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’.
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Image copyright GETTY IMAGESImage caption India has an estimated 48,000 ventilators and most of them are already in use
In an 8,000 sq ft (743 sq m) facility in the western Indian city of Pune, a bunch of young engineers are racing against time to develop a low-cost ventilator that could save thousands of lives if the coronavirus pandemic overwhelms the country’s hospitals.
These engineers – from some of India’s top engineering schools – belong to a barely two-year-old start-up which makes water-less robots that clean solar plants.
Last year, Nocca Robotics had a modest turnover of 2.7 million rupees ($36,000; £29,000). The average age of the mechanical, electronic and aerospace engineers who work for the firm is 26.
India, by most estimates, only has 48,000 ventilators. Nobody quite knows how many of these breathing assistance machines are working. But it is a fair assumption that all those available are being used in intensive care units on existing patients with other diseases.
About one in six people with Covid-19 gets seriously ill, which can include breathing difficulties. The country faces seeing its hospitals hobbled as others around the world have been, with doctors forced to choose who they try to save.
At least two Indian companies make ventilators at present, mostly from imported components. They cost around 150,000 ($1,987; £1,612) rupees each. One of them, AgVa Healthcare, plans to make 20,000 in a month’s time. India has also ordered 10,000 from China, but that will meet just a fraction of the potential demand.
The invasive ventilator being developed by the engineers at Nocca Robotics will cost 50,000 rupees ($662). Within five days of beginning work, a group of seven engineers at the start-up have three prototypes of a portable machine ready.
They are being tested on artificial lungs, a prosthetic device that provides oxygen and removes carbon dioxide from the blood. By 7 April, they plan to be ready with machines that can be tested on patients after approvals.
Image copyright GETTY IMAGESImage caption India is beefing up isolation beds in hospitals
“It is most certainly doable,” said Dr Deepak Padmanabhan, a cardiologist at Bangalore’s Jayadeva Institute of Cardiovascular Sciences and Research, and a key advisor on this project. “The simulations on artificial lungs have been done and seem to work well.”
Inspiring story
The race to develop this inexpensive, home-grown invasive breathing machine is an inspiring story of swift coordination and speedy action involving public and private institutions, something not common in India.
“The pandemic has brought us all together in ways I could never imagine,” says Amitabha Bandyopadhyay, a professor of biological sciences and bioengineering at Indian Institute of Technology (IIT), Kanpur, and a key mover of the project.
The young engineers mined open source medical supplies groups on the internet to find information on how to make the ventilators. After securing permissions, it took them exactly eight hours to produce the first prototype. Of particular use, say doctors, were some designs by engineers at MIT. With imports stalled, the engineers picked up pressure sensors – a key component of the machine that helps supply oxygen to lungs at a pressure that doesn’t cause injury – from those used in drones and available in the market.
Image copyright AFPImage caption India needs thousands of ventilators to cope with a possible rush of patients
Local authorities helped open firms that stock components – each machine needs 150 to 200 parts – and made sure that a bunch of engineers who had returned home to Nanded after the lockdown were still able to travel 400km (248 miles) back to Pune to work on the machine.
Some leading Indian industrialists, including a major medical device-making company, have offered their factories to manufacture the machines. The plan is to make 30,000 ventilators, at around 150-200 a day, by the middle of May.
Social media influencers joined the effort. Rahul Raj, a lithium battery-maker and an IIT alumnus, crowd-sourced a group called Caring Indians to “pool resources and experience” to cope with the pandemic. Within 24 hours, 1,000 people had signed up. “We tweeted to the local lawmaker and local police in Pune to help the developers, and made contacts with people who would be interested in the project,” Mr Raj said.
‘No-frills machine’
Expat Indian doctors and entrepreneurs who went to the same school – IIT is India’s leading engineering school and alumni include Google chief Sundar Pichai – held Zoom meetings with the young developers, advising them and asking questions about the machine’s development. The head of a US-based company gave them a 90-minute lecture on how to manage production. A former chief of an info-tech company told them how to source the components.
