the World Bank said there is a strong case for including migrants in the near-term health strategies of all countries, given the externalities associated with the health status of an entire population in the face of a highly contagious pandemic.

The Bank said governments would do well to consider short, medium and long-term interventions to support stranded migrants, remittance infrastructure, loss of subsistence income for families back home, and access to health, housing, education, and jobs for migrant workers in host/transit countries and their families back home.

The pandemic has also highlighted the global shortage of health professionals and an urgent need for global cooperation and long-term investments in medical training, it said.