Archive for ‘hand-washing’

09/04/2020

Coronavirus: Why India cannot afford to lift its lockdown

India man during lockdownImage copyright GETTY IMAGES
Image caption More than a billion people have been staying at home during the lockdown

Will India extend its rigorous 21-day lockdown to slow the spread of coronavirus beyond its end date next week? By all accounts, yes.

On 24 March, India shut its $2.9 trillion economy, closing its businesses and issuing strict stay-at-home orders to more than a billion people. Air, road and rail transport systems were suspended.

Now, more than two months after the first case of Covid-19 was detected in the country, more than 5,000 people have tested positive and some 150 people have died. As testing has ramped up, the true picture is emerging. The virus is beginning to spread through dense communities and new clusters of infection are being reported every day. Lifting the lockdown could easily risk triggering a fresh wave of infections.

A harsh lockdown is certain to slow down the disease. Virologists I spoke to believe India is still at an early stage of the infection. The country still doesn’t have enough data on the transmissibility of the virus or even how many people could have been infected and recovered to develop adequate herd immunity. (It is slowly beginning finger prick blood tests to look at the presence of protective antibodies.)

More than 250 of India’s 700-odd districts have reported the infection. Reports say at least seven states have a third of all infections, and want the lockdown extended. Six states have reported clusters of rapidly growing infections – from the capital Delhi in the north to Maharashtra in the west and Tamil Nadu in the south.

Economic fallout

Not surprisingly, the lockdown is already hurting the economy. Many of the early hotspots are economic growth engines and contribute heavily in revenues to the exchequer. Mumbai, India’s financial capital and Maharashtra’s main city, accounts for more than a third of overall tax collection. The densely populated city has reported more than 500 cases and 45 deaths, and numbers are steadily rising. Authorities say the infection is now spreading through the community. Mumbai has made wearing face masks mandatory.

Testing in IndiaImage copyright GETTY IMAGES
Image caption India has ramped up testing during the lockdown

Many of these hotspot clusters are also thriving manufacturing bases. The spread of infection means that they will be under lockdown for a longer period of time.

The services industry, which generates almost half of India’s GDP, is also likely to remain shut for some more time. Construction, which employs a bulk of migrant workers, will remain similarly suspended. The unemployment rate may have already climbed to more than 20% after the lockdown, according to a report by the Center for Monitoring Indian Economy.

For the moment, economists say, the government will have to prioritise farming over everything else to ensure the livelihoods of millions and secure the country’s future food supplies.

Half of India’s labour force work on farms. The lockdown happened at a time when a bumper winter crop had to be harvested and sold, and the rain-fed summer crop had to be sowed. The immediate challenge is to harvest and market the first crop, and secure the second.

Moving trucks to pick up produce and take them to markets, with adequate social distancing and hand washing will be something the government will have to move on quickly.

“The immediate challenge is to ensure that rural India is not hit,” says Rathin Ray, an economist. “Realistically, a complete lockdown cannot be continuously maintained beyond early May. We don’t have a choice but to reopen gradually after that.”

Mumbai street signImage copyright GETTY IMAGES
Image caption India has been under a lockdown from 24 March

There is little doubt about that. For his part, SK Sarin, who heads a government advisory panel on combating the disease, says the lockdown can be only eased in a “graded manner in areas that are not hotspots” and that the hotspots remained cordoned off.

Like other affected countries, India will have to prepare itself for what Gabriel Leung, an infectious disease epidemiologist and dean of medicine at the University of Hong Kong, describes as several rounds of “suppress and lift” cycles.

During these periods “restrictions are applied and relaxed, applied again and relaxed again, in ways that can keep the pandemic under control but at an acceptable economic and social cost.”

Also, Dr Leung observes, “how best to do that will vary by country, depending on its means, tolerance for disruption and its people’s collective will. In all cases, however, the challenge essentially is a three-way tug of war between combating the disease, protecting the economy and keeping society at an even keel”.

