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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.
US now has world’s most coronavirus cases, surpassing China
Chia, who works at the Singapore General Hospital, said doctors had been split up according to their functions.
“We try not to meet at all with the other teams as much as possible. We’ll just say hi from across the corridor. Meals are the same. All our cafeterias and everything have got social distancing spaced in already,” said Chia, who is also a member of parliament and chairs a shadow committee on health.
Chia said the health care system could also tap on doctors in the private sector.
Not every country has a plan like this. Last year’s Global Health Security Index by the Economist Intelligence Unit found that 70 per cent of 195 countries scored poorly when it came to having a national plan for dealing with epidemics or pandemics. Almost three in 10 had failed to identify which areas were insufficiently staffed. In India, with a population of 1.3 billion, only about 20,000 doctors are trained in key areas such as critical care, emergency medicine and pulmonology.
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In contrast, Singapore published its first Influenza Pandemic Preparedness and Response Plan in June 2005 and has since honed it to a tee. Hospitals regularly war-game scenarios such as pandemics or terrorist attacks and the simulations are sometimes observed by the Ministry of Health, which grades the performance and recommends areas for improvement.
The plan also covers the need to stockpile equipment to avoid the sort of shortages many countries are now facing, another lesson inspired by Sars when masks, gloves and gowns were in short supply.
In a pandemic preparation paper published in 2008, Singapore public health specialist Jeffery Cutter wrote that Singapore’s stockpile was sufficient to cover at least 5 to 6 months’ use by all front-line health care workers.
During the Covid-19 outbreak, it has also told citizens to not wear masks so it can conserve supply for medical staff.
Having enough protective gear has reassured Singapore’s health care workers such as Kua, a mother of six who blogged about her experience fighting Covid-19. Kua said: “I’m safe and my family is safe.”
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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.” ■
Anyone caught breaking Singapore’s social distancing rules could be jailed from Friday, as the city state ramped up its coronavirus defence and announced the introduction of distance learning for schools.
Under updates to its powerful infectious diseases law, anyone who intentionally sits less than 1 metre away from another person in a public place or on a fixed seat demarcated as not to be occupied, or who stands in a queue less than a metre away from another, will be guilty of an offence.
Offenders can be fined up to S$10,000 (US$6,990), jailed for up to six months, or both. The rules, in place until April 30, can be applied to individuals and businesses.
The news was followed later by an announcement from the education ministry that starting from April, schools will start conducting one day of home-based learning for students per week.
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“The recent spike in imported cases signals a new phase in our nation’s fight against Covid-19. To support further safe distancing, schools will progressively transit to a blended learning model, starting with one day of home-based learning a week,” the ministry said in a statement.
It added schools will remain open for students whose parents are not able to secure alternative childcare arrangements.
Hundreds of thousands of students in Singapore returned to class on Monday after a week of school holidays, despite growing calls for schools to be closed.
Singapore is one of the few jurisdictions in the region that has yet to suspend schools, unlike Hong Kong, Thailand, Indonesia, and Malaysia.
Education Minister Ong Ye Kung had earlier cited scientific evidence, saying that the pneumonia-like Covid-19 illness does not affect the young as much as adults.
Authorities in the city state, however, have said that suspending schools and closing workplaces are among the next steps to be taken should the situation worsen. Singapore has confirmed 683 cases so far, of which 172 have recovered and two died.
Global condom shortage looms amid virus lockdowns
A global shortage of condoms is looming, the world’s biggest producer said, after a coronavirus lockdown forced it to shut down production.
Malaysia’s Karex makes one in every five condoms globally. It has not produced a single condom from its three Malaysian factories in the past 10 days because of the lockdown imposed by the government to halt the spread of the virus.
That’s already a shortfall of 100 million condoms, normally marketed internationally by brands such as Durex, supplied to state health care systems such as Britain’s NHS or distributed by aid programmes such as the UN Population Fund.
“We are going to see a global shortage of condoms everywhere, which is going to be scary,” Karex Chief Executive Goh Miah Kiat said this week.
“My concern is that for a lot of humanitarian programmes deep down in Africa, the shortage will not just be two weeks or a month. That shortage can run into months.”
The other major condom-producing countries are China, where the coronavirus led to widespread factory shutdowns, and India and Thailand, which are seeing infections spiking only now.
Goh said Karex was in the process of appealing to the government for an exemption to operate under specific conditions. Malaysia is approving other essential goods producers to operate with half of their workforce.
“The good thing is that the demand for condoms is still very strong because like it or not, it’s still an essential to have,” Goh said. “Given that at this point in time people are probably not planning to have children. It’s not the time, with so much uncertainty.”
China to ban most foreign arrivals
China has banned most foreigners from entering the country in an effort to block the spread of the coronavirus through imported cases.
With several exceptions, including transit visas and foreigners arriving via Hong Kong and Macau with short-term entry permits, entry visas issued to foreigners will be suspended as an “interim measure”, according to a statement late on Thursday by the country’s foreign ministry.
“In view of the rapid spread of the new coronavirus epidemic worldwide, China has decided to temporarily suspend entry of foreigners with currently valid visas and residence permits in China,” the ministry said.
“This is an interim measure that China has to take in order to respond to the current epidemic situation, with reference to the practice of many countries,” it added. “The Chinese side will adjust the above measures according to the epidemic situation through separate announcements.”
Pakistan aid workers lack basic kit
Pakistan’s biggest charity, famous for its emergency services for the poor, is kitting staff out in raincoats and rubber boots in the battle against the coronavirus as it can’t get hold of proper personal protective equipment, the organisation says.
Pakistan has reported the highest number of coronavirus infections in South Asia, with 1,179 cases and nine deaths, but health experts say there is a lack of public awareness about the virus and the cash-strapped government is ill-prepared to tackle it.
