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The R 0 of an infection determines its potential to start an outbreak, the severity of control measures needed to contain the spread, and the fraction of the population that will be infected in the absence of interventions ( Longini et al., 2005). India reported its first COVID-19 case on 30 January 2020, although the actual epidemic growth started from early March (, 2020).įor any novel infectious disease, the scale of its public health impact is determined by the basic reproduction number ‘R 0’ which is the average number of secondary infections generated by an infectious index case in a wholly susceptible population. As of May 2, 2020, there have been more than 3 200 000 cases and 230 000 deaths worldwide and close to 40 000 cases and 1200 deaths in India ( Johns Hopkins CSSE, 2020). Originating out of Wuhan, China, in December 2019 ( Zhu et al., 2020), the coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on Ma( WHO, 2020). Lower levels of social distancing when coupled with a testing ramp-up could achieve similar outbreak control as an aggressive social distancing regime where testing was not increased. We observed that the delay from the date of lockdown relaxation to the start of the second wave increases as lockdown is extended farther after the first wave peak-this delay is longer if lockdown is relaxed gradually.Īggressive measures such as lockdowns may be inherently enough to suppress an outbreak however, other measures need to be scaled up as lockdowns are relaxed. R 0 for India was estimated to be 2♰8, and the R t decreased from 1♶7 on March 30 to 1♱6 on April 22. Using a SEIR-QDPA model, we simulated lockdown relaxation scenarios and increased testing to evaluate lockdown exit strategies. We estimated the basic and time-varying reproduction number (R 0 and R t) after adjusting for imported cases and delay to confirmation using incidence data from March 4 to April 25, 2020. We obtained patient-level data to estimate the delay from onset to confirmation and the asymptomatic proportion. We estimated epidemiological parameters, evaluated the effect of control measures on the epidemic in India, and explored strategies to exit lockdown.

India imposed one of the world’s strictest population-wide lockdowns on Mafor COVID-19.

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