It is now clear that shutdowns need to continue until transmission has slowed down markedly, and testing and health infrastructure has been scaled up to manage the outbreak.

Experts from the southern state of Kerala, a striking outlier that is containing the infection thanks to a transparent government and a robust public health system, say it isn’t time to lift the lockdown yet and have recommended a three-phase relaxation.

For most countries, easing the lockdown is a tricky policy choice. It sparks fears of triggering a fresh wave of infection and presents the inevitable trade-off between lives and livelihoods. French Prime Minister Edouard Phillipe, says relaxing the lockdown in his country is going to be “fearsomely complex”. In a crisis like this, according to his Dutch counterpart Mark Rutte, leaders have to “make 100% of the decisions with 50% of the knowledge, and bear the consequences.”

MumbaiImage copyright GETTY IMAGES
Image caption India’s financial capital, Mumbai, is emerging as a hotspot

It is going to be tougher for India with its vast size, densely packed population and enfeebled public health system. Also, no country in the world possibly has so much inter-state migration of casual workers, who are the backbone of the services and construction industries.

How will India manage to return these workers to their work places – factories, farms, building sites, shops – without a substantial easing of public transport at a time when crowded trains and buses can be a vector of transmission and easily neutralise the gains of the lockdown? Even allowing restricted mobility – allowing social distancing, temperature checks and passenger hygiene – would put considerable pressure on the public transport system.

The policy choices are fiendishly tough, and the answers are far from easy. India bungled the lockdown by not anticipating the exodus of millions of migrant workers from cities. The weeks ahead will tell whether the fleeing men, women and children carried the infection to their villages. The country simply cannot afford to make similar mistakes again while trying to relax the lockdown. Nitin Pai of The Takshashila Institution, a think tank, believes states should be left to decide on easing restrictions, and decisions “should be based on threat [of infection], which should be determined by extensive testing”.

This week Prime Minister Narendra Modi said that the “situation in the country is akin to a social emergency”. His government now needs make sure that the looming threat to the nation’s health and economic progress is tackled skilfully.

Source: The BBC

01/03/2020

Coronavirus: how China’s face mask shortage inspired people to learn to make their own

  • Materials can bought cheaply online and combined to filter out germs, while people exchange tips in online chat groups
  • Urgent demand has forced individuals and hospitals alike to get to work to meet the shortfall
A worker in northern China makes a face mask as companies strive to match demand – but some people are buying similar materials to assemble at home. Photo: Xinhua
A worker in northern China makes a face mask as companies strive to match demand – but some people are buying similar materials to assemble at home. Photo: Xinhua
Living in the scenic Puer city in southwestern China’s Yunnan province, 30-year-old Zhang Jianing had thought the coronavirus outbreak in Hubei was far away and irrelevant, until cases were confirmed in her province and then her city at the end of January.
Heeding the warnings to protect herself, Zhang rushed out to buy masks, only to find them all snapped up. When she plucked up the courage to go out to buy groceries, she realised she needed to have a mask on to be allowed to enter shops.
After doing some research online, Zhang made a mask herself: two layers of cotton on the outside, with a sheet of plastic food wrap inside.
“The mask fit my face well and protected me from droplets,” Zhang said. “There was just one thing: it was too difficult to breathe through.”
Experts devise do-it-yourself face masks to help people battle coronavirus
When a nation of 1.4 billion people was suddenly alerted and in many cases ordered to wear masks not only in public indoor places but also in the open air, the huge demand quickly exhausted supply.
Mask production capacity in China was 22 million a day – insufficient for the country’s population. There were hopes that the supply of masks would pick up after a Lunar New Year holiday that was extended to help prevent further spread of infection, but things did not look promising after factories reopened. By Monday, despite mask manufacturers making 10 per cent more than in early February, masks remained a rare commodity.

Making DIY masks became the top trending topic on Chinese online shopping site Taobao for several days. Materials became much sought-after, from nose bars to the non-woven fabric used in disposable surgical masks to filter out viral droplets. An online shop based in Fujian, southeast China, said it had sold more than 5,500 packages of DIY mask materials that can make 50 to 200 surgical masks apiece.