The Edhi Foundation has for decades stepped in to help when government services fail communities and it runs the country’s largest ambulance service.
Now it has had to train dozens of staff on how to handle suspected coronavirus patients. But providing them with proper protection is a problem given a nationwide shortage of the equipment.
“We’ve compromised on certain things and use alternatives,” Facial Edhi, head of the Edhi Foundation, said at his office in Karachi, Pakistan’s biggest city, on Thursday.
“Full aprons are in short supply in the market.”
He said he was confident the raincoats would work just as well.
South Korea pleads with residents to stay indoors
Authorities in South Korea pleaded with residents on Friday to stay indoors and avoid large gatherings as new coronavirus cases hovered close to 100 per day.
South Korea reported 91 new infections on Friday, taking the national tally to 9,332, the Korea Centres for Disease Control and Prevention said. The country has reported similar daily numbers for the past two weeks, down from a high of over 900 in late February.
The government has sought to convince a restless public that several more weeks of social distancing and self-isolation may be needed to allow health authorities to tamp down the smaller but still steady stream of new cases.
“As the weather is getting nicer, I know many of you may have plans to go outside,” said Yoon Tae-ho, director general for public health policy at the health ministry. “But social distancing cannot be successful when it’s only an individual, it needs to be the whole community.”
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Italy reports 662 new deaths, with uptick in new cases
Italy is reporting an uptick in new novel coronavirus infections, after four consecutive days in which new cases had decreased.
The country now has 62,013 active cases, a daily increase of 4,492, the Italian Civil Protection Agency said in its bulletin.
On Wednesday the daily variation was 3,491, on Tuesday 3,612, on Monday 3,780, on Sunday 3,957, and on Saturday a record 4,821.
There are also 662 new fatalities, bringing the total death toll to 8,165, while overall infections, including deaths and recoveries, have risen to 80,539, a daily increase of 8.3 per cent.
Recoveries are up by around 11 per cent to 10,361, while the number of intensive care patients – a closely watched figure given the shortage of hospital beds – has risen by 3.5 per cent, to 3,612.
Russia closes all restaurants nationwide
Russia is temporarily closing restaurants nationwide for a nine-day period starting on Saturday to prevent the spread of the coronavirus.
Restaurants will still be able to provide delivery services during that time, according to the decree by Prime Minister Mikhail Mishustin, published on his website on Friday.
Russia has reported more than 800 cases of coronavirus, predominantly in Moscow, which has seen at least two virus-related deaths. Mayor Sergei Sobyanin has warned that the actual number of cases is probably “significantly more”.
The country has already prohibited regular international flights, and imposed strict quarantine measures for anyone entering the country and anyone who could have been exposed to someone infected with the virus – though has not yet opted to impose lockdown measures like those seen elsewhere.
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First casualty in Kenya
Kenya has recorded its first coronavirus death as a rapid rise in confirmed cases puts Africa’s fragile health systems to the test.
Kenyan Health Cabinet Secretary Mutahi Kagwe said a 66-year-old Kenyan man died on Thursday afternoon despite treatment in an intensive care unit.
Kagwe said the man, who arrived into the country on March 13 from South Africa via Swaziland, was a diabetic. Also on Thursday, three women aged between 30 and 61 tested positive for Covid-19, the disease caused by the coronavirus, taking the country’s total to 31.
Kenya is the second country in East Africa and the 15th on the continent to confirm a coronavirus-related death. Algeria has the highest death toll in Africa with 25 fatalities, while Egypt has reported 24 and Morocco 11.
About a week ago, the continent of 54 countries had reported fewer than 300 cases. But by Friday Africa had 3,221 confirmed cases and 87 deaths. WHO regional director for Africa Matshidiso Moeti said on Thursday that the situation in Africa was “evolving very quickly in terms of geographic spread and the increasing number of cases”.
Australian military to enforce quarantine
The Australian military will help enforce the quarantine of travellers returning to the country, with the prime minister unveiling strict new measures and door-to-door checks on Friday to rein in the spread of Covid-19.
With some two-thirds of Australia’s 3,000 Covid-19 cases still linked to overseas travel, Scott Morrison said 14-day home quarantines would now be actively policed with the help of the military.
Thousands of citizens and residents are still arriving in Australia every day and there have been instances of return travellers repeatedly breaking a promise to stay at home.
Morrison said all returnees arriving after midnight Saturday would now be kept in hotels in the city of arrival for the duration of their quarantine.
Those already on Australian soil and under orders to self-quarantine for two weeks will face active checks, he said.
Quarantine measures will be getting “a lot tougher and a lot stricter,” Morrison said, adding the Australian Defence Force would “assist in the compliance with these arrangements.”
Afghanistan to release 10,000 prisoners
Afghanistan will release at least 10,000 prisoners over the age of 55 in an attempt to prevent the spread of the coronavirus, officials said on Thursday.
“The president has issued a decree that several thousand prisoners will be released soon due to coronavirus,” an official in President Ashraf Ghani’s office said.
Those released will not include members of Islamist militant groups the Taliban or Islamic State, and the process will be completed within 10 days, said two government officials.
Afghanistan has reported 91 cases of coronavirus and three deaths. The country’s western Herat province has recorded at least 54 of the 75 total cases reported in the last week.
International aid groups in recent weeks have raised concerns about the possibility of the coronavirus spreading in prisons across Afghanistan.
BEIJING, March 28 (Xinhua) — China has sent a team of medical experts to Pakistan to help the country fight the COVID-19 pandemic, Foreign Ministry spokesperson Geng Shuang announced Saturday.
The team, organized by the National Health Commission, consists of experts selected by the health commission of Xinjiang Uygur Autonomous Region, Geng said in a press statement.
