Chindia Alert: You’ll be Living in their World Very Soon
aims to alert you to the threats and opportunities that China and India present. China and India require serious attention; case of ‘hidden dragon and crouching tiger’.
Without this attention, governments, businesses and, indeed, individuals may find themselves at a great disadvantage sooner rather than later.
The POSTs (front webpages) are mainly 'cuttings' from reliable sources, updated continuously.
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Image copyright GETTY IMAGESImage caption Air India has flown a number of rescue missions
India’s national carrier Air India has been praised for flying a number of flights to rescue Indians stranded in coronavirus-affected countries. Now, a group of pilots have alleged their safety was compromised – a charge the airline denies.
Air India’s fleet has long been used by the government to help Indians in crisis. This has included everything from delivering relief materials during natural calamities to airlifting citizens from Middle Eastern countries during the 2011 Arab Spring.
But this time, as Covid-19 sweeps across the world, crew members have made several allegations about serious shortcomings with regards to ensuring the safety of crew and passengers on recent rescue flights.
In a letter seen by the BBC, the Executive Pilots Association, a body that represents senior long-haul pilots of the airline, says they have been given “flimsy” pieces of Personal Protective Equipment (PPE) that “tear and disintegrate easily on rescue flights”.
The letter, which has been sent to the airline and the aviation ministry, adds that “disinfection processes [for aircraft] are short of international industry best practices”.
Image copyright GETTY IMAGESImage caption Air India is India’s largest airline
“These inadequacies compound the chances of viral exposure and equipment contamination and may even lead to community transmissions of Covid-19 within crew members, passengers and the public at large,” the letter states.
The Indian Pilots’ Guild, which also represents Air India’s long-haul pilots, has written to the ministry citing similar concerns. The BBC has seen this letter as well.
A senior pilot, who did not wish to be identified, told the BBC it is not that the crew “doesn’t want to work in these testing times for the country”.
“All we are asking is that proper safety procedures should be followed. If we don’t have the right PPE and disinfection processes, we are risking the safety of everybody on the plane, our family, and residents of the buildings where we live,” he said.
“We are being compared to soldiers and that is very humbling. But you have to give the right gear to your soldiers.”
An Air India spokesperson acknowledged the letters and said: “Air India is proud of its crew.”
“Our crew has shown tremendous strength, integrity and dedication. All possible measures have been taken towards their health and safety. Best available PPE are procured for our crew,” he told the BBC.
‘Quarantine violations’
The pilot also added that in some cases the norm of following 14-day quarantine period for everybody returning from abroad was not applied to crew members.
The BBC is aware of at least one case where a pilot who returned from a Covid-19-affected country was asked to fly again within seven days.
The spokesperson denied these allegations, saying that “all crew having done international flights have been home quarantined”.
“They have been advised to self-isolate should they develop any symptoms and report immediately. We are following all government quarantine guidelines,” he added.
Image copyright GETTY IMAGESImage caption Air India is due to take stranded Europeans from India to Germany
The two letters add that the crew do not have any specific Covid-19-related insurance policies and don’t have medical teams to examine them when they return from international flights.
“Medical teams all over India are now being covered under a government scheme, although surprisingly air crew are not,” the letters say.
The pilot added that “we are not comparing ourselves to medical staff – they really are the frontline soldiers”.
“But we are also risking our lives, and an insurance will just give us some peace of mind,” he said.
The association has also highlighted the issue of unpaid allowances to the crew.
“Our flying-related allowances, comprising 70% of our total emoluments, remain unpaid since January 2020. This is grossly unfair,” the letter says.
The pilot added that this went against Prime Minister Narendra Modi’s request to employers not to withhold or cut wages in this time of crisis.
“I will repeat again that we do not mind serving the nation, but we need our pay to be protected. We need to be able to look after our families,” he said.
The airline spokesperson said that “all salaries have been paid and efforts are on to clear some pending dues”, but pilots say the withheld allowances are around 70% of their total earnings.
Air India has been saddled with massive debts and several efforts to sell it have failed.
However despite this, the airline is in the midst of planning a massive operation to evacuate foreigners in India at great cost.
The passengers will be collected from several major Indian cities and flown to Frankfurt, but Air India will not be bringing back any Indian citizens who may still be stuck in Europe.
The pilot said “it’s commendable that Air India is helping those in need” but asked why Indians could not be on the return flights as the planes would be flying home empty.
“I want to stress that we will not stop flying rescue and supply missions at any cost. We just want to be heard,” another pilot told the BBC.
“Otherwise it feels like we are alone in this battle when the need is for all of us to work together and look after each other.”
Image copyright GETTY IMAGESImage caption The Netherlands has been among the countries reporting faulty Chinese-made equipment
A number of European governments have rejected Chinese-made equipment designed to combat the coronavirus outbreak.
Thousands of testing kits and medical masks are below standard or defective, according to authorities in Spain, Turkey and the Netherlands.
Europe has reported hundreds of thousands of cases of coronavirus.
More than 10,000 people have died in Italy since the outbreak began.
The virus was first detected in China at the end of 2019. The government implemented strict lockdown measures to bring it under control.
What’s wrong with the equipment?
On Saturday, the Dutch health ministry announced it had recalled 600,000 face masks. The equipment had arrived from a Chinese manufacturer on 21 March, and had already been distributed to front-line medical teams.
Dutch officials said that the masks did not fit and that their filters did not work as intended, even though they had a quality certificate,
“The rest of the shipment was immediately put on hold and has not been distributed,” a statement read. “Now it has been decided not to use any of this shipment.”
Spain’s government encountered similar problems with testing kits ordered from a Chinese company.
It announced it had bought hundreds of thousands of tests to combat the virus, but revealed in the following days that nearly 60,000 could not accurately determine if a patient had the virus.
The Chinese embassy in Spain tweeted that the company behind the kits, Shenzhen Bioeasy Biotechnology, did not have an official license from Chinese medical authorities to sell its products.
It clarified that separate material donated by the Chinese government and technology and retail group Alibaba did not include products from Shenzhen Bioeasy.
Turkey also announced that it had found some testing kits ordered from Chinese companies were not sufficiently accurate, although it said that some 350,000 of the tests worked well.
Allegations of defective equipment come after critics warned China could be using the coronavirus outbreak to further its influence.
“China is aggressively pushing the message that, unlike the US, it is a responsible and reliable partner,” he wrote. “Armed with facts, we need to defend Europe against its detractors.”
What’s the situation in Europe?
On Monday, Spain reported 812 new deaths in the space of 24 hours – bringing its total death toll to 7,340. It now has more than 85,000 infections – surpassing the number of cases reported in China.
Media caption Spanish doctor “scared and exhausted” by pandemic
New measures have also come into force in Spain banning all non-essential workers from going to their jobs. The restrictions will be in place for at least two weeks.
Italy remains the worst affected country worldwide. More than 10,000 people have died from the virus there, and it has recorded nearly 100,000 infections. Only the US has more confirmed cases, although the death toll there is far lower.
US death toll passes 3,000 as New York’s hospitals are pushed to breaking point
Italy extends lockdown as cases exceed 100,000; UN Security Council votes by email for first time
The USNS Comfort passes the Statue of Liberty as it enters New York Harbour on Monday. Photo: Reuters
Harsh lockdowns aimed at halting the march of the coronavirus pandemic extended worldwide Monday as the death toll soared toward 37,000 amid new waves of US outbreaks.
The tough measures that have confined some two-fifths of the globe’s population to their homes were broadened. Moscow and Lagos joined the roll call of cities around the globe with eerily empty streets, while Virginia and Maryland became the latest US states to announce emergency stay-at-home orders, followed quickly by the capital city Washington.
