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.
The PAGEs (see Tabs, above) attempt to make the information more meaningful by putting some structure to the information we have researched and assembled since 2006.
Chinese President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, takes part in a deliberation with his fellow deputies from the delegation of Inner Mongolia Autonomous Region at the third session of the 13th National People’s Congress (NPC) in Beijing, capital of China, May 22, 2020. (Xinhua/Ju Peng)
BEIJING, May 23 (Xinhua) — “What is people first?” Chinese President Xi Jinping asked, before offering his own answer when he was talking with lawmakers at the ongoing national legislative session.
“So many people worked together to save a single patient. This, in essence, embodies doing whatever it takes (to save lives),” he said.
Xi, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, is a deputy to the 13th National People’s Congress.
During his deliberations with fellow deputies from Inner Mongolia Autonomous Region on Friday, “people” was a keyword.
Xi referred to a story told by another deputy that morning. Luo Jie, from the COVID-19 hard-hit province of Hubei, told reporters at the session how medical workers in his hospital spent 47 days saving an 87-year-old COVID-19 patient.
“About 10 medical workers meticulously took care of the patient for dozens of days, and finally saved the patient’s life,” Xi said. “I am really impressed.”
In the COVID-19 pandemic, health workers around the world got to know the elderly are the most difficult to treat and require the most sophisticated medical resources. China has given every patient equal treatment irrespective of their age or wealth.
Chinese President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, takes part in a deliberation with his fellow deputies from the delegation of Inner Mongolia Autonomous Region at the third session of the 13th National People’s Congress (NPC) in Beijing, capital of China, May 22, 2020. (Xinhua/Huang Jingwen)
In Hubei alone, more than 3,600 COVID-19 patients over the age of 80 have been cured. In the provincial capital Wuhan, seven centenarian patients have been cured.
“We mobilized from around the nation the best doctors, the most advanced equipment and the most needed resources to Hubei and Wuhan, going all out to save lives,” Xi said during the deliberations, adding that the eldest patient cured is 108 years old.
“We are willing to save lives at all costs. No matter how old the patients are and how serious their conditions have become, we never give up,” Xi said.
Xi joined political advisors and lawmakers on Thursday and Friday in paying silent tribute to the lives lost to COVID-19 as the top political advisory body and the national legislature opened their annual sessions.
This year’s government work report said China’s economy posted negative growth in the first quarter of this year, but it was “a price worth paying” to contain COVID-19 as life is invaluable.
“As a developing country with 1.4 billion people, it is only by overcoming enormous difficulties that China has been able to contain COVID-19 in such a short time while also ensuring our people’s basic needs,” the report said.
Epidemic response is a reflection of China’s governing philosophy.
The fundamental goal for the Party to unite and lead the people in revolution, development and reform is “to ensure a better life for them,” Xi said.
The nation’s average life expectancy reached 77 years in 2018, more than double that in 1949, when the people’s republic was founded.
Chinese people are not just living longer but better lives, with more material wealth and broader choices to pursue individual dreams. All rural poor will bid farewell to poverty this year as part of the goal of building a moderately prosperous society in all respects.
The Party’s long-term governance, Xi said, rests on “always maintaining close bond with the people.”
“We must always remain true to the people’s aspiration and work in concert with them through thick and thin,” Xi said.
People work at a construction site of a utility tunnel in Wuhan, central China’s Hubei Province, April 30, 2020. (Xinhua/Xiao Yijiu)
BEIJING, May 1 (Xinhua) — China is getting the world’s largest workforce back to work as the nationwide battle against COVID-19 has secured major strategic achievements.
The unprecedented fight has nurtured new trends in the workplace. For example, more attention is being paid to public health and e-commerce to boost consumption and emerging sectors brought by new applications based on the country’s rapid new infrastructure development of 5G networks and data centers.
In this aerial photo taken on April 29, 2020, representatives of frontline health workers fighting COVID-19 attend a bell-ringing ceremony at the Yellow Crane Tower, or Huanghelou, a landmark in Wuhan, central China’s Hubei Province. (Xinhua/Xiao Yijiu)
ANGELS OF PUBLIC HEALTH
Ye Man, head nurse of gastrointestinal department of Hubei General Hospital East District, one of the five remaining COVID-19 designated hospitals in Wuhan, is taking her first weeklong vacation since January.
The 34-year-old mother of two started to take a week off on Monday, one day after her hospital cleared all remaining confirmed COVID-19 patients. The nine ICU wards in her hospital had been kept occupied over the past several months.
Friday marked International Workers’ Day, and the start of China’s five-day public holiday. Ye said she planned to visit urban parks with her family during the holiday.
At her busiest point, she and her colleagues took care of a ward filled with 40 COVID-19 patients.
“It was a really tough time,” she recalled. She had to wear a protective gown and a mask for nine hours a day and be separated from her family to avoid possible cross-infections.
Wuhan, capital of central China’s Hubei Province and once hard hit by COVID-19, cleared all confirmed cases in hospitals on April 26. Over 42,000 medical workers mobilized nationwide to aid Hubei have contributed to achieving a decisive outcome in the fight to defend Hubei and Wuhan.
In an inspection tour to Wuhan on March 10, President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, lauded medical workers as “the most beautiful angels” and “messengers of light and hope.”
To reward brave and dedicated medics, major tourist sites in Hubei are offering free entry to medical staff over the following two years.
Chinese President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, learns about development of the black fungus industry in Jinmi Village of Xiaoling Township in Zhashui County, Shangluo City, northwest China’s Shaanxi Province, April 20, 2020. (Xinhua/Xie Huanchi)
LIVESTREAMING ANCHORS
“We have a new batch of supplies today. Those who did not get the goods should hurry to buy now,” said Li Xuying, a livestreaming anchorwoman selling agaric mushrooms in Zhashui, a small county deep in the Qinling Mountains in northwest China’s Shaanxi Province.
Li has been prepared for a boom of online shopping in the holiday, because online buyers rushed to her livestreaming website to place orders, after Xi inspected the county and chatted with her in the village of Jinmi during a recent tour to Shaanxi.
“I used to sell goods worth about 50,000 yuan (7,070 U.S. dollars) on average after a six-hour livestreaming session. Now the sales are 10 times that,” she said.
Li was one of the 10 sales staff sent by the local agricultural e-commerce firm to Chinese e-commerce platform Taobao’s headquarters for livestreaming training. She said livestreaming is effective in bridging buyers and farmers, through which viewers can watch planting and harvesting online.
With the number of netizens in China reaching 904 million in March, e-commerce has been one of the popular means of promoting the sale of farm produce and helping farmers shake off poverty. Despite the impact of COVID-19, the country is determined to eradicate absolute poverty by the end of this year.
