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Third Wave "Inevitable, Could Hit India In 6 To 8 Weeks": AIIMS Chief
A new frontier will have to be developed in India's fight against Covid to further study the mutation of the virus, AIIMS chief Dr Randeep Guleria said.
All India
Reported by Rishika Baruah, Edited by Swati Bhasin
Updated: June 19, 2021 3:41 pm IST



New Delhi:
A third Covid wave in India is "inevitable", and it could hit the country in the next six to eight weeks, AIIMS chief Dr Randeep Guleria told NDTV this morning amid unlocking in parts of the country after weeks of strict restrictions. The country's main challenge is vaccinating a huge population and the increase in dose gaps for Covishield "may not be a bad" approach to provide protection to cover more people, he explained.

A new frontier will have to be developed in India's fight against Covid to further study the mutation of the virus, Dr Guleria stressed, as he talked about the new Delta-plus variant, which has evolved from the Delta variant of COVID-19, triggering fresh concerns about monoclonal antibody treatment.

"As we have started unlocking, there is again a lack of Covid-appropriate behaviour. We don't seem to have learnt from what happened between the first and the second wave. Again crowds are building up... people are gathering. It will take some time for the number of cases to start rising at the national level. Third wave is inevitable and it could hit the country within the next six to eight weeks... may be a little longer," Dr Guleria said. "It all depends on how we go ahead in terms of Covid-appropriate behaviour and preventing crowds," he added.

Nearly 5 per cent of the country's population has so far been vaccinated with two doses. The government aims to vaccinate 108 crore of over 130 crore people in the country by the end of this year.

"That (vaccination) is the main challenge. A new wave can usually take up to three months but it can also take much lesser time, depending on various factors. Apart from Covid-appropriate behaviour, we need to ensure strict surveillance. Last time, we saw a new variant - which came from outside and developed here - and led to the huge surge in the number of cases. We know the virus will continue to mutate. Aggressive surveillance in hotspots is required," the AIIMS chief said.

"Mini-lockdown in any part of the country, which witnesses a surge and a rise in positivity rate beyond 5 per cent, will be required. Unless we're vaccinated, we're vulnerable in the coming months," he underlined, stressing that "testing, tracking, and treating" should be the focus in hotspots.

"We have to factor in human behaviour while unlocking, which needs to be done in a graded manner," Dr Guleria stressed.

On the spread of the Delta variant in the United Kingdom, which is now facing a third wave, he said, "Virus is still mutating, we need to be careful".

The highly transmissible variant first identified in India is now making up 99 per cent of fresh COVID-19 cases in the UK, news agency PTI reported.

The gap between the new waves is shortening and it's "worrying", Dr Guleria said.

"During the first wave (in India), the virus was not spreading that rapidly... all that changed during the second wave, and the virus became much more infectious. Now the Delta variant that's spreading is much more infectious. Faster spread is likely," said the AIIMS chief.



A debilitating second wave had led to the shortage of hospital beds and medical supplies in various parts of India. SOS messages on social media had caught the world's attention with many nations coming forward to help. Several states have now eased the restrictions after weeks of strict curbs; however, preparations are on against the third wave.

In Maharashtra, experts have now warned that at its peak, the third wave of the virus could cause 8 lakh active cases in the state, which currently has around 1.4 lakh patients.

"When there is a huge increase in the number of cases, shortage of (hospital) beds follows. The strategy should be multi-pronged - we have to make sure fresh cases don't rise. Any healthcare system globally will tend to collapse with the unprecedented rise in the infections," Dr Guleria said today.

Does India need to rethink its 12-16 week gap decision between two doses of Covishied, a vaccine the country is largely dependent on? "Nothing is written in stone. We will have to look at new strategies. But we need to have strong data to take that decision," the AIIMS chief said.

The decision should be driven by science and not the shortage of doses, he suggested.

The United Kingdom adopted the one-shot strategy not only for AstraZeneca (which is being used as Covishield in India), but also for Pfizer, Dr Guleria pointed out.

"One-shot strategy may not be a bad strategy as it can give protection to larger number of people," Dr Guleria said.