In a symbol of the scale of the challenge facing humanity, a US military medical ship sailed into New York to relieve the pressure on overwhelmed hospitals bracing for the peak of the pandemic.
France reported its highest daily number of deaths since the outbreak began, saying 418 more people had succumbed in hospital.
Spain, which announced another 812 virus deaths in 24 hours, joined the United States and Italy in surpassing the number of cases in China, where the disease was first detected in December.
On Tuesday, mainland China reported a rise in new confirmed coronavirus cases, reversing four days of declines, due to an uptick in infections involving travellers arriving from overseas.
Mainland China had 48 new cases on Monday, the National Health Commission said, up from 31 new infections a day earlier.
All of the 48 cases were imported, bringing the total number of imported cases in China to 771 as of Monday.
There was no reported new case of local infection on Monday, according to the National Health Commission. The total number of infections reported in mainland China stood at 81,518 and the death toll at 3,305. Globally, more than 760,000 have been infected, according to official figures.
Here are the developments:
Hospital ship arrives in New York
New York’s governor issued an urgent appeal for medical volunteers Monday amid a “staggering” number of deaths from the coronavirus, saying: “Please come help us in New York, now.”
The plea from Governor Andrew Cuomo came as the death toll in New York State climbed past 1,200 – with most of the victims in the big city – and authorities warned that the crisis pushing New York’s hospitals to the breaking point is just a preview of what other cities across the US could soon face.
Cuomo said the city needs 1 million additional health care workers.
“We’ve lost over 1,000 New Yorkers,” he said. “To me, we’re beyond staggering already. We’ve reached staggering.”
The governor’s plea came as a 1,000-bed US Navy hospital ship docked in Manhattan on Monday and a field hospital was going up in Central Park for coronavirus patients.
New York City reported 914 deaths from the virus as of 4:30pm local time Monday, a 16 per cent increase from an update six hours earlier. The city, the epicentre of the US outbreak, has 38,087 confirmed cases, up by more than 1,800 from earlier in the day.
Coronavirus field hospital set up in New York’s Central Park as city’s health crisis deepens
Gloom for 24 million people in Asia
The economic fallout from the coronavirus pandemic will prevent almost 24 million people from escaping poverty in East Asia and the Pacific this year, according to the World Bank.
In a report released on Monday, the Washington-based lender also warned of “substantially higher risk” among households that depend on industries particularly vulnerable to the impact of Covid-19. These include tourism in Thailand and the Pacific islands; manufacturing in Vietnam and Cambodia; and among people dependent on “informal labour” in all countries.
The World Bank urged the region to invest in expanding conventional health care and medical equipment factories, as well as taking innovative measures like converting ordinary hospital beds for ICU use and rapidly trining people to work in basic care.
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Indonesia bans entry of foreigners
Indonesia barred foreign nationals from entering the country as the world’s fourth-most populous country stepped up efforts to contain the spread of the coronavirus pandemic.
The travel ban, to be effective soon, will also cover foreigners transiting through the country, Foreign Minister Retno Marsudi said after a cabinet meeting in Jakarta Tuesday. The curbs will not apply to holders of work permits, diplomats and other official visitors, she said.
The curbs on foreign citizens is the latest in a raft of measures taken by Indonesia to combat the deadly virus that’s sickened more than 1,400 people and killed 122. President Joko Widodo’s administration previously banned flights to and from mainland China and some of the virus-hit regions in Italy, South Korea and Iran. The president on Monday ordered stricter implementation of social distancing and health quarantine amid calls for a lockdown to contain the pandemic.
Indonesia has highest coronavirus mortality rate in Southeast Asia
First US service member dies
The first US military service member has died from the coronavirus, the Pentagon said on Monday, as it reported another sharp hike in the number of infected troops.
The Pentagon said it was a New Jersey Army National Guardsman who had tested positive for Covid-19 and had been hospitalised since March 21. He died on Saturday, it said.
Earlier on Monday, the Pentagon said that 568 troops had tested positive for the coronavirus, up from 280 on Thursday. More than 450 Defence Department civilians, contractors and dependents have also tested positive, it said.
US military has decided to stop providing more granular data about coronavirus infections within its ranks, citing concern that the information might be used by adversaries as the virus spreads.
The new policy, which the Pentagon detailed in a statement on Monday, appears to underscore US military concerns about the potential trajectory of the virus over the coming months – both at home and abroad.
School to resume in South Korea … online
South Korean children will start the new school year on April 9 with only online classes, after repeated delays due to the outbreak of the new coronavirus, the government said Tuesday.
Prime Minister Chung Sye Kyun said that despite the nation’s utmost efforts to contain the virus and lower the risk of infection, there is consensus among teachers and others that it is too early to let children go back to school.
The nation’s elementary schools, and junior and senior high schools were supposed to start the new academic year in early March, but the government has repeatedly postponed it to keep the virus from spreading among children.
The start was last postponed until April 6, but has now been delayed three more days to allow preparations to be made for online classes.
The nation now has 9,786 confirmed cases in total, with 162 deaths.
Italy extends lockdown as cases exceed 100,000
Italy’s government on Monday said it would extend its nationwide lockdown measures
against a coronavirus outbreak, due to end on Friday, at least until the Easter season in April.
The Health Ministry did not give a date for the new end of the lockdown, but said it would be in a law the government would propose. Easter Sunday is April 12 this year. Italy is predominantly Roman Catholic and contains the Vatican, the heart of the church.
Italians have been under lockdown for three weeks, with most shops, bars and restaurants shut and people forbidden from leaving their homes for all but non-essential needs.
Italy, which is the world’s hardest hit country in terms of number of deaths and accounts for more than a third of all global fatalities, saw its total death tally rise to 11,591 since the outbreak emerged in northern regions on February 21.
The death toll has risen by 812 in the last 24 hours, the Civil Protection Agency said, reversing two days of declines, although the number of new cases rose by just 4,050, the lowest increase since March 17, reaching a total of 101,739.
Deadliest day in Italy and Spain shows worst not over yet
28 Mar 2020
Women stand near the body of a man who died on the sidewalk in Guayaquil, Ecuador. Photo: Reuters
Ecuador struggles to collect the dead
Ecuadorean authorities said they would improve the collection of corpses, as delays related to the rapid spread of the new coronavirus has left families keeping their loved ones’ bodies in their homes for days in some cases.
Residents of Guayaquil, Ecuador’s largest city, have complained they have no way to dispose of relatives’ remains due to strict quarantine and curfew measures designed to prevent spread of the disease. Last week, authorities said they had removed 100 corpses from homes in Guayaquil.
But delays in collecting bodies in the Andean country, which has reported 1,966 cases of the virus and 62 deaths, were evident midday on Monday in downtown Guayaquil, where a man’s dead body lay on a sidewalk under a blue plastic sheet. Police said the man had collapsed while waiting in line to enter a store. Hours later, the body had been removed.
More than 70 per cent of the country’s coronavirus cases, which is among the highest tallies in Latin America, are in the southern province of Guayas, where Guayaquil is located.
Panama to restrict movement by gender
The government of Panama announced strict quarantine measures that separate citizens by gender in an effort to slow the spread of the novel coronavirus.
From Wednesday, men and women will only be able to leave their homes for two hours at a time, and on different days. Until now, quarantine regulations were not based on gender.
Men will be able to go to the supermarket or the pharmacy on Tuesdays, Thursdays and Saturdays, and women will be allowed out on Mondays, Wednesdays and Fridays.
