While in absolute numbers, this may be a marginal increase in cases, each time such a reversal has occurred in India’s outbreak, it has marked a crucial turning point in the cycle.

The week-on-week change in the case curve has now been above zero for the past six days, the first time this has happened since May 10 — when the second wave peaked (see chart). A positive change in this number means an outbreak is expanding, while when this value drops below 0%, it denotes a contraction. The last time this number rose above 0% was on February 17, the statistical point from where India’s second wave started.

Meanwhile, the national average positivity rate – a crucial metric that shows the spread of infection – has also started slowly inching upwards, and has risen from a low of 2% to 2.4% in the past two weeks.

To be sure, this increase in cases as well as positivity rate (at least at the national level) has been very gradual so far, but it is a cause for alarm as it comes at a time when restrictions on several economic and social activities have been eased, and people and governments are becoming complacent.

The biggest centre of the outbreak in the country continues to be Kerala, which reported 20,337 new cases every day in the past week, accounting for nearly half of all new infections in the country. But there are plenty of other regions that are either seeing high levels of infections, or where cases are rising again. The states in the country’s North-East continue to see large number of cases. To be sure, cases in the region have peaked , with three of the region’s biggest outbreak centres , Mizoram, Manipur and Meghalaya , seeing a decline in cases.

Two more states, however, appear to be taking their space. In both Uttarakhand and Himachal Pradesh, the seven-day average of new cases has risen 76% from the lowest levels since the peak of the second wave.

In Himachal, the case trajectory d dropped to a low of 95 new infections a day on average for the week ending June 23, but has again started rising and currently stands at 167.

In the same period, the numbers have gone from 34 to 60 in Uttarakhand. Both states, interestingly, have seen a massive influx of tourists in recent weeks as cases have abated across the country.

Even Delhi has seen a slight uptick in cases in recent weeks. The seven-day average of new cases in the national capital has gone up 26% in the past 11 days, data shows.

These findings were echoed in the epidemiological estimates by the University of Michigan’s Centre for Precision Health Data Science, which showed that India’s overall effective reproduction number (Rt) has climbed to 1.04. An Rt of more than 1 means an outbreak is expanding in a region, while that below 1 denotes a contraction. Kerala had an Rt of 1.23, while Uttarakhand had an Rt of 1.33. The Rt of Delhi, meanwhile, was 1.05.

During Tuesday’s Covid-19 media briefing, joint secretary of Union health ministry Lav Agarwal stressed it was too early to say the second wave has ended. He said that whenever R-number is above one, it means that the case trajectory is increasing and it needs to be controlled.

“As far as India is concerned, the second wave is still not over,” he said, adding that there are 44 districts, located primarily in Kerala, Manipur, Mizoram and Nagaland where the government is keeping a close watch on as they continue to have high positivity rates.

Experts warn that these regions cannot be treated as isolated islands of infection as an outbreak in one state can easily spread to another.

“This trend of a few isolated pockets of rising cases in some areas is something that we’ve seen before. Every wave has started like this with one or two states reporting cases, then it spreads to more, until the outbreak finally goes out of control... even more so in case of tourist states like Himachal Pradesh and Uttarakhand. So it would be wise to prepare our strategies accordingly. Governments should try to isolate these pockets by forming microcontainment zones in districts with rising cases and stop the chain of transmission immediately,” said Dr Lalit Kant, former head of epidemiology at the Indian Council of Medical Research