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United Nations, Jun 6: The coronavirus disease has not "exploded" in India, but the risk of that happening remains as the country moves towards unlocking its nationwide lockdown that was imposed in March to contain the Covid-19, according to a top WHO expert.

WHO Health Emergencies Programme Executive Director Michael Ryan on Friday said the doubling time of the coronavirus cases in India is about three weeks at this stage.

“So the direction of travel of the epidemic is not exponential but it is still growing,” he said, adding that the impact of the pandemic is different in different parts of India and varies between urban and rural settings.

“In South Asia, not just in India but in Bangladesh and...in Pakistan, other countries in South Asia, with large dense populations, the disease has not exploded. But there is always the risk of that happening,” Ryan said in Geneva.

He stressed that as the disease generates and creates a foothold in communities, it can accelerate at any time as has been seen in a number of settings.

Ryan noted that measures taken in India such as the nationwide lockdown have had an impact in slowing transmission but the risk of an increase in cases looms as the country opens up.

“The measures taken in India certainly had an impact in dampening transmission and as India, as in other large countries, open up and as people begin to move again, there's always a risk of the disease bouncing back up,” he said.

He added that there are specific issues in India regarding the large amount of migration, the dense populations in the urban environment and the fact that many workers have no choice but to go to work every day.

India went past Italy to become the sixth worst-hit nation by the COVID-19 pandemic.

India saw a record single-day jump of 9,887 coronavirus cases and 294 deaths on Saturday, pushing the nationwide infection tally to 2,36,657 and the death toll to 6,642, according to the health ministry.

The lockdown in India, was first clamped on March 25 and spanned for 21 days, while the second phase of the curbs began on April 15 and stretched for 19 days till May 3. The third phase of the lockdown was in effect for 14 days and ended on May 17. The fourth phase ended on May 31.

The country had registered 512 coronavirus infection cases till March 24.

The nation-wide lockdown in containment zones will continue till June 30 in India but extensive relaxations in a phased manner from June 8 are listed in the Union home ministry's fresh guidelines on tackling the Covid-19 pandemic issued last week.

WHO Chief Scientist Soumya Swaminathan said the over 200,000 current coronavirus cases in India, a country of over 1.3 billion people, "look big but for a country of this size, it's still modest.”

She stressed that it is important for India to keep track of the growth rate, the doubling time of the virus and to make sure that that number doesn't get worse.

She said that India is a “heterogeneous and huge country” with very densely populated cities and much lower density in some rural areas and varying health systems in different states and these offer challenges to the control of Covid-19.

Swaminathan added that as the lockdown and restrictions are lifted, it must be ensured that all precautions are taken by people.

“We've been making this point repeatedly that really if you want behaviour change at a large level, people need to understand the rationale for asking them to do certain things (such as) wearing masks,” she said.

In many urban areas in India, it's impossible to maintain physical distancing, she said adding that it then becomes very important for people to wear appropriate face coverings when they are out, in office settings, in public transport and educational institutions.

“As some states are thinking about opening, every institution, organisation, industry and sector needs to think about what are the measures that need to be put in place before you can allow a functioning and it may never be back to normal.”

She said that in many professions working from home can be encouraged but in several jobs, people have to go to work and in such cases measures must be put in place that allow people to protect themselves and others.

“I think communication and behaviour change is a very large part of this whole exercise,” she added.

May 7: India is projected to record the highest number of births in the 9 months since COVID-19 was declared a pandemic in March, with more than 20 million babies expected to be born in the country between March and December, according to top UN body.

The United Nations Children's Fund (UNICEF) warned that pregnant mothers and babies born during the pandemic across the world were threatened by strained health systems and disruptions in services.

An estimated 116 million babies will be born under the shadow of COVID-19 pandemic, UNICEF said on Wednesday, ahead of Mother's Day, observed on May 10.

These babies are projected to be born up to 40 weeks after COVID-19 was recognised as a pandemic on March 11.

The highest numbers of births in the 9 months since the pandemic was declared are expected to occur in India, where 20.1 million babies are projected to be born between March 11 and December 16. Other countries with the expected highest numbers of births during this period are China (13.5 million), Nigeria (6.4 million), Pakistan (5 million) and Indonesia (4 million), it said.

"Most of these countries had high neonatal mortality rates even before the pandemic and may see these levels increase with COVID-19 conditions," UNICEF said.

It is estimated that there will be 24.1 million births in India for the January-December 2020 period.

UNICEF warned that COVID-19 containment measures can disrupt life-saving health services such as childbirth care, putting millions of pregnant mothers and their babies at great risk.

Even wealthier countries are affected by this crisis. In the US, the sixth-highest country in terms of the expected number of births, over 3.3 million babies are projected to be born between March 11 and December 16.