No one will be allowed to go out on Sundays. The new measures will last for 15 days.
Police in Kenya use tear gas to enforce coronavirus curfew
Remote vote first for UN Security Council
The UN Security Council on Monday for the first time approved resolutions remotely after painstaking negotiations among diplomats who are teleworking due to the coronavirus pandemic.
The Security Council unanimously voted by email for four resolutions, including one that extended through April 2021 the expiring mandate of UN experts who are monitoring sanctions on North Korea, diplomats said.
The UN mission in Somalia was also prolonged, until the end of June, and the mission in Darfur until the end of May – two short periods decided due to uncertainty over the spread of the pandemic.
The Council also endorsed a fourth resolution aimed at improving the protection for peacekeepers.
The resolutions are the first approved by the Security Council since it began teleworking on March 12 and comes as Covid-19 rapidly spreads in New York, which has become the epicenter of the disease in the United States.
Congo ex-president dies in France
Former Republic of Congo president Jacques Joaquim Yhombi Opango died in France on Monday of the new coronavirus, his family said. He was 81.
Yhombi Opango, who led Congo-Brazzaville from 1977 until he was toppled in 1979, died at a Paris hospital of Covid-19, his son Jean-Jacques said. He had been ill before he contracted the virus.
Yhombi Opango was an army officer who rose to power after the assassination of president Marien Ngouabi.
Yhombi Opango was ousted by long-time ruler Denis Sassou Nguesso. Accused of taking part in a coup plot against Sassou Nguesso, Yhombi Opango was jailed from 1987 to 1990. He was released a few months before a 1991 national conference that introduced multiparty politics in the central African country.
When civil war broke out in Congo in 1997, Yhombi Opango fled into exile in France. He was finally able to return home in 2007, but then divided his time between France and Congo because of his health problems.
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EU asks Britain to extend Brexit talks
The European Union expects Britain to seek an extension of its post-Brexit transition period beyond the end of the year, diplomats and officials said on Monday, as negotiations on trade have ground to a halt due to the coronavirus pandemic.
Europe has gone into a deep lockdown in a bid to curb the spread of the disease, with more than 330,000 infections reported on the continent and nearly 21,000 deaths.
In Britain, Prime Minister Boris Johnson and his health minister have both tested positive for the virus and the prime minister’s senior adviser Dominic Cummings – one of the masterminds behind Britain’s departure from the EU earlier this year – was self-isolating with symptoms.
London and the EU have been seeking to agree a new trade pact by the end of the year to kick in from 2021, even though the bloc has long said that such a time frame was extremely short to agree rules on everything from trade to security to fisheries.
The pyramid of Khufu, the largest of the Giza pyramid complex. Photo: Reuters
Great Pyramid in Egypt lights up in solidarity
Egypt’s famed Great Pyramid was emblazoned Monday evening with messages of unity and solidarity with those battling the novel coronavirus the world over.
“Stay safe”, “Stay at home” and “Thank you to those keeping us safe,” flashed in blue and green lights across the towering structure at the Giza plateau, southwest of the capital Cairo.
Egypt has so far registered 656 Covid-19 cases, including 41 deaths. Of the total infected, 150 reportedly recovered.
Egypt has carried out sweeping disinfection operations at archaeological sites, museums and other sites across the country.
In tandem, strict social distancing measures were imposed to reduce the risk of contagion among the country’s 100 million inhabitants.
Tourist and religious sites are shuttered, schools are closed and air traffic halted.
Myanmar braces for ‘big outbreak’ after migrant worker exodus from Thailand
30 Mar 2020
Saudi king to pay for all patients’ treatment
Saudi Arabia will finance treatment for anyone infected with the coronavirus in the country, the health minister said on Monday.
The kingdom has registered eight deaths among 1,453 infections, the highest among the six Gulf Arab states.
Health Minister Tawfiq Al Rabiah said King Salman would cover treatment for citizens and residents diagnosed with the virus, urging people with symptoms to get tested.
“We are all in the same boat,” he told a news conference, adding that Crown Prince Mohammed bin Salman was overseeing containment efforts “night and day”.
Denmark eyes gradual reopening after Easter
Denmark may gradually lift a lockdown after Easter if the numbers of coronavirus cases and deaths remain stable, Prime Minister Mette Frederiksen said on Monday.
The Nordic country, which has reported 77 coronavirus-related deaths, last week extended until after Easter a two-week lockdown to limit physical contact between its citizens that began on March 11.
The number of daily deaths slowed to five on Sunday from eight and 11 on Saturday and Friday respectively. Denmark has reported a total of 2,577 coronavirus infections.
“If we over the next two weeks across Easter keep standing together by staying apart, and if the numbers remain stable for the next two weeks, then the government will begin a gradual, quiet and controlled opening of our society again, at the other side of Easter,” Frederiksen said.
Throughout the world, overworked health care professionals are being infected with Covid-19, yet the Lion City has kept numbers low
Preparation, planning, patient ratios and protective equipment have all played a part. Still, even the best gear cannot guard against discrimination
Medical staff walk to the National Centre for Infectious Diseases building at Tan Tock Seng Hospital in Singapore. Photo: AFP
Uncooperative patients, long hours and a lack of protective equipment are hampering health care workers across the world as they take the fight to the coronavirus, leading many to fall sick themselves.
In Malaysia, a pregnant woman who did not disclose that her father was infected tested positive after giving birth, leading to the shutdown of the entire hospital for cleaning. In the Philippines, nine doctors have died, two of whom had dealt with a patient who lied about her travel history.
In Spain, where more than 5,400 health care workers have been infected, accounting for about 14 per cent of the country’s patients, there are no longer enough workers to care for patients.
In Italy, which has more than 69,000 patients, the virus killed a doctor who had no choice but to work without gloves.
In the United States, which has surpassed China to become the world’s most infected nation with more than 83,000 people testing positive for Covid-19, hospitals are being overrun with patients.
Health care staff in the country say patients are packed into emergency wards and intensive care units (ICUs), further raising the risk of infections. They also report shortages of ventilators, face masks, gowns and shields.
The US Centres for Disease Control and Prevention on March 7 released interim guidelines saying health care workers exposed to the coronavirus could be asked to return to work as long as they wore face masks and were not showing symptoms, if their employers had no other manpower available.
Malaysian health workers at Kuala Lumpur International Airport. Photo: AFP
A REASON FOR OPTIMISM
However, amid all the gloom, Singapore’s experienceis being held up as a reason for optimism. The city state has reported more than 630 cases of infection, all of which are being treated in hospital, yet only a handful of its health care professionals have been infected. What’s more, even these cases, according to Vernon Lee, director of communicable diseases at the Ministry of Health, are thought to have been infected outside the health care setting.
Experts suggest this has been more than just luck, pointing to a case in which 41 health workers were exposed to the coronavirus in a Singapore hospital yet evaded infection.
The workers had all come within two metres of a middle-aged man with Covid-19 who was being intubated, a procedure which involves a tube being inserted into the patient’s trachea. The procedure is seen as being particularly hazardous for health workers as it is “aerosol generating” – patients are likely to cough.
The workers had not known at the time that the man had the virus and all were quarantined after he tested positive. However, on their release two weeks later, none of them had the virus.
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The case has come to widespread attention partly because the workers were wearing a mix of standard surgical masks and the N95 mask, which doctors see as the gold standard as it filters out 95 per cent of airborne particles.
The conclusion, published in The Annals of Internal Medicine this month, was this: “That none of the health care workers in this situation acquired infection suggests that surgical masks, hand hygiene, and other standard procedures protected them from being infected.”
