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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, Apr 25: Neighbourhood and standalone shops, including those selling garments, mobile phones, hardware and stationery items have been allowed to open but those located in market places, malls and COVID-19 hotspots and containment zones, will continue to remain shut till May 3.

In rural areas, all shops, except those in single and multi-brand shopping malls, are allowed to open.

However, a Home Ministry official said the final decision of whether to allow the additional shops to open or not will be taken by the state governments and Union Territory administrations depending on their respective COVID-19 situation.
 
While allowing opening of more shops, a move seen as a relief to people who have been under lockdown since March 24, the government order issued on Friday night said the shops will be functioning with 50 per cent of workforce and after adhering strictly to precautions which include social distancing and wearing of masks.

The Union Home Ministry also said malls, liquor and cigarette shops, sale of non-essential items through e-commerce platforms continue to remain shut.

Restaurants, hair salons and barber shops will not be allowed to open as these render services and do not fall under the shop category.

Amending its April 15 order, Union Home Secretary Ajay Bhalla said in the Friday night order that "all shops, including neighbourhood shops and standalone shops, shops in residential complexes, within the limits of municipal corporations and municipalities, registered under the the Shops and Establishment Act of the respective State and UT" will be allowed to open during the lockdown.

The ministry also said shops located in registered markets located outside the municipal corporations and municipalities can open after following the drill of social distancing and wearing of masks but with 50 per cent of strength.

However, single and multi-brands shall continue to remain closed in these areas also.

"All shops registered under the the Shops and Establishment Act of the respective State/UT, including shops in residential complexes and market complexes, except shops in multi-brand and single brand malls, outside the limits of municipal corporations and municipalities, with 50 per cent strength of workers with wearing of masks and social distancing being mandatory" will be allowed to function, the order said.

In a statement on Saturday, the Home Ministry said the order implies that in rural areas, all shops, except those in shopping malls are allowed to open.

In urban areas, all standalone shops, neighbourhood shops and shops in residential complexes are allowed to open.

Shops in markets and market complexes and shopping malls are not allowed to open.

"It is clarified that sale by e-commerce companies will continue to be permitted for essential goods only," the order said and also added that sale of liquor and other items continues to be prohibited as specified in the national directives for COVID-19 management.

The ministry said that liquor shops were given licence under the Excise Act of the states and the establishments thrown open from Saturday were covered under the Shops and Establishment Act of the states.

Sale of cigarettes, gutka are continue to be prohibited during the lockdown.

"As specified in the consolidated revised guidelines, these shops will not be permitted to open in areas, whether rural or urban, which are declared as containment zones by respective States and Union Territories," the statement said.

The lockdown was first announced by Prime Minister Narendra Modi on March 24 in a bid to combat the coronavirus pandemic. It was further extended till May 3.

New Delhi, Apr 16: The number of COVID-19 cases in India has reached 12,759, the Health Ministry said on Thursday.

According to the official data, India has 10,824 active cases and 1514 discharged and cured cases. Meanwhile, 420 people have died from the disease which originated in China.

Maharashtra has reported the highest number of cases in the country which stands at 2919, including 295 cured and discharged and 187 deaths.

With 1578 coronavirus cases, Delhi is in the second position of India's tally of corona infected people; followed by Tamil Nadu (1242) and Rajasthan (1023).

Kerala, which reported India's first coronavirus case, has 388 confirmed cases, including 295 cured and discharged and 187 deaths.

On the other hand, Uttar Pradesh and Haryana, that border the national capital, have 773 and 205 cases, respectively.

Chhattisgarh, Chandigarh and Pudducherry have reported 33, 21 and 7 cases respectively. While West Bengal has 231 coronavirus infected people, Odisha has confirmed 60 cases.

The newly carved union territories -- Ladakh and Jammu and Kashmir--- have 17 and 300 cases, respectively.

In the Northeast, 33 people were detected positive for COVID-19 in Assam, which is the worst-affected states in the region. Six corona cases were confirmed from Meghalaya, two each from Manipur and Tripura and one from Arunachal Pradesh. Nagaland remains free from coronavirus till date, said the Ministry.