The team left for Pakistan on Saturday afternoon, he said.
Image copyright EPAImage caption Wuhan has been sealed off since mid-January
The lockdown in Wuhan, the Chinese city where the global coronavirus outbreak began, will be partially lifted on 8 April, officials say.
Travel restrictions in the rest of Hubei province, where Wuhan is located, will be lifted from midnight on Tuesday – for residents who are healthy.
A single new case of the virus was reported in Wuhan on Tuesday following almost a week of no reported new cases.
Countries around the world have gone into lockdown or imposed severe curbs.
The UK is getting to grips with sweeping new measures to tackle the spread of coronavirus, including a ban on public gatherings of more than two people and the immediate closure of shops selling non-essential goods.
Image copyright AFPImage caption The WHO has urged the G20 group of nations to boost production of protective equipment
Meanwhile, health experts say Americans must limit their social interactions or the number of infections will overwhelm the health care system in the US.
Spanish soldiers helping to fight the coronavirus pandemic have found elderly patients in retirement homes abandoned and, in some cases, dead in their beds, the defence ministry has said.
An ice rink in Madrid is to be used as a temporary mortuary for Covid-19 victims.
The World Health Organization (WHO) has warned that the pandemic is accelerating, with more than 300,000 cases now confirmed. It is urging countries to adopt rigorous testing and contact-tracing strategies.
Wuhan has been shut off from the rest of the world since the middle of January. But officials now say anyone who has a “green” code on a widely used smartphone health app will be allowed to leave the city from 8 April.
Earlier, the authorities reported a new case of coronavirus in Wuhan, ending a five-day run of no reported new cases in the city.
Media caption Coronavirus: People in Beijing begin to head outdoors
It comes after health officials there confirmed that they were not counting cases of people who were positive but had not been admitted to hospital or did not show any symptoms of the disease.
Official government figures say there have been 78 new cases reported on the Chinese mainland in the last 24 hours. All but four of them were caused by infected travellers arriving from abroad.
This so-called “second wave” of imported infections is also affecting countries like South Korea and Singapore, which had been successful in stopping the spread of disease in recent weeks.
South Korea has been seeing a drop in its daily tally of new cases. On Tuesday it reported its lowest number since 29 February.
China looks to repair its reputation
By Robin Brant, BBC News, Shanghai
China considers itself to be – very nearly – a “post corona” country.
In the last week we’ve heard Wuhan medics warning the UK and others that they need to do more to protect frontline health workers, citing the mistakes they made early on when some treated patients without wearing proper protective clothing.
But there’s also been reporting in state media of the reported death toll in Italy surpassing that in China. This has been combined with some commentary from prominent media figures that has appeared distasteful, almost triumphalist.
At the same time there is a panic about the threat of a second wave from imported cases – travellers arriving from abroad. This has fuelled the view – right or wrong – that some other countries aren’t taking the threat seriously because they aren’t doing what China did. (Almost all the cases in Beijing that have been made public are of Chinese nationals returning home).
Meanwhile, well away from senior leaders, there are some high-profile diplomatic figures using international-facing social media to spread theories that the US may have weaponised and dumped the virus in China. Or that Italy had cases that may have been Covid-19 earlier than China. China is sowing seeds of doubt and questioning assumed truths as it looks to repair its reputation.
Almost all of India with its 1.3bn people is under lockdown. Buses, trains and other forms of public transport are suspended. On Monday, the authorities said domestic flights would also stopped. The country has reported 485 cases and nine people have died. Prime Minister Narendra Modi will address the nation again this evening.
Image copyright GETTY IMAGESImage caption Mumbai’s suburban train network carries eight million passengers a day
Neighbouring Pakistan has almost twice as many confirmed cases – 878 as of Monday evening. Sweeping restrictions are in place although the government has stopped short of imposing a nationwide lockdown. However, several provinces have announced them independently. The army is being brought in to help enforce the restrictions.
Bangladesh, which has reported 33 cases and three deaths, is also deploying its armed forces to help maintain social distancing and boost Covid-19 preventive measures. The soldiers will also monitor thousands of quarantined expatriate returnees. Across South Asia, there are concerns that the actual number of cases could be much higher than is being reported.
Indonesia, which has 49 confirmed Covid-19 deaths – the highest in South-East Asia – has converted an athlete’s village built for the 2018 Asian Games into a makeshift hospital for coronavirus patients. A state of emergency was declared in Jakarta on Monday.
In Thailand, a month-long state of emergency which will include curfews and checkpoints will begin on Thursday. The government has been criticised for failing to take strong action so far. Four people have died and nearly 900 tested positive.
Talks between the Japanese PM and the International Olympic Committee are expected this evening.
The most populous country that was without a case until now – Myanmar – has announced two cases.
Europe’s battle against virus intensifies
UK Prime Minister Boris Johnson announced on Monday night that, with immediate effect, “people will only be allowed to leave their home…for very limited purposes”. They include shopping for basic necessities, taking one form of exercise per day, fulfilling any medical need, or travelling to work if working from home is impossible.
Media caption Reality Check tackles misleading health advice being shared online
The number of people who have died in the UK rose to 335 on Monday.
In Italy, the worst-hit country in the world, the authorities said 602 people with Covid-19 had died in the past 24 hours, bringing the total death toll there to 6,077.
But the daily increase in cases was the smallest since Thursday, raising hope that the stringent restrictions imposed by the government were starting to have an effect.
Spain, however, said on Tuesday that its death toll had risen by 514 to 2,696. Nearly 40,000 are infected, about 5,400 of them healthcare workers.
But in Delhi and the financial capital, Mumbai, people fearing shortages quickly thronged shops and pharmacies.
“I have never witnessed such a chaos in my life,” the owner of one store in the Shakarpur district of Delhi said, quoted by the Press Trust of India.