Surgeon and writer Atul Gawande mentioned the case in an article for The New Yorker on how health care workers could continue seeing patients without becoming patients. He said there were things to learn from Asia and that some of the lessons came out of the “standard public health playbook”. In other words, there is much to be said for social distancing, basic hand hygiene and cleaning regimens.
A health worker in protective gear walks into a quarantine room at a hospital in Banda Aceh, Indonesia. Photo: AFP
COMING TOGETHER
With critical supplies running short in many countries, experts say it is increasingly vital that countries share both knowledge and resources.
To this end, China has been donating personal protective equipment to places including the Philippines, Pakistan and Europe. China’s richest man Jack Ma is donating 1.8 million masks, 210,000 Covid-19 test kits and 36,000 pieces of protective clothing to 10 countries in Asia.
At the same time, doctors are encouraging the Western world to learn from Asia.
Infectious diseases expert Leong Hoe Nam said that being “bitten by Sars” (severe acute respiratory syndrome) in 2003 had prepared Asia for Covid-19, while Western countries were not similarly prepared and hence lacked sufficient protective equipment.
He pointed to how about 2,000 health care workers had fallen sick in China early in the outbreak because workers did not initially have protective gear. The trend reversed as equipment became available.
“Once the defences were up, there were very few health care workers who fell sick at work. Rather, they fell sick from contact with sick individuals outside the workplace,” he said.
Malaysia is a case in point. While it has reported 80 health care workers falling ill, most are thought to be community infections.
Coronavirus: Doctor explains the proper way to wash your hands and put on a face mask
In a webinar organised by Caixin Global on Thursday night, Peng Zhiyong, an intensive care specialist at Zhongnan Hospital of Wuhan University, shared how they managed a shortage of personal protective equipment early on in the outbreak by rationing workers to two sets of gear per shift.
Meanwhile, in the Philippines, doctors from Manila’s Chinese General Hospital held a video conference call with doctors in Zhejiang to learn from China’s experience of treating Covid-19 patients.
Crowdsourcing platforms have also been created to share advice. The Brigham and Women’s Hospital in Boston has released guidelines for treating critically ill patients and its website includes information from Chinese doctors.
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The Jack Ma Foundation has also launched an online platform for doctors and nurses around the world to share knowledge on fighting the virus. “One world, one fight,” it said in a tweet.
Associate Professor Jeremy Lim from the global health programme at the Saw Swee Hock School of Public Health said it was crucial for countries to work together.
“Viruses don’t respect borders. Countries have to share information and help each other as we are only as strong as the weakest link. Any country can become a reservoir of disease and the world may then be forced to endure a ping-pong of outbreaks over and over again.”
And the advice of Lee, at Singapore’s Ministry of Health? “Practise good hygiene and wash hands regularly.”
Indonesian medical staff administer mass testing for Covid-19 in Bekasi, West Java. Photo: AFP
SINGAPORE, A CASE STUDY
Amid this sharing of advice, it is often Singapore that is held up as an example to replicate. Despite the country grappling with a rising load of Covid-19 patients, most of whom have recently returned to the city state from abroad, its health care system has continued to run smoothly. Doctors say this is because it has been preparing for a pandemic ever since Sars caught it by surprise. During the Sars outbreak, health care workers accounted for 41 per cent of Singapore’s 238 infections.
Consequently its hospitals swung into contingency planning mode early on in the coronavirus outbreak, telling staff to defer leave and travel plans after its first cases emerged.
Meanwhile, its hospitals swiftly split their workforces into teams to ensure there were enough workers if the outbreak worsened, and to ensure workers got enough rest.
Singapore has 13,766 doctors, or 2.4 doctors for every 1,000 people. That compares to 2.59 in the US, 1.78 in China and 4.2 in Germany. Places like Myanmar and Thailand have fewer than one doctor for every 1,000 people.
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“The objective is that you can run essential services with the greatest amount of security. Make sure functional units have redundancy built in, and are separate from each other. It depends on what you feel is sufficient to carry on services if one team is affected, factoring in rest periods and some system of rotation,” said Chia Shi-Lu, an orthopaedic surgeon.
The key is to ensure a good doctor-to-patient ratio and ensure there are enough specialists for the critical work, such as doctors and nurses who can provide intensive care, and know how to operate mechanical ventilators or machines to pump and oxygenate a patient’s blood outside the body.
At the emergency department where paediatrics emergency specialist Jade Kua treats Covid-19 cases in addition to regular emergencies, doctors are split into four teams of 21. Each team takes alternate 12-hour shifts and does not interact with other teams.
“We are in modular teams so the teams move together. So you and I would both do morning, off, night, off, morning off. Together. And then the other teams would do the same and we don’t intermingle,” said Kua.
US now has world’s most coronavirus cases, surpassing China
Chia, who works at the Singapore General Hospital, said doctors had been split up according to their functions.
“We try not to meet at all with the other teams as much as possible. We’ll just say hi from across the corridor. Meals are the same. All our cafeterias and everything have got social distancing spaced in already,” said Chia, who is also a member of parliament and chairs a shadow committee on health.
Chia said the health care system could also tap on doctors in the private sector.
Not every country has a plan like this. Last year’s Global Health Security Index by the Economist Intelligence Unit found that 70 per cent of 195 countries scored poorly when it came to having a national plan for dealing with epidemics or pandemics. Almost three in 10 had failed to identify which areas were insufficiently staffed. In India, with a population of 1.3 billion, only about 20,000 doctors are trained in key areas such as critical care, emergency medicine and pulmonology.
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In contrast, Singapore published its first Influenza Pandemic Preparedness and Response Plan in June 2005 and has since honed it to a tee. Hospitals regularly war-game scenarios such as pandemics or terrorist attacks and the simulations are sometimes observed by the Ministry of Health, which grades the performance and recommends areas for improvement.
The plan also covers the need to stockpile equipment to avoid the sort of shortages many countries are now facing, another lesson inspired by Sars when masks, gloves and gowns were in short supply.
In a pandemic preparation paper published in 2008, Singapore public health specialist Jeffery Cutter wrote that Singapore’s stockpile was sufficient to cover at least 5 to 6 months’ use by all front-line health care workers.
During the Covid-19 outbreak, it has also told citizens to not wear masks so it can conserve supply for medical staff.
Having enough protective gear has reassured Singapore’s health care workers such as Kua, a mother of six who blogged about her experience fighting Covid-19. Kua said: “I’m safe and my family is safe.”
India’s poor hit hard by 21-day nationwide lockdown amid the coronavirus pandemic
SOMETHING YOU CAN’T GUARD AGAINST
Despite the many positives to emerge from the Lion City, its health care workers are struggling with another problem: discrimination.
While in France, Italy and Britain, residents cheer health care workers from their windows, in Singapore health care workers are seen by some people as disease carriers.
“I try not to wear my uniform home because you never know what kind of incidents you may encounter,” said one Singapore nurse. “The public is scared and wearing our uniforms actually causes quite a bit of inconvenience. One of my staff tried to book a private-hire car to the hospital for an emergency and she was rejected by five drivers.”
There is a similar stigma in India, where the All India Institute of Medical Sciences has appealed to the government for help after health workers were forced out of their homes by panicked landlords and housing societies.
“Many doctors are stranded on the roads with all their luggage, nowhere to go, across the country,” the institute said in a letter.
Lim, from the Saw Swee Hock School of Public Health, said the worst human impulses and “every man for himself” attitudes could emerge in crises and “that is exactly why governments have to step in”.