Lastly, a bunch of doctors vetted every development and asked hard questions. In the end, more than a dozen top professionals – pulmonologists, cardiologists, scientists, innovators, venture capitalists – have guided the young team.
Doctors say the goal is to develop a “no-frills” breathing machine tailored to Indian conditions.
Ventilators depend on pressurised oxygen supply from hospital plants. But in a country where piped oxygen is not available in many small towns and villages, developers are seeing whether they can also make the machine run on oxygen cylinders. “In a way we are trying to de-modernise the machine to what it was barely 20 years ago,” says Dr Padmanabhan.
“We are not experienced. But we are very good at making products easily. The robots that we make are much more complex to make. But this is a life-saving machine and carries risk, so we have to be very, very careful that we develop a perfect product which clears all approvals,” said Nikhil Kurele, the 26-year-old co-founder and chief executive officer of Nocca Robotics.
In just a week’s time, India will learn whether they pulled off the feat.
WUHAN, China (Reuters) – China reported a drop in new coronavirus infections for a fourth day as drastic curbs on international travellers reined in the number of imported cases, while policymakers turned their efforts to healing the world’s second-largest economy.
The city of Wuhan, at the centre of the outbreak, reported no new cases for a sixth day, as businesses reopened and residents set about reclaiming a more normal life after a lockdown for almost two months.
Smartly turned out staff waited in masks and gloves to greet customers at entrances to the newly-reopened Wuhan International Plaza, home to boutiques of luxury brands such as Cartier and Louis Vuitton.
“The Wuhan International Plaza is very representative (of the city),” said Zhang Yu, 29. “So its reopening really makes me feel this city is coming back to life.”
Sunday’s figure of 31 new cases, including one locally transmitted infection, was down from 45 the previous day, the National Health Commission said.
As infections fall, policymakers are scrambling to revitalise an economy nearly paralysed by months-long curbs to control the spread of the flu-like disease.
On Monday, the central bank unexpectedly cut the interest rate on reverse repurchase agreements by 20 basis points, the largest in nearly five years.
The government is pushing businesses and factories to reopen, as it rolls out fiscal and monetary stimulus to spur recovery from what is feared to be an outright economic contraction in the quarter to March.
China’s exports and imports could worsen as the pandemic spreads, depressing demand both at home and abroad, Xin Guobin, the vice minister of industry and information technology, said on Monday.
The country has extended loans of 200 billion yuan (22.75 billion pounds) to 5,000 businesses, from 300 billion allocated to help companies as they resume work, Xin said.
Authorities in Ningbo said they would encourage national banks to offer preferential credit of up to 100 billion yuan to the eastern port city’s larger export firms. The city government will subsidize such loans, it said in a notice.
VIRUS CONCERNS
While new infections have fallen sharply from February’s peak, authorities worry about a second wave triggered by returning Chinese, many of them students.
China cut international flights massively from Sunday for an indefinite period, after it began denying entry to almost all foreigners a day earlier.
Average daily arrivals at airports this week are expected to be about 4,000, down from 25,000 last week, an official of the Civil Aviation Administration of China told a news conference in Beijing on Monday.
The return to work has also prompted concern about potential domestic infections, especially over carriers who exhibit no, or very mild, symptoms of the highly contagious virus.
Northwestern Gansu province reported a new case of a traveller from the central province of Hubei, who drove back with a virus-free health code, national health authorities said.
Hubei authorities say 4.6 million people in the province returned to work by Saturday, with 2.8 million of them heading for other parts of China.
Most of the departing migrant workers went to the southern provinces of Guangdong and Fujian, the eastern provinces of Zhejiang and Jiangsu, and northeast China.
In Hubei’s capital of Wuhan, more retail complexes and shopping streets reopened.
Electric carmaker Tesla Inc has also reopened a showroom in Wuhan, a company executive said on Weibo.
Shoppers queued 1-1/2 metres (5 ft) apart for temperature checks at Wuhan International Plaza, while flashing “green” mobile telephone codes attesting to a clean bill of health.
To be cleared to resume work, Wuhan residents have been asked to take nucleic acid tests twice.