On the Delta-plus variant, the AIIMS chief explained: "We need an aggressive genome sequencing to see how the virus is behaving. Does the vaccine efficacy come down, does the monoclonal antibody treatment work? To do all of that, we need to have a large or very good network of labs to study the data. I think that's where to move in the next few weeks. And that's the new frontier we need to develop if we want to succeed in our fight against Covid."


Third Wave "Inevitable, Could Hit India In 6 To 8 Weeks": AIIMS Chief
 

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Covid: Chandigarh reduces night curfew by an hour, extends shop timings


  • Updated At: Jun 22, 2021 05:47 PM (IST)
Covid: Chandigarh reduces night curfew by an hour, extends shop timings


Tribune file photo


Tribune News Service
Chandigarh, June 22

The Chandigarh administration reduced night curfew by an hour and extended shop timings in the union territory till 8 pm in a development that comes as Covid cases from the second wave continue to fall in the city.
New orders from the administration say shops can remain open from 10 am to 8 pm and that shop owners must ensure Covid protocols are strictly followed.

What the order says:
—Shops can remain open up to 8 pm
—Night curfew will be imposed from 11 pm to 5 am
—Restaurants and bars can function at 50 per cent capacity from 10 am to 10.30 pm

—Gatherings such as weddings and funerals can have up to 50 people, up from the previous 30
—Sports complexes will be thrown open to members with strict adherence to Covid protocols

—Boating will resume at Sukhna Lake at 50 per cent capacity

Covid: Chandigarh reduces night curfew by an hour, extends shop timings
 

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22 cases of Delta Plus variant of Covid found in Maharashtra, MP, Kerala: Centre
Not yet in the category of variant of concern


  • Updated At: Jun 22, 2021 08:52 PM (IST)
22 cases of Delta Plus variant of Covid found in Maharashtra, MP, Kerala: Centre


A beneficiary receives a dose of Covid-19 vaccine at a vaccination centre in Jammu on Tuesday. PTI photo


New Delhi, June 22
Twenty-two cases of the Delta Plus variant of the coronavirus have been detected in India, with 16 of them being reported from Maharashtra and the remaining from Madhya Pradesh and Kerala, the government said on Tuesday.
India is among the 10 countries where the Delta Plus mutation has been found so far, Union Health Secretary Rajesh Bhushan said at a press briefing.
A statement issued by the Union Health Ministry stated INSACOG had informed that the Delta Plus variant, "currently a variant of concern (VOC)", has these characteristics—increased transmissibility, stronger binding to receptors of lung cells and potential reduction in monoclonal antibody response.

Besides India, the Delta Plus variant has been found in the US, UK, Portugal, Switzerland, Japan, Poland, Nepal, China and Russia.
The Delta variant is found in 80 countries around the world, including India, and it is a variant of concern, Bhushan said.


Cases of the Delta Plus variant have been detected in Maharashtra's Ratnagiri and Jalgaon and parts of Kerala and Madhya Pradesh.

"Any variant's transmissibility and virulence decides whether it is a variant of concern or interest. Delta variant is found in 80 countries around the world, including India and it is a variant of concern.
"Delta Plus variant has been detected in nine countries besides India. In India, 22 cases of Delta Plus variant have been found and it is in the category of variant of interest, (and) not yet in the category of variant of concern," Bhushan said at the briefing.

He said the Health Ministry has released an advisory on the kind of public health response that Maharashtra, MP and Kerala should initiate to address this issue which "presently looks fairly small in terms of number but we would not want this to assume significant proportions".


According to the Health Ministry statement, it has alerted and advised Maharashtra, Kerala and Madhya Pradesh to take up immediate containment measures, enhanced testing, tracking and vaccination in districts and clusters where the Delta Plus variant of COVID-19 is found.
"Union Health Secretary has communicated to these three states this variant has been found in genome sequenced samples from Ratnagiri and Jalgaon Districts of Maharashtra; Palakkad and Pathanamthitta Districts of Kerala; and Bhopal and Shivpuri Districts of Madhya Pradesh," the statement said.

The Union Health Ministry has advised Maharashtra, Kerala and Madhya Pradesh that the public health response measures, while broadly remaining the same as have been implemented by them earlier, have to become more focused and effective.
The chief secretaries of these states have been advised to take up immediate containment measures in the districts and clusters, including preventing crowds and intermingling of people, widespread testing, prompt tracing as well as vaccine coverage on a priority basis, the statement said.

