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India has jumped past 4.5 lakh coronavirus cases and 14,476 people have succumbed to the viral infection so far. In this backdrop, speaking to IANS in an exclusive interview, AIIMS Director Randeep Guleria said India is also vulnerable to second wave of coronavirus and people should continue to follow social distancing, wearing mask and other precautions, after cases begin to decline.

He added that in order to contain the outbreak of Covid-19, a limited lockdown in hotspots, where volume of cases is very high, may be considered along with a micro-plan to prevent leakage of cases from these areas to other non-containment areas. Excerpts of the interview are below:

Q: Reports say China and South Korea are witnessing a second wave of coronavirus infection, what is this second wave, is India also vulnerable to this?

A: When cases come down significantly, people tend to drop their guard against the viral infection, and this leads to the second wave (which means a sudden increase in the number of cases). After cases begin to decline, people should continue to follow the precautions -- continue to maintain social distancing and wear masks regularly. See what happened in Singapore, it was struck by a second wave of coronavirus. Look, what happened in the 1918 pandemic, people dropped their guard and the second wave of viral infection struck back. If people do not follow social distancing then the spike in cases is apparent. We need to take these precautions at least for one year. India is also vulnerable to this second wave.

Q: If Covid-19 cases continue to rise rapidly, do you think we need another lockdown in areas where volume of cases are very high?

A: A large volume of cases is concentrated in specific areas like hotspots, and in order to maintain things in order, we may need a limited lockdown in these areas. This should be followed by a micro-plan which entails extensive testing of people and also extensive contact tracing of people who have got in touch with positive people. Need to ensure there is no leakage of cases from these areas. People from these areas should not mix with others in non-containment areas. This will aid in containing the outbreak of the virus. People who have developed symptoms should get themselves tested, especially in the containment areas.

Q: With more than 4.5 lakh cases and close to 14,500 deaths, do you think India has reached its peak and a decline in cases is prominent?

A: The cases will continue to increase for some time. The doubling time of cases has also increased. But, the cases will also begin to flatten. Though, it is difficult to give an exact time period in this viral infection, it seems, the growth in cases will flatten in the end of July or beginning of August. A decline will come to this viral infection, but it does not mean that people should drop their guard. As a measure, we need to decrease community participation and citizens should continue to follow social distancing. People should get themselves tested. All these efforts will help in preventing people from contracting this virus. These precautions will also prevent us from the second wave, and we must continue to take precautions. The virus has not gone away, it is still lurking.

Q: India has crossed the 4.5 lakh coronavirus cases so far, although our recovery rate is good, but still 10,000 to 15,000 cases are reported daily. Why do cases continue to spiral, what is the reason?

A: We have to remember a few things -- the bulk of cases are in 10 cities, nearly 70 per cent, and if we take into account cases per million population, the number is not very high, as compared with countries including countries in Europe. Many European countries put together still do not add up to the Indian population. Do not compare India to countries like Italy, Spain etc. We need to focus on hotspots, which contribute to between 70 -80 per cent of cases, and we have to identify cases in these areas at an early stage. The population density is very high in these cities. People in lower socio-economic status are highly vulnerable to the viral infection, as many live together in small spaces and there is a lot of mixing of people happening there. Look at the market places, people are not following social distancing and not wearing masks. In fact, many are in close vicinity of each other.

Dubai, Mar 18: Emirates, one of the world's biggest international airlines, has asked pilots to take unpaid leave to help it mitigate the impact of the coronavirus pandemic that has shattered demand for global travel.

"To this end you are strongly encouraged to make use of this opportunity to volunteer for additional paid and unpaid leave," the airline said in an internal email to pilots, seen by Reuters.

Emirates earlier this month asked some staff to take unpaid leave, although at that time it was not available to pilots.

United Nations, May 7: An average of 80,000 COVID-19 cases were reported each day in April to the World Health Organization, the top UN health agency has said, noting that South Asian nations like India and Bangladesh are seeing a spike in the infections while the numbers are declining in regions such as Western Europe.

WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that countries must also be able to manage any risk of the disease being imported into their territories, and communities should be fully educated to adjust to what will be a "new norm".

He said as the countries press forward in the common fight against COVID-19, they should also lay the groundwork for resilient health systems globally.

"More than 3.5 million cases of COVID-19 and almost 250,000 deaths have now been reported to the WHO. Since the beginning of April, an average of around 80,000 new cases have been reported to the WHO every day," Ghebreyesus said in Geneva yesterday.

Asserting that the virus cases were not just numbers, he said: "every single case is a mother, a father, a son, a daughter, a brother, sister or friend".

He said while the numbers are declining in Western Europe, more cases are being reported every day from Eastern Europe, Africa, South-East Asia, the Eastern Mediterranean and the Americas. Even within regions and within countries, there are divergent trends, the agency added.

While some countries are reporting an increase in COVID-19 cases over time, many have seen caseloads rise because they have ramped up testing, the WHO official said.

"We've also seen in Europe and Western Europe a fundamental decrease in the number of cases, but we have seen an associated increase in the number of cases reported in places like the Russian Federation. Southeast, the Western Pacific areas are relatively on the downward trend like Korea and others, but then we do see in South Asia, in places like Bangladesh, in India, some trends towards increase.

"So it's very difficult to say that any particular region is improving or (not improving). There are individual countries within each region that are having difficulties getting on top of this disease and I am particularly concerned about those countries that have (an) ongoing humanitarian crisis," WHO's Executive Director Michael Ryan said.

The death toll due to COVID-19 in India rose to 1,783 while the number of cases climbed to 52,952 on Thursday, registering an increase of 89 deaths and 3,561 cases in the last 24 hours, the Union Health Ministry said.

The number of active COVID-19 cases stood at 35,902 while 15,266 people have recovered, it said.

Noting that while seeing an increase in the number of cases is not good in terms of transmission, WHO's Emerging Diseases and Zoonoses Unit head Maria Van Kerkhove said: "but I don't want to equate that with something (being) wrong".

"I want to equate that with countries are working very hard to increase their ability to find the virus, to find people with the virus, to have testing in place to identify who has COVID-19, and putting into place what they need to do to care for those patients," Kerkhove said.

With more countries considering easing restrictions implemented to curb the spread of the coronavirus, the WHO has again reminded the authorities of the need to maintain vigilance.

"The risk of returning to lockdown remains very real if countries do not manage the transition extremely carefully, and in a phased approach," Ghebreyesus said.

He urged countries to consider the UN agency's six criteria for lifting stay-at-home measures.

That advice includes ensuring surveillance is strong, cases are declining and transmission is controlled. Health systems also must be able to detect, isolate, test and treat cases, and to trace all contacts.

Additionally, the risk of outbreak in settings such as health facilities and nursing homes needs to be minimised, while schools, workplaces and other public locations should have preventive measures in place.

"The COVID-19 pandemic will eventually recede, but there can be no going back to business as usual. We cannot continue to rush to fund panic but let preparedness go by the wayside," he said.

He said the crisis has highlighted the importance of strong national health systems as the foundation of global health security: not only against pandemics but also against the multitude of health threats that people across the world face every day.

"If we learn anything from COVID-19, it must be that investing in health now will save lives later," Ghebreyesus said.

While the world currently spends around USD 7.5 trillion on health annually, the WHO believes the best investments are in promoting health and preventing disease.

"Prevention is not only better than cure, it's cheaper, and the smartest thing to do," he said.

The deadly coronavirus, which originated from the Chinese city of Wuhan in December last year, has infected over 3.7 million people and killed 263,831 people globally, according to a tally by Johns Hopkins University.