“Being able to be healthy and leave the house, and meet other colleagues who are also healthy is a very happy thing,” said Wang Xueman, a cosmetics sales representative.
BEIJING/SHANGHAI (Reuters) – Chinese President Xi Jinping told U.S. President Donald Trump during a phone call on Friday that he would have China’s support in fighting the coronavirus, as the United States faces the prospect of becoming the next global epicentre of the pandemic.
The United States now has the most coronavirus cases of any country, with 84,946 infections and 1,259 deaths. Hospitals in cities like New York and New Orleans struggle to cope with the wave of patients.
Xi’s offer of assistance came amid a long-running war of words between Beijing and Washington over various issues including the coronavirus epidemic.
Trump and some U.S. officials have accused China of a lack of transparency on the virus, and Trump has at times called the coronavirus a “China virus” as it originated there, angering Beijing.
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In the call, Xi reiterated to Trump that China had been open and transparent about the epidemic, according to an account of the conversation published by the Chinese foreign ministry.
Trump said on Twitter that he discussed the coronavirus outbreak “in great detail” with Xi.
“China has been through much & has developed a strong understanding of the virus,” Trump said. “We are working closely together. Much respect!”.
The World Health Organization has said the United States, which saw 17,099 new coronavirus cases and 281 deaths in the past 24 hours, is expected to become the epicentre of the pandemic.
CHINA CUTS FLIGHTS
Like U.S. hospitals now, China’s medical system struggled to contain the coronavirus just two months ago, but draconian city lockdowns and severe travel restrictions has seen China dramatically ease the epidemic.
Mainland China on Friday reported its first local coronavirus case in three days and 54 new imported cases, as Beijing ordered airlines to sharply cut international flights, for fear travellers could reignite the coronavirus outbreak.
The 55 new cases detected on Thursday were down from 67 a day earlier, the National Health Commission said on Friday, taking the tally of infections to 81,340. China’s death toll stood at 3,292 as of Thursday, up by five from a day earlier.
The central province of Hubei, with a population of about 60 million, reported no new cases on Thursday, a day after lifting a lockdown and reopening its borders as the epidemic eased there.
The commercial capital of Shanghai reported the most new imported cases with 17, followed by 12 in the southern province of Guangdong and four each in the capital Beijing and the nearby city of Tianjin.
Shanghai now has 125 patients who arrived from overseas, including 46 from Britain and 27 from the United States.
In effect from Sunday, China has ordered its airlines to fly only one route to any country, on just one flight each week. Foreign airlines must comply with similar curbs on flights to China, although many had already halted services.
About 90% of current international flights into China will be suspended, cutting arrivals to 5,000 passengers a day, from 25,000, the civil aviation regulator said late on Thursday.
From Saturday, China will temporarily suspend entry for foreigners with valid visas and residence permits, in an interim measure, the foreign ministry added.
Before the new curbs, foreign nationals made up about a tenth of the roughly 20,000 travellers arriving on international flights every day, an official of China’s National Immigration Administration said last week.
As commercial flights dwindle, Chinese students from wealthy families are paying tens of thousands of dollars to fly home on private jets.
International demand for chartered and private flights into China increased 227% in March from a year earlier, said Shanghai-based private jet service provider iFlyPlus.
Notably, requests for flights from the United States to China rose 10-fold in late March, iFlyPlus told Reuters.
NEW YORK (Reuters) – The number of U.S. coronavirus infections climbed above 82,000 on Thursday, surpassing the national tallies of China and Italy, as New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages of supplies, staff and sick beds.
With medical facilities running low on ventilators and protective masks and hampered by limited diagnostic testing capacity, the U.S. death toll from COVID-19, the respiratory disease caused by the virus, rose beyond 1,200.
“Any scenario that is realistic will overwhelm the capacity of the healthcare system,” New York Governor Andrew Cuomo told a news conference. He described the state’s projected shortfall in ventilators – machines that support the respiration of people have cannot breathe on their own – as “astronomical.”
“It’s not like they have them sitting in the warehouse,” Cuomo added. “There is no stockpile available.”
