Archive for ‘how’

31/05/2020

India coronavirus: Why is India reopening amid a spike in cases?

A rush of people and motorists in a marketplace area as shops start opening in the city under specific guidelines, on May 20, 2020 in Jammu, IndiaImage copyright GETTY IMAGES
Image caption Within a week of reopening, India has seen a sharp spike in cases

India is roaring – rather than inching – back to life amid a record spike in Covid-19 infections. The BBC’s Aparna Alluri finds out why.

On Saturday, India’s government announced plans to end a national lockdown that began on 25 March.

This was expected – the roads, and even the skies, have been busy for the last 10 days since restrictions started to ease for the first time in two months. Many businesses and workplaces are already open, construction has re-started, markets are crowded and parks are filling up. Soon, hotels, restaurants, malls, places of worship, schools and colleges will also reopen.

But the pandemic continues to rage. When India went into lockdown, it had reported 519 confirmed cases and 10 deaths. Now, its case tally has crossed 173,000, with 4,971 deaths. It added nearly 8,000 new cases on Saturday alone – the latest in a slew of record single-day spikes.

A worker cleans the mascot of fast-food company McDonald's for the reopening of the outlet in Hyderabad on May 20.Image copyright GETTY IMAGES
Image caption Fast food chains like McDonald’s have begun reopening outlets in parts of India.

So, why the rush to reopen?

The lockdown is simply unaffordable

“It’s certainly time to lift the lockdown,” says Gautam Menon, a professor and researcher on models of infectious diseases.

“Beyond a point, it’s hard to sustain a lockdown that has gone on for so long – economically, socially and psychologically.”

From day one, India’s lockdown came at a huge cost, especially since so many of its people live on a daily wage or close to it. It put food supply chains at risk, cost millions their livelihood, and throttled every kind of business – from car manufacturers to high-end fashion to the corner shop selling tobacco. As the economy sputtered and unemployment rose, India’s growth forecast tumbled to a 30-year-low.

Raghuram Rajan, an economist and former central bank governor, said at the end of April that the country needed to open up quickly, and any further lockdowns would be “devastating”.

The opinion is shared by global consultant Mckinsey, whose report from earlier this month said India’s economy must be “managed alongside persistent infection risks”.

Passengers maintaining social distance as they are on board in a DTC Bus after government eased lockdown restriction, at AIIMS on May 20, 2020 in New Delhi, India.Image copyright GETTY IMAGES
Image caption As restrictions ease, Indians are slowly getting used to the new normal

“The original purpose of the lockdowns was to delay the spike so we can put health services and systems in place, so we are able handle the spike [when it comes],” says Dr N Devadasan, a public health expert. “That objective, to a large extent, has been met.”

In the last two months, India has turned stadia, schools and even train coaches into quarantine centres, added and expanded Covid-19 wards in hospitals, and ramped up testing as well as production of protective gear. While grave challenges remain and shortages persist, the consensus seems to be that the government has bought as much time as possible.

“We have used the lockdown period to prepare ourselves… Now is the time to revive the economy,” Delhi Chief Minister Arvind Kejriwal said last week.

The silver lining

For weeks, India’s relatively low Covid-19 numbers baffled experts everywhere. Despite the dense population, disease burden and underfunded public hospitals, there was no deluge of infections or fatalities. Low testing rates explain the former, but not the latter.

In fact, India made global headlines not for its caseload but for its botched handling of the lockdown – millions of informal workers, largely migrants, were left jobless overnight. Scared and unsure, many tried to return home, often desperate enough to walk, cycle or hitchhike across hundreds of kilometres.

Perhaps the choice – between a virus that didn’t appear to be wreaking havoc yet, and a lockdown that certainly was – seemed obvious to the government.

But that is changing quickly as cases shoot up. “I suspect we will keep finding more and more cases, but they will mostly be asymptomatic or will have mild symptoms,” Dr Devadasan says.

The hope – which is also encouraging the government to reopen – is that most of India’s undetected infections are not severe enough to require hospitalisation. And so far, except in Mumbai city, there has been no dearth of hospital beds.