“All our stocks, including rice, flour, bread, biscuits, edible oils, have been sold out.”
Police in the busy city of Ghaziabad, in Uttar Pradesh state, patrolled the streets with megaphones to tell residents to stay indoors.
Image copyright AFPImage caption People in Mumbai rushed to stock up on essentials following Mr Modi’s address
Under the new measures, all non-essential businesses will be closed but hospitals and other medical facilities will continue to function as normal. Schools and universities will remain shut and almost all public gatherings will be banned.
Anyone flouting the new rules faces up to two years in prison and heavy fines.
In his address, Prime Minister Modi also:
Stressed that the 21-day lockdown was “very necessary to break the chain of coronavirus”
Emphasised the seriousness of the situation and said that even developed countries had faced problems in combating it
Said that “social distancing was the only way to stop” the virus spreading
Announced that nearly $2bn (£1.8bn) would be made available to boost the country’s health infrastructure
Called on people not to “spread rumours” and to follow instructions
His announcement came after several Indian states introduced measures of their own, such as travel restrictions and the closure of non-essential services.
India has already issued a ban on international arrivals and grounded domestic flights. The country’s rail network has also suspended most passenger services.
Many parts of India, including cities such as Delhi and Mumbai, are already under tight restrictions. But this move extends those provisions to every corner of the country.
An earlier one-day curfew, which was seen as a trial, was flouted by many.
Mr Modi called on Indians to clap and cheer the emergency services from their balconies on Sunday. But many misunderstood the call and congregated in the streets as they danced and chanted.
“It’s impossible to fathom the cost that India may have to pay if such irresponsible behaviour continues,” Mr Modi warned at the time. “Social distancing is the only option to combat coronavirus.”
The implications of a total lockdown in India are huge, not just economically, but socially.
This is a nation where community is everything. Going to worship at a temple, mosque or church is an essential part of daily life for so many.
This is a seismic cultural shift but – like the rest of the world facing similar restrictions – a necessary one.
What’s the latest from around Asia?
Neighbouring Pakistan has almost twice as many confirmed cases – 878 as of Monday evening. Sweeping restrictions are in place although the government has stopped short of imposing a nationwide lockdown. However, several provinces have announced them independently. The army is being brought in to help enforce the restrictions
Bangladesh, which has reported 33 cases and three deaths, is also deploying its armed forces to help maintain social distancing and boost Covid-19 preventive measures. The soldiers will also monitor thousands of quarantined expatriate returnees. Across South Asia, there are concerns that the actual number of cases could be much higher than is being reported.
Indonesia, which has 49 confirmed Covid-19 deaths – the highest in South East Asia – has converted an athlete’s village built for the 2018 Asian Games into a makeshift hospital for coronavirus patients. A state of emergency was declared in Jakarta on Monday
In Thailand, a month-long state of emergency which will include curfews and checkpoints will begin on Thursday. The government has been criticised for failing to take strong action so far. Four people have died and nearly 900 tested positive
The most populous country that was without a case until now – Myanmar – has announced two cases
And what about the rest of the world?
Elsewhere, governments are continuing to work to stem the spread of the virus which has now affected more than 190 countries worldwide
More than 2.6 billion people are in lockdown now India has introduced its new measures, according to a tally by the AFP news agency
Media caption Reality Check tackles misleading health advice being shared online
Europe remains at the epicentre of the pandemic. On Tuesday, the death toll jumped by 514 in a single day in Spain and other European countries also reported sharp increases
Italy is the worst affected country in the world in terms of deaths. The virus has killed almost 7,000 people there over the past month
The World Health Organization (WHO) has warned that the US has the potential to become the new epicentre of the pandemic
In other developments, Japanese Prime Minister Shinzo Abe said the International Olympic Committee has agreed that the 2020 Tokyo Olympics should be postponed by a year
An insect-killing fungus has been turned into a mass-produced biopesticide that will face its biggest challenge in East Africa
Current swarm has put 13m people at risk of famine and this will be the first large-scale test of its effectiveness
Young locusts in Somalia, where the fungus will be used to try to kill them. Photo: AP
Chinese factories are producing thousands of tonnes of a “green zombie fungus” to help fight the swarms of locusts in East Africa.
Metarhizium is a genus of fungi with nearly 50 species – some genetically modified – that is used as a biological insecticide because its roots drill through the insects’ hard exoskeleton and gradually poisons them.
In China it was named lu jiang jun, which means green zombie fungus, because it gradually turns its victims in a green mossy lump.
There are now dozens of factories across the country dedicated to producing its spores and despite the curbs introduced to stop the spread of Covid-19, many of them have resumed operations and are shipping thousands of tonnes to Africa.
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These factories are set up in a similar way to breweries, growing the spores on rice which is kept in carefully controlled conditions to ensure the correct temperature and humidity.
Each plant can produce thousands of tonnes of fungi powder per year, each gram of which contains tens of billions of spores.
“I am sending off a truckload right now. Our stock is running out,” said the marketing manager of a production plant in Jiangxi province. “Some customers need it urgently. They need it to kill the locusts.”
The need is particularly pressing in East Africa at the moment, where abnormally high levels of rainfall during the dry season allowed hundreds of billions of locusts to hatch in recent months.
So far the swarms have devastated crops in countries such as Ethiopia, Kenya, Somalia and Uganda and are moving on to neighbouring countries.
Up to 13 million people face the risk of famine in East Africa. Photo: AFP
The UN’s Food and Agriculture Organisation (FAO) has warned the situation could be the “worst in decades” and the resulting famine may affect 13 million people and cause international food prices to soar.
Last week, Science magazine reported that the Somalian government, working with the FAO, was preparing to a metarhizium species that only kills locusts and grasshoppers in what it described as the largest ever use of biopesticides against the insects.