Workers work at the construction site of a 5G base station at Chongqing Hi-tech Zone in Chongqing, southwest China, April 15, 2020. (Xinhua/Wang Quanchao)
HI-TECH WORKERS IN “NEW INFRASTRUCTURE” BUILDING
As an elasticity calculation engineer of Alibaba Cloud, Zhao Kun and his colleagues always stay on alert for high data flow, for example, brought by the anticipated online shopping spike during the holiday.
“The profession, which may sound obscure, is actually closely connected to everyone’s life, as cloud computing is the infrastructure supporting high-tech applications of artificial intelligence and blockchain,” said Zhao.
The Chinese leadership has underscored expediting “new infrastructure” development to boost industrial and consumption upgrading and catalyze new growth drivers.
Seizing the opportunities of industrial digitization and digital industrialization, China needs to expedite the construction of “new infrastructure” projects such as 5G networks and data centers, and deploy strategic emerging sectors and industries of the future including the digital economy, life health services and new materials, President Xi has said.
During the epidemic, Zhao and his colleagues expanded more than 100,000 cloud servers to ensure the stable operation of “cloud classrooms” and “cloud offices” for millions of people working and studying from home.
In the “new infrastructure” building, people like Zhao contribute to constructing the virtual infrastructure of an ecosystem, which enables e-commerce, e-payment, online teaching and the digital transformation of manufacturing and supply chain management.
In early April, China released a plan on promoting the transformation of enterprises toward digitalization and intelligence by further expanding the application of cloud and data technologies, to nurture new business models of the digital economy.
Researchers conclude that the virus was circulating undetected in France in February
Findings highlight the difficulties governments face in tracing the source of coronavirus outbreaks
Researchers in France have carried out genetic analysis and found that the dominant types of the viral strains in the country did not come from China or Italy. Photo: AP
The coronavirus outbreak in France was not caused by cases imported from China, but from a locally circulating strain of unknown origin, according to a new study by French scientists at the Institut Pasteur in Paris.
Genetic analysis showed that the dominant types of the viral strains in France belonged to a clade – or group with a common ancestor – that did not come from China or Italy, the earliest hotspot in Europe.
“The French outbreak has been mainly seeded by one or several variants of this clade … we can infer that the virus was silently circulating in France in February,” said researchers led by Dr Sylvie van der Werf and Etienne Simon-Loriere in a non-peer reviewed paper released on bioRxiv.org last week.
The Covid-19 pandemic has infected more than 128,000 people in France and caused more than 23,000 deaths.
France detected the virus in late January, before any other country in Europe. A few patients with a travel history that included China’s Hubei province were sampled on January 24 and tested positive.
The Covid-19 pandemic has infected more than 128,000 people in France and caused more than 23,000 deaths. Photo: AFP
The French government took quick and decisive measures to trace contacts of the infected people and shut down the chance of further infection.
However, these strains were not found in patients tested after the initial imported cases, suggesting “the quarantine imposed on the initial Covid-19 cases in France appears to have prevented local transmission”, the researchers said.
The Pasteur institute collected samples from more than 90 other patients across France and found the strains all came from one genetic line. Strains following this unique path of evolution had so far only been detected in Europe and the Americas.
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The earliest sample in the French clade was collected on February 19 from a patient who had no history of travel and no known contact with returned travellers.
Several patients had recently travelled to other European countries, the United Arab Emirates, Madagascar and Egypt but there was no direct evidence that they contracted the disease in these destinations.
To the researchers’ surprise, some of the later strains collected were genetically older – or closer to the ancestral root – than the first sample in this clade.
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A possible explanation, according to the authors, was that local transmission had been occurring in France for some time without being detected by health authorities.
The French government may have missed detecting the transmission. According to the researchers, a large proportion of those patients might have had mild symptoms or none at all.
The researchers also found that three sequences later sampled in Algeria were closely related to those in France, suggesting that travellers from France might have introduced the virus to the African country and caused an outbreak.
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Benjamin Neuman, professor and chair of biological sciences with the Texas A&M University-Texarkana, said the French strains might have come from Belgium, where some sequences most closely related to the original strain from China were clustered.
“Since the earliest European strains of [the coronavirus] Sars-CoV-2 seem to be associated with Belgium, the idea that the virus spread from Belgium to both Italy and France at around the same time seems plausible, as this paper contends,” he said.
France is the latest in a growing number of countries and areas where no direct link between China and local outbreaks could be established.
The dominant strains in Russia and Australia, for instance, came from Europe and the United States, respectively, according to some studies.
These findings have drawn fire from some politicians who have tried to deflect domestic anger over their handling of the crisis by blaming China.
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“So now the Fake News @nytimes is tracing the CoronaVirus origins back to Europe, NOT China. This is a first!” he tweeted on April 11, referring to a story about the studies in the The New York Times’ science section.
The findings also highlight the difficulties governments face in tracing the source of coronavirus outbreaks.
Less-developed countries may never know where their strains came from due to inadequate testing and sequencing capability.
India, for example, has released the genetic sequence of fewer than 40 samples to the public so far, a small number considering its huge population.
Most of the strains sampled in 35 early cases came from clades that could be traced to Italy and Iran, with only a few from China, according to a recent study. But researchers were not able to track further because of the lack of data.
A scientist on the study, Dr Mukesh Thakur, of the Zoological Survey of India, said it was too early to rule out China as the source of outbreaks in India because the number of samples at hand was limited.
A 20-year-old student studying medicine in Wuhan, for instance, might have come in contact with many people on the way home before she was tested positive on January 30.
Thakur said local media reported that the Indian government quarantined 3,500 people possibly linked to three positive cases imported from Wuhan.
“God knows how many of them tested positive in the subsequent stages,” Thakur said in an email response to the Post’s queries on Tuesday.
Some prominent scientists, including Francis Collins, director of the US National Institutes of Health, said the virus might have been spreading quietly in humans for years, or even decades, without causing a detectable outbreak.
The virus had thus adapted well to the human body. Some genes regulating its binding to host cells were similar, or even identical, to those found in some other highly infectious human viruses, such as HIV and Ebola.
According to some estimates, the ancestor of Sars-CoV-2, the virus causing Covid-19, might have left bats between 50 and 70 years ago. A recent study by a team of geneticists in Oxford University estimated the first outbreak of the current pandemic could have occurred as early as September last year.
They found that the dominant strains circulating in China and Asia were genetically younger than some popular strains in the United States.
Residents of nine regions, including Wuhan, Beijing and Shanghai, to be sampled using both nucleic acid and antibody tests, state media reports
Research ‘very important as it will help us to direct our countermeasures in the future’, molecular virologist says
China is using dual testing to determine how many people have been infected with Covid-19 but recovered without showing symptoms. Photo: AP
China has begun a major survey to determine how many people might have been infected with the coronavirus and then recovered without ever showing symptoms, while also assessing immunity levels within different communities, state media reported.