India’s Covid-19 data is spotty and sparse, but what it does have suggests that it hasn’t been as badly hit by the virus as some other countries.

The government, for instance, has been touting India’s mortality rate as a silver lining – at nearly 3%, it’s among the lowest in the world.

But some are unconvinced by that. Dr Jacob John, a prominent virologist, says India has never had, and still doesn’t have, a robust system for recording deaths – in his view, the government is certainly missing Covid-19 deaths because they have no way of knowing of every fatality.

A woman jogs at Lodhi Garden after the local government eased restrictions imposed as a preventive measure against the spread of the COVID-19 coronavirus in New Delhi on May 21, 2020.Image copyright GETTY IMAGES
Image caption Indians are venturing out again but it’s unclear how many of them are asymptomatic.

And, he says, “what we must aim for is flattening the mortality curve, not necessarily the epidemic curve”.

Dr John, like several other experts, also predicts a peak in July or August, and believes the country is reopening so quickly because the “government realised the futility of such leaky lockdowns”.

A shift in strategy

So is the government gearing up for another lockdown when the peak comes?

While Dr Menon believes the lockdown was well-timed, he says it was too focused on cases coming from abroad.

“There was a hope that by controlling that, we could prevent epidemic spread, but how effective was our screening [at airports]?”

Now, he adds, is the time for “localised lockdowns”.

Media caption Coronavirus: Death and despair for migrants on Indian roads

The federal government has left it to states to decide where, how and to what extent to lift the lockdown as the virus’ progression varies wildly across India.

Maharashtra alone accounts for more than a third of India’s active cases. Add Tamil Nadu, Gujarat and Delhi, and that makes up 67% of the national total.

But other states – such as Bihar – are already seeing a sharp uptick as migrant workers return home.

“Initially, most of your cases were in the cities,” Dr Devadasan says. “But we kept the migrant workers in cities and didn’t allow them to go home. Now, we are sending them back. We have facilitated transporting the virus from urban areas to rural areas.”

While the government has said how many infections have been avoided – up to 300,000 – and lives saved – up to 71,000 – by the lockdown, there is no indication of what lies ahead.

There is only advice: The day the government began to ease restrictions, Mr Kejriwal tweeted, urging people to “follow discipline and control the coronavirus disease” as it was their “responsibility”.

The famous Paranthe wali gali (bylane of fried bread) in Chandni Chowk, on August 20, 2014 in New Delhi, India.Image copyright GETTY IMAGES
Image caption Social distancing will prove to be India’s biggest post-lockdown challenge

Because the alternative – of curfews and constant policing – is unsustainable.

“My worry is more the circumstances of people – it’s not as though they have an option to practise social distancing,” Dr Menon says.

And they don’t – not in joint family homes or one-room hovels packed together in slums, not in crowded markets or busy streets where jostling is second nature, or in temples, mosques, weddings or religious processions where more is always merrier.

The overwhelming message is that the virus is here to stay, and we have to learn to live with it – and the only way to do that, it appears, is to let people live with it.

Source: The BBC

18/04/2020

Coronavirus: China outbreak city Wuhan raises death toll by 50%

Medical staff from Jilin Province (in red) hug nurses from Wuhan after the Covid-19 lockdown was lifted, 8 April 2020Image copyright GETTY IMAGES
Image caption The Chinese city of Wuhan recently lifted its strict quarantine measures

The Chinese city of Wuhan, where the coronavirus originated last year, has raised its official Covid-19 death toll by 50%, adding 1,290 fatalities.

Wuhan officials attributed the new figure to updated reporting and deaths outside hospitals. China has insisted there was no cover-up.

It has been accused of downplaying the severity of its virus outbreak.

Wuhan’s 11 million residents spent months in strict lockdown conditions, which have only recently been eased.

The latest official figures bring the death toll in the city in China’s central Hubei province to 3,869, increasing the national total to more than 4,600.

China has confirmed nearly 84,000 coronavirus infections, the seventh-highest globally, according to Johns Hopkins University data.

The virus has had a huge impact on the Chinese economy, which shrank for the first time in decades in the first quarter of the year.

