Justice J.S. Verma passes away

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

New Delhi, Apr 8: The number of confirmed coronavirus cases in the country have continued to rise even on the 15th day of the lockdown, and reached 5,274 cases on Wednesday evening, according to the Ministry of Health and Family Welfare.

The tally includes 4,714 active, 411, cured/discharged and migrated cases as well as deaths. A total of 149 deaths have been reported due to the infection so far in the country.

Maharashtra with 1,018 confirmed cases has the highest number of COVID-19 patients in the country, while Tamil Nadu (690) and Delhi (576) are the two next most affected regions.

Fresh cases were reported on Wednesday from Telangana, Tamil Nadu, West Bengal, Maharashtra, Rajasthan and the union territory of Andaman and Nicobar Islands, among other states and UTs.

Meanwhile, in an interaction between Prime Minister Narendra Modi and floor leaders of several parties held today via video conferencing, discussions were held on extending the lockdown even further after the 21-day period.

The 21-day lockdown was announced on March 24 by Prime Minister Narendra Modi.
At the regular media briefing at 4 pm, Lav Aggarwal, Joint Secretary in the Health Ministry said that the government has ensured that there is no shortage of hydroxychloroquine in the country at present as well as in the future.

In the wake of COVID-19 outbreak, the Ministry of Human Resource and Development (MHRD) has launched 'Integrated Government Online Training Portal' wherein required resources will be provided for capacity building of the frontline workers.

"MHRD's training portal will provide required resources to the doctors, paramedics, nurse, technicians and ANMs and state government officials and civil defence officials, volunteers of National Cadet Corps (NCC), National Surveillance teams, Red Cross society and other organisations to have a large skill workforce to combat the coronavirus outbreak," said Aggarwal at a press conference here.

Speaking on government's preparedness on dealing with the patients having mild, very mild and serious conditions, Aggarwal said, "For people who have mild or very mild symptoms we have temporary hospitals, ie COVID care hospitals. Work is now being done to develop the field level infrastructure to take care of the mild and very mild symptomatic patients.

Similarly, for serious patients, we have dedicated healthcare centre and dedicated hospitals."

With fresh COVID-19 cases being reported across the country, several states and union territories, including Uttar Pradesh and Chandigarh, on Wednesday made it compulsory for people to use masks while venturing out of their houses.

Here's a quick read on the COVID-19 related updates:

1. Prime Minister Narendra Modi hinted that the lockdown might be extended after the completion of the 21-day period.
2. Floor party leaders of various political parties from both the Rajya and Lok Sabha assured the government of their full support in the decisions needed to be taken in the coming days and also suggested taking various measures to help the people.
3. According to the Indian Council of Medical Research (ICMR), a total of 1,21,271 tests have been conducted in the country.
4. The Uttar Pradesh government has decided to strictly implement 100 per cent lockdown in hotspots located across 15 districts in the state till the morning of April 15. These areas will be completely cordoned off and civilian passes will stay suspended while essentials would be delivered to citizens at their doorsteps.
5. The Supreme Court suggested that all tests to identify coronavirus positive patients should be conducted free of cost in the identified private laboratories and said that the court will pass appropriate order on the matter. The SC bench also asked the central government to look into creating a mechanism for providing reimbursement for the same.
6. Prime Minister Narendra Modi urged people to take the responsibility of a poor family, at least till the COVID-19 crisis persists if they wanted to honour him.
7. Union Home Ministry announced that Rs 3000 crores have been distributed among two crore registered construction workers till now, according to Saheli Ghosh Roy, Joint Secretary.
8. The MHA official said that the Home Secretary has written to the state Chief Secretaries to ensure a continuous supply of essential commodities under the Essential Commodities Act, 1955. The states can use measures like fixing stock limits, capping of price and checking bank accounts of the dealers.
9. The Health Ministry has assured that there will be no shortage of Hydroxychloroquine in the country. This came after India lifted the ban on the export of the anti-malarial drug being sued to treat COVID-19
10. The Maharashtra government too has issued an order to compulsorily wear masks while entering any government offices in Mumbai Metropolitan Region and Pune Metropolitan Region.

New Delhi, Mar 7: Prime Minister Narendra Modi turned emotional on Saturday when a woman beneficiary of his government's generic medicine programme told him that she had seen God in him.

Dehradun-resident Deepa Shah, who suffered paralysis in 2011, was interacting with the prime minister through video-conference on the occasion of Jan Aushadhi Diwas.

"I have not seen god, but I have seen God in you," she said, tears rolling down her eyes.

Modi was visibly emotional as the woman repeated her remark.

She also thanked the Uttarakhand chief minister and others who had helped her all along and said doctors had once told her that she cannot be cured.

"But on hearing your voice I have become better," she told Modi while profusely thanking the prime minister for his efforts to reduce the cost of medicines.

An emotional prime minister paused for a moment before telling her that it was her courage that had won over her disease and that she must carry on with the spirit.

Shah was expressing her plight and how she had suffered due to high cost of medicines after she suffered from paralysis in 2011 and has now started saving Rs 3,500 every month after benefitting from the government's low-cost generic medicines programme.

Soon after Shah rose to express her views, Modi asked her to sit and speak as he said she was uncomfortable while standing.

"You have defeated disease with your own will power. Your courage is your god and that same courage has given you the strength to emerge from such a big crisis. You should carry on this confidence in you," Modi told her.

He said some people still keep spreading rumours about generic medicines, going by their past experience, wondering how can medicines be available so cheap and that there must be something wrong with the medicine.

"But, by seeing you countrymen would gain confidence that there is nothing wrong in generic medicines. These medicines are not at all of inferior quality than any other medicine. These medicines have been certified by the best laboratories. These medicines are made in India and is 'Make in India' and are cheap," the prime minister said.

He said there is demand for generic medicines from India across the world and the government has made it mandatory for doctors to prescribe generic medicines to patients, unless necessary.