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At least one New York City hospital, New York-Presbyterian/Columbia University Medical Center in Manhattan, has begun a trial of sharing single ventilators between two patients.
While New York was the coronavirus epicenter in the United States this week, the next big wave of infections appeared headed for Louisiana, where demand for ventilators has already doubled. In New Orleans, the state’s biggest city, Mardi Gras celebrations late last month are believed to have fueled the outbreak.
Louisiana Governor John Bel Edwards said New Orleans would be out of ventilators by April 2 and potentially out of bed space by April 7 “if we don’t flatten the infection curve soon.”
“It’s not conjecture, it’s not some flimsy theory,” Edwards told a press conference. “This is what is going to happen.”
About 80% of Louisiana’s intensive care patients are now on breathing machines, up from the normal rate of 30-40%, said Warner Thomas, chief executive of Ochsner Health System, the state’s hospital group.
Scarcities of protective masks, gloves, gowns and eyewear for doctors and nurses – reports abound of healthcare workers recycling old face masks, making their own or even using trash bags to shield themselves – have emerged as a national problem.
“Our nurses across the country do not have the personal protective equipment that is necessary to care for COVID patients, or any of their patients,” Bonnie Castillo, head of the largest U.S. nurses union, National Nurses United, told MSNBC.
In an ominous milestone for the United States as a whole, at least 82,153 people nationwide were infected as of Thursday, according to a Reuters tally from state and local public health agencies. China, where the global pandemic emerged late last year, had the second highest number of cases, 81,285, followed by Italy with 80,539.
At least 1,204 Americans have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, Reuters’ tally showed.
MORE BEDS NEEDED
For New York state, Cuomo said a key goal was rapidly to expand the number of available hospital beds from 53,000 to 140,000.
New York hospitals were racing to comply with Cuomo’s directive to increase capacity by at least 50%. At Mount Sinai Hospital’s Upper East Side location, rooms were being constructed within an atrium to open up more space for beds.
At Elmhurst Hospital in New York’s borough of Queens, about a hundred people, many wearing masks with their hoods pulled up, lined up behind barriers outside the emergency room entrance, waiting to enter a tent to be screened for the coronavirus.
The city coroner’s office has posted refrigerated trucks outside Elmhurst and Bellevue Hospital to temporarily store bodies of the deceased.
Deborah White, vice chair of emergency medicine at Jack D. Weiler Hospital in the city’s Bronx borough, said 80% of its emergency room visits were patients with coronavirus-like symptoms.
A ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.
Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy told reporters such bioethical discussions “haunted him” but were unavoidable.
Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Detroit.
Brandon Allen, 48, was buying groceries in Detroit for his 72-year-old mother, who has tested positive and was self-quarantining at home.
“It’s surreal,” Allen said. “People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it.”
RECORD UNEMPLOYMENT CLAIMS
Desperate to slow virus transmissions by limiting physical contact among people, state and local governments have issued stay-at-home orders covering about half the U.S. population. A major side effect has been the strangulation of the economy, and a wave of layoffs.
The U.S. Labor Department reported Thursday the number of Americans filing claims for unemployment benefits last week soared to a record of nearly 3.28 million – almost five times the previous weekly peak of 695,000 during the 1982 recession.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said warmer weather may help tamp down the U.S. outbreak as summer approaches, though the virus could re-emerge in the winter.
“We hope we get a respite as we get into April, May and June,” Fauci said on WNYC public radio.
Washington state Governor Jay Inslee said he may extend a stay-at-home order tentatively set to expire April 6, encouraged by what he called a “very modest improvement” in the Seattle area.
Washington experienced the first major U.S. outbreak of COVID-19 and has been among the hardest-hit states. As of Thursday the state reported about 3,200 cases and 147 deaths.
In California’s Coachella Valley, a region rife with retirees who are especially vulnerable, 25 members of the state’s National Guard helped a non-profit distribute food to people stuck in their homes, as most of the regular volunteers are senior citizens.
More than 10,000 troops have been deployed in 50 states to provide humanitarian aid during the pandemic.
