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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

Bhopal, June 7: In a shocking incident of medical cruelty, an 80-year-old man was tied to a hospital bed in Madhya Pradesh after he allegedly failed to make payment of fees for his treatment. The incident took place at the City Hospital in Shajapur.  

The hospital, however, claimed that he was having convulsions and as a result had his hands and legs tied so that he could not hurt himself.

The man’s family members have accused the hospital authorities of resorting to the heinous act after they failed to pay a fee of Rs 11,000 for his treatment at the. 

“We had deposited a bill of Rs 5,000 at the time of admission but when the treatment took a few more days, we did not have the money to pay the bill,” his daughter told the channel.

The hospital, however, maintained that the man was shackled because he was suffering from an electrolyte imbalance. “He was having convulsions because of electrolyte imbalance,” an unidentified doctor said. “We tied him so that he could not hurt himself.” 
The doctor claimed the hospital had waived off the man’s bill on “humanitarian grounds”.

Chief Minister Shivraj Singh Chouhan took cognizance of the matter and promised strict action against the hospital authorities. 

The Shajapur administration has also ordered an inquiry and has sent a police team to the hospital for investigation, the district collector told media persons.

New Delhi, Apr 5: Joining efforts to fight COVID-19, the Defence Research and Development Organisation (DRDO) has designed a full-body disinfection chamber and a special face protection mask for healthcare professionals, officials said.

The special chamber called 'PSE' has been designed by Vehicle Research Development Establishment (VRDE), Ahmednagar, a DRDO Laboratory.

The walk through enclosure is designed for personnel decontamination, one person at a time. It is a portable system equipped with sanitiser and soap dispenser, officials said.

The decontamination is started using a foot pedal at the entry. On entering the chamber, electrically-operated pump creates a disinfectant mist of hypo sodium chloride for disinfecting, the DRDO said in a statement.

The mist spray is calibrated for an operation of 25 seconds and stops automatically indicating completion of operation. As per procedure, personnel undergoing disinfection will need to keep their eyes closed while inside the chamber, it said.

The system consists of roof mounted and bottom tanks with a total of 700 litres capacity. Approximately 650 personnel can pass through the chamber for disinfection until the refill is required, the DRDO said.

The system has see-through glass panels on side walls for monitoring purpose and is fitted with lights for illumination during night-time operations, it added.

This system can be used for disinfection of personnel at the areas of controlled ingress and egress such as entry and exit to hospitals, malls, office buildings and critical installations, officials said.

Also, Research Centre Imarat (RCI), Hyderabad, and Terminal Ballistics Research Laboratory (TBRL), Chandigarh, have developed face protection mask for healthcare professionals handling COVID-19 patients, the DRDO added.

Its light weight construction makes it convenient for comfortable wear for long duration. This design uses commonly available A4 size Over-Head Projection (OHP) film for face protection, it said.

One thousand face shields are being produced daily in TBRL and provided to Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, it said.

Similarly, 100 are produced at RCI and these have been handed over to Employees' State Insurance Corporation (ESIC), Hyderabad. A demand of 10,000 shields has been received from PGIMER and ESIC hospitals based on successful user trials, the DRDO added.