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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

New Delhi, Jul 2: India's COVID-19 tally breached the 6 lakh cases mark with 19,148 new coronavirus cases being reported in the last 24 hours, informed the Union Ministry of Health and Family Welfare on Thursday.

The total cases now stand at 6,04,641 of which there are 2,26,947 active cases while 3,59,860 patients have been cured/discharged/migrated.

434 deaths have been reported in the last 24 hours taking the number of COVID-19 deaths in the country to 17,834.

Maharashtra, the worst-hit state, has a total of 1,80,298 cases including 8,053 fatalities. Meanwhile, Tamil Nadu has 94,049 cases inclusive of 1,264 deaths.

Delhi has 89,802 coronavirus cases including 2,803 deaths.

New Delhi, May 23: Carrying a sack full of belongings and a backpack on shoulders daily wager Mohammed Sunny and his friend Mohammed Danish are determined to reach home for Eid in Bihar's Araria district, facing all odds stacked up against them.

Shahjehanpur native Adesh Singh with his wife and three little children, who left their residence in south Delhi three days ago, are still scrambling to reach home, haggling with taxi drivers, to take them to their home town charging a reasonable fare.

This was among the many scenes of migrants' life on Friday at Delhi-Uttar Pradesh border touching Ghazipur in east Delhi who are struggling to make their way to their native places amid a COVID-19-induced lockdown across the country.

"We left home three days ago near Chhatarpur, we have walked and rested by roadsides, people gave us food on the way, so we survived. Now, we just want to reach home, we can't survive in Delhi," Manju Singh, wife of Adesh Singh told PTI as she waited at the UP Gate to get a taxi to cross the border on way to her home.

Their three children Alok (12), Ankesh (8) and Rupali (9), all wearing simple masks, were seen squatting on the roadside beside their luggage as their wearied parents, using cloths to cover their nose and mouth, bargained with taxi drivers to take them home, without charging much above the regular fare, saying they "did not have much cash left".

Police personnel could be seen asking many migrants who were marching on foot towards the inter-state border, to turn back.

Many did, but not Sunny and Danish, who feel if "Allah wants us to reach home, we surely will".

Both of them worked at a chemical plant in Delhi, and said, they have been "kicked out" after the lockdown was imposed, making their survival difficult in the national capital.

"We don't have money to pay rent now, or buy food, we have to go home now, what option do we have," Sunny said.

Danish alleged that the poor have been "abandoned" by the government and left in the lurch.

"The government has money to bring home Indians stranded abroad, but can't take home the Indians who have been toiling hard all these years. Is it fair to us," he asked.

"But, Inshallah, we will reach home if the Almighty wants us to, and will be joining our family for Eid, though it will hardly be a celebration this time. But, we want the comfort of being with our family at least," Sunny said.

Eid which marks the end of the holy Ramzan month, will be celebrated either on Sunday or Monday, depending on sighting of the moon.

Lakhs of migrant labourers stranded away from home in Delhi and other big cities have been attempting to reach home in the last two months, a large number of them walking on foot after they found no mode of conveyance.

The coronavirus death toll in Delhi has mounted to 208, while 660 fresh cases of COVID-19 infection reported on Friday, the highest single-day spike here, took the total in the city to 12,319.

Roshan Shrivastav (19), his nephew Shivam Shrivastav (19) and friend Prince Gupta (21), all hailing from Siwan in Bihar, were seen standing on a pavement after being told by the police to turn back from the barricade posted bear the Delhi-UP border.

"We live together in Baljeet Nagar in West Delhi, in a single room. I had come from Bihar after Holi, seeking a job, but then I got stuck in lockdown here without a job. Whatever money I had brought, and Rs 10,000 our parents had sent online, all has got exhausted in these three months," Roshan lamented.

"Our landlord has been very kind, and didn't even ask for any rent after the lockdown, but how long can we survive on charity. And, I don't like being dependent on someone, so we want to go home," he said.

Roshan said, he and Shivam, both also write and sing songs in Hindi and their native tongue Bhojpuri.

"We have written a few lines on lockdown crisis too -- 'Hum mazdooran ke ghar bhejwa da sarkar, nahin to ketna log hiyan par ho jai bimar' (please send us home or else many would fall sick here)," Shivam said, as he stood in scorching heat of May, carrying his leftover cash in pocket and hope in heart.