The research will be conducted in six provinces, including Hubei which was the focus of the initial outbreak, as well as Beijing, Shanghai and Chongqing.
, the capital of Hubei and home to about 60 per cent of all infections reported in mainland China, is taking the lead in the study, which involves giving both nucleic acid and antibody tests to 11,000 of its 11 million residents, state news agency Xinhua reported on Wednesday.
Health workers collected throat swabs and blood samples from about 900 people randomly selected from eight subdistricts of the city on Tuesday, Ding Gangqiang, head of the Wuhan epidemiological survey team, was quoted as saying.
“The purpose is to learn about the immunity level in communities and provide scientific support on how we should adjust our disease control strategies,” he said.
Professor Lu Hongzhou, a specialist in infectious diseases who heads the Shanghai Public Health Clinical Centre where Covid-19 patients are being treated, said he supported the research though the collection of samples had yet to start in the city.
“We haven’t received notification from the top [to start],” he said. “The number of infections [in Shanghai] is not very big, but I think we’d better do this so as to have an idea of the scale of asymptomatic carriers.”
Professor Jin Dong-yan, a molecular virologist at the Li Ka Shing Faculty of Medicine at the University of Hong Kong, said that the use of both nucleic acid and antibody tests would enable scientists to determine those people who had been infected but recovered without medical aid and without showing symptoms.
The study into asymptomatic infections got under way in Wuhan in Tuesday. Photo: Simon Song
If a person tested positive in a nucleic acid test, it meant they were carrying the virus, and if positive in an antibodies test, it meant that they had contracted the virus and had recovered, he told the South China Morning Post.
“This is very important as it will help us to direct our countermeasures in the future,” Jin said.
“If we find, say 60 per cent, of the population has acquired immunity, then lockdowns will no longer be meaningful. If it turns out that there are many people with a high viral load but without symptoms, then we should be on high alert and take stricter measures.
“For people in Hubei, the tests can also save them from discrimination when they get back to work – those who prove to have developed immunity are very unlikely to get infected [again] for at least a year,” he said.
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to the nation’s daily infections tally at the start of April amid concerns that such people could trigger a second outbreak once the widespread lockdowns in cities like Wuhan and elsewhere were lifted.
China reported 103 new coronavirus infections on Wednesday, of which 39 were imported. Of the total, 57 people had no symptoms, including three of the imported cases.
Since the outbreak began, China has reported 82,295 cases, of which 95 per cent have recovered and been discharged from hospital.
More than 15,000 workers infected as hospitals struggle with a lack of test kits and protective gear
Chronic shortages are forcing emergency teams to ration equipment and come up with their own makeshift solutions
Health workers in protective gear outside an emergency entrance to a hospital in northern Spain. Photo: AFP
Overburdened hospitals and a shortage of protective measures and tests are taking a toll on Spanish medical professionals who are contracting Covid-19 – the illness caused by the new coronavirus – at an alarming rate.
To date, more than 15,000 health professionals in Spain – about 14 per cent of the national total – have been infected. In contrast, Italy reported that health workers accounted for about 10 per cent of its infections.
“I have tried to be careful, but when you work in a hospital, no one can guarantee that one of your colleagues doesn’t have the virus in the asymptomatic phase,” said ambulance crew member Xevi Mateu, who tested positive for the virus a week ago.
Mateu, who lives and works in Catalonia, said he thought he might have got infected during a meal break at the hospital or while on duty in the cramped space of an emergency vehicle.
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Information on how to protect himself from the rampaging pandemic was conflicting, he said, and with no guarantee on future supplies he was forced to ration his use of protective equipment as soon as the demand for ambulance services began to exceed capacity.
Albert Gual, another emergency worker in Catalonia, said protocols had changed since he first started transferring Covid-19 patients to hospital, and he believes the shortage of protective equipment is to blame.
“At the beginning of the crisis, we threw away the glasses, the medical suit and the mask after one use. Now we are using one mask per day, until the stock runs out,” Gual said.
“Yesterday I talked to a colleague from the emergency service who told me they are overwhelmed – without material, without resources, without people. The medical suits are reused and sterilised until they have holes,” he said.
There have also been reports of doctors and nurses in Spain making their own protective clothing out of bin liners.
To ease the burden on Spain’s medical workforce, retirees have been asked to return to practice and newly licensed personnel have been recruited to make up the shortfall. One of the new recruits is Candela Lebrero, who completed her medical degree last year and is now a nurse at a hospital in Madrid.
The Spanish capital has seen the country’s largest number of infections – with more than 36,000 – and staff at the Madrid Principe de Asturias Hospital, where Lebrero works have been among those falling ill from the disease.
Reports of an overload of patients were very real, she said, with emergency rooms forced to send less serious cases to “medicalised hotels” and additional hospital wards switched to caring for Covid-19 patients.
As for rapid testing, it “hadn’t arrived yet” at Lebrero’s hospital, which was relying on PCR tests – the swab technique which identifies the presence of any genetic material belonging to the virus – as a diagnostic for both patients and health personnel who presented with symptoms, she said.
Similar problems have been reported across Spain and last week the health ministry’s coordinator for the emergency response, Fernando Simon, acknowledged the difficulties for health care workers to access protective equipment.
On March 25, Simon admitted the jump in infections among medical staff was due to “a market access problem” as supplies “are scarce and there is non availability” – a problem not limited to Spain.
“We are on the way to a solution,” he said. On Monday, Simon also tested positive for the disease.
While equipment shortages are a global problem, Spain was hit particularly hard after its two largest distributors of medical supplies – located in France and Germany – were ordered to stop selling by their governments in early March, fearful of depleted stocks in their own countries as the pandemic spread.
The decision, which was criticised for being contrary to the spirit of the European Union, forced the Spanish government to turn to other measures, including the purchase of €432 million (US$467 million) worth of supplies from China.
A freight corridor was also opened to speed deliveries, and Spanish manufacturers were put on a “war footing” to urgently switch to making medical supplies. The car industry is now turning out respirators and gels, while textile manufacturers have turned their hand to producing gowns and face masks.
Sports equipment chain Decathlon has even adapted its snorkel goggles for medical use and donated its entire stock to Spanish hospitals.
A Covid-19 patient wears a full-face snorkelling mask which has been converted into a ventilator. Photo: Reuters
The scramble to address shortages in Spain’s overstretched health system has not been without problems. Last week, the government withdrew 58,000 Covid-19 rapid test kits
it bought from a Chinese company, after their accuracy rate was reported to be just 30 per cent.
China said the kits were not approved for sale and not included in supplies sent by Beijing to Spain.
It is not clear if the supplies from China have arrived, but on the ground medical personnel said they had not yet seen the equipment.