"New mothers and newborns will be greeted by harsh realities," UNICEF said, adding they include global containment measures such as lockdowns and curfews; health centres overwhelmed with response efforts; supply and equipment shortages; and a lack of sufficient skilled birth attendants as health workers, including midwives, are redeployed to treat COVID-19 patients.

"Millions of mothers all over the world embarked on a journey of parenthood in the world as it was. They now must prepare to bring a life into the world as it has become – a world where expecting mothers are afraid to go to health centres for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns," UNICEF Executive Director Henrietta Fore said.

"It is hard to imagine how much the coronavirus pandemic has recast motherhood" Fore said.

UNICEF said its analysis was based on data from World Population Prospects 2019 of the UN Population Division.

An average full-term pregnancy typically lasts a complete 9 months, or 39 to 40 weeks. For the purposes of this estimate, the number of births for a 40-week period in 2020 was calculated.

The 40-week period of March 11 to December 16 is used in this estimate based upon the WHO's March 11 assessment that COVID-19 can be characterised as a pandemic.

UNICEF warned that although evidence suggests that pregnant mothers are not more affected by COVID-19 than others, countries need to ensure they still have access to antenatal, delivery and postnatal services.

Similarly, sick newborns need emergency services as they are at high risk of death. New families require support to start breastfeeding, and to get medicines, vaccines and nutrition to keep their babies healthy, it said.

"This is a particularly poignant Mother's Day, as many families have been forced apart during the coronavirus pandemic, but it is also a time for unity, a time to bring everyone together in solidarity. We can help save lives by making sure that every pregnant mother receives the support she needs to give birth safely in the months to come," Fore said.

Issuing an urgent appeal to governments and health care providers to save lives in the coming months, UNICEF said efforts must be made to help pregnant women receive antenatal checkups, skilled delivery care, postnatal care services, and care related to COVID-19 as needed.

Ensure health workers are provided with the necessary personal protective equipment and get priority testing and vaccination once a COVID-19 vaccine becomes available so that can deliver high quality care to all pregnant women and newborn babies during the pandemic, it said.

While it is not yet known whether the virus is transmitted from a mother to her baby during pregnancy and delivery, UNICEF advised all pregnant women to follow precautions to protect themselves from exposure to the virus.

Closely monitor themselves for symptoms of COVID-19 and seek advice from the nearest designated facility if they have concerns or experience symptoms. Pregnant women should also take the same precautions to avoid COVID -19 infection as other people: practice physical distancing, avoid physical gatherings and use online health services, it said.

UNICEF said even before COVID-19 pandemic, an estimated 2.8 million pregnant women and newborns died every year, or 1 every 11 seconds, mostly of preventable causes.

The agency called for immediate investment in health workers with the right training, who are equipped with the right medicines to ensure every mother and newborn is cared for by a safe pair of hands to prevent and treat complications during pregnancy, delivery and birth.

Feb 22: A 20-year-old Chinese woman from Wuhan, the epicentre of the coronavirus outbreak, travelled 400 miles(675 km) north to Anyang where she infected five relatives, without ever showing signs of infection, Chinese scientists reported on Friday, offering new evidence that the virus can be spread asymptomatically.

The case study, published in the Journal of the American Medical Association, offered clues about how the coronavirus is spreading, and suggested why it may be difficult to stop.

"Scientists have been asking if you can have this infection and not be ill? The answer is apparently, yes," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, who was not involved in the study.

China has reported a total of 75,567 cases of the virus known as COVID-19 to the World Health Organization (WHO) including 2,239 deaths, and the virus has already spread to 26 countries and territories outside of mainland China.

Researchers have reported sporadic accounts of individuals without any symptoms spreading the virus. What's different in this study is that it offers a natural lab experiment of sorts, Schaffner said.

"You had this patient from Wuhan where the virus is, travelling to where the virus wasn't. She remained asymptomatic and infected a bunch of family members and you had a group of physicians who immediately seized on the moment and tested everyone."

According to the report by Dr Meiyun Wang of the People's Hospital of Zhengzhou University and colleagues, the woman travelled from Wuhan to Anyang on Jan. 10 and visited several relatives. When they started getting sick, doctors isolated the woman and tested her for coronavirus. Initially, the young woman tested negative for the virus, but a follow-up test was positive.

All five of her relatives developed COVID-19 pneumonia, but as of Feb. 11, the young woman still had not developed any symptoms, her chest CT remained normal and she had no fever, stomach or respiratory symptoms, such as cough or sore throat.

Scientists in the study said if the findings are replicated, "the prevention of COVID-19 infection could prove challenging."

Key questions now, Schaffner said, are how often does this kind of transmission occur and when during the asymptomatic period does a person test positive for the virus.