Surgical masks ‘protect more from germs on fingers than viruses in the air’

16 Feb 2020

Zhang spent 200 yuan (US$29) on materials online, from which she made 60 surgical masks when they arrived last week. She is a qipao designer and has a sewing machine at home. The outer layer was a blue waterproof non-woven fabric, over a layer of melt-blown fabric that can filter out most germs and droplets. The inner layer was made with a face flannel.

Hongkongers make reusable fabric masks as Covid-19 epidemic leads to shortages and sky-high prices
“I sent some to my parents and relatives,” Zhang said. “I am not sure how protective they are, but the good thing is our city hasn’t had any new cases for a long time.”

DIY mask production is being taken very seriously, spawning online chat groups to discuss reliability of materials and disinfection methods as people try to make theirs as safe and professional as possible.

Alex Zhang, an office worker in Shanghai, donated her N95 masks to Wuhan, the epicentre of the coronavirus outbreak, when hospitals in the city appealed to the public for protective gear amid an acute shortage – but soon found herself short of masks herself.

Shanghai companies begin production of first reusable face masks

25 Feb 2020

The Shanghai government allowed households to buy a certain number of surgical masks, but it was not enough for her family. Taking apart an N95 mask to see what it was made of, she felt assembling the layers of fabric required no special technique, and decided to do it herself.

Zhang spent 45 yuan on two square metres of melt-blown fabric to stop viruses, and sandwiched it with two layers of nonwoven fabric and an air pad. She sewed the layers together and put them in an electric oven at 70 degrees Celsius (158 Fahrenheit) for a minute, for disinfection. The finished mask is attached using a plastic band.

“Each mask cost about 3 yuan [43 US cents] and was almost like an N95 filter,” Zhang said. “I didn’t find it difficult. I am quite satisfied with my masks and feel very safe to wear them in crowded places.”

How to properly remove and discard face masks to reduce the risk of infection

She later bought nursing pads, which are already disinfected, to replace the layer closest to the face.

DIY masks have also been used where large amounts of protective gear are needed. Garment manufacturer Shenzhou International, in the coastal Zhejiang province, assigned 100 staff to make masks with melt-blown non-woven fabric to meet the needs of its factory workforce of nearly 15,000, who needed two masks each per day, according to a report by Ningbo Daily.

Hospitals short of masks have mobilised nurses to make their own using a non-woven fabric used to wrap disinfected medical products. At least three hospitals, in Xian in central China and in Jinhua, Zhejiang, have tried making masks for medical staff not serving on the front line, according to media reports.

DIY handmade face masks in Hong Kong

The World Health Organisation has said that wearing masks alone is not sufficient protection against the coronavirus, and should be combined with precautions including hand-washing with soap or an alcohol-based hand rub.

However, facing a shortage that will not end any time soon, health authorities have changed from saying people should discard masks every four hours to advising recycling them when possible.

A guideline issued by the National Health Commission said healthy people could wear masks repeatedly and for a longer time.

Chinese driver wears 12 face masks amid coronavirus outbreak
“Masks for repeat use can be hung in clean, dry and airy places or put in a clean paper bag,” its guidelines said. “The masks must be placed separately to avoid contact with other masks.”
Making masks with layers of cotton bandage is acceptable, because they can stay dry when breathed on, but plastic wrap is not recommended, because it blocks the ability to breathe entirely, according to Cai Haodong, an infectious diseases specialist at Beijing’s Ditan Hospital.
Coronavirus: Thais urged to make their own masks, sanitisers due to shortage
7 Feb 2020

Cai said her hospital did not have surgical masks, nor N95s, during the severe acute respiratory syndrome (Sars) outbreak in 2003, and hospital staff made masks for use by front-line medics, disinfecting them with boiling water and drying them in the sun.

“The key is to keep the mask dry,” Cai said. “Self-made masks offer some degree of protection and it is better to wear them than nothing.”

Source: SCMP

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