Discrimination could affect both the performance and motivation of health care workers, Lim warned.
Meanwhile, when health care workers are infected, it creates a “triple whammy” threat.
“It means one fewer professional in an already-strained system, another patient to care for and, potentially, a team of colleagues who need to be quarantined,” said Lim.
“We must do everything possible to keep our health care workforce safe and free from Covid-19.” ■
Image copyright EPAImage caption Wuhan has been sealed off since mid-January
The lockdown in Wuhan, the Chinese city where the global coronavirus outbreak began, will be partially lifted on 8 April, officials say.
Travel restrictions in the rest of Hubei province, where Wuhan is located, will be lifted from midnight on Tuesday – for residents who are healthy.
A single new case of the virus was reported in Wuhan on Tuesday following almost a week of no reported new cases.
Countries around the world have gone into lockdown or imposed severe curbs.
The UK is getting to grips with sweeping new measures to tackle the spread of coronavirus, including a ban on public gatherings of more than two people and the immediate closure of shops selling non-essential goods.
Image copyright AFPImage caption The WHO has urged the G20 group of nations to boost production of protective equipment
Meanwhile, health experts say Americans must limit their social interactions or the number of infections will overwhelm the health care system in the US.
Spanish soldiers helping to fight the coronavirus pandemic have found elderly patients in retirement homes abandoned and, in some cases, dead in their beds, the defence ministry has said.
An ice rink in Madrid is to be used as a temporary mortuary for Covid-19 victims.
The World Health Organization (WHO) has warned that the pandemic is accelerating, with more than 300,000 cases now confirmed. It is urging countries to adopt rigorous testing and contact-tracing strategies.
Wuhan has been shut off from the rest of the world since the middle of January. But officials now say anyone who has a “green” code on a widely used smartphone health app will be allowed to leave the city from 8 April.
Earlier, the authorities reported a new case of coronavirus in Wuhan, ending a five-day run of no reported new cases in the city.
Media caption Coronavirus: People in Beijing begin to head outdoors
It comes after health officials there confirmed that they were not counting cases of people who were positive but had not been admitted to hospital or did not show any symptoms of the disease.
Official government figures say there have been 78 new cases reported on the Chinese mainland in the last 24 hours. All but four of them were caused by infected travellers arriving from abroad.
This so-called “second wave” of imported infections is also affecting countries like South Korea and Singapore, which had been successful in stopping the spread of disease in recent weeks.
South Korea has been seeing a drop in its daily tally of new cases. On Tuesday it reported its lowest number since 29 February.
China looks to repair its reputation
By Robin Brant, BBC News, Shanghai
China considers itself to be – very nearly – a “post corona” country.
In the last week we’ve heard Wuhan medics warning the UK and others that they need to do more to protect frontline health workers, citing the mistakes they made early on when some treated patients without wearing proper protective clothing.
But there’s also been reporting in state media of the reported death toll in Italy surpassing that in China. This has been combined with some commentary from prominent media figures that has appeared distasteful, almost triumphalist.
At the same time there is a panic about the threat of a second wave from imported cases – travellers arriving from abroad. This has fuelled the view – right or wrong – that some other countries aren’t taking the threat seriously because they aren’t doing what China did. (Almost all the cases in Beijing that have been made public are of Chinese nationals returning home).
Meanwhile, well away from senior leaders, there are some high-profile diplomatic figures using international-facing social media to spread theories that the US may have weaponised and dumped the virus in China. Or that Italy had cases that may have been Covid-19 earlier than China. China is sowing seeds of doubt and questioning assumed truths as it looks to repair its reputation.
Almost all of India with its 1.3bn people is under lockdown. Buses, trains and other forms of public transport are suspended. On Monday, the authorities said domestic flights would also stopped. The country has reported 485 cases and nine people have died. Prime Minister Narendra Modi will address the nation again this evening.
Image copyright GETTY IMAGESImage caption Mumbai’s suburban train network carries eight million passengers a day
Neighbouring Pakistan has almost twice as many confirmed cases – 878 as of Monday evening. Sweeping restrictions are in place although the government has stopped short of imposing a nationwide lockdown. However, several provinces have announced them independently. The army is being brought in to help enforce the restrictions.
Bangladesh, which has reported 33 cases and three deaths, is also deploying its armed forces to help maintain social distancing and boost Covid-19 preventive measures. The soldiers will also monitor thousands of quarantined expatriate returnees. Across South Asia, there are concerns that the actual number of cases could be much higher than is being reported.
Indonesia, which has 49 confirmed Covid-19 deaths – the highest in South-East Asia – has converted an athlete’s village built for the 2018 Asian Games into a makeshift hospital for coronavirus patients. A state of emergency was declared in Jakarta on Monday.
In Thailand, a month-long state of emergency which will include curfews and checkpoints will begin on Thursday. The government has been criticised for failing to take strong action so far. Four people have died and nearly 900 tested positive.
Talks between the Japanese PM and the International Olympic Committee are expected this evening.
The most populous country that was without a case until now – Myanmar – has announced two cases.
Europe’s battle against virus intensifies
UK Prime Minister Boris Johnson announced on Monday night that, with immediate effect, “people will only be allowed to leave their home…for very limited purposes”. They include shopping for basic necessities, taking one form of exercise per day, fulfilling any medical need, or travelling to work if working from home is impossible.
Media caption Reality Check tackles misleading health advice being shared online
The number of people who have died in the UK rose to 335 on Monday.
In Italy, the worst-hit country in the world, the authorities said 602 people with Covid-19 had died in the past 24 hours, bringing the total death toll there to 6,077.
But the daily increase in cases was the smallest since Thursday, raising hope that the stringent restrictions imposed by the government were starting to have an effect.
Spain, however, said on Tuesday that its death toll had risen by 514 to 2,696. Nearly 40,000 are infected, about 5,400 of them healthcare workers.
‘What we are seeing here is reciprocity,’ the German leader says, referencing the EU’s aiding stricken China earlier this year
But critics dismissed China’s show of largesse as propaganda designed to deflect US claims that the contagion originated in China
The colours of the Italian flag are projected onto the Palazzo Senatorio building on Capitoline Hill in Rome on Tuesday as a “sign of hope in this difficult and delicate moment”, Rome’s mayor stated. Photo: AFP
German Chancellor Angela Merkel has downplayed concerns over China’s provision of medical supplies to European countries hit hardest by the Covid-19 pandemic, calling the move a gesture of reciprocity.
The European Union continued to face criticism over its slow reaction to calls for medical supplies from Italy and Spain, amid the encouraging news that new cases in Italy were seeing their slowest rate of increase since the contagion came to light in late February.
“The European Union sent medical equipment to China [when] China asked for help at that time,” Merkel said at a Tuesday press conference, referring to the outbreak’s start earlier this year. “What we are seeing here is reciprocity.”
“As we are having a crisis at this time, we cannot expect everything to be provided in the framework of the EU. We are very pleased about [China’s provision],” Merkel said.
Chinese President Xi Jinping has guaranteed that China will provide Italy and Spain – the two most severely hit European countries – with medical equipment such as face masks, ventilators and protective equipment for medical professionals.
Critics, however, called China’s action part of a propaganda campaign designed to deflect US claims that the coronavirus originated in China.
Spanish Prime Minister Pedro Sanchez reached out to Xi for help obtaining medical supplies in a phone call on Tuesday.
Speaking to reporters, Sanchez confirmed that the matter had come up during the call, just days after the Spanish government had ordered an unprecedented national lockdown to halt the virus’ spread.
