COVID updates: Second wave on downswing, but numbers still high, says Centre; MHA extends guidelines till 30 June

As India's infection tally climbed to 2,73,69,093 with 2,11,298 more people testing positive for the disease in a day, the Centre on Thursday said that the country is noting a downswing of the second wave of in India.

The downward trend is a result of steadily improving metrics in a number of states. The Centre said that only seven were reporting more than 10,000 fresh cases each day and at least 24 states have reported decline in active cases since the last week.

On the vaccine front, the Centre rubbished criticism over delays in vaccine procurement and insisted that it has been pursuing Pfizer, Johnson and Johnson and Moderna since mid-2020 for the earliest possible imports. In addition to this, PTI quoted sources at the Central Government as saying that the authorities are looking at a speedy launch of single-dose vaccine Sputnik Light in India.

Meanwhile, French pharmaceutical giant Sanofi and Britain's GSK announced the start of final tests of their belated vaccine as they race to add their jab to the global arsenal against the 2019 SARS .

Research is also underway to find alternatives to a vaccine for people who can't get it or are immune-suppressed in form of an oral treatment that can halt the disease in its track and stop it from turning into a severe infection. Several global players are working on so-called oral antivirals, which would mimic what the drug Tamiflu does for influenza. In India, Zydus Cadila sought permission from Drugs Controller General of India (DCGI) to initiate human clinical trials for monoclonal antibodies cocktail for the treatment of .

Meanwhile, the global toll due to crossed 35 lakh, according to an AFP tally. The US is the worst-affected country with 5,91,957 deaths, followed by Brazil with 4,54,429, India with 3,15,235, Mexico with 2,22,232 and Britain with 1,27,748. 

The figures are based on reports by the health authorities in each country, but do not take into account upward revisions carried out later by statistical bodies. The WHO says that up to three times more people have died directly or indirectly due to the pandemic than official figures suggest.

The numbers

A steady decline in new cases has been recorded in India for the last 20 days, with 24 states witnessing a dip in active cases since the last week, the Union health ministry said on Thursday.

The toll due to the disease rose to 3,15,235 with 3,847 fresh fatalities being reported in a span of 24 hours, the data updated at 8 am showed. On the other hand, the country's recovery went up to 90 percent, according to the Union Health Ministry on Thursday.

The daily positivity was recorded at 9.79 percent. It has been less than 10 percent for three consecutive days now, the ministry said. The weekly positivity rate has also declined and now stands at 10.93 percent.

The count of active cases has further reduced to 24,19,907, which is 8.84 percent of the total infections, while the national recovery rate has improved to 90.01 percent, the data showed.

The number of people who have recuperated from the disease surged to 2,46,33,951, while the case fatality rate stands at 1.15 percent, it stated.

India's infection tally crossed 20 lakh on 7 August last year, 30 lakh on 23 August, 40 lakh on 5 September, 50 lakh on 16 September, 60 lakh on 28 September, 70 lakh on 11 October, 80 lakh on 29 October, 90 lakh on 20 November and one crore on 19 December. India crossed two crore cases on 4 May, 2021.

The 3,847 new fatalities include 992 from Maharashtra, 530 from Karnataka, 475 from Tamil Nadu, 193 from Uttar Pradesh, 185 from Punjab, 153 from West Bengal, 151 from Kerala, 130 from Delhi, 107 from Rajasthan and 106 from Haryana.

A total of 3,15,235 deaths have been reported so far in the country, including 91,341 from Maharashtra, 26,929 from Karnataka, 23,695 from Delhi, 21,815 from Tamil Nadu, 19,712 from Uttar Pradesh, 14,827 from West Bengal, 13,827 from Punjab and 12,779 from Chhattisgarh.

The Health Ministry stressed that more than 70 percent of the deaths occurred due to comorbidities.

"Our figures are being reconciled with the Indian Council of Medical Research," the ministry said on its website, adding that state-wise distribution of figures is subject to further verification and reconciliation. It also noted that the country is on a downswing of the second wave of .