“It is assumed that the new ones have already arrived, but they have to pass the approval of the Carlos III Public Health Institute [a Spanish public health research institute], and their use is not yet widespread,” Laura Díez, press officer for the State Confederation of Medical Unions said.
“Their arrival will improve the situation since at least it would be known if someone in contact with the infected could transmit the disease, especially health personnel,” she said.
Medical staff in Spain acknowledge the daily applause from the public which has become a feature of the coronavirus pandemic. Photo: DPA
Several health organisations have appealed to the courts in their desperate bid to get hold of protective equipment. A Madrid court did accept the argument by an association of doctors that the authorities should be forced to provide adequate supplies to all health personnel.
But the Supreme Court refused to support the claim, saying it recognised the government was doing everything it could.
“We presented precautionary measures and they were dismissed, we have filed an appeal,” Díez said.
“At the moment we have no answer. Authorities said that planes with the material are arriving, but at the hospitals, they are not seen.”
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Meanwhile, the General Councils of Dentists, Nurses, Pharmacists, Doctors, and Veterinarians, which represent more than 700,000 health professionals in Spain, expressed its “absolute rejection” of new guidelines for medical workers set by the health ministry.
In a notice issued on Friday, the ministry said that health professionals that had not been tested for Covid-19 but who took time off should return to work seven days after the onset of symptoms as long as they did not have a fever or respiratory problems.
Once back at work, they should wear a surgical mask for 14 days from the onset of symptoms and avoid contact with other people.
The general councils said some of the guidelines represented “a serious risk” to the health of professionals and their patients.
Ambulance worker Mateu is currently in isolation at home as he recovers from the disease, but his thoughts are with his colleagues and their daily struggle. He said he thanked his supervisors and coordinators for working hard every day.
With so many of the staff themselves sick, there was a lot of stress on those who were still at work, he said.
“I have the feeling that the effort and management is not being done from the top down, but from the bottom up: from us who work directly with the patients, our supervisors and they are continuing the chain of gestures and efforts,” he said.
The US saw 1,169 deaths in 24 hours and its infections are 20 per cent of the global total
China to hold day of mourning for victims; Singapore announces fifth death and school closures; Boris Johnson says he’s still ill; Angela Merkel ends quarantine
A group of nurses gather in the Bronx, New York, for a strike about the lack of personal protective equipment, on April 2, 2020. Photo: EPA-EFE
The number of confirmed coronavirus cases around the world soared past one million on Thursday and deaths topped 50,000 as Europe reeled from the pandemic and the
reported the highest daily death toll so far of any country.
Despite more than half the planet imposing some form of lockdown, the virus claimed thousands more lives, with the US, Spain and Britain seeing the highest number of daily fatalities yet.
Covid-19 is currently spreading the most rapidly in the US, where there have been 243,453 infections and 5,926 deaths, according to a tally by Johns Hopkins University.
The US saw 1,169 deaths in 24 hours, the highest one-day toll recorded in any country since the global pandemic began. The grim record was previously held by Italy, where 969 people died on March 27.
Here are other developments:
Singapore shuts schools, workplaces in ‘circuit-breaking’ move
Singapore’s coronavirus case number hits 1,000 after city state reports biggest single-day spike
Singapore Prime Minister Lee Hsien Loong on Friday afternoon announced most workplaces would be shut from April 7, and schools would be closed from April 8, in its
The city state has 1,114 infections and five people have died. More than 200 have recovered.
Essential services such as food establishments, markets and supermarkets, clinics, hospitals, utilities, transport and banking services will remain open.
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Lee on Friday said instead of tightening measures incrementally over the next few weeks, Singapore should “make a decisive move now, to pre-empt escalating infections”.
“Looking at the trend, I am worried that unless we take further steps, things will gradually get worse, or another big cluster may push things over the edge,” Lee said, describing the new measures as a “circuit breaker”.
Medical experts say the stringent measures require the cooperation of citizens to stay at home, given that local infection clusters have ballooned from six at the end of February to more than 20 currently.
People stand behind markers as they practice physical distancing while queuing up to buy food at a Singapore supermarket on April 3, 2020. Photo: Reuters
The Lion City has launched a website to help individuals with symptoms that might be related to Covid-19 decide whether they should see a doctor or not.
On the Covid-19 Symptom Checker website, individuals will be prompted to answer a short list of questions including their age, if they have any chronic diseases, if they have travelled outside Singapore in the past 14 days, or have been in touch with a suspected or confirmed Covid-19 case.
They will also be asked to choose which symptoms they are experiencing from a predetermined list including symptoms such as cough, difficulty breathing and the loss of taste/smell. The site will then recommend what the person should do next. This includes whether they should see a doctor or continue to monitor their symptoms.
China to hold day of mourning for Covid-19 victims
At 10am on April 4, 2020, the public will be asked to observe three minutes of silence. Photo: EPA-EFE
Flags will be flown at half-mast across the country and at embassies overseas, while all public entertainment will be halted for the day, said the State Council, China’s cabinet, on Friday.
At 10am, the public will be asked to observe three minutes of silence, during which sirens will blast out across the country and the owners of cars and boats should sound their vehicles’ horns, the council said.
Saturday also coincides with Ching Ming, or the Tomb-sweeping Festival, when Chinese traditionally gather to remember their ancestors.
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Mainland China on Friday reported 31 new confirmed coronavirus cases, including two locally transmitted infections, the country’s National Health Commission said.
It also reported four new deaths as of Thursday, all in Wuhan, the city where the outbreak began, the commission said in a statement. The total number of infections now stands at 81,620 and 3,322 deaths have been reported from mainland China to date.
The commission said 60 new asymptomatic coronavirus patients were also reported on Thursday.
UK’s Boris Johnson still ill with virus fever
Boris Johnson #StayHomeSaveLives
✔@BorisJohnson
Another quick update from me on our campaign against #coronavirus.
You are saving lives by staying at home, so I urge you to stick with it this weekend, even if we do have some fine weather.#StayHomeSaveLives
British Prime Minister Boris Johnson remains in isolation with a high temperature, more than a week after testing positive for coronavirus.
Johnson made the announcement in a video posted on Twitter on Friday, saying that even after seven days, “alas I still have one of the symptoms, a minor symptom: I still have a temperature”.
“In accordance with government advice I must continue my self-isolation,” he said.
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With coronavirus deaths still rising, the PM is anxious to drum home his message that Britons must obey government orders to stay in their homes as much as possible.
On March 23 he ordered a national lockdown, with the closure of schools, stores, restaurants and leisure facilities. Under emergency laws, police have the power to fine individuals who flout the rules and break up gatherings of more than two people in public.
Germany to crack down on people flouting physical distancing rules
Police officers ask people to disperse as they gather at a park in Berlin, Germany, on March 28, 2020. Photo: Reuters
People in Germany risk being fined up to €500 (US$540) for standing too close to each other from Friday, as officials crack down on people flouting rules brought in to control the coronavirus outbreak.