Chinese state media reported that Xi had told Sanchez that “China is willing to respond to the urgent needs of Spain and spare no effort to provide support and assistance, and share experience in prevention, control and treatment.”
Workers loading boxes of surgical masks donated by China’s BYD, bound for the United States. Photo: Jack Ma Foundation
On Tuesday, a plane from Shanghai landed in the northern Spanish city of Zaragoza, carrying 500,000 masks donated by e-commerce giant Alibaba, AFP reported. (Alibaba owns the South China Morning Post.)
According to a statement, the delivery was part of a donation of 2 million masks and coronavirus test kits to certain countries from Alibaba’s Chinese billionaire founder Jack Ma.
Europe to shut border for month as France braces for 15-day coronavirus lockdown
17 Mar 2020
Xi’s call with Sanchez came a day after one with Italian Prime Minister Giuseppe Conte, in which the Chinese leader similarly pledged to provide Italy with medical support, including teams with expertise in treating Covid-19.
On Tuesday, Italy reported 345 new coronavirus deaths in 24 hours, taking its overall death toll to 2,503.
Spain registered 183 deaths, 53 per cent more than in the previous 24 hours, driving the total number of deaths to 524. More than 2,000 newly infected cases were reported, pushing the total to 11,681.
Elsewhere on Tuesday, France entered a national shutdown, while Belgium, where the EU is headquartered, announced a similar halt to public activities starting on Wednesday.
European Commission President Ursula von der Leyen said all 27 member states have agreed to ban non-EU citizens from visiting the region for the next 30 days. The method of enforcement will be determined by the individual countries, she said.
Image copyright GETTY IMAGESImage caption Chief Executive Carrie Lam said the majority of Hong Kong’s cases had been imported
Hong Kong will quarantine all people arriving from abroad for 14 days, its leader Carrie Lam has said.
The restrictions, which will kick in on Thursday, will not apply to those from Macau or Taiwan. Entrants from mainland China already had to self-isolate.
Ms Lam said the majority of Hong Kong’s cases had been imported, adding that “strict measures” were needed.
Hong Kong has seen 57 new infections over the past two weeks, 50 of which were imported, said Ms Lam.
“If we exclude these imported, we only have seven local cases in the past week,” she said.
“If we do not impose strict measures, our previous efforts could be wasted.”
Ms Lam also advised residents to avoid all non-essential travel.
There are at least 155 confirmed cases in the territory, which detected its first cases in January.
The territory – a special administrative region of China – has so far been able to avoid the contagion seen elsewhere, thanks partly to a quick government response.
In January, cross-border travel with mainland China was slashed. Soon afterwards, health workers went on strike to demand a total border shutdown.
Some of the restrictions in the Asia-Pacific region, as of 17 March:
Australia – All travellers will have to self-isolate for 14 days. Foreign nationals who have been to China, Iran, Korea and Italy not allowed in
New Zealand – Everyone entering the country will have to self-isolate for 14 days. This excludes those from small Pacific islands with no confirmed virus cases
South Korea – Travellers from China’s Hubei province not allowed in. International arrivals from certain countries will need to submit papers on their health condition
Singapore – All visitors with travel history to France, Germany, Italy, Spain, South Korea and China banned from entering or transiting. Residents with recent history to these countries will have to self-isolate for 14 days. All those entering from Japan, Switzerland, the UK and Asean countries will have to self-isolate for 14 days
Malaysia – All foreign visitors have been banned, all Malaysians will not be allowed to travel overseas until 31 March. All returning Malaysians will have to self quarantine for 14 days
Japan – Ban on entry to travellers who have been to parts of China, South Korea, Iran or Italy in 14 days before arrival
The number of confirmed coronavirus cases and deaths outside China has now surpassed the number inside.
More than 100,000 people have been infected outside China, while just over 80,000 cases have been reported inside.
There have been more than 182,000 confirmed cases of coronavirus globally and over 7,000 deaths, according to a tally from Johns Hopkins University.
Media caption Steps the NHS says you should take to protect yourself from Covid-19
South Africa, Kenya latest to halt arrivals from ‘high-risk’ countries as cases across the continent double over the weekend
Concerns are growing over whether health care systems in some African nations will be able to cope
Masked volunteers provide soap and water for participants to wash their hands against the new coronavirus at a women’s 5km fun run in Addis Ababa, Ethiopia on Sunday. Photo: AP
Travel bans and school closures were announced in South Africa and Kenya on Sunday, as concerns grew over the capacity of the continent’s fragile health systems to cope with the spread of the deadly new coronavirus, with more than a dozen countries reporting their first cases.
South African President Cyril Ramaphosa declared a national state of disaster, banning arrivals by foreign nationals from high-risk countries including Italy, Iran, South Korea, Spain, Germany, the United States, Britain and China, effective Wednesday.
“We have cancelled visas to visitors from those countries from today and previously granted visas are hereby revoked,” Ramaphosa said in a televised address on Sunday evening, adding that any foreign national who had visited high-risk countries in the past 20 days would be denied a visa.
South African schools will also be closed from Wednesday until after the Easter weekend. Gatherings of more than 100 people have been banned and mass celebrations for Human Rights Day and other events cancelled. “Never before in the history of our democracy has our country been confronted with such a severe situation,” Ramaphosa said.
In Kenya, where three cases of Covid-19 – the disease caused by the new coronavirus – have now been confirmed, President Uhuru Kenyatta suspended travel from any country with reported infections. Only Kenyan citizens and foreigners with valid residency permits would be allowed entry, provided they proceeded to self-quarantine or a government-designated quarantine facility, he said.
Kenyan President Uhuru Kenyatta reports two more cases of coronavirus in the country, bringing its total number of cases to three. Photo: DPA
Kenyatta also suspended learning in all educational institutions with immediate effect. “Some of the measures may cause inconvenience, but I want to assure you they are designed to ensure that we effectively contain the spread of the virus,” he said.
Kenya and South Africa join Ghana, Rwanda and Morocco in implementing travel restrictions or outright bans, while others are closing churches, museums, sporting activities, nightclubs and tourist attractions in a bid to curb the spread of the disease.
The continent was largely spared in the early days of the outbreak but has now recorded more than 300 cases and six deaths. Algeria, Morocco, Senegal and Tunisia all reported more new cases over the weekend, which saw numbers of new infections across Africa more than double in just two days.
As numbers rise, the Africa Centres for Disease Control and Prevention (CDC) has said there are around a dozen countries on the continent without the capacity to do their own testing.
They will have to send samples to countries like South Africa, which itself is struggling to contain the virus, with confirmed cases doubling to 61 on Sunday, a day after 114 of its citizens were repatriated from the central Chinese city of Wuhan, the original epicentre of the outbreak and the first to be placed in lockdown.
John Nkengasong, director of the Africa CDC, warned that the risk of other African countries detecting new cases of Covid-19 remained high. “Our strategy is clear: we want to capacitate the member states, so they can quickly detect and mitigate the effects of the disease in Africa, and, if widespread transmission occurs, prevent severe illness and death,” he said.
The World Health Organisation has already warned that critical gaps remain in the capacity of many African nations to trace, detect and treat the disease. On Friday, the WHO Africa office said it was “striving to help member states fill these gaps” but warned of global shortages in personal protective equipment (PPE) including gloves, masks and hand sanitiser.
Major coronavirus outbreak in Africa ‘just a matter of time’
13 Mar 2020
WHO said its first blanket distribution of PPEs, to 24 African countries, had been completed and another wave of distributions was planned.
