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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, May 22: India on Friday recorded its biggest spike in COVID-19 cases with 6,088 new cases and 148 deaths reported in the last 24 hours, taking the tally of coronavirus cases in the country to 1,18,447, as per the Union Ministry of Health and Family Welfare (MoHFW).

Out of the total cases, 66,330 are active cases and 3,583 have succumbed to the infection.

As many as 48,533 patients have been cured/discharged and one migrated till date.

Maharashtra continues to remain the worst-affected state with 41,642 cases, followed by Tamil Nadu (13,967 cases), Gujarat (12,905 cases), and Delhi (11,659 cases).

While Rajasthan has confirmed 6,227 cases of which 3,485 people have recovered while 151 patients are dead, Madhya Pradesh reported 5,981 cases including 2,843 patients recovered and 270 patients dead.

Uttar Pradesh has 5,515 COVID-19 positive cases.

In Kerala, which reported the first COVID-19 case, 690 people have been detected positive for coronavirus.

Ladakh has confirmed 44 coronavirus cases, 1,449 people have infected by the virus in Jammu and Kashmir.

Mangaluru, May 4: No major crowds were seen in the coastal city of Mangaluru today except in front of the liquor shops after the district administration relaxed the lockdown norms for 12 hours a day (between 7am and 7pm).

There was no mad rush of vehicles either on city roads when the relaxed lockdown began. There were fewer people to buy essentials in front of grocery and vegetable shops as they had time till late evening.

There was no let down in the number of police pickets as well as curbs on vehicular movement across the city either. 

The government has allowed sale of liquor in CL2 (standalone wine shops) and CL 11 (MSIL outlets) to mop up revenues when Lockdown-3 commenced from Monday. Compared the other parts of Karnataka, the size of queues in front of liquor shops in Mangaluru were smaller. 

Like other parts of the country, the lockdown was imposed in the coastal district on March 24 to prevent the spread of Covid-19. Prior to that, a curfew was imposed in the district from March 22 midnight. The lockdown did not apply to essential services such as sale of food, groceries, milk, vegetables, fruits, and meat and fish. Gradually the district administration had to intensify the lockdown and allow those shops to remain open only between 7 a.m. and 12 noon. 

With the lockdown relaxation extending till 7 p.m., Mangaluru today witnessed people and private vehicles moving freely in the afternoon for the first time in more than a month. However, only those who had to go for work and do other essential activities were seen on roads. After 7 p.m. movements of all kinds of vehicles will be prohibited. 

The relaxation was to facilitate economic activities that had come to a standstill during the first two phases of lockdown. Mangaluru City Police Commissioner Dr P S Harsha, meanwhile, warned the people against misusing lockdown relaxation and venturing out without any genuine reason.