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
The spring session of China’s Canton Fair has been postponed due to fears about the spread of the coronavirus pandemic, authorities in Guangdong province say
Premier Li Keqiang had insisted early this month that the fair’s spring session would go ahead as it was crucial for efforts to ‘stabilise’ the global economy
The spring session of China’s Canton Fair has been postponed due to the coronavirus outbreak. Photo: Xinhua
The spring session of China’s largest trade expo, the Canton Fair, has been suspended over concerns about the spread of the coronavirus, Chinese authorities said on Monday.
The announcement comes amid reports that regular foreign buyers were scrapping plans to attend the event, which was due to open on April 15. The fair has held its spring session in Guangzhou, the capital of Guangdong province, between mid-April and early May since 1957.
The decision was made after considering the current development of the pandemic, especially the high risk of imported infections, Ma Hua, deputy director of Guangdong’s department of commerce, was quoted as saying on Monday by the official Nanfang Daily.
Guangdong will assess the epidemic situation and make suggestions to the relevant departments of the central government, Ma said at a press conference.
No new date for the fair was announced, but veteran traders who regularly attend the event said the Guangdong government is talking with Beijing about a new time, possibly in May.
Premier Li Keqiang had insisted early this month that the fair’s spring session would go ahead despite the virus outbreak, as it was an important part of Beijing’s efforts to
Authorities of Guangdong, China’s main export and manufacturing hub, joined other large cities, including Beijing and Shanghai, in introducing new restrictions on Saturday that require all foreign visitors be isolated for 14 days at their own expense.
The containment measures, which come as China braces for a second wave
of imported coronavirus cases, would have applied to tens of thousands of foreign merchants attending the fair.
Coronavirus: Chinese companies cut salaries and staff in industries hit hardest by Covid-19
The Canton Fair occurs twice a year and is China’s oldest and largest exhibition. The spring session last year attracted 195,454 foreign buyers from 213 countries and regions across the world. The top five sources of buyers were from Hong Kong, India, the United States, South Korea and Thailand.
But a growing number of regular attendees have recently cancelled plans to take part in this year’s spring session, Chinese exporters said, as concerns mount about possible infection and extra expenses due to a mandatory two week quarantine after arrival.
“About 80 per cent of our firm’s veteran clients told us last month they won’t come this time,” said Jason Liang, a sales manager at a Guangzhou-based exporter of electronic products, who did not want his company identified. “Plus with this new [quarantine], I think at least 90 per cent or almost all of them would drop the trip.
“The costs – time, security and expense – are totally uncontrollable for international travel currently. We also have no plans to attend any exhibition before the summer.”
About 80 per cent of our firm’s veteran clients told us last month they won’t come this time … The costs – time, security and expense – are totally uncontrollable for international travel currently. Jason Liang
Felly Mwamba, a leader of the Congolese community in Guangzhou who has been in the city since 2003, said China’s quarantine measures made it hard for people to visit Guangzhou.
Xie Jun, a furniture and fabric exporter from Zhejiang, said buyers from developing countries that were part of the Belt and Road Initiative would be hard hit if they were forced to pay for quarantine and treatment.
“In February before the pandemic occurred, to cushion the impact some local governments in China’s exporting trade hubs, such as Yiwu and Jinhua, introduced subsidies to attract foreign merchants,” he said. “But now all the subsidies policies are cancelled from what I know.”
Coronavirus and the ‘war economy’: the US and China bicker as the shop goes down
Chinese exporters, traders, and even local residents in Guangdong, have previously voiced concern about authorities’ decision to press on with the even due to the growing number of imported cases to China.
“We strongly call on the government to cancel the spring session of the Canton Fair,” said Zhu Yinghua, a retired teacher in Guangzhou, said before the announcement.
“It’s too dangerous for us local residents if dozens of thousands of foreigners to flock into Guangzhou.”
Image copyright GETTY IMAGESImage caption Many passengers have been wearing masks while travelling on the network
One of the world’s busiest urban rail systems will be shut down for ordinary commuters from Monday morning to prevent the spread of coronavirus infection in Mumbai, one of India’s most populous cities. Only government workers in “essential services” will be allowed to travel on a truncated service.