“With Covid-19 officially declared a pandemic, all countries in Africa must act,” said Dr Matshidiso Moeti, WHO regional director for Africa. “Every country can still change the course of this pandemic by scaling up their emergency preparedness or response.
“Cases may still be low in Africa and we can keep it that way with robust all-of-government actions to fight the new coronavirus.”
The 55 member states of the African Union have suspended meetings until May, while the six countries that make up the East African Community have suspended all planned meetings until further notice.
In Algeria – one of the worst-hit North African countries, with 48 cases and four deaths, as of Monday morning – all schools and universities have been closed, while Senegal, with 24 cases to date, has closed schools and cancelled its Independence Day festivities on April 4, which this year marks 60 years since its independence from France. Cruise ships have also been banned from docking in Senegal.
On Sunday, Rwanda closed all its places of worship and suspended large gatherings such as weddings and sporting activities. Schools and universities in the central African country are also closed. National airline RwandAir has also suspended flights between the capital Kigali and Mumbai until April 30.
This is in addition to earlier suspensions of its routes with Tel Aviv and the southern Chinese city of Guangzhou, which remain in place until further notice.
While most African airlines have suspended flights to cities in mainland China, Ethiopian Airlines has continued flying to most of its destinations, describing its China routes as among its most profitable. Nevertheless, chief executive Tewolde GebreMariam last week said coronavirus fears had cut demand by a fifth on most of its routes.
BEIJING (Reuters) – The global coronavirus pandemic could be over by June if countries mobilize to fight it, a senior Chinese medical adviser said on Thursday, as China declared the peak had passed there and new cases in Hubei fell to single digits for the first time.
Around two-thirds of global cases of the coronavirus have been recorded in China’s central Hubei province, where the virus first emerged in December. But in recent weeks the vast majority of new cases have been outside China.
Chinese authorities credit strict measures they have taken, including placing Hubei under near total lockdown, with preventing big outbreaks in other cities, and say other countries should learn from their efforts.
“Broadly speaking, the peak of the epidemic has passed for China,” said Mi Feng, a spokesman for the National Health Commission. “The increase of new cases is falling.”
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Zhong Nanshan, the government’s senior medical adviser, told reporters that as long as countries take the outbreak seriously and are prepared to take firm measures, it could be over worldwide in a matter of months.
“My advice is calling for all countries to follow WHO instructions and intervene on a national scale,” he said. “If all countries could get mobilized, it could be over by June.”
Speaking to U.N. Secretary-General Antonio Guterres, President Xi Jinping similarly expressed confidence, state television reported.
“After hard work, China has shown a trend of continuous improvement in epidemic prevention and control,” the report cited Xi as saying.
“I am confident that the Chinese people will be able to overcome this epidemic and achieve their intended economic and social development goals.”
Zhong, an 83-year-old epidemiologist renowned for helping combat the SARS outbreak in 2003, said viruses in the same family typically became less active in warm months.
“My estimate of June is based on scenarios that all countries take positive measures.”
Later on Thursday, Zhong held a teleconference with a group of U.S. medical experts, including from Harvard University, state television reported.
Zhong and his team shared their experiences of quickly testing and containing the virus, difficulties in treatment, and cooperation in clinical research, the report added.
The United States is now facing its own virus crisis as the number of infected people rises.
BUSINESSES REOPEN
With the marked slowdown of the spread of the virus in China, more businesses have reopened, with authorities cautiously easing strict containment measures.
Hubei province announced a further loosening of travel restrictions and will also allow some industries to resume production.
Hubei’s economy, driven by manufacturing and trade, including a sizable auto sector in the provincial capital, Wuhan, had been virtually shut down since Jan. 23.
While the virus is spreading quickly globally, its progress in China has slowed markedly in the past seven days. In all, 15 new cases were recorded in mainland China on Wednesday, down from 24 the day before. Seven of the new cases were outside Hubei, including six imported from abroad.
While only 85 of the cases in China have come from abroad, the rising number of such incidences has prompted authorities to shift their focus on containing the risk of imported cases.
The total number of cases recorded in mainland China was 80,793. As of Tuesday, 62,793 people had recovered and been discharged from hospital, or nearly 80% of the infections.
In Wuhan, the epicenter of the outbreak, 34,094 patients had been discharged from hospitals, but over half were still under observation at so-called “recovery stops” – quarantine venues repurposed from hotels and student dormitories.
Hubei’s health authority said the post-discharge quarantine was a precautionary measure, after a few discharged patients tested positive again.
As of the end of Wednesday, the death toll in mainland China had reached 3,169, up by 11 from the previous day. Hubei accounted for 10 of the new deaths, including seven in Wuhan.
China is focusing on restarting factories and businesses hit by the containment policies. Factory activity plunged to its worst level on record in February, and while more businesses have reopened in recent weeks as containment measures have been eased, analysts do not expect activity to return to normal until April.
Airlines have been hit particularly hard. China’s airlines reported total losses of 20.96 billion yuan ($3 billion) in February. The total number of airline passengers fell 84.5% year-on-year last month, China’s aviation regulator said.
China is now making more than 100 million masks a day, up from 20 million before the coronavirus outbreak, and may start to export more to other countries
Mask shortages elsewhere once more raise the debate about an over-reliance on China, with critics pointing to a lack of US industrial policy
China was producing 116 million masks per day of February 29, including a mix of disposable and high-end masks like the American-designed N95 model worn by President Xi Jinping on his trip on Tuesday to Wuhan. Photo: Xinhua
The Liu family factory has been making diapers and baby products in the Chinese city of Quanzhou for over 10 years, but in February, for the first time, it started making face masks, as demand soared spectacularly due to the coronavirus outbreak.
The business – which employs 100 people in the Southeastern Fujian province – has added two production lines to make up to 200,000 masks a day.
And while the decision was primarily commercial, “encouragement” from the Chinese government – in the form of subsidies, lower taxes, interest-free loans, fast-track approvals for expansion and help alleviating labour shortages – made the decision an obvious one, said Mr Liu who preferred only to give his family name.
“The government is advocating an expansion in production,” Liu said. “With faster approvals, producers need to prioritise the government’s needs over exports.”
WHO declares coronavirus crisis a pandemic
The factory is one of thousands of refitted pop-ups around China making masks and other protective equipment for the first time, part of a massive industrial drive to respond to the spread of the coronavirus.
Before the outbreak, China already made about half the world’s supply of masks, at a rate of 20 million units a day. That rose to 116 million as of February 29, according to China’s state planning agency, a mix of disposable and high-end masks like the American-designed N95 model worn by President Xi Jinping on his trip on Tuesday to Wuhan, the epicentre of the outbreak.
This exponential jump is the result of a wartime-like shift in industrial policy, with Beijing directing its powerful state-owned enterprises to lead the nationwide mask-making effort, and the country’s sprawling manufacturing engine following their lead.
For me, this is the big advantage of China, the speed Thomas Schmitz
“For me, this is the big advantage of China, the speed,” said Thomas Schmitz, president of the China branch of Austrian engineering giant Andritz, which has seen a big uptick in demand for its wet wipe-making machines in recent weeks, also due to the virus. “When you need to run, people know how to run, and this is something which has been lost in other countries since their industrial heydays.”
Chinese oil and gas major Sinopec upped production of mask raw materials such as polypropylene and polyvinyl chloride in January. This week, it set up two production lines in Beijing to produce melt-blown non-woven fabric, intended to make four tonnes of the fabric each day, which can then be used to produce 1.2 million N95 respirators or six million surgical masks a day.