Chancellor Angela Merkel’s government has ordered people not leave their homes unless they have an exceptional reason such as grocery shopping, exercise or medical appointments.
Gatherings of more than two people are banned and a distance of at least 1.5 metres must be kept from others at all times.
Local governments have the power to set fines for transgressors, with city officials in Berlin saying their fines would be as high as 500 euros. Similar announcements have come from across Germany’s 16 states.
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According to figures by the Robert Koch Institute (RKI) on Friday, Germany has recorded more than 79,000 cases of the novel coronavirus, and 1,017 deaths, although RKI president Lothar Wieler warned on Friday that the actual number of casualties could be much higher.
“We won’t manage to test every single person … I assume we will have more deaths than are officially recorded,” he said.
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Meanwhile, Merkel on Friday left her Berlin home for the first time in almost two weeks, after she was forced into quarantine following contact with an infected doctor.
Merkel was tested several times, with all tests coming back negative.
The 65-year-old leader has returned to her office, where she will continue to observe social distancing rules and lead the country via video and audio conferencing, her spokesman said.
Spain records over 900 virus deaths
Members of the Red Cross prepare food for families in need at a food bank in Ronda, Spain, on April 3, 2020. Photo: Reuters
on Friday recorded over 900 new coronavirus deaths over the past day, bringing the number of casualties to 10,935, in the first decline in new Covid-19 deaths in four days.
The country has the world’s second-highest death toll after Italy, but health ministry figures confirm a consistent downward trend in the rate of new cases and fatalities.
The 932 deaths on Friday was a smaller gain than Thursday’s 950, according to Health Ministry data. The number of confirmed cases also increased by less than the previous day, with 7,472 new infections taking the total to 117,710.
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Prime Minister Pedro Sanchez’s government has been struggling to bring the virus under control. Hospitals are overwhelmed, nursing homes have been especially hard hit in a nation with one of the world’s oldest populations, and the army has been mobilised.
Sanchez may extend the current four-week lockdown for another two weeks beyond April 11, Spanish media reported on Friday. The stay-at-home order limits people’s movement to shopping for food and essentials, while some workers are also allowed to circulate.
Passengers disembark from virus-hit cruise ship in Florida
The Zaandam cruise ship docked in Florida on Friday. Photo: TNS via ZUMA Wire/dpa
Passengers from an ill-fated cruise were carefully freed from their cabins and allowed to disembark on Friday, following the removal of 14 critically-ill people who were wheeled off to Florida hospitals bracing for an onslaught of coronavirus patients.
The exodus from the Zaandam and its sister ship the Rotterdam, both operated by Holland America Line, was expected to continue throughout the day.
Floridians were getting off first, followed by other passengers. Buses were taking people healthy enough to travel directly to the airport, where they will board chartered flights home without going through the terminal.
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“This is a humanitarian situation, and the County Commission’s top priority is protecting our 1.9 million residents while providing a contained disembarkation option for people on board who need to get safely home,” Broward County Mayor Dale Holness said in a statement late on Thursday.
Four people have died on the Zaandam, for reasons not yet disclosed. All told, 107 passengers and 143 crew reported flu-like symptoms during the voyage, but many have since recovered.
It was unclear when the bodies of four passengers who died on the Zaandam would be removed from the ship, which set sail on March 7, the day before the US State Department warned people against cruising during the pandemic.
South Korea’s infections top 10,000
South Korean hospital’s ‘phone booth’ coronavirus tests
on Friday said the number of confirmed coronavirus cases in the country has surpassed 10,000, with 174 deaths linked to Covid-19, the disease caused by the new virus.
The Health and Welfare Ministry reported 86 new coronavirus infections over 24 hours to the end of Thursday, taking the total to 10,062 cases. It also logged five more deaths.
The numbers confirmed an encouraging stabilisation of numbers, which have hovered around the 100 mark for the past three weeks, a clear downward trend which began in March after numbers peaked at the end of February with over 900 cases recorded in a day.
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For a fourth straight day, more new cases were recorded from Seoul and the surrounding Gyeonggi province, than in what has so far been the outbreak epicentre in the country – North Gyeongsang province and city of Daegu – with the capital area registering 34 new cases, and the latter recording 23.
Imported cases in patients recently returned from abroad also continued to increase, with 22 new infections bringing the total to 264.
Japan to give US$2,800 payouts to households
A man seen in a protective mask at Shinjuku in Tokyo, Japan, on April 2, 2020. Photo: EPA-EFE
Japanese ruling party executive Fumio Kishida said on Friday he has agreed with Prime Minister Shinzo Abe to offer 300,000 yen (US$2,800) in cash payments per household that suffers a certain degree of income declines from the coronavirus pandemic.
About 10 million of Japan’s 58 million households are expected to be eligible for the cash programme, a key pillar of an emergency economic package that the government plans to compile possibly on Tuesday.
The relief measure will be funded by a supplementary budget for this fiscal year that the government wants to pass in parliament before Japan’s Golden Week holiday starts in early May.
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The government will not set a household income limit for the cash handout, which will be tax free, officials said.
“If we set an income limit, we would have to check individual incomes, which would take a lot of time,” Yasutoshi Nishimura, minister in charge of economic and fiscal policy, told a press conference. “Instead of that, we’ll come up with an unprecedented way (to judge who should receive cash).”
Nishimura said recipients will be limited to those who are facing livelihood difficulties, and that civil servants, politicians and major corporate executives who have not been significantly affected by the economic impact of the virus outbreak, for example, will be excluded from the scheme.
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Abe said the government will provide cash “as soon as possible” not only to households but also to small-and mid-sized business operators that have seen their revenues drop.
Abe has said the package to tackle the coronavirus will be larger than the 56.8 trillion yen emergency package compiled in April 2009 following the previous year’s global financial crisis.
Indonesian Muslims banned from travelling home for Eid al-Fitr
A police officer in a coronavirus helmet sprays disinfectant at a motorcycle in East Java, Indonesia, on April 3, 2020. Photo: AP
Islamic scholars in Indonesia on Friday issued an edict to forbid people from travelling home for Eid al-Fitr, the festival marking the end of the Muslim fasting month of Ramadan, as the country recorded nearly 2,000 infections during the
decided to allow millions of Muslims to travel to celebrate Eid in their hometowns next month, despite fears that they could spread the Covid-19 disease.
“The virus spreads very easily. Doing something like that at a time of a pandemic is haram [forbidden],” the council’s sectary general Anwar Abbas said.
Eid al-Fitr is expected to start on May 23, depending on the sighting of the new moon.
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Indonesia confirmed 196 new infections on Friday, bringing the total number of cases to 1,986.
The death toll rose to 181 after 11 new deaths, making Indonesia the the country with the highest number of fatalities in Asia outside China.