This was waiting to happen.
Consider this. Eight million people take Mumbai’s crowded suburban train network every day. Packed to nearly three times its capacity, this is one of the busiest railway systems in the world.
The 459km (285-mile) network is the lifeline of India’s financial and entertainment capital, accounting for nearly 80% of all commuting trips in the populous western city. The suburban trains “cover almost the distance up to [the] moon in one week,” the network’s website says.
The 66-year-old network carries 60,000 passengers per km per day, the highest among all the leading commuter rail systems in the world, say officials. The coaches are sturdy enough to carry a “super dense crush load”, a phrase coined by the railways to describe the intense crowding on Mumbai’s trains. This means that a nine-car train designed for 1,800 standing passengers will often carry up to 7,000 passengers, according to Monisha Rajesh, author of Around India in 80 Trains. “Mumbai’s local trains were certainly not for the fainthearted,” she wrote.
Image copyright GETTY IMAGESImage caption Mumbai’s suburban train network carries eight million passengers every day
Now consider this. The western state of Maharashtra, of which Mumbai is the capital, has confirmed more than 60 coronavirus infections, the highest in India so far. Scores of long distance trains out of the city have been cancelled, but the suburban network has continued to rumble on, raising fears of the mass spread of the virus on these packed trains. The crowded service was an easy target of a terror attack in 2006 when serial blasts ripped though a number of trains. At least 180 people were killed and more than 800 injured – the high casualty figure was attributed to overcrowding.
“From ports and landing places the local transport networks, particularly the railways, carried the virus from large cities to the smallest, remotest settlements,” said a report on the spread of the flu in Britain in 1918-1919.
So should one of the world’s busiest rail networks be shut down to stop a possible spread of the virus in a city that many fear could turn into a coronavirus hotspot?
Image copyright GETTY IMAGESImage caption Officials say ridership on the trains has dropped by 17% after the coronavirus scare
Economists like Shruti Rajagopalan believe so.
“India is conducting the fewest tests per million at the moment. If the virus is truly within the community, then given these two issues, the Mumbai outbreak cannot be contained and people will die without healthcare.
“Mumbai trains are the fastest and surest way to spread the virus (if it is within the community) to the densest parts of the city,” she told me.
There is enough precedent: China stopped trains, ferries, planes and buses from leaving the city of Wuhan; and on Thursday, London officials announced that up to 40 stations on the London Underground network are to be shut as the city attempts to contain the outbreak.
Others are not so sure about linking the spread of a pandemic to public transport systems. One study does not support the effectiveness of suspending mass urban transport systems to reduce or slow down a pandemic because, “whatever the relevance of public transport is to individual-level risk, household exposure most likely poses a greater threat”.
“I have not seen any data on the relative risk of public transportation compared with [dense places like] workplaces or schools,” Timothy Brewer, a professor of epidemiology at the University of California Los Angeles told Vox.com.
He said data from China suggested that “household contact was an important means of transmission outside of Wuhan, suggesting that prolonged contact [with a sick person] increases the risk of transmission”.
“If correct, then the time spent commuting and the density of people commuting could be important factors in assessing if public transportation is a risk factor for the disease’s transmission.”
Image copyright GETTY IMAGESImage caption Trains on the network are being scrubbed clean to avoid the spread of infection
Shivaji Sutar, a senior communications officer of the railways, told me that the network was running an aggressive campaign to ease the rush: awareness announcements, posters and videos containing virus information.
They were also monitoring crowds, scrubbing the trains, taking the temperature of willing passengers and embarking on a drive against public spitting, he said.
A combination of awareness and panic has already led to a 27% drop in traffic on the network. But millions of people continue to take the train to work and home every day.
“This is more because of fear than anything else. Most of us have to take the network because we have to come to work. There is still no government directive to all companies to work from home. And apart from passengers wearing masks, I haven’t seen any other precautions being taken,” Rekha Hodge, who has been using the network for three decades, told me. That is bad news.