MHA extends COVID guidelines till 30 June

The Centre on Thursday directed states and Union territories to continue the ongoing guidelines till 30 June and asked them to go for intensive and local containment measures in districts with a high number of cases to check the spread of the deadly disease.

In a fresh order, Union Home Secretary Ajay Bhalla said strict implementation of containment and other measures has led to a declining trend in the number of new and active cases, across states and Union territories, barring some areas in the southern and northeastern regions.

"I would like to highlight that in spite of the declining trend, the number of active cases presently is still very high. It is, therefore, important that containment measures may continue to be implemented strictly.

"Any relaxation by states and UTs, may be considered at an appropriate time, in a graded manner, after assessing the local situation, requirements and resources," Bhalla said in his order issued to chief secretaries of the states and union territories.

He said the guidelines issued on 29 April for the month of May will continue till end of June.

According to the guidelines, the home ministry told the states to take necessary action to ensure sufficient oxygen-supported beds, ICU beds, ventilators, ambulances including creation of makeshift hospitals, oxygen, as needed, besides sufficient quarantine facilities.

The home ministry, however, did not mention anything about the imposition of lockdown anywhere in the country in the fresh guidelines issued in view of the pandemic.

The home ministry asked the states and Union territories to identify the districts where either the positivity rate was more than 10 percent or the bed occupancy was over 60 percent in the last one week.

The districts fulfilling any of the above two criteria should be considered for taking intensive and local containment measures, a statement issued by the MHA said.

The spread of the infection has to be controlled through restricting the intermingling among people, the only known host for the virus, the guidelines said.

Social, political, sports, entertainment, academic, cultural, religious, festival related and other gathering and congregations have been prohibited.

Marriages should be attended by up to 50 people and funerals should be attended by a maximum of 20 people.

All shopping complexes, cinema halls, restaurants, bars, sports complexes, gym, spas, swimming pool and religious places should remain closed.

Essential services and activities such as healthcare services, police, fire, banks, electricity, water and sanitation, regulated movement of public transport including all incidental services and activities needed for a smooth functioning of these activities shall continue.

Such services shall continue in both public and private sector, the guidelines said.

Public transport like railways, metros, buses, cabs will operate at a maximum capacity of 50 percent. There shall be no restrictions on inter-state and intra-state movement including transportation of essential goods.

All offices, both government and private, to function with a maximum staff strength of 50 percent.

All industrial and scientific establishments, both government and private may be allowed subject to the workforce following physical distancing norms.

They shall also be tested through Rapid Antigen Test in case of individuals identified with flu like symptoms from time to time.

However, states and union territories should make a careful analysis of the local situation, areas to be covered, and probability of transmission and then take a decision.

Maharashtra, Bengal, Punjab extend lockdown

The Maharashtra government will extend the -enforced lockdown-like curbs in the state after 1 June and relax them later in a phased manner, Chief Minister Uddhav Thackeray said on Thursday.

Currently, a wide range of restrictions are in force till 1 June to stem the spread of .

The Punjab government also extended the restrictions till 10 June but removed the limit on the number of passengers in personal vehicles and allowed the resumption of elective surgeries and OPD operations in hospitals.

The state government had imposed extensive curbs, in addition to measures like a weekend lockdown and a night curfew to check the spread of the infection.

The government directed the resumption of elective surgeries in both government and private hospitals besides the restoration of outpatient department (OPD) operations in view of the improvement in the situation. The state government had stopped elective surgeries on 12 April to ensure adequate availability of beds and medicine oxygen for serious infection cases.

West Bengal chief minister Mamata Banerjee also extended the ongoing restrictions till 15 June, saying that the curbs have helped ease the pandemic situation a little. The announcement for extension of the curbs came three days before they were scheduled to come to an end.

Hunt on for cure of COVID

The hunt is on for a treatment that can be taken as a pill soon after a confirmed positive, halting the disease in its tracks so that cases that might have been severe end up being nothing more than a bad cold. Several companies are working on so-called oral antivirals.