Scientists do not believe that the fungus will be enough to solve the problem – monitoring the outbreak and targeting their breeding grounds will be more important in the long-run – but if it proves effective it could be an important weapon to target future outbreaks.
It will take time to gauge the effectiveness, partly because each fungus will take several days to take effect and partly because of the sheer scale of the challenge; a single swarm in Kenya was estimated to contain between 100 billion and 200 billion locusts.
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The locusts have also swept eastward into the Middle East, travelling up to 150km (90 miles) a day, and are moving closer to China now that they have now reached some of its neighbours, including India and Pakistan.
At present China’s agriculture ministry believes some locusts may follow the monsoon into the country but “the chances of them causing damage is very small”.
Most scientists agree the swarms will not have lasting effect on food production but say developing countries can tap into China’s cutting-edge anti-locust technology.
Radar stations have been set up all the way along China’s western and southern borders to detect possible clouds of locusts, while unmanned devices lure the insects into traps to collect data about their species population and size.
A locust being eaten inside out by the metarhizium fungi. Photo: Chinese Academy of Sciences and the University of Maryland
The data is streamed to the ministry’s programme command, which is responsible for the planning and coordination of the national efforts to prevent an outbreak.
The scientists also said that planes loaded with biological and chemical sprays were standing by.
Today, most locust outbreaks happen in developing countries that do not have advanced monitoring networks and some of them are unable to produce pesticides on a mass scale, according to Li Hu, an associate professor with the China Agricultural University in Beijing.
The Chinese locust treatment technologies were highly advanced, and usually cheaper than competing solutions from the West, he said.
Chinese researchers are now working with colleagues in other countries to help them solve the problem.
One disadvantage of the Chinese research is that it is mostly focused on local species, or the East Asia migratory locust. The desert locusts currently swarming East Africa have different genes and behaviour, and Li warned that some methods that work in China might not work elsewhere.
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There were some sightings of the species reported in Yunnan and Tibet in the past, but they did not build up to large colonies, Professor Kang Le, lead scientist of the locust research programme with the Institute of Zoology at the Chinese Academy of Sciences in Beijing, told China Science Daily last week.
The vast west China region of Xinjiang, which shares a border with eight countries, is currently too cold for a locust migration, but once temperatures start to rise in the spring it could see locusts swarming across the border with Afghanistan.
Shi Wangpeng, a senior government locust expert, told China Business Network on Sunday that China should be on high alert because many Afghan farms had already been affected.
“These areas share a long border with us, there are almost no barriers,” he was quoted as saying by the Shanghai-based magazine.
China has a long and bitter history of locust swarms, with more than 840 being recorded in the official records over the past 2,700 years.
One famine, in the year 628 was so devastating that even the Tang dynasty emperor Taizong was reported to have run short of food and resorted to eating the insects to survive.
China has a long and bitter history of locust swarms. Photo: AFP
This, in turn, means that China’s rulers have long been looking for innovative ways to solve the problem
In the past farmers tried remedies such as building huge fires, burying the insects in ditches or trying to kill them with sticks.
In one campaign organised by prime minister Yao Chong in 715, the farms collected 9 million sacks of dead locusts and managed to save a significant proportion of their crops, according to historic text.
In more recent times more sophisticated technologies have been deployed to tackle the menace.
Some researchers have spent decades chasing locust colonies and studying their individual and collective behaviour everywhere from coastal areas to inland deserts, and in 2014 Chinese scientists released the world’s most comprehensive genetic map of locusts.
Researchers have also developed chemical agents that can disorient swarms of locusts and disperse them.
Chinese scientists first became interested in the green zombie’s potential in the 1980s after discovering that South Pacific islanders had been using them to kill insects on coconut trees.
Research by US scientists confirmed its effectiveness in the 1990s and the Chinese started importing the fungus from the United States and Britain.
Their experiments led to the development of newer and deadlier strains and mass production started in the past decade.
Other fungi or bacteria can be used to fight locusts, and some laboratories are working with agricultural technology companies to modify their genes to turn them into more deadly or precise killers.
One genetically engineered species of microsporidia, another type of insect-killing fungus, for instance, can generate three times as many as the spores to those produced by nature species, according to a document from the China Association of Agricultural Science Societies last year.
While it remains to be seen whether the current swarms will reach China, these treatments have been effective in the past and there has not been a locust outbreak in China for a decade.
In the Chinese city of Wuhan, where the virus emerged, the authorities earlier announced that some non-residents would be allowed to leave if they showed no symptoms of the virus.
However, local officials now say that order was made without authorisation and has been revoked.
The city has been in lockdown since January 23, with authorities cutting off transport links in and out of the city.
More than 2,500 people have died from the virus in mainland China, with some 77,150 cases confirmed cases reported.
Image copyright AFPImage caption A worker sprays disinfectant to help prevent the spread of the novel coronavirus at a market in Seoul
What is the situation in North Korea?
North Korea has not confirmed any cases but the country shares a long and often porous border with China. There are concerns that North Korea, which is subject to international sanctions, lacks the health infrastructure to test and treat those infected and that any outbreak could quickly spread unchecked.
At the moment, all foreigners coming into the country must be quarantined for 30 days.
There are relatively few foreigners in North Korea, and only around 200 Westerners, according to one expert.
North Korean authorities have also cancelled the annual Pyongyang marathon, which typically sees people from all over the world participating.
Around 3,000 people in North Pyongan province – a north-western region bordering China – are also now under monitoring for reportedly showing suspected symptoms, said state media.
What about South Korea?
Media caption People in Daegu have voiced concern over the spread of the virus
South Korea has the largest number of confirmed cases outside China, after a huge spike in the past week.
