India reported 2,380 Covid-19 cases and 56 deaths in the 24 hours till Thursday morning. According to a report in the Indian Express, India’s effective reproduction number (R-value) for Covid-19 “has increased to over 1 for the first time since mid-January”. R-value is an indicator of how quickly the disease is spreading, and “was 1.07 for April 12-18,” according to Sitabhra Sinha, a researcher from Chennai’s Institute of Mathematical Sciences who has been tracking the country’s R-value since the beginning of the pandemic and was quoted in the story. “It was 0.93 the previous week,” stated the news report. 

The national capital Delhi has recorded around 1,009 cases in the last 24 hours, and on Wednesday the Delhi Disaster Management Authority made wearing masks mandatory with a Rs 500 fine for violating the rule. Before that Uttar Pradesh government had made wearing masks mandatory in Lucknow, Gautam Buddh Nagar, Ghaziabad, Hapur, Meerut, Bulandshahr, and Baghpat. By Thursday, the Punjab government also made face masks mandatory in crowded places. The Punjab government order stated, “Wearing of masks should be ensured in closed environments like public transport (bus, train, taxi and aircraft), cinema halls, shopping malls and departmental stores, and classrooms, offices and indoor gatherings.” Haryana, Chandigarh are also likely to make masks mandatory again.

According to the IE report even though Covid cases are rising in Delhi, its vaccination coverage remains low at “around 22,500 on an average over the last seven days”. The vaccination numbers in Delhi reportedly fell “went down in mid-February and early March because Delhi reached a saturation point in most categories. Over 90% of the adult population in the capital have been fully-vaccinated”. However after this, the number rose as the vaccinations  for children were started.

Looking at the rise in Covid cases in states like Delhi, other states such as Odisha have also asked officials to monitor the situation, and “keep a contingency plan ready to deal with any possible exigency.” According to IE, Public Health Director Dr Niranjan Mishra, asserted that the situation in Odisha is under control and “there is nothing to worry about.”  

Reinfections on the rise?

The Pune-based Indian Council of Medical Research-National Institute of Virology (ICMR-NIV) has reported “three episodes of Covid-19 infection in a healthcare professional.” A report published in the Journal of Infection on Tuesday stated that the 38-year-old healthcare professional from New Delhi “had primary SARS-CoV2 infection, breakthrough infection with Delta and reinfection with Omicron over a 16-month period.” The ET too reported that “the rise in cases in Delhi and Haryana has begun to sound alarm bells once again.” Unlike the other major cities such as Mumbai, Bengaluru, Chennai or Pune where the number of daily new cases dropped to the lower double-digits, Delhi has continued to report a significantly higher number of cases, over 100 per day on an average, stated the news report.

According to a report in The Economic Times Rajeev Jayadevan, co-chairman of Indian Medical Association’s (IMA) National Covid Task Force, said “it is possible to get reinfected in less than three months but that’s not an indication that vaccines don’t work.” The report also quoted epidemiologist Chandrakant Lahariya, who said, “A previous infection does not alter the risk of future infection. In the Delta wave 70% got infected and then in Omicron again 50 to 60% got infected. Whether past infection or not, every second Indian got an infection in the recent wave.”

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Seeing the rapid increase of positive Covid-19 cases in Mumbai, the city became the first to order that hereon it would be compulsory to wear masks in public places. On Wednesday, a notification issued by Praveen Pardeshi, Brihanmumbai Municipal Corporation (BMC) chief Praveen Pardeshi, read, “All person moving for whatever purpose and under whatever reason in public place, like street, hospital, office, markets, must be wearing a 3 play mask or cloth mask compulsorily.”

#OfficialUpdateMumbai

1️⃣Wearing of mask in public & work places now compulsory

2️⃣Masks are also to be worn while traveling

3️⃣These may be standard masks available at the chemist or homemade washable ones

4️⃣Action will be taken against offenders u/s 188 of IPC#NaToCorona https://t.co/sdRhniJgPU pic.twitter.com/m5p5Jab0oQ

— माझी Mumbai, आपली BMC (@mybmc) April 8, 2020

People moving around in their personal offices and official vehicles and others travelling in traffic vehicles, working at any site / office / workplace are also required to wear these masks at all times.

The notification also says that no person or officer is to attend any meeting / gathering without these masks. The masks that the BMC recommends can be the 3 ply masks found at the chemist and if those aren’t available, even home-made washable masks can be made and used after proper washing and disinfection.

The letter has also issued instructions for those who violate these orders. People found breaching the order will be booked under Section 188 of the IPC and strictly penalized, apart from being liable to arrest.

The city saw 72 fresh coronavirus cases on Wednesday. The total count of Covid-19 positive cases now stands at 714, with 45 people having passed away due to the infection.

Apart from Mumbai, Pune too has made it mandatory to wear face masks in public, reported The Indian Express. Currently, there are 197 positive coronavirus cases reported in Pune. The order was issued by the Joint Commissioner of Pune Police Ravindra Shisve and it read, “The number of people who have contracted coronavirus is increasing day by day. As per directives of the World Health Organization, the disease can spread at a very rapid rate. To prevent this, there are several prohibitory orders in force in the city including curfew in some areas. To stop further spread, experts have advised continuous use of masks, hand gloves and sanitizers.”

The order further read, “We are now making use of masks mandatory in all places in jurisdiction of Pune City Police. The masks should be of standard quality or home-made which have been property sanitized. Those in violation of the order will be liable to prosecution under Indian Penal Code section 188 and Provisions of Epidemic Diseases Act.”

