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Muzaffarpur, Mar 18: Prisoners in the central jail here are working overtime to produce facemasks to prevent the deadly COVID-19 striking. In addition to providing protection to fellow inmates and prison staff, the produce will be shared with nine district and sub jails falling under Muzaffarpur Central Prison as well, Deputy Superintendent of the jail Sunil Kumar Maurya said. From supplications at places of worship to hectic activities at the biggest hospital, this north Bihar district is witnessing invocation of all powers, human and otherwise, to prevent novel coronavirus hitting them.

Although nobody has so far tested positive for the dreaded virus in Bihar, where the state government has imposed a semi-lockdown as a preventive measure, Muzaffarpur which hit the headlines last year for losing close to 200 children to an outbreak of brain fever seems determined not to fall prey to yet another virulent affliction.

On making of facemasks by about 50 prisoners, the Deputy Superintendent of the jail said, "We have had a tradition of producing fabric at the Muzaffarpur Central Jail. An idea was floated why not use the skills acquired for producing masks which are in great demand but in short supply.

The local administration seems impressed with the endeavour of the social outcasts to rise to a global challenge.

"It is a welcome step. Despite all precautions, we never know who is going to catch the infection at which place. The efforts by prisoners to protect themselves and the staff manning their premises is laudable. "Full assistance will be provided to Central Jail authorities in supply of the masks to other prisons," Sub Divisional Magistrate (East) Kundan Kumar said.

A conservative town inhabited by a deeply religious citizenry, Muzaffarpur is also witnessing prayer congregations at temples and mosques in keeping with the tradition here of people of all faiths coming together when faced with a major challenge.

The Garib Nath temple, a renowned shrine devoted to Lord Shiva which attracts devotees from far and wide, is witness to the power of faith trumping the biggest fears as the footfall seems to have increased since the outbreak.

The temples mahant Vinay Pathak says, "faith can move mountains. People come here in search of strength to face a crisis which has caused worldwide scare. We advise the visitors to conduct regular 'havans' at their houses just like we have been performing here. "The smoke emitted by burning of purified offerings cleanses the air and, who knows, could be an antidote as well," Pathak added.

Chanting of 'Mahamrityunjay mantra', which the faith believe to be potent enough to dispel illness and untimely death, is taking place round the clock at the shrine in addition to 'havans', the mahant said.

Just a few yards away stands the Chhata Chowk mosque where large number of devotees appear in skull-caps to offer namaz.

"It is a pandemic threatening to engulf the entire world and dua (prayers) are needed as much as dawa (medicines). May God, who is one, listen to the common wish expressed by humanity in myriad ways," says Imtiaz Ahmed, a devout local resident.

Meanwhile, the health authorities are busy with their own efforts, not leaving prevention and cure to divine intervention.

District Medical Officer Shailesh Kumar Singh says a total of 42 people here who have come from abroad, have been tested but their results have been negative.

"Nonetheless, a five-bed special ward has been set up at the Sadar Hospital, manned by medical staff armed with a special kit comprising medicines and other logistics required for primary care of those with suspected symptoms," he said.

The SKMCH referral hospital, which bore the brunt of last years brain fever epidemic accounting for over 120 deaths is fully geared up to meet the latest challenge.

SKMCH superintendent Sunil Shahi says "we have a 30- ward insulation ward ready. Samples of patients with suspected symptoms are being routinely sent to RMRI, Patna. We appeal to all to remain alert, but avoid panic."

Kozhikode, Apr 24: A four-month-old baby girl, who had tested positive for COVID-19 and suffering from congenital heart disease, died in a hospital here in Kerala early Friday after suffering a cardiac arrest, officials said.

This is the third COVID-19 death and the first infant fatality in the state where two elderly people had succumbed to the disease earlier.

The baby was admitted to the Medical College Hospital here on April 21 with history of fever, cough, breathing difficulties and seizure after being treated at two other hospitals and the end came at 6 am, a medical bulletin said.

State Health Minister K K Shailaja said doctors had made maximum efforts to save the life of the child, whose family belonged to Payyanad near Manjeri in Malappuram district.

"Preliminary information which we have is that there has been some primary contact", she told reporters in Thiruvananthapuram.

The protocol for COVID-19 cases would be followed for the baby's last rites, the Minister added.

As of Thursday, the total active COVID-19 cases in the state stood at 129.

The bulletin said on arrival at the hospital on Tuesday the baby was in shock and had respiratory failure.

"She was resuscitated, mechanically ventilated and appropriate antibiotics for pneumonia and supportive measures to correct shock were started", it said adding the baby, however, continued to remain sick.

"Even though there was no history of any high or low risk contact or any epidemiological links as the child comes from SARI (Sever Acute Respiratory infection) criteria, she was admitted to the COVID-ICU and swab was taken and she tested positive", the bulletin said.

Contact tracing of those who had come in contact with the child was in progress.

Mallapuram District Medical Officer (Health) Dr Sakeena K said the child was having severe health issues from its birth itself and was admitted to a private hospital in Manjeri near here with breathing problem.

As her condition worsened, the baby was shifted to another hospital and later to the medical college hospital.

"The baby was having chest deformity and Atrial Septal Defect by birth which developed into severe health issues, the official added.

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