"It's great that we have vaccine rollout that has been significant, but it certainly will not be taken by everybody in our population, and not everybody who takes the vaccine will have a full response to it," David Hirschwerk, an infectious diseases physician at Northwell Health in New York told AFP.

An easily storable and transportable pill would also offer practical advantages over existing treatments such as monoclonal antibodies, which are mainly injected by drips at hospital infusion centres.

One of the frontrunners in these efforts is a twice-a-day drug called Molnupiravir, which is being developed by Merck in partnership with Ridgeback Biotherapeutics.

Early results from a Phase 2 trial showed that, among dozens of volunteers who tested positive at the start, none of those who received the drug had any detectable virus by day five; while a quarter of those who received a placebo did.

The numbers are promising but too small to draw firm conclusions from, and the company is now enrolling for a Phase 3 trial involving 1,850 people with results expected by fall.

"Viruses are basically little machines and they need certain components to replicate themselves," Daria Hazuda, Merck's chief scientific officer of the company's exploratory science centre, told AFP. Antivirals are designed to interfere with that process. Because antibodies target a surface protein of the that is continually evolving, antivirals are expected to be more variant-proof.

Currently, there's just one antiviral approved by the Food and Drug Administration to treat Covid, which is Remdesivir by Gilead Sciences. Like Molnupiravir, it is a polymerase inhibitor, though their precise actions differ.

Remdesivir's biggest disadvantage is that it was developed as an intravenous drug and targeted at hospitalised patients, among whom it was shown to modestly reduce recovery time.

But by the time has progressed to severe, much of the harm to patients' health comes from their own immune systems going into overdrive and damaging their organs, rather than viral replication.

That's why the focus now is on oral formulations that can be taken within days of infection, and apart from Merck, there are a few other notable entrants.

Different vaccine as second dose not a cause of concern, claims Niti Aayog's VK Paul

Any significant adverse effect is unlikely if the second dose of a different vaccine is administered, but reaching a firm opinion on this will need more scrutiny and understanding, the Centre said on Thursday.

It, however, clarified that both doses administered to an individual should be of the same vaccine as per the existing protocol.

The clarification comes following reports that health workers in Uttar Pradesh's Siddharthnagar district administered COVAXIN to 20 villagers who had been given Covishield in the first dose.

Commenting on the UP incident, NITI Aayog member VK Paul said, "Even if it has happened, it should not be a cause of concern for the individual, but I urge all health workers to give the second dose of the same vaccine." 

The incident was reported from the primary health centre in Barhni where people from Audahi Kala and another village received Covaxin shots on 14 May.

Vaccination may pick up by July

Paul also said the pace of vaccination against should pick up in July.

"We have a total of 51.6 crore doses, a large proportion of it is available and has to be used in an efficient manner even as we build our efforts to build our stockpile in the time to come. I would like to state that Bharat Biotech (the maker of COVAXIN) which started with 90 lakh capacity is ramping up and it is well within our expectation that it can reach ten times the production level to 10 crore per month in the next few months," he said.

Paul said similarly the Serum Institute of India(SII), which produces the Covishield vaccine, is also ramping up vaccine production from 6.5 crore per month to 11 crore or even more in the months to come.

"We are also reaching out to international manufacturers, in particular Pfizer, for making vaccine available now that they have shown interest and indicated possibility of vaccine to be spared for India," he said.

The official said the government has been making significant efforts in reaching out to foreign manufacturers and also making intense relentless efforts to increase the production and supply of 'made in India' vaccines.

Speaking about booster shots, Paul said, "If there is a need for a booster dose it will be told. There are studies that are going on... Covaxin trial is going on... whether it should be taken after six months or not."

On Pfizer seeking indemnity, Paul said, "Yes we are engaged with Pfizer and they have indicated the availability of a certain amount of vaccine in the coming months, possibly starting in July and we are looking at what their expectations from the government are and they are looking at what our expectations from them are.

"They have requested indemnity to all the nations including the country of origin. We are examining this request and will make a decision in the larger interest of people and on merits. This is under discussion and there is no decision as of now," Paul said.

With inputs from PTI