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Covid cases across the country crossed 258,000 on Monday, even as the two big metros - Mumbai and Delhi - reported a dip in reported cases. The national daily positivity rate increased to more than 19 per cent, signaling the need to step up testing, Business Standard reported.

As the third wave persists, the health ministry has issued new clinical guidelines for adult Covid patients. The government may also consider starting vaccination for those in the 12-14 age group from March, PTI has reported.

Mumbai reported 5,956 cases - 24 per cent lower than Sunday. Delhi had over 12,000 cases - a decline of 31 per cent, compared to Sunday. While on a day-to-day basis, there was a slight drop in countrywide cases, compared with 271,000 infections reported on Sunday, this could also be because of low levels of testing during the weekend. The fewer reported cases could also be due to a large number of people opting for home antigen tests, instead of the reverse transcription-polymerase chain reaction (or RT-PCR) test.

The health ministry on Monday also issued new clinical guidelines for adult Covid patients. For severe cases described as having peripheral capillary oxygen saturation (or SpO2) below 90 per cent in room air and respiration at less than 30 per cent, admission to an intensive care unit or high-dependency unit is to be followed.

While most protocols remain the same as in the previous waves, the government, while suggesting the use of Remdesivir and Tocilizumab in severe patients under very specific circumstances, has not included Molnupiravir in its advisory.

“Consider Remdesivir for five days to treat hospitalised patients,” the guidelines stated, stressing there was no evidence of benefit beyond that period. The drug is not to be used on patients who are not on oxygen support or in a home setting.

If a cough persists for more than two or three weeks, the health ministry has suggested that the patient be investigated for tuberculosis and other conditions.

The guidelines have been framed by the Indian Council of Medical Research and the All India Institute of Medical Sciences' joint monitoring group and the national task force.

In the current wave being spurred by the highly transmissible Omicron variant of the novel coronavirus, the government has said that patients with upper respiratory tract symptoms, with or without fever and with no shortness of breath, are mild cases.

For those with moderate disease, the government has said there is no evidence of benefit for injectable steroids in those not requiring oxygen supplementation, or on continuation after discharge.

Learning from past experience, the guidelines also state that anti-inflammatory or immunomodulatory therapy, such as steroids, can have a risk of secondary infection, such as invasive mucormycosis, when used too early at a higher dose or for a longer-than-required period.

Meanwhile, a PTI report said India may begin inoculating children in the 12-14 age group against Covid in March as the 15-18 population is likely to get fully vaccinated by then, said N K Arora, chairman of the Covid-19 working group of the National Technical Advisory Group on Immunisation in India.

"Adolescents in this age group have been actively participating in the inoculation process, and going by this pace of vaccination, the rest of the beneficiaries in the 15-18 age group are likely to be covered with the first dose by January-end and subsequently their second dose is expected to be done by February-end," said Arora.

An earthquake rocked western Afghanistan on Monday, killing more than 20 people and destroying hundreds of homes, local authorities said, Reuters reported.

The 5.6 magnitude tremor shook the western province of Badghis, bordering Turkmenistan, in the afternoon, reducing brick homes to rubble, according to photos shared by local authorities.

"Unfortunately, our initial reports show that 22 people, including women and children, have been killed and four others injured," said Baz Mohammad Sarwari, the director of Information and Culture of the Badghis provincial administration.

"The Mujahideen have reached to some of the affected areas, but Badghis is a mountainous province, the number of casualties might go up," he added, referring to Taliban fighters, and adding that heavy rain was also lashing the area.

Mullah Janan Saeqe, head of the Emergency Operations Centre of the Ministry of State for Emergency Affairs, confirmed the death toll and said more than 700 houses had been damaged.

Sanullah Sabit, the head of the nursing unit at the main hospital in Badghis' capital said they had received five patients injured in the quake, mostly with broken bones and fractures.

The quake was at a depth of 30 km (18.64 miles), according to the European-Mediterranean Seismological Centre

A report published by World Economic Forum has identified five socials, economic and environmental risks of Nepal.

The report titled The Global Risks Report 2022 states that employment and livelihood crisis, human-made environmental damage, geopoliticization of strategic resources, infectious disease, digital inequality and prolonged economic stagnation are the major risks Nepal is facing.

The Global Risks Report 2022 presents the results of the latest Global Risks Perception Survey (GRPS), followed by an analysis of key risks emanating from current economic, societal, environmental and technological tensions. The report concludes with reflections on enhancing resilience, drawing from the lessons of the last two years of the COVID-19 pandemic. 

Nepal recorded 6,734 fresh Covid-19 cases on Monday.

As per the latest data provided by the Health Ministry, a total of 17,465 tests were conducted in the last 24 hours of which 5,747 were PCR tests while 987 were antigen tests.

According to the ministry, there are over 30,877 0 active cases in the country.

Similarly, 547 people recovered from the infection while three lost their lives to the virus.