The maker of China’s new J-20 stealth fighter jet, Chengdu Aircraft Industry Group, repurposed part of its factory to design a mask production line, according to local media reports. The SichuanDaily said 258 of the company’s engineers spent three days fast-tracking development of an assembly line with more than 1,200 components.
Coronavirus: From mysterious origins to a global threat
More than 2,500 companies in China have reportedly started making masks, among them 700 technology companies including iPhone assembler Foxconn and smartphone makers Xiaomi and Oppo, in an extraordinary mobilisation of resources.
The result resembles “the war effort” in the middle of the last century in the United States and western Europe, but arguably no other nation could undergo such a transformation so quickly today.
It is a reminder of what can happen in a centrally-planned economy with a strong manufacturing base, but also brings into sharp focus some of the geopolitical issues which have characterised China’s at-times difficult relationship with the rest of the world, particularly the European Union and US, over the past couple of years.
China’s dominance in manufacturing has become all the more evident as the rest of the world scrambles to shore up their own dwindling medical supplies, leading many to wonder why the world is so dependent on it for vital supplies.
The lesson for Washington is not that we need to emulate the Chinese economic model, but rather that we need to better steward the industrial base in key sectors Rush Doshi
The Italian government, which is dealing with the highest number of coronavirus cases and deaths after China, is to take shipment of 1,000 ventilators, 2 million masks, 100,000 respirators, 200,000 protective suits and 50,000 testing kits from China.
Italian foreign minister Luigi Di Maio said after a phone call with Chinese counterpart Wang Yi, they had agreed the export deal in the same week that European neighbours France and Germany banned masks from being exported because of low domestic supplies.
The Italy export deal showed that “China is emerging as a global public goods provider as the US proves unable and unwilling to lead,” said Rush Doshi, the director of the China Strategy Initiative at the Washington-based Brookings Institute think tank.
“China’s ability to produce what is needed to fight coronavirus is not simply a product of its economic model – it’s also a product of its industrial capacity,” Doshi said. “The US once had this capacity too, but it has lost important parts of it. The lesson for Washington is not that we need to emulate the Chinese economic model, but rather that we need to better steward the industrial base in key sectors.”
The frustration is felt acutely by Michael Einhorn, president of medical equipment distributor Dealmed-Park Surgical in New York, who has been trying to source stock from China for weeks, “but cannot get straight answers” from vendors.
Einhorn said he placed an order with a private seller in China’s virus-stricken city last week, but that the goods had not been shipped.
“Everyone is running out here, people are panicking in hospitals and we want to be able to help our most important customers,” Einhorn said. “We are dealing with hospitals that do not have products, how in the United States of America in 2020 did this happen?”
With the number of confirmed coronavirus cases in China falling daily, it is not inconceivable that the sort of export deal struck with Italian leaders becomes commonplace, although for now, it deal can be chalked up as a significant public relations coup for Beijing.
The World Medical Association is unable to specify how many masks are required to supply frontline medical staff in virus-hit areas, but said that “this crisis should be a wake up call for politicians and societies to make the necessary investment in emergency preparedness and to look into the vulnerability of our supply chains”.
Australian-listed manufacturer Eagle Health announced on Friday that it had installed production lines at its Xiamen factory in southern China to make 300 million masks a year and said it had already received orders from China and would be securing further larger orders internationally.
The group, which normally makes products including amino acids, protein supplements and lozenges in China, said it would prioritise meeting the large domestic demand, but was aware of an impending global shortage.
Eagle Health has already commenced production of its first order of 3.2 million medical masks for the Yiling Hospital Management Group in China, a process which will take 10 days. It has other smaller orders from Chinese government agencies and expects to receive more orders outside China.
The decision to make more masks came from increased demand. These are opportunities. The global demand for high quality masks will be significant Xu Gang
“The decision to make more masks came from increased demand. These are opportunities,” said chief executive Xu Gang. “The global demand for high quality masks will be significant. Imagine when the schools open. The situation will take some time to peak.”
Last week, the Australian Dental Association said supplies of masks at many practices were expected to run out within four weeks. The Australian government has since arranged a supply of 54 million masks for both the dental and medical industries.
At the same time, the US only has 1 per cent of the 3.5 billion masks it would need to counter a serious outbreak, Bloomberg reported.
While China has no quota on the volume of masks that had to be hived off for local consumption, the government has said domestic demand needs to be prioritised.
Businesses are free to export but overseas demand has yet to explode like it has in China, said Fujian factory owner Liu.
Wendy Min, sales director of Pluscare, a manufacturer based near the virus’ epicentre in Hubei province, said her company is making 200,000 masks per day, much of which are sold to the government, with exports still restricted by partial lockdown of workers and cargo transport.
“We previously exported to Europe, South America and other parts of Asia,” Min said. “But at the moment we can’t export. We are trying to discuss this with the government, but we cannot wait any more – we have to export soon.”
Min said that while she was receiving countless cold calls up until last week from people in China looking for masks, these have stopped, perhaps unsurprising given the abundance in supplies becoming available.
An influx of Chinese-made masks, though, is likely to be welcomed in other virus-stricken parts of the world.
Self-quarantine of all international travellers to Beijing as China fights import of coronavirus
Miguel Luiz Gricheno, CEO of Brazilian mask manufacturer Destra, said that his company is making 30,000 masks a day, but cannot meet local demand due to a lack of supplies, including the non-woven fabric from which masks are made.
“In disposable masks, most Brazilian companies are paralysed due to the lack of raw materials,” Gricheno said. “With the arrival of the coronavirus in Brazil, the demand has increased a lot but the main raw material comes from abroad.”
However, a short-term supply fix will not answer underlying questions about how so many countries found themselves in such dire straits,meaning the geopolitical fallout of the coronavirus will be extensive.
Decades of weak industrial policy helped elect US President Donald Trump, who said he would bring manufacturing jobs back to America at China’s expense. While he has waged a bruising two-year trade war with China in response, the current situation shows just how difficult it will be to change the global manufacturing processes, which are so heavily controlled by China.
One of the great flaws of globalisation is that everyone wanted things cheaper, but did you compromise your health care infrastructure in the process? Stephen Roach
“In the guise of trying to improve efficiency and create value for price-sensitive consumers, we’ve created a global production network that is very difficult to unwind,” said Stephen Roach, a professor of economics at Yale University and a veteran China watcher. “One of the great flaws of globalisation is that everyone wanted things cheaper, but did you compromise your health care infrastructure in the process.
Reuters reported that Trump is considering invoking the emergency provisions of the Defence Production Act, which would allow the government to instruct companies to alter production to help address the domestic shortage of medical supplies like masks. If a company is producing 20 per cent N95 masks and 80 per cent standard masks, the White House could order them to rejig the ratio, an unnamed official said.
The New York Times reported on Wednesday that the White House is preparing an executive order that would allow the government to buy medical supplies from overseas in the hope that it will incentivise companies to make them within the US.
But these changes still do not give Trump the sort of sweeping powers enjoyed by Chinese counterpart Xi.
“When you have a pluralistic, democratic situation that Trump is overseeing, it becomes more unwieldy” to take the steps necessary to address a crisis situation, said Harry Broadman, chair of the emerging markets practise at the Berkeley Research Group and a senior US government official in the 1980s and 1990s.
“That is why I think Trump looks at Xi with envy, because he doesn’t have to deal with a disparity of views or democratic interests,” Broadman said. “I think Trump is at heart a bilateral guy, as you saw with the phase one [US-China] trade deal and the state-to-state purchases. That is why he likes dealing with [Russian President Vladimir] Putin and Xi, because each of them can move mountains. I think Trump is very envious of that ability.”
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