They were also advised to ensure that adequate samples of positive persons are promptly sent to the designated laboratories of INSACOG so that clinical epidemiological correlations can be made for further guidance to be provided to states, the statement said.
In response to a question at the press briefing, Bhushan said, "Broadly speaking, both the Indian vaccines—Covishield and Covaxin—are effective against Delta variant but to what extent and what is the proportion of antibody titers they produce, that information we would very shortly share." Bhushan further informed that INSACOG has 28 laboratories and they have sequenced 45,000 samples, of which 22 cases of delta plus variant have been found.

"The labs of INSACOG bring this information to the notice of Health Ministry which then in timely and prompt manner indicates to the concerned states what are the activities that have to be initiated to curb the spread. The public health response is standardised for the variants," he said.
INSACOG, or Indian SARS-CoV-2 Consortium on Genomics, was set up to conduct genome sequencing of the coronavirus.

The INSACOG is tasked with not just the whole genome sequencing but also for giving timely inputs on appropriate public health response measures to be adopted by States and Union Territories.
Speaking on the overall pandemic situation in the country, NITI Aayog Member (Health) V K Paul said there is a consistent improvement in the pandemic situation but stressed that people must continue to follow COVID-19-appropriate behaviour and avoid crowds and parties. Uptake of vaccination has to be increased, he said.

"The number of districts reporting more than 100 daily cases have shrunk to 135 from 531 (in the week ending May 20) which is reassuring and even with restrictions being eased we are able to maintain the declining pace.
"But with the restrictions being lifted our responsibility increases...it is in our hands to ensure that pandemic remains localised and suppressed," Paul said.

Bhushan said there has been an almost 90 per cent decline in India's daily COVID-19 cases as compared to the highest peak reported on May 7.
Also a sharp decline in weekly positivity rate—84 per cent decrease has been noted since the highest reported weekly positivity of 21.4 per cent recorded between May 4 and 10. — PTI


22 cases of Delta Plus variant of Covid found in Maharashtra, MP, Kerala: Centre
 

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Bharat Biotech’s Covaxin shows 77.8% efficacy in Phase III trials
Govt expert panel accepts Covaxin phase-3 trial data


  • Updated At: Jun 22, 2021 09:22 PM (IST)
Bharat Biotech’s Covaxin shows 77.8% efficacy in Phase III trials


The meeting is taking before Bharat Biotech’s ‘pre-submission’ meeting on Wednesday with the World Health Organization (WHO)


New Delhi, June 22
An expert panel of the country's central drugs authority has reviewed and accepted the phase-3 trial data of Bharat Biotech's Covid-19 vaccine Covaxin, sources said on Tuesday.
According to the data submitted by the Hyderabad-based firm, the indigenously developed vaccine has shown 77.8 per cent efficacy in the trial conducted on 25,800 subjects, they said.
The firm had submitted the results of its phase-3 trial efficacy data of Covaxin to the Drugs Controller General of India (DCGI) over the weekend, they added.

The Covid-19 Subject Expert Committee (SEC) of the Central Drugs Standard Control Organisation (CDSCO) on Tuesday reviewed the data and accepted it. Their recommendations have been sent to the DCGI now, a source said.
Bharat Biotech is also expected to attend a "pre-submission" meeting on July 23 with the World Health Organisation (WHO), which will take the vaccine-maker closer to a WHO Emergency Use Listing (EUL).

Though the meeting will not be a detailed review on the product, the vaccine-maker will have an opportunity to submit a summary on the overall quality of the jab, according to the WHO.
The information was provided on the WHO website in the Status of Covid-19 Vaccines within WHO EUL-PQ evaluation process document.

Covaxin is one of the three vaccines approved by the DGCI for emergency use and is being deployed in India's Covid-19 vaccination programme. — PTI


Bharat Biotech’s Covaxin shows 77.8% efficacy in Phase III trials
 

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3 likely scenarios for 3rd wave, peak in Sept-Oct, 2-5 lakh cases/day — IIT-K team predicts

IIT team forecasts 3 scenarios of possible 3 Covid wave, using data from 2nd. Prediction model assumes India will fully unlock by 15 July, doesn't take vaccination into consideration.

