Sharad Pawar injured, taken to Mumbai

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

Bengaluru, Mar 23: Indian stocks plunged over 9% on Monday, as the rapidly spreading coronavirus pandemic sent major states including the country's capital into a lockdown amid increasing fears that outbreak could bring world economies to a grinding halt.

The NSE Nifty 50 index slipped 9.17% to 7,937.75 by 0408 GMT, while the S&P BSE Sensex was 9.42% lower at 27,093.24.

Over the weekend in India, the virus drove several companies to shut operations and the government sent states into lockdowns, bringing normal life to a grinding halt.

"Panic has gone up domestically because of the lockdown situation," said Vinod Nair, head of research at Geojit Financial Services.

"There is fear that the situation will not be brought under control soon."

The rupee hit a fresh record low of 76.05 against the dollar, as a flight into cash and worries about tightening liquidity boosted demand for the world's reserve currency.

Meanwhile, global markets crumbled, with MSCI's broadest index of Asia-Pacific shares outside Japan sliding nearly 4% as the global death toll climbed to over 14,000, further battering economic activity, and raising fears of a global recession.

After market hours on Friday, the Securities and Exchange Board of India halved position limits for certain stock futures, restricted short-selling of index derivatives and raised margin rates for some shares to curb "abnormally high" volatility amid the pandemic.

In domestic trading, the Nifty PSU Bank Index plunged 8%, while the Nifty bank index crashed nearly 10%.

The Nifty Auto Index slid 9% after several carmakers over the weekend suspended production due to the virus.

Noida, May 6: Not having Aarogya Setu app on smartphone while out in public in Noida or Greater Noida will be considered a violaton of lockdown rules and the person will be punished.

Action will also be taken against people going outdoors without a face mask or spitting in public places, Gautam Buddh Nagar police said, news agency reported.

Aarogya Setu is a mobile application developed by the central government to connect essential health services with the people to fight Covid-19.

The app is aimed at augmenting the initiatives of the Centre, particularly the Department of Health, in proactively reaching out to and informing the users of the app regarding risks, best practices and relevant advisories pertaining to the containment of Covid-19.

"If smartphone users do not have the 'Aarogya Setu' app installed on their mobile phones, then that will be punishable and considered a violation of the lockdown directions," Additional Deputy Commissioner of Police, Law and Order, Ashutosh Dwivedi said.

The district police had on Sunday announced extending the Criminal Procedure Code section 144, which bars assembly of four or more people, till May 17, as the central government extended the nationwide lockdown by another two weeks in a bid to check the spread of the virus.

"Spitting in public places will attract punishment along with a fine. Not wearing a face mask in public places or offices will also be a punishable offence.

During the lockdown period, political, social, religious, sports gatherings as well as protest marches and rallies will remain banned across Noida and Greater Noida, the official said in the order.

"The central government has extended the lockdown till May 17 in view of the coronavirus pandemic. Gautam Buddh Nagar has been identified as 'red zone' and hotspots have been identified here. During this duration, all guidelines of the lockdown are to be followed," he said.

Gautam Buddh Nagar, which falls in the 'Red Zone', has 34 containment zones and has recorded 179 positive cases of coronavirus so far, with 102 of these patients being cured and discharged from hospitals, according to official figures.