Before last Wednesday, the country had recorded just 31 cases. That number has now jumped to 763.
Eight new cases of the virus have been reported in the army, and one in the navy, air force and marine corps – bringing the number to 11.
But the biggest virus clusters have been linked to a hospital and a religious group near the south-eastern city of Daegu.
A handful of South Korea airlines, including Korean Air Lines – the country’s biggest airline – has suspended flights going to Daegu, which has a population of around 2.5m.
Korean Air says the suspension will last until March 27
What’s happening in Italy?
Italian officials have introduced sweeping measures to control what is now the worst outbreak of the coronavirus in Europe – at least three people have died and more than 150 cases confirmed.
In the regions of Lombardy and Veneto, a lock-down is in place in several small towns. For the next two weeks, 50,000 residents will not be able to leave without special permission.
Even outside the zone, many businesses and schools have suspended activities, and sporting events have been cancelled – including several top-flight football matches.
Officials have yet to find the first carrier of the virus in the country.
World edges closer to coronavirus pandemic
Analysis by Fergus Walsh, medical correspondent
The combined situation in South Korea, Iran and Italy points to the early stages of pandemic. This means a global outbreak, with the coronavirus spreading in the community in multiple parts of the world.
In each of these countries we are seeing spread of the virus with no connection to China. The lockdown efforts in Italy mirror those that have happened in China.
The situation in Iran is especially worrying, because the health authorities have reportedly said the virus has spread to multiple cities, and it appears the first case in Lebanon is linked to a traveller from Iran.
If we have a pandemic, it will still be important to limit the speed of spread of the virus.
If countries could hold it somewhat at bay until the end of winter, there is a hope that warmer temperatures will reduce the time the virus can survive in the air, as we see with seasonal flu. But this may not be certain.
What’s the latest from Iran?
Iran said on Sunday it had 43 confirmed cases of the virus, most of them in the holy city of Qom. Eight of those infected have died, the highest number of deaths outside China.
Iraq, Pakistan, Armenia and Turkey have closed their borders with Iran, and Afghanistan has suspended air and road travel to and from Iran.
What about China, where the outbreak started?
China’s President Xi Jinping has described the outbreak as the “largest public health emergency” in the country’s recent history.
Speaking on Sunday, he acknowledged “shortcomings” in China’s response and said lessons must be learned.
China reported 409 new infections on Monday, the bulk of which were from Wuhan.
But outside China, cases with no clear link to that country or other confirmed cases continue to rise, prompting concern from the World Health Organization (WHO).
BEIJING/SEOUL (Reuters) – Italy, South Korea and Iran reported sharp rises in coronavirus infections on Monday, triggering concern from the World Health Organization (WHO), but China relaxed some curbs on movement, including in Beijing, as the rate of new infections there eased.
The virus has put Chinese cities into lockdown, disrupted air traffic to the workshop of the world and blocked global supply chains for everything from cars and car parts to smartphones.
The surge of cases outside mainland China triggered steep falls in global share markets and Wall Street stock futures as investors fled to safe havens. Gold soared to a seven-year high, oil tumbled nearly 4% and the Korean won KRW= fell to its lowest level since August.[MKTS/GLOB]
But U.S. Treasury Secretary Steven Mnuchin cautioned against jumping to conclusions about the impact on the global economy or supply chains, saying it was simply too soon to know.
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The World Health Organization (WHO) said it no longer had a process for declaring a pandemic, but that the coronavirus outbreak remained an international emergency.
“We are specially concerned about the rapid increase in cases in … Iran, Italy and the Republic of Korea,” WHO head Tedros Adhanom Ghebreyesus told a news conference in Sweden via video link from Geneva.
South Korea reported 231 new cases, taking its total to 833. Many are in its fourth-largest city, Daegu, which became more isolated with Asiana Airlines (020560.KS) and Korean Air (003490.KS) suspending flights there until next month.
Iran, which announced its first two cases last Wednesday, said it had confirmed 43 cases and eight deaths. Most of the infections were in the Shi’ite Muslim holy city of Qom.
Elsewhere in the Middle East, Bahrain and Iraq reported their first cases and Kuwait reported three cases involving people who had been in Iran.
Saudi Arabia, Kuwait, Iraq, Turkey, Pakistan and Afghanistan imposed restrictions on travel and immigration from Iran. Afghanistan also reported its first case, officials said.
The WHO has been saying for weeks that it dreads the disease reaching countries with weak health systems.
Europe’s biggest outbreak is in Italy, with some 150 infections – compared with just three before Friday – and a fifth death.
‘SEVERE AND COMPLEX’
Scientists around the world are scrambling to analyze the virus, but a vaccine is probably more than a year away.
“Worryingly, it seems that the virus can pass from person to person without symptoms, making it extremely difficult to track, regardless of what health authorities do,” said Simon Clarke, an expert in cellular microbiology at the University of Reading in Britain.
China postponed the annual meeting of its parliament in Beijing.
But there was a measure of relief for the world’s second-largest economy as more than 20 province-level jurisdictions, including Beijing and Shanghai, reported zero new infections, the best showing since the outbreak began.
President Xi Jinping urged businesses to get back to work, though he said the epidemic was still “severe and complex, and prevention and control work is in the most difficult and critical stage”.
Excluding the central Hubei province, center of the outbreak, mainland China reported 11 new cases, the lowest since the national health authority started publishing nationwide daily figures on Jan. 20.
The coronavirus has infected nearly 77,000 people and killed more than 2,500 in China, most in Hubei.
Overall, China reported 409 new cases on the mainland, down from 648 a day earlier, taking the total number of infections to 77,150 cases as of Feb. 23. The death toll rose by 150 to 2,592.
Outside mainland China, the outbreak has spread to about 29 countries and territories, with a death toll of about two dozen, according to a Reuters tally.