MOHANA BASU 22 June, 2021 1:38 pm IST


Covid swab testing | Representational image | ANI


Covid swab testing | Representational image | ANI


New Delhi: A possible third wave of the Covid-19 pandemic in India is likely and it will peak between September and October this year, assuming India fully unlocks by 15 July, according to a prediction model by researchers at the Indian Institute of Technology-Kanpur. The team also noted that daily cases could peak at over 5 lakh cases a day in September, in the worst-case scenario.
The prediction model, however, does not take into account the effect of vaccinations in India, which the researchers say will have a significant impact on breaking the chain of transmission.


Using susceptible-infected-recovered (SIR) model — an epidemiological model that computes the theoretical number of people infected with a contagious illness in a closed population over time — three scenarios of a possible third wave using data from the second wave in India was constructed by the IIT Kanpur team, led by professors Rajesh Ranjan and Mahendra Verma.
The model assumes what would happen if India is fully unlocked on 15 July.
In the first scenario, where restrictions are lifted, the team predicts that the third wave will peak in October. However, this peak height will be lower than that of the second wave. At the peak, a maximum of 3.2 lakh cases will be recorded daily.



In the second scenario, the researchers assume the emergence of new, more infectious variants of SARS-CoV-2. If there are no lockdowns or restrictions, the peak could be higher than the second one and may appear earlier, in September. This is the worst-case scenario where the number of new infections on a daily basis could reach as high as 5 lakh a day.
The researchers predict a third scenario where the peak of the third wave could be delayed until late October. The model suggests if stricter interventions to prevent the spread of the disease are implemented, the peak of the third wave will be lower than the second wave, with less than 2 lakh cases reported in the worst case.
All three scenarios, however, predict a peak bigger than the first wave.

Limitations of the model
One of the limitations of the SIR model is that it assumes that the entire population is equally susceptible to the virus, and that is it does not take into account the effect of vaccinations.

It also assumes that the population is ‘closed’ — there is no migratory flow in or out so that changes in the population occur through births and deaths only.

“Vaccination is known to break the transmission chain. At present, the model does not include vaccination, which should decrease the peak significantly. Revised model with vaccination and with more recent data on the same is being worked out,” the researchers said.

The IIT Kanpur team has also been providing daily Covid-19 forecasts in India.
According to them, the second wave has waned significantly almost everywhere except in some states in the Northeast, such as Mizoram, Manipur and Sikkim.
As of Tuesday, India recorded 42,640 new cases of Covid across the country. At its peak in May, the country was reporting about 4 lakh cases daily.
While India’s test positivity has dropped to 2.6 per cent at present, the researchers said there is significant anxiety among policy makers and the public about the third wave.

3 likely scenarios for 3rd wave, peak in Sept-Oct, 2-5 lakh cases/day — IIT-K team predicts
 

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Covid-19: First Delta Plus variant detected in Chandigarh
The sample was among 50 random samples of cases that were reported in May, June

  • Updated At: Jun 26, 2021 10:26 PM (IST)
Covid-19: First Delta Plus variant detected in Chandigarh


For representation only. PTI file photo

Tribune News Service

Chandigarh, June 26

The Chandigarh Administration said on Saturday that it had found one Delta Plus Variant of Covid-19 in one of the random 50 samples sent for genome sequencing among cases that were reported in the union territory in May and June.
A press release that the administration issued on Saturday said variants of concern (VoC) were found in 35 of the 50 samples sent for whole genome sequencing—a process by which scientists determine the DNA sequence of an organism’s genome.
The Delta variant—the variant that is believed to have primarily driven the deadly second wave in April and May this year—was found in 33 of the 35 VoC samples. One sample had the Alpha variant—a variant first detected in Kent in the United Kingdom late last year, and one was Delta Plus.

The press release said the sample belonged to a 35-year-old from Mauli Jagran, and that authorities had sent samples of the person’s family members who’d tested positive for genome sequencing.
None of the family was hospitalised, the press statement said, and they had all fully recovered.