The State Intelligence Agency warned that the outbreak in Indonesia could peak in June with more than 105,000 cases.
Thailand’s night curfew to begin; people banned from making virus pranks
An officer checks the temperature of a passenger in a bus at a health checkpoint in Bangkok, Thailand, on April 3, 2020. Photo: AP
Thailand will on Friday night begin a daily nationwide curfew to try to curb the spread of the coronavirus.
The 10pm-4am curfew, which will run indefinitely, is the latest measure by the government to curb gatherings and have people stay at home as much as possible.
Exceptions include those people transporting medical supplies and health workers travelling to and from work, Prime Minister Prayuth Chan-ocha said.
“We prioritise health over freedom,” Prayuth said. “We might not feel as comfortable as before, but we all need to adapt for survival and have social responsibility, so that we can make it through this crisis.”
In a televised address, Prayuth also asked all Thai citizens abroad to “delay” returning to
until after April 15 in a bid to stop imported cases.
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Thais have also been banned from making public gatherings, in an order signed on Friday by defence forces chief General Pornpipat Benyasri.
The order prohibits people from public gatherings, carrying out activities, or gathering for unlawful purposes in a manner that risks spreading the coronavirus.
It also bans any act that aggravates people’s suffering and pranks to spread the virus. Family gatherings at residences and civic activities carried out according to safe social distancing guidelines are allowed.
Violation of the order carries a maximum penalty of two years’ imprisonment and a fine of 40,000 baht (US$1,215).
Pakistan’s mosques remain open amid shutdowns
Coronavirus: In Pakistan food aid is distributed to the poor in Karachi
Mosques in Pakistan were allowed to remain open on Friday, when adherents gather for weekly prayers, even as much of the country had shut down.
Pakistan, with 2,450 confirmed coronavirus cases and 35 deaths, has been sharply criticised for moving too slowly to curb large gatherings.
Prime Minister Imran Khan was relying on restricting the size of congregations attending mosques and advice to stay at home from religious groups like the country’s Islamic Ideology Council.
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However, some provinces had issued their own lockdown orders to prevent Muslims from gathering for Friday prayers.
In southern Sindh province, a complete lockdown was being enforced from noon until 3pm, the time when the faithful gather for prayers. Anyone found on the streets would be arrested, according to the provincial local government minister in a statement.
In eastern Punjab province, where 60 per cent of Pakistan’s 220 million people live, checkpoints had been set up in major cities stopping people from congregating.
Tunisia ‘robocop’ enforces virus lockdown
The PGuard robot patrols the streets of Tunis, in Tunisia, on April 1, 2020. Photo: EPA-EFE
Tunisia’s interior ministry has deployed a police robot to patrol the streets of the capital and enforce a lockdown as the country battles the spread of coronavirus.
Known as PGuard, the “robocop” is remotely operated and equipped with infrared and thermal imaging cameras, in addition to a sound and light alarm system.
In images and a soundtrack posted on the interior ministry’s website last month, PGuard calls out to suspected violators of the lockdown: “What are you doing? Show me your ID. You don’t know there’s a lockdown?”
The PGuard robot checks the exit permit of a citizen in Tunis on April 1, 2020. Photo: EPA-EFE
Tunisia has been under night-time curfew since March 17 and authorities imposed stricter lockdown orders from March 22.
Fourteen people have died from coronavirus in Tunisia, where 455 confirmed cases have tested positive for the disease.
The robot’s Tunisian creator Anis Sahbani said the machine was first produced in 2015 essentially to carry out security patrols and it also operates autonomously through artificial intelligence.
The robot, built by Sahbani’s Enova Robotics firm, costs between 100,000 and 130,000 euros (US$100,000 and $140,000), and has been selling mostly overseas to companies for security uses.
France death tally passes 5,000
A cashier runs a store counter covered up with a plastic barrier in Paris, France, on April 3, 2020. Photo: Xinhua
reported a jump in coronavirus deaths on Thursday as the country included fatalities in some nursing homes for the first time. Still, a decline in intensive-care admissions suggest the country’s lockdown is starting to slow the pace of the outbreak.
The health ministry reported 471 new hospital deaths from the coronavirus on Thursday. In addition, it reported 884 deaths in a partial count from nursing homes, bringing the total number to 5,387. Nursing homes were not previously included in the statistics.
in number of deaths, behind Italy and Spain. The number of confirmed cases is now at 59,105.
Italy reported another 760 fatalities on Thursday. Its death toll, already the world’s highest, now stands at 13,915. Total infections, including recoveries and deaths, have reached 115,242.
Spain reported 950 more deaths from the coronavirus, the most in a single day, taking the total to 10,003.
India plans staggered exit from lockdown
Indian policemen in Hyderabad, India, wear virus-themed helmets for a campaign to raise awareness at preventing the spread of the coronavirus on April 2, 2020. Photo: AP
infections, but the world’s biggest shutdown has left millions without jobs and forced migrant workers to flee to their villages for food and shelter.
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He told state chief ministers that the shutdown had helped limit infections but that the situation remained far from satisfactory around the world and there could be a second wave.
“Prime minister said that it is important to formulate a common exit strategy to ensure staggered re-emergence of the population once lockdown ends,” the government quoted him as saying in a video conference.
India has had 2,069 confirmed infections, of whom 53 have died, low figures by comparison with the US, China, Italy and Spain. But the big worry is the
because of a gathering held by a Muslim missionary group last month that has spawned dozens of cases across the country, officials said.
Five-minute virus tests ‘may give inaccurate results’
A Chinese drug and diagnostic firm has cautioned that the slew of new test kits that promise to detect the coronavirus in just a few minutes may not be as accurate as conventional kits, a potential setback for countries seeking to rapidly test their citizens.
“Such rapid testing is not as accurate as the traditional nucleic acid test that takes about two hours to turn out results,” Wu Yifang, Shanghai Fosun Pharmaceutical Group’s chief executive officer, said. The drugmaker also has a swift testing technology but it’s working on making the results more accurate, according to Wu.
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Abbott Laboratories unveiled a coronavirus test on March 28 that can confirm if someone is infected in as little as five minutes. Shenzhen Bioeasy Biotechnology has been supplying its version of rapid testing kits to the European Union even before getting regulatory approval in China for domestic use.
The faster and easy-to-deploy diagnostic kits seemingly save time and resources for nations under pressure to widen their testing efforts. But there have been reports of faulty kits, like those bought by Spain and the Czech Republic.
Shenzhen Bioeasy, which sold thousands of test kits to Spain, said in a statement on March 27 that false results could be due to improper use of its kits or faulty specimen collection.
Trump tests negative again
US President Donald Trump was was first tested last month after coming into contact with a Brazilian official who later tested positive. Photo: UPI/Bloomberg
US President Donald Trump on Thursday was tested again to determine whether he had been infected by the coronavirus, and the test came back negative, the White House said.
