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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, Jan 28: Stepping up attack on Chief Minister Arvind Kejriwal, Union Home Minister Amit Shah on Monday dared the AAP chief to visit the anti-CAA protest site at Shaheen Bagh so that the people of Delhi can decide whom to vote for in the assembly election.

Addressing a rally in Rithala in northwest Delhi, Shah said Kejriwal and Congress leader Rahul Gandhi were against the construction of Ram temple, the scrapping of provisions of Article 370 and not bothered about the country's image and soldiers.

The opposition fears that they will upset their vote bank, he said and asked, "Are you their vote bank? Where is their vote bank?" To this, the crowd replied, "Shaheen Bagh".

The BJP leader claimed that the Delhi Police has booked Sharjeel Imam, a JNU student, on the charge of sedition for his comment of "trying to cut chicken's neck" and breaking the North East from the rest of the country.

"I want to ask Kejriwal whether he is in favour of apprehending Sharjeel Imam or not? Whether you are with the people of Shaheen Bagh or not, please tell the people of Delhi," Shah said.

Imam was one of the initial organisers of the Shaheen Bagh protest.

Hitting back at the BJP, Kejriwal alleged that the saffron party does not want to open the Shaheen Bagh stretch of the Kalindi Kunj road as it is doing "dirty politics" over it.

He said law and order in the national capital lies entirely with the Centre and "if they are saying that they need permission from me, I am giving them permission, open the road in one hour".

"I can give it to you in writing, the BJP does not want to open the route in Shaheen Bagh. The Shaheen Bagh route will remain closed till February 8 (election day) and it will open February 9," Kejriwal told reporters.

Calling Kejriwal a member of the 'tukde tukde' gang, a term used by the BJP to attack groups it accuses of working to promote violent leftists and separatism, Shah sought to return fire and said the protesters of Shaheen Bagh will not listen to his party.

"They will not listen to us. You people (AAP leaders) say that you are with Shaheen Bagh, if you have the guts then go and sit with them and let Delhi decide," Shah said.

At another election rally in Janakpuri, Shah accused Gandhi and Kejriwal of doing politics of "vote bank" on national issues and "supporting" the protest at Shaheen Bagh while instigating riots and vandalism.

"The Modi government will not spare anti-national elements," he warned.

Upon mentioning the recent Supreme Court judgment on Ayodhya, Shah was greeted with cheers and chants of 'Jai Shri Ram'.

The home minister further said that this was the first Republic Day in Jammu and Kashmir after the abrogation of Article 370 and the tricolour was unfurled there with enthusiasm and without any bloodshed.

The former BJP president also attacked the Kejriwal government for not fulfilling promises like regularising temporary employees, providing free wifi, opening new schools and colleges, constructing roads and cleaning the Yamuna.

"Kejriwal government is in power since five years but till today there is no clean drinking water in the city. There are no good schools or hospitals as claimed by him. When I visited a Delhi government school, I saw that it was operating from a building that was illegally built and falls in the list of those that to be erased," Shah said.

He claimed that Kejriwal came to power with the help of Anna Hazare's anti-corruption movement but "completely changed" later on.

"He had said that he would not take any government accommodation or vehicles and other facilities but after becoming chief minister he availed all these facilities," Shah said.

He also slammed the Delhi government for not sanctioning the prosecution of former JNU students' union leader Kanhaiya Kumar in a sedition case.

Shah said if the national capital comes under the leadership of Modi, it will become the best city in the world.

The BJP has a vision for development of Delhi and cleaning the Yamuna river will be on top of our agenda, he said.

"Yamuna river is still dirty as against his (Kejriwal) claims of cleaning the river... Modi and Yogi (Adityanath) have cleaned Ganga river as promised. We will make Yamuna Riverfront like Sabarmati riverfront in Ahmedabad," Shah said.

However, a sizeable majority of those present at the public meeting was not convinced by the claims and promises made by Shah.

Bablu Yadav, a migrant and resident of Janakpuri said, "Shah and Modi can only talk but Kejriwal knows how to perform. They keep raking up issues like Ayodhya, Kashmir, Muslims and Pakistan... what are they waiting for if they want to attack Pakistan? They are in power, so why don't they destroy it instead of telling us how wrong Pakistan is?"

Another local Deepak Shrivastava who attended the Janakpuri meeting said, "All we hear from Modi and Shah are pep talks. I am an engineer from BHU and searching for a job. This government has failed the country's youth."

"Now, they have a problem with protests in universities but it is the same youth who brought them to power in 2014. The same youth will ensure their defeat," he added.

The public meeting in Janakpuri witnessed two incidents of pick-pocketing as the thieves managed to steal Rs 37,500 in cash and a mobile phone, police said.