Image copyright EPAImage caption The world’s second-most populous country has reported about 182 infections
“We have a simple message to all countries – test, test, test,” World Health Organisation (WHO) head Tedros Adhanom Ghebreyesus told reporters in Geneva earlier this week.
He was alluding to the coronavirus outbreak, which has killed more than 10,000 people and infected nearly 250,000 in at least 159 countries.
“All countries should be able to test all suspected cases, they cannot fight this pandemic blindfolded,” he said.
With 182 reported infections and four deaths so far, is India taking this advice seriously? Is the world’s second-most populous country testing enough?
The jury is out on this one. India had tested some 14,175 people in 72 state-run labs as of Thursday evening – one of the lowest testing rates in the world. The reason: the country has limited testing. So, only people who have been in touch with an infected person or those who have travelled to high-risk countries, or health workers managing patients with severe respiratory disease and developing Covid-19 symptoms are eligible for testing.
Why is a densely populated country with more than a billion people testing so little? The official assumption is the disease has still not spread in the community. As early “evidence” health authorities say 826 samples collected from patients suffering from acute respiratory disease from 50 government hospitals across India between 1 and 15 March tested negative for coronavirus. Also, hospitals have not yet reported a spike in admissions of respiratory distress cases.
“It is reassuring that at the moment there is no evidence of community outbreak,” says Balram Bhargava, director of the Indian Council of Medical Research (ICMR). He believes Mr Ghebreyesus’s advice is “premature” for India, and it would only “create more fear, more paranoia and more hype”.
Media caption Dr Ramanan Laxminarayan: “India’s going to be the next hot spot for this epidemic”
But experts are not so sure.
Many of them believe India is also testing below scale because it fears that its under-resourced and uneven public health system could be swamped by patients. India could be buying time to stock up on testing kits and add isolation and hospital beds. “I know mass testing is not a solution, but our testing appears to be too limited. We need to quickly expand to restrict community transmission,” K Sujatha Rao, former federal health secretary and author of But Do We Care: India’s Health System, told me.
On the other hand, say virologists, random, on-demand testing will create panic and completely strain the feeble public health infrastructure. Increased and targeted “sentinel screening” of patients suffering from influenza and diagnoses in hospitals across the country can provide a better idea of whether there is community transmission, they say. “We need focused testing. We cannot do a China or Korea because we simply don’t have the capacity,” a senior virologist told me.
In many ways, it is all about India trying to battle a pandemic with limited resources. Experts talk about the country’s success in defeating polio, combating small pox, successfully controlling the spread of HIV/Aids, and more recently H1N1 with rigorous surveillance, sharp identification of vulnerable people, targeted intervention, and an early engagement with the private sector to prevent disease spread.
Yet, coronavirus is one of the deadliest transmissible viruses in recent history. Every day lost in effective response means the looming danger of a surge in infections. India spends a paltry 1.28% of its GDP on health care, and that may begin to bite if there’s a full-blown outbreak. Partial lockdowns in many cities – shutting schools, colleges, businesses and suspending some rail transport – proves that the government fears that community transmission of the virus might have begun.
Image copyright GETTY IMAGESImage caption The official assumption is the disease has still not spread in the community
Bracing for the inevitable, India is scaling up testing. Officials say existing labs are able to provide results in six hours and each lab has the capacity to test 90 samples a day which can be doubled. Fifty more state labs are expected to begin testing samples by the end of the week, bringing the total number of testing facilities to 122. Authorities claim that together, the labs will be able to test 8,000 samples a day – a significant scaling up. In addition, the government is planning to allow around 50 private labs to start testing, but they will take up to 10 days to procure kits. (Testing at state-run labs is free, and it is unclear whether the private labs will charge.)
Two rapid testing labs, capable of doing 400 tests a day, are expected to be operational by the end of the week. India has also placed orders for a million test kits, and will be possibly asking the WHO for a million more.
“On testing, the government response has been proportionate, taking into account scope, need and capacity,” Henk Bekedam, WHO Representative to India told me. “We recognise that laboratory networks are expanding the scope and testing and they now include patients with severe acute respiratory infection and influenza-like illness detected through the surveillance system. It would also be important to look at ‘atypical pneumonia’ cases. If they are without any distinctive cause, then they need to be considered for testing.”