What’s China’s explanation for the rise in deaths?

In a statement released on Friday, officials in Wuhan said the revised figures were the result of new data received from multiple sources, including records kept by funeral homes and prisons.

Deaths linked to the virus outside hospitals, such as people who died at home, had not previously been recorded.

Media caption Learn how Wuhan dealt with the lockdown

The “statistical verification” followed efforts by authorities to “ensure that information on the city’s Covid-19 epidemic is open, transparent and the data [is] accurate”, the statement said.

It added that health systems were initially overwhelmed and cases were “mistakenly reported” – in some instances counted more than once and in others missed entirely.

A shortage of testing capacity in the early stages meant that many infected patients were not accounted for, it said.

A spokesman for China’s National Health Commission, Mi Feng, said the new death count came from a “comprehensive review” of epidemic data.

In its daily news conference, the foreign ministry said accusations of a cover-up, which have been made most stridently on the world stage by US President Donald Trump, were unsubstantiated. “We’ll never allow any concealment,” a spokesman said.

Why are there concerns over China’s figures?

Friday’s revised figures come amid growing international concern that deaths in China have been under-reported. Questions have also been raised about Beijing’s handling of the epidemic, particularly in its early stages.

In December 2019, Chinese authorities launched an investigation into a mysterious viral pneumonia after cases began circulating in Wuhan.

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China reported the cases to the World Health Organization (WHO), the UN’s global health agency, on 31 December.

But WHO experts were only allowed to visit China and investigate the outbreak on 10 February, by which time the country had more than 40,000 cases.

The mayor of Wuhan has previously admitted there was a lack of action between the start of January – when about 100 cases had been confirmed – and 23 January, when city-wide restrictions were enacted.

Around that time, a doctor who tried to warn his colleagues about an outbreak of a Sars-like virus was silenced by the authorities. Dr Li Wenliang later died from Covid-19.


Analysis box by Stephen McDonell, China correspondent

Wuhan’s death toll increase of almost exactly 50% has left some analysts wondering if this is all a bit too neat.

For months questions have been asked about the veracity of China’s official coronavirus statistics.

The inference has been that some Chinese officials may have deliberately under-reported deaths and infections to give the impression that cities and towns were successfully managing the emergency.

If that was the case, Chinese officials were not to know just how bad this crisis would get in other countries, making its own figures now seem implausibly small.

The authorities in Wuhan, where the first cluster of this disease was reported, said there had been no deliberate misrepresentation of data, rather that a stabilisation in the emergency had allowed them time to revisit the reported cases and to add any previously missed.

That the new death toll was released at the same time as a press conference announcing a total collapse in China’s economic growth figures has led some to wonder whether this was a deliberate attempt to bury one or other of these stories.

Then again, it could also be a complete coincidence.


China has been pushing back against US suggestions that the coronavirus came from a laboratory studying infectious diseases in Wuhan, the BBC’s Barbara Plett Usher in Washington DC reports.

US President Donald Trump and some of his officials have been flirting with the outlier theory in the midst of a propaganda war with China over the origin and handling of the pandemic, our correspondent says.

Mr Trump this week halted funding for the World Health Organization (WHO), accusing it of making deadly mistakes and overly trusting China.

“Do you really believe those numbers in this vast country called China, and that they have a certain number of cases and a certain number of deaths; does anybody really believe that?” Mr Trump said at the White House on Wednesday.

French President Emmanuel Macron has also questioned China’s handling of the coronavirus outbreak, saying it was “naive” to suggest the country had dealt better with the crisis, adding things “happened that we don’t know about”.

On Thursday, UK Foreign Secretary Dominic Raab said: “We’ll have to ask the hard questions about how [coronavirus] came about and how it couldn’t have been stopped earlier.”

But China has also been praised for its handling of the crisis and the unprecedented restrictions that it instituted to slow the spread of the virus.

WHO Director General Dr Tedros Adhanom Ghebreyesus has hailed China for the “speed with which [it] detected the outbreak” and its “commitment to transparency”.

Source: The BBC

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