Fifty-two cases of the Delta Plus mutation of SARS-CoV2 coronavirus have been reported in India—the highest of these in Maharashtra, Tamil Nadu and Madhya Pradesh. The three states account for 70 per cent of cases from the variant.
Three deaths have been reported from the variant, which scientists say has increased transmissibility, stronger binding to receptors of lung cells, and potential reduction in monoclonal antibody response.

Covid-19: First Delta Plus variant detected in Chandigarh
 

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Delhi oxygen row: Guleria terms audit report interim
Source: PTI - Edited By: Roshneesh Kmaneck
Last updated on: June 26, 2021 18:42 IST


The apex court audit on Delhi's oxygen demand is an interim report and not the final word, AIIMS director Randeep Guleria said on Saturday as Chief Minister Arvind Kejriwal, under fire for purportedly exaggerating the city's needs, insisted the acute shortage of oxygen during Covid's second wave was real. He also appealed for an end to political bickering and for everyone to work together so no one suffers in the third wave.



The virus will win if there is a fight among stakeholders, Kejriwal tweeted, a day after his Aam Aadmi Party and the Bharatiya Janata Party hit out at each other over the report that said Delhi's oxygen needs were “exaggerated” four times over during the second Covid wave.
The five-member Supreme Court appointed panel was headed by Guleria said, "It is an interim report. The oxygen needs are dynamic and change from day to day. The matter is sub-judice."
While the BJP charged the Delhi government with "criminal negligence" after the report came into the public domain on Friday, AAP leader and Deputy Chief Minister Manish Sisodia alleged that the "bogus" report was "cooked up" at BJP's office.

"May we work now if your fight over oxygen is finished? Let us together make a system so no one faces shortage of oxygen in third wave,” Kejriwal said in his tweet in Hindi a day later.
“There was an acute shortage of oxygen in the second wave. It should not be so in the third wave. Corona will win if we fight with each other. The nation will win if we fight together," he added.
Dubbing the BJP the ‘Bharatiya Jhagda Party’, his deputy Sisodia said its leaders know only how to have fights and have nothing to do with either oxygen or the third Covid wave.
“When the third wave will start, they will be causing fights someplace else...,” he tweeted in Hindi.
The report of the Supreme Court constituted sub-group to audit oxygen consumption in hospitals in the national capital during the second wave in April-May said the Delhi government "exaggerated" the consumption of oxygen and made a claim of 1,140 MT, four times higher than the formula for bed capacity requirement of 289 MT.
The panel said the Delhi government had made the claims for allocation of 700 MT oxygen on April 30 of medical grade oxygen using a "wrong formula".
Two members, B S Bhalla, Delhi government's principal home secretary, home, and Max Healthcare's Sandeep Budhiraja, questioned the conclusions.
The report has an annexure of communication sent by Bhalla on May 31 in which he said a reading of the draft interim report makes it “painfully apparent” that the sub-group, instead of focusing on the task, delineated from the terms of order of the Supreme Court dated May 6.
The manner in which the proceedings of the sub-group were conducted, he said, suggested that the purpose of proceedings was to satisfy a “preconceived and predetermined conclusion and narrative to recommend a lower quantity of LMO to Delhi”. It was also aimed at further portraying an impression that the assessment by the Government of National Capital Territory of Delhi before the high court and the Supreme Court was “exaggerated or not genuine”, Bhalla added.
He objected to the finding of the sub-group that medical oxygen consumption as per actual bed occupancy was 250 tonnes in late April, 470-490 MT in the first week of May and 900 MT as claimed on May 10.
“This para should be deleted as it is neither correct nor based on verified data. With the number of new positive cases peaking in the first week of May, and hospital bed occupancy continuing to rise even after that, the Oxygen requirement based on occupancy was around 625 MT at the end of April and 700 MT in the first week of May,” he said.
Regarding the finding that the Delhi government made “exaggerated” oxygen requirement claims, Bhalla said the GNCTD clarified that the calculation for 700 MT has been made in accordance with standard oxygen requirement specified by the government of India/ICMR, which is 24 litres per minutes for ICU beds and 10 LPM for non-ICU beds.
“Doubts about the percentage of non-ICU beds that need oxygen can only be resolved through an actual on-ground audit of hospitals, which the audit sub-group is yet to do,” he said.
Budhiraja said in his comments that a decision was taken in the first meeting itself to get actual details of oxygen consumption from all the hospitals of NCT Delhi.
"After repeated corrections (as hospital medical Superintendent used a different format), the total calculation of Oxygen consumption (based on actual consumption data of 214 hospitals) came to around 490 MT. This did not take into account, oxygen cylinder refilling and non-COVID requirement of hospitals," Budhiraja said.
He also brought to the notice of the sub-group that he did not attend the May 18 meeting. He said he gave prior information to the group on WhatsApp that minutes of the previous meeting (held on May 15) should be circulated prior to the fixing of the next meeting.