#FightAgainstCoronavirus #PuneFightsCorona #SanitationWarriors #Awarenessofcoronavirus @collectorpune1 @RajSarag @PMCPune@PuneZp @gsfunde1985 @suhassatwadhar @CPPuneCity @PuneCityPolice pic.twitter.com/7LYFjJCPcG

— DISTRICT INFORMATION OFFICE, PUNE (@Info_Pune) April 8, 2020

Wearing masks in public has also been mandatory by the Uttar Pradesh, Delhi, and Chandigarh and Odisha governments.

Currently, the government has sealed 20 hotspots in Delhi and even the Uttar Pradesh government has sealed 22 hotspots in 15 districts.

While a lot has been said about the efficacy of masks and that they should only be worn by three groups – people who are afflicted by the virus, caregivers and healthcare workers, medical experts all over the world have come forward to suggest that wearing masks is emerging as a good precautionary measure for the general public from contracting the virus.

The New Yorker spoke to stem-cell biologist and the author of “The Emperor of All Maladies: A Biography of Cancer” and “The Gene: An Intimate History” in this regard. Mentioning that he thinks everyone should be wearing a mask, he said, “There are the expensive and highly efficient N95 respirators. Doctors have to get fitted for them. They are hard to get. Not everyone should be wearing those, and no one should be hoarding those. Those should be reserved for medical personnel. But then there is a simpler, so-called surgical mask, which is just a filter across your face, which prevents you from secreting respiratory droplets, and prevents others from getting respiratory droplets from you. These are cheap. In the hospital, we used to just use one and throw it away. But under these circumstances, we need a good decontamination protocol. So if you are talking about the simpler ones, then yes. Everyone should be wearing them, because the risk is low, and the return may be high.”

He also told the magazine that there is a vast amount of evidence that viruses that are secreted through respiratory secretions and cough droplets, including influenza and SARS, are decreased in their exposure when people wear masks. So, under conditions when the infections are spreading fast, the evidence suggests that mask wearing really decreases the chance of infecting others and getting infected yourself.

Related:

Covid Confusion: Do masks really protect you from the Covid-19 pandemic?

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After the Karnataka government issued an advisory saying ‘everyone need not wear a mask’ and the Central and other state governments backing the same claim, questions are now being raised about the efficacy of masks in protecting one from the coronavirus infection.

While these advisories come in, the masses are confused about whether the healthy should refrain from wearing masks at all. People are also wondering whether or not amid the shortage of regular surgical masks that people are sporting these days, other protective gear like dupattas (stoles) and handkerchiefs stand to provide the same amount of protection as surgical masks.

It has been proven that the N95 masks are imperative to be worn to protect oneself, these are largely advised and preserved for patients suffering from the disease, their caregivers and the frontline healthcare workers working around the clock so that the infection is not spread to the community.

Here’s a look at some of the advisories issued by the government.

While India grips with the Covid-19 pandemic, the Health and Family Welfare Commissionerate, Karnataka, has come up with an advisory stating ‘everyone need not wear a mask’, the Deccan Herald reported.  

Kannada actor #PuneethRajkumar on Tuesday presented Rs 50 lakh to Chief Minister @BSYBJP towards the CM relief fund.@CMofKarnataka #COVID19 #CoronavirusKarnataka #karanataka pic.twitter.com/cq0D6vLHis

— Bangalore Mirror (@BangaloreMirror) March 31, 2020

For the past few days, there has been a confusion between the administration and the police over who is required to wear masks amid the pandemic. The police have made it compulsory for everyone stepping out of their homes to wear a mask. There have been instances reported where people not wearing masks have been asked to cover half their faces with their ties or shirt, by the police. However, the advisory doesn’t mention the police but says that many departmental stores, shops and establishments.

The advisory states that a only those people have to wear a mask if he or she has symptoms such as cold, cough, fever or any other respiratory problem. Those caring for COVID-19 patients also need to wear a mask. While the former can wear a triple-layered mask, the latter has to wear an N-95 mask.

This advisory came a day after the Bengaluru City Police circulated a video showing officers giving a “lesson” to individuals for not wearing a mask.

The Union Ministry guidelines too state that it is not compulsory for everyone to wear a mask. The triple-layered masks that the police insist must be worn in public, are advised only for those visiting healthcare facilities. Many state governments too have asserted this, reports The Hindu.

Everyone need not wear a mask.
Know, when and how to wear a mask!#COVID19 #IndiaFightsCorona #CoronaOutbreak #HealthForAll #SwasthaBharat pic.twitter.com/FPqTHOZBdH

— Ministry of Health ?? #StayHome #StaySafe (@MoHFW_INDIA) March 17, 2020

The World Health Organization (WHO) says that masks can give one a false feeling of protection and can be sources of infection, when not used correctly. According to WHO, masks should only be worn by healthcare workers, caregivers and people who are ill with symptoms of the coronavirus.

While many people in India, doctors included, had to say that masks are not imperative to be worn by everyone, except for those ill or around the ill, George Gao, Director General of the Chinese CDC and part of the team that did the first isolation and sequencing of Covid-19 in Wuhan where the virus broke out first, had something else to say.

Science Mag interviewed Gao over days to understand his perspective from ground zero. On being asked what mistakes other countries are making in their efforts to prevent the pandemic, Gao said, “The big mistake is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.”

While Gao was talking about people from the United States and Europe where cases have seen a humongous spike, the Indian government too can heed his advice if it wants to curb the spread and keep community transmission of the coronavirus at bay.

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