Xi said on Sunday the outbreak would have a relatively big, but short-term, impact on the economy and the government would step up policy adjustments to help cushion the blow.
Mnuchin, speaking to Reuters in the Saudi city of Riyadh, said he did not expect the coronavirus to have a material impact on the Phase 1 U.S.-China trade deal.
“Obviously that could change as the situation develops,” he added.
In northern Italy, authorities sealed off the worst-affected towns and banned public gatherings across a wide area, halting the carnival in Venice, where there were two cases.
Austria briefly suspended train services over the Alps from Italy after two travelers coming from Italy showed symptoms of fever.
Both tested negative for the new coronavirus but Austrian Interior Minister Karl Nehammer said a task force would meet on Monday to discuss whether to introduce border controls.
Japan had 773 cases as of late Sunday, mostly on a cruise ship quarantined near Tokyo. A third passenger, a Japanese man in his 80s, died on Sunday.
In South Korea, authorities reported a seventh death and dozens more cases on Monday. Of the new cases, 115 were linked to a church in the city of Daegu.
Drone footage showed what appeared to be hundreds of people queuing in a neat line outside a Daegu supermarket under the winter sunshine to buy face masks. ( tmsnrt.rs/37WP6lA )
Image copyright GETTY IMAGESImage caption Mr Trump is making his first official visit to India
US President Donald Trump is expecting a raucous welcome on his first official state visit to India on Monday and Tuesday.
He follows a long line of leaders who have made the journey. Some of his predecessors were greeted enthusiastically; others stumbled through diplomatic gaffes; one even had a village named after him.
Can history be a guide to how this diplomatic tryst might go? Here’s a brief look at past visits, ranked in order of how they went.
The good: President Eisenhower
Let’s begin at the beginning.
Dwight D Eisenhower, the first US president to visit India, was greeted with a 21-gun salute when he landed in the national capital, Delhi, in December 1959. Huge crowds lined the streets to catch a glimpse of the World War Two hero in his open-top car – Mr Trump is expecting a similar reception in Ahmedabad city, where he will be doing a road show.
Image copyright US EMBASSY ARCHIVESImage caption Dwight D Eisenhower, pictured with Prime Minister Jawaharlal Nehru, was the first US president to make the trip
The warmth between President Eisenhower and Indian Prime Minister Jawaharlal Nehru helped during what was a rocky phase in US-India ties. This was early in the Cold war, when the US and Pakistan had become become close allies, and India insisted on staying neutral or “non-aligned”. Like today, relations with China were at the core of the India-US equation, with Washington pressuring Delhi to take an aggressive stance with Beijing on the issue of Tibet.
But, on the whole, Eisenhower’s four-day trip was billed a success. And nearly every US president on a state visit to India has emulated his itinerary: he laid flowers at Mahatma Gandhi’s memorial, took in the splendour of the Taj Mahal, addressed parliament and spoke at Delhi’s iconic Ramlila grounds, which, according to one news report, attracted one million people.
When he left, Nehru said he had taken with him “a piece of our heart”.
Image copyright US EMBASSY ARCHIVESImage caption President Eisenhower was greeted by large crowdsThe game-changer: Bill Clinton
If there was a game-changing visit, it would be Bill Clinton’s in March 2000 with Prime Minister Atal Bihari Vajpayee. Mr Clinton’s arrival came after a two-decade lull – neither Ronald Reagan nor George Bush Snr made the journey East. It came at a tricky time as Washington had imposed sanctions on Delhi following its 1999 test of a nuclear bomb.
But, according to Navtej Sarna, a former Indian Ambassador to the US, the five-day trip was “a joyous visit”. It included stops in Hyderabad, a southern city that was emerging as a tech hub, and Mumbai, India’s financial capital. “He came and saw the economic and cyber potential of India, and democracy in action,” says Mr Sarna.
Image copyright GETTY IMAGESImage caption Bill Clinton’s visit was described as “joyous”Mr Clinton also danced with villagers, took a tiger safari and sampled Delhi’s famously creamy black dal (lentils) at a luxury hotel that has since been associated with the president.
The country’s reaction is perhaps best expressed in this New York Times headline: “Clinton fever – a delighted India has all the symptoms.”
The nuclear deal: George W Bush
George W Bush, as Forbes magazine once put it, was the “best US president India’s ever had”. His three-day visit in March 2006 was a highlight in the two countries’ strategic relationship – especially in matters of trade and nuclear technology, subjects they have long wrangled over. His strong personal dynamic with Prime Minister Manmohan Singh was hard to miss – after he left office, Mr Bush, a keen artist, even painted a portrait of Mr Singh.
The two leaders are credited for a historic but controversial nuclear deal, which was signed during Mr Bush’s visit. It brought India, which had for decades refused to sign the Nuclear Non-Proliferation Treaty (NPT), out of isolation. Energy-hungry India got access to US civil nuclear technology in exchange for opening its nuclear facilities to inspection.
Image copyright US EMBASSY ARCHIVESImage caption George W Bush and Manmohan Singh had a very good relationshipHowever, while the visit was substantive, it was not as spectacular as others – there was no trip to the Taj, nor an address to parliament. But the timing was important. Anti-US sentiment over the invasion of Iraq was running high – left-wing MPs had staged a protest against Mr Bush’s visit, and there were demonstrations in other parts of India.
Double visit: Barack Obama
Barack Obama was the only president to make two official visits. First, in 2010 with Prime Minister Manmohan Singh, and then in 2015 with Prime Minister Narendra Modi.
On his first visit – in a break from the past – he landed in Mumbai, instead of Delhi, with a large trade delegation. This was not just about economic ties but a show of solidarity following the Mumbai terror attacks of 2008, which killed 166 people. Mr and Mrs Obama even stayed at the Taj Mahal hotel, one of the main targets.