"This was never done," he had said and added that his comment be added in the interim report.
Besides Guleria, Bhalla and Budhiraja, the panel comprises Subodh Yadav, joint secretary in the Jal Shakti Ministry, and Sanjay Kumar Singh, controller of explosives, Petroleum and Explosives Safety Organization.


Delhi oxygen row: Guleria terms audit report interim
 

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Delta Plus variant: Govt alerts 8 states, UTs
Source: PTI - Edited By: Utkarsh Mishra
June 25, 2021 23:17 IST


The Union health ministry on Friday urged eight states and Union Territories to take up immediate containment measures including preventing crowds, conducting widespread testing as well as increasing vaccine coverage on a priority basis in districts where the Delta Plus variant of coronavirus has been detected.



IMAGE: People crowd seen at a wholesale vegetable market during relaxation hours of COVID-19 induced lockdown, at Narwal in Jammu, on Thursday. Photograph: PTI Photo

The measures were suggested by Union Health Secretary Rajesh Bhushan in a letter to Tamil Nadu, Rajasthan, Karnataka, Punjab, Andhra Pradesh, Jammu and Kashmir, Gujarat and Haryana.
He also urged them to ensure that adequate samples of people who test positive for COVID-19 are promptly sent to the designated laboratories of Indian SARS-CoV-2 Genomic Consortia (INSACOG) so that clinical epidemiological correlations can be established.


Bhushan said the Delta Plus variant of SARS-CoV-2 has been detected in Tirupati district in Andhra Pradesh, Surat in Gujarat, Faridabad in Haryana, Katra in Jammu and Kashmir, Bikaner in Rajasthan, Patiala and Ludhiana in Punjab, Mysuru in Karnataka, Chennai, Madurai and Kanchipuram in Tamil Nadu.
"You are aware that INSACOG is a consortium of laboratories for whole genome sequencing in the context of the COVID-19 pandemic. INSACOG is tasked with not just the whole genome sequencing but also giving timely inputs on appropriate public health response in specific geographies where variants have been found.
"It has been intimated by INSACOG that the Delta Plus variant, which is currently a variant of concern (VOC), has the following characteristics -- increased transmissibility, stronger binding to receptors of lung cells and potential reduction in monoclonal antibody response," he said.
Bhushan stressed the public health response in this case, while broadly remaining the same, has to become more focused and stringent.
"Thus, you are requested to take up immediate containment measures in these districts and clusters including preventing crowds and intermingling of people, (conducting) widespread testing, prompt (contact) tracing as well as (increasing) vaccine coverage on a priority basis.
"You are also requested to ensure that adequate samples of positive persons are sent to the designated laboratories of INSACOG promptly so that the clinical epidemiological correlations can be established," he said.
Earlier in the day, the Centre said 51 cases of the Delta Plus variant of coronavirus have been found in 45,000 samples sequenced so far in the country with Maharashtra reporting the highest number of 22.
It emphasised there are still very limited cases of this mutation and it cannot be inferred that it is showing an upward trend.


Sujeet Singh, director of the National Centre for Disease Control (NCDC), said 22 cases of the Delta Plus variant has been found in Maharashtra, followed by nine in Tamil Nadu, seven in Madhya Pradesh, three in Kerala, two each in Punjab and Gujarat, and one each in Andhra Pradesh, Odisha, Rajasthan, Jammu and Kashmir, Haryana and Karnataka.


Delta Plus variant: Govt alerts 8 states, UTs
 
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