A letter from Trump’s doctor, Sean Conley, said Trump had undergone what was a second test for coronavirus. He was tested last month after coming into contact with a Brazilian official who later tested positive.
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Conley said in a letter released by the White House that Trump was tested with a new, rapid point-of-contact test and the result came back in 15 minutes.
“He is healthy and without symptoms,” Conley said.
Trump said Americans should wear protective face masks if they wish. “If people want to wear them, they can” he said. Scarves work just as well, he said.
NRA sues NY governor over closure of gun stores
A pedestrian pushes a stroller as people wait in line outside a gun store to buy supplies on March 15, 2020. Photo: Reuters
The National Rifle Association (NRA) sued New York Governor Andrew Cuomo for closing gun shops during the coronavirus pandemic, saying the restriction is unconstitutional and leaves citizens defenceless while prisoners are being released early as a result of the crisis.
Cuomo’s March 20 executive order that included firearms retailers as non-essential businesses, which must close is a “pointless and arbitrary attack on the constitutional rights of New York citizens and residents,” the NRA said in a complaint filed late Thursday in Syracuse, New York.
New York ordered most businesses to close to prevent the spread of the virus, but deemed grocery stores, liquor stores, pharmacies and restaurants that do take-out as essential and allowed them to remain open.
The New York lawsuit follows similar action the NRA took in Northern California, where it sued several cities including San Jose for ordering gun stores to close.
Corona beer producer halts brewing
The Mexican brewer of Corona beer said on Thursday it was suspending production because of the health emergency in the country over the Covid-19 pandemic.
Grupo Modelo said the measure was in line with the Mexican government’s order to suspend all non-essential activities until April 30 to slow the spread of coronavirus.
“We are in the process of lowering production at our plants to the bare minimum,” the company said in a statement, adding it would complete the suspension in the following days.
Mexico’s government has said that only key sectors such as agribusiness will be able to continue to function.
US stops issuing passports, except in emergencies
The US State Department will not be processing new passports and renewals except for emergency cases because of the coronavirus pandemic, the agency’s website said.
“Due to public health measures to limit the spread of Covid-19, effective March 20, 2020, we are only able to offer service for customers with a qualified life-or-death emergency and who need a passport for immediate international travel within 72 hours,” said a March 27 online statement.
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Passport applications received on or before March 19 will be processed.
Travellers who paid extra for expedited service can expect to receive their passport in the next two to three weeks.
If you applied in-person at a passport agency or centre before March 19, the agency will contact you about getting your passport.
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.
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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.
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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 GETTY IMAGESImage caption Many Indians face losing their income and some say they could starve
India has announced a $22bn (£19bn) bailout for the country’s poor to help counter the economic effects of the Covid-19 outbreak.
“We don’t want anyone to remain hungry, and we don’t want anyone to remain without money in their hands,” finance minister Nirmala Sitharaman said.
The package, which includes free food and cash transfers, was for “those who need immediate help”, she said.
She also said health workers would get medical insurance of up to $66,500.
Correspondents point out that this amounts to just 1% of India’s GDP – in stark contrast to the US and Singapore which are spending about 10% of their GDP on similar packages.
However, this could be just stage one, with similar packages set to be announced later, they added.
India’s economy was already in the midst of a severe slowdown before the country went into lockdown, shutting workplaces, factories and affecting millions of daily-wage and informal workers.
They form India’s vast informal sector, which constitutes a large part of its workforce. The lockdown and social distancing have left many of them with no viable means of getting any income, and many have expressed fears that they could starve.
Growth had slumped to 4.7% last month – the slowest pace in years – as a steep drop in manufacturing affected overall economic health.
Barclays said the total shutdown cost to India would be around $120bn, or 4% of the country’s GDP.
Ms Sitharaman, who is also the head of an economic task force announced by the prime minister, said that workers under an employment guarantee scheme would get a wage increment, and that recipients of other welfare schemes would also get benefits, like free gas cylinders instead of just subsidised ones.
Image copyright PTIImage caption This city of five million people has been under a lockdown since last week
At 05:00 local time (23:30 GMT) of 8 March, the intensive care unit of a private hospital in the northern Indian state of Rajasthan received a 68-year-old man suffering from pneumonia. He was also having problems breathing.
At the Brijesh Bangar Memorial Hospital in Bhilwara, the new patient was examined by 58-year-old Alok Mittal, a doctor of internal medicine, and his team. The patient wasn’t asked about any travel history; nor did he disclose anything. There were six other patients in the ICU.
The man’s condition did not improve much, and two days later, he was sent to a private hospital in Jaipur, some 250km (155 miles) away, for specialised treatment. In Jaipur, he was treated in two hospitals. “We had no idea what was in store,” Shantilal Acharya, an intensive care nurse who received the patient in the Bhilwara hospital, told me.
For reasons that are still unclear, even the hospitals in Jaipur didn’t test a patient with severe pneumonia for coronavirus. His condition deteriorated swiftly and he died a few days later, on 13 March. The news of his death was conveyed to Dr Mittal and his team.
Image copyright SHAUKAT AHMEDImage caption The infection possibly spread from a private hospital in Bhilwara
Strangely enough, the doctors didn’t appear to comprehend the gravity of the situation even though it was clear that India was facing an imminent outbreak of Covid-19. The country has reported more than 460 confirmed cases and nine deaths so far, and testing remains low. On 9 March, according to reports, Dr Mittal and a few others travelled to the city of Udaipur, put up in a resort and played Holi, the Indian spring festival of colours. (Repeated attempts at getting through to Dr Mittal by phone and text yielded no results.)
Days after the death of the pneumonia patient, Dr Mittal and a colleague checked themselves into an isolation ward of a government hospital. Over the next few days, a few more colleagues from the hospital joined them in isolation. Twelve of them, including Dr Mittal, tested positive for Covid-19.
Next day, as news of the infections leaked, all hell broke loose. The private hospital was popular with its residents, and many regularly visited its thriving out-patient department for treatment. As people panicked and began blaming the doctors for spreading the infection, authorities moved swiftly.
Image copyright SHAUKAT AHMEDImage caption People have been stopped from entering or leaving Bhilwara
They imposed a “civil curfew”, prohibiting people from coming out of their homes and banning public gatherings. They shut schools, colleges, offices, and stopped people from leaving or entering the district. The private hospital was sealed and its 88 patients moved to other healthcare facilities in the area. “Officials were telling us the threat was serious and there was a chance of an outbreak,” local journalist Pramod Tiwari told me.
So Bhilwara, fearing a serious outbreak, did everything that India did a few days later. So could this city of 400,000 people and a major textile making hub, turn out to be India’s first coronavirus “hotspot”?