Image copyright GETTY IMAGESImage caption India could be buying time to stock up on testing kits and add isolation and hospital beds
The weeks and months ahead will show whether these steps have been enough. “We cannot say India has escaped community transmission,” Mr Bhargava says candidly. And if and when there is an explosion of infections and more sick people require hospitalisation, India will face formidable challenges.
India has eight doctors per 10,000 people compared to 41 in Italy and 71 in Korea. It has one state-run hospital for more than 55,000 people. (Private hospitals are out of reach for most people). The country has a poor culture of testing, and most people with flu symptoms do not go to doctors and instead try home remedies or go to pharmacies. There’s a scarcity of isolation beds, trained nursing staff and medics, and ventilators and intensive care beds.
India’s influenza cases peak during the monsoon season, and there is no reason why the coronavirus will not make a second coming, virologists say. “Given the way it is progressing in India, it seems it is about two weeks behind Spain and three weeks behind Italy. But that’s the number of known cases. And without sufficient testing and shutting down large gatherings, the numbers could be a lot worse,” Shruti Rajagopalan, economist and a Senior Research Fellow at the Mercatus Center at George Mason University, told me.
India’s traditional neglect of public healthcare will begin to bite if the disease spreads to its teeming small towns and villages. “This is a very unique and real public health challenge,” says Ms Rao. And it’s early days yet.
In Madrid, local health authorities describe ‘one case every 16 minutes’
New cases in Europe include new Prince Albert of Monaco and Michel Barnier, the European Union’s chief Brexit negotiator
Italian military trucks and soldiers are seen by Bergamo’s cemetery after the army was deployed to move coffins from the cemetery to neighbouring provinces. Photo: Sergio Agazzi/Fotogramma via Reuters
Italians on Thursday mourned a record number of deaths from the Covid-19 pandemic and expected the toll to surpass that of China, where the crisis began. On the mainland, there was a sense of relief as there were no new domestic cases reported for the first time since the outbreak began.
As opposite turning points were marked in China and Europe, the worldwide total of infections exceeded 220,000. The new cases include Monaco’s reigning monarch, Prince Albert, and Michel Barnier, the European Union’s chief Brexit negotiator.
More than 9,000 people have died around the world, at least 2,978 of them in Italy, including five doctors. The death rate in Madrid is described by local health authorities as “one case every 16 minutes”.
Concerns are also growing that the surge in cases in Europe and North America could result in a second wave in Asia, amid reports of mass movements of travellers fleeing the current epicentres.
Australia and New Zealand became the latest countries to ban non-citizens from entry.
In China, the National Health Commission said on Thursday that all 34 new infections reported the previous day had been imported cases.
It is also the first time Hubei province, where the crisis began, recorded no new cases either domestically or from abroad.
The number of new deaths in mainland China was down to single digits, with eight reported, bringing the total fatalities to 3,245.
Coronavirus: Italy’s hospitals overflow with the dead as toll tops 1,000
13 Mar 2020
Italy experienced its worst death toll on Wednesday with 475 reported, the highest one-day official toll of any nation.
Italy has the world’s second-highest number of diagnosed cases, after China.
Dramatic footage has been circulating on social media, showing military vehicles taking corpses out of the Italian city of Bergamo because cremation facilities were overloaded.
Prime Minister Giuseppe Conte extended a nationwide lockdown that is weighing on the economy, saying: “We managed to avoid the collapse of the system and the measures are working.”
Prince Albert of Monaco (pictured in 2019) has tested positive for the coronavirus, it was announced on Thursday. Photo: Xinhua
The government is considering tightening restrictions amid concern that many Italians are not respecting rules that confine them to their homes except for work, health or emergency reasons.
In Spain, the second hardest hit country in Europe, the virus’ spread continues with a rate of 25 per cent new cases per day.
Spanish King Felipe VI, in a rare televised address, told his citizens: “This virus will not defeat us. On the contrary. It will make us stronger as a society.”
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