It was significant that the US president declared support for India to join a reformed and expanded UN Security Council, says Alyssa Ayres, a former US deputy assistant secretary of state for South Asia. “That all these years later nothing has changed in the UN system is another matter, but that was a major policy shift for the United States.”
Image copyright US EMBASSY ARCHIVESImage caption Barack Obama visited India twiceMr Obama returned in 2015 as chief guest at India’s Republic Day celebrations, at PM Modi’s invitation. Trade, defence and climate change were at the heart of the talks. The trip also emphasised an Indo-Pacific strategy, where both leaders expressed unease over Beijing’s provocations in the South China Sea.
The not-so-good: Jimmy Carter
Although Jimmy Carter’s two-day visit in 1978 was a thaw in India-US relations, it was not free of hiccups.
With some 500 reporters in tow, Carter followed a packed itinerary: he met Prime Minister Morarji Desai, addressed a joint session of parliament, went to the Taj Mahal, and dropped by a village just outside Delhi.
The village, Chuma Kheragaon, had a personal connection: Carter’s mother, Lillian, had visited here when she was in India as a member of the Peace Corps in the late 1960s. So when Carter and his wife, Rosalynn, made the trip, they gave the village money and its first television set. It was even renamed “Carterpuri”, a moniker it still holds.
Image copyright US EMBASSY ARCHIVESImage caption Jimmy Carter being greeted by villagers of ‘Carterpuri’But beyond the photo-ops, India and the US were sparring. India was building its nuclear programme, and had conducted its first test in 1974. The US wanted India to sign the NPF, which sought to stop the spread of nuclear weapons. But India refused, saying the agreement discriminated against developing countries.
In a leaked conversation that made headlines and threatened to derail the visit, Mr Carter promised his Secretary of State, Cyrus Vance, a “very cold and very blunt” letter to Desai. The two leaders signed a declaration, promising greater global co-operation, but Carter left India without the assurances he had hoped for.
The ugly: Richard Nixon
Richard Nixon was no stranger to India when he arrived in August 1969 for a day-long state visit. He had been here as vice-president in 1953, and before that on personal trips. But, by all accounts, he wasn’t a fan.
“Nixon disliked Indians in general and despised [Prime Minister] Indira Gandhi,” according to Gary Bass, author of Blood Telegram: Nixon, Kissinger and a Forgotten Genocide. And, he adds, the feeling was said to be mutual.
This was also at the height of the Cold War, and India’s non-alignment policy “appalled” American presidents. Mr Bass says that under Gandhi, India’s neutrality had turned into a “noticeably pro-Soviet foreign policy”.
Image copyright GETTY IMAGESImage caption Richard Nixon waves to the crowds alongside Mohammad Hidyatullah, India’s acting presidentThe relationship only turned frostier after the trip as India backed Bangladesh (then East Pakistan) in its fight for independence from Pakistan, a close American ally. The differences were laid bare when Gandhi visited the White House in 1971. Declassified state department cables later revealed that Nixon referred to her as an “old witch”.
And the future: Donald Trump
The US and India have certainly had their ups and downs, but during the last official visit in 2015, Mr Obama and Mr Modi signed a declaration of friendship: “Chalein saath saath (Let’s move forward together)…” it began.
President Trump’s visit will take the relationship forward, but it’s unclear how.
Image copyright AFP
His arrival in Ahmedabad, the main city in PM Modi’s home state of Gujarat, followed by a big arena event, is expected to draw a massive crowd. It will echo President Eisenhower’s rally in Delhi years ago, perhaps cementing the personal ties between the two leaders.
But while Mr Trump’s trip will be packed with pageantry, it could be light on policy. Unlike other presidential visits, this one is not expected to yield concrete agreements, with the trade deal Mr Trump so badly wants looking unlikely.
Image copyright ANIImage caption Ms Leona was charged with sedition at a protest event in Bangalore city
An Indian woman has been arrested and charged with sedition for chanting “long live Pakistan” at a protest in the southern city of Bangalore.
Amulya Leona was participating in a demonstration against a controversial citizenship law, which critics say discriminates against Muslims.
Her comments were immediately condemned by a prominent local Muslim politician.
Asaduddin Owaisi, who was at the rally, said neither he nor his party supported India’s “enemy nation Pakistan”.
Muslim politicians in Hindu-majority India are often targeted as being “pro-Pakistan” by political rivals, particularly in the last few years. The neighbouring countries have a historically tense relationship, fighting three wars since Pakistan’s formation following the partition of India in 1947.
After the incident at the protest against the Citizenship Amendment Act (CAA) went viral, Ms Leona and her family were the target of massive outrage.
Clips of her comment were circulated widely, and her father has complained that a group of people came to his house and forced him to chant “hail mother India”. They also told him that he had not brought his daughter up properly and threatened him against getting bail for her.
Police in the district told BBC Hindi that they are investigating his complaint, adding that Ms Leona would be produced before a judicial magistrate in 14 days.
What is the CAA?
The law offers amnesty to non-Muslim illegal immigrants from three countries – Pakistan, Bangladesh and Afghanistan.
It amends India’s 64-year-old citizenship law, which currently prohibits illegal migrants from becoming Indian citizens.
Media caption Anti-citizenship law protests spread across Indian cities
It also expedites the path to Indian citizenship for members of six religious minority communities – Hindu, Sikh, Buddhist, Jain, Parsi and Christian – if they can prove that they are from Muslim-majority Pakistan, Afghanistan or Bangladesh. They will now only have to live or work in India for six years – instead of 11 years – before becoming eligible to apply for citizenship.
The government says this will give sanctuary to people fleeing religious persecution, but critics argue that it will marginalise India’s Muslim minority.
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