Of the 69 people tested in the city until Sunday evening, 13 people – including doctors and paramedics – aged between 24 and 58, have tested positive. They include three doctors and nine health workers. Thirty-one people – mostly hospital workers – are in isolation. “Most of them are doing fine,” Dr Arun Gaur, the chief medical officer of the district, told me.
But things could get really bad.
Between 20 February and before going into isolation last week, Dr Mittal and his team of doctors at the hospital saw 6,192 patients who came from 13 districts of Rajasthan and 39 patients belonging to four other states. Drawing from the experience in China and Italy, doctors now know that hospitals might turn out to be the “main source” of Covid-19 transmission. Also, both MERS and SARS had high transmission rates within hospitals. The potential for community transmission of the infection across a large geographical area from the Bhilwara hospital is real, officials fear.
Image copyright SHAUKAT AHMEDImage caption The city’s borders have been sealed
So did the virus reach this city through the patient who was treated at three hospitals and went untested before he died? Or did one of the more than 80 patients admitted in the hospital transmit it? Or was it spread by another patient in the intensive care? Or had one of the doctors picked up the infection separately and spread it unknowingly?
Nobody will know until all the contact tracing and testing is complete, and that’s the scary part.
The lack of early credible information on the transmission meant that rumours had a field day. Local media reported that one of the infected doctors had received guests from Saudi Arabia at home and had contracted the infection. He had then gone to the hospital and spread the infection to co-workers, the reports added.
Dr Niyaz Khan had to record a mobile phone video from his intensive care bed to squelch the rumour. With monitors beeping around him, Dr Khan, masked and breathless, implored: “Just to set the record straight, I have no relative in Saudi Arabia. I have a son and a wife. None of them is positive. Please don’t believe what is coming in the media.” Another doctor said it was unfair to blame the hospital: “The patient fooled us and told us he didn’t travel outside the country for the two days he was in the ICU with us.” And Dr Mittal himself – his wife has also tested positive – recorded videos in isolation saying that he had tested positive, and he was doing well. “Please do not panic,” the well-known doctor said.
Image copyright GETTY IMAGESImage caption Residents in the city have begun panicking
That is easier said than done.
Realising the gravity of the situation, 300 teams of government workers and volunteers have fanned out in Bhilwara city. They are knocking on the doors of some 78,000 houses, and asking residents whether they’ve had a guest from outside the country, been treated in the hospital or know anyone who has tested positive. The survey began on 18 March and will finish on 25 March. “They are asking if we have cold, cough and fever and telling us if we have any of the symptoms we should report for tests at the government hospital,” a resident told me.
Another 1,900 similar teams have travelled out into neighbouring villages where more than 2.5 million people live. People in homes with suspect cases are being put into quarantine. Seven thousand people have been put into home quarantine so far.
Fearing a surge in infections, 20 more beds are being added to the hospital’s 30-bed isolation ward, which is already full. Six private hospitals have promised to provide an additional 35 beds for isolation. Thirteen places with 450 beds – extendable to 2,000 beds – where people can be quarantined have also been identified, Rajendra Bhatt, the senior-most official of the district told me. “It’s like fighting a war, but we have been agile and alert,” he said.
Meanwhile the residents, like elsewhere in India, are enduring an extended lockdown and curfew. Rajkumar Jain, a professor of computer science, is locked down with 14 members of his joint family in a two-storey home. “We are in complete panic,” he told me. “People are saying here that Bhilwara is going to become India’s Italy.”
Media captionWATCH: Millions of Indians bang pots and pans in support of health workers
Woman becomes angry over long delay on tarmac waiting for health assessments
Customs official says that Shanghai is stepping up medical checks as precaution against imported infection but that travellers need only wait one or two hours
Video taken on board a Thai Airways flight at Shanghai on Friday purports to show flight attendants trying to control a passenger who coughed on one of their colleagues. Photo: Handout
Thai Airways staff had to restrain a Chinese woman after she coughed at a flight attendant while passengers waited for hours to get acoronavirus check upon landing in Shanghai from Bangkok.
The carrier said the woman coughed deliberately at the attendant because she was angered about the long wait for a check on Friday. It said the passengers had to wait seven hours to be screened at Shanghai Pudong International Airport Thai Airways said that after the passenger coughed at the woman attendant, some of her colleagues approached the passenger to stop her “inappropriate” behaviour. They then explained the situation to her and asked her to cooperate and calm down, the airline said.
The woman had to be subdued and no further action was taken, the airline said in a statement.
In footage posted online, the woman is subdued by at least one male attendant, who presses her into her seat by her neck as two more male attendants stand nearby, saying “sit down” to her in English.
The woman then yells “What have I done?” in Chinese.
Thai Airways said that every passenger arriving in Shanghai or flying through the airport from countries with a high incidence of coronavirus cases such as Italy, South Korea, Japan and Iran must be examined by medical staff on the aircraft. Planes that were not checked were not permitted to open their doors to let passengers off.
The airline said the length of wait depended upon the number of passengers coming from those “key areas”.
An official from Shanghai Customs said that passengers on the flight had to be checked because some had transferred from Iran, where more than 7,000 cases and 230 fatalities have been reported.
The Thai Airways flight was on the ground at Shanghai for seven hours pending medical checks on passengers and crew. Photo: EPA
The woman’s behaviour divided opinion on social media.
“Shame on her!” a user of Weibo, China’s Twitter-like service, wrote. “It’s so shameful for her to act like that in front of foreigners.”
“I think the flight attendants were fairly gentlemanly,” another user wrote. “She should have been taken away.”
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A Weibo user who claimed to be on the plane at that time said it was not right for “three men” to subdue the woman.
“I don’t want to see my compatriot be bullied,” she wrote. “The attendants only stopped their action after two Chinese passengers stood up to intervene.”
Shanghai’s two airports have tightened medical checks on travellers from overseas, leading to complaints about long waiting times.
Health workers check passengers’ temperatures, screen their health disclaimer cards and check their travel histories.
Music video about Covid-19 safety released by rail operator in Thai capital Bangkok
Each passenger arriving from “key areas”, where there are a lot of infections, have to have their temperature checked twice after they get off the plane. Some may have to undergo simple physical checks.
Passengers who travelled to those key areas in the past 14 days, no matter their nationality, would be sent to designated places for 14 days of medical observation, authorities said.
The Shanghai Customs official said passengers were disembarked in batches to avoid crowding, making the examination process longer.
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She said that after the authorities allocated more than 300 customs staff to support monitoring at border ports at the end of last week, the examination process now took one to two hours.
“Many people blamed us for low speed and low efficiency, but didn’t ask why,” she said, adding that people’s messy handwriting on their health disclaimer cards and poor memory of where they had been in the past 14 days also complicated the clearance process.
“As a citizen, shouldn’t they cooperate in this critical moment?” she said.
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