Chindia Alert: You’ll be Living in their World Very Soon
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Image copyright GETTY IMAGESImage caption An empty stretch of the road and Delhi Police barricades to screen commuters during lockdown, at Delhi Gate on April 16, 2020 in New Delhi, India.
India has eased some restrictions imposed as part of a nationwide lockdown to curb the spread of the coronavirus.
Most of the new measures are targeted at easing pressure on farming, which employs more than half the nation’s workforce.
Allowing farms to operate again has been seen as essential to avoid food shortages.
But some other measures announced last week, will not be implemented.
This includes the delivery of non-essential items such as mobile phones, computers, and refrigerators by e-commerce firms – the government reversed its decision on that on Sunday.
And none of the restrictions will be lifted in areas that are still considered “hotspots” for the virus – this includes all major Indian cities.
Domestic and international flights and inter-state travel will also remain suspended.
So what restrictions are being eased?
Most of the new measures target agricultural businesses – farming, fisheries and plantations. This will allow crops to be harvested and daily-wagers and others working in these sectors to continue earning.
To restore the supply chain in these industries, cargo trucks will also be allowed to operate across state borders to transport produce from villages to the cities.
Essential public works programmes – such as building roads and water lines in rural areas – will also reopen, but under strict instructions to follow social distancing norms. These are a huge source of employment for hundreds of thousands of daily-wage earners, and farmers looking to supplement their income.
Banks, ATMs, hospitals, clinics, pharmacies and government offices will remain open. And the self-employed – such as plumbers, electricians and carpenters – will also be allowed to work.
Some public and even private workplaces have been permitted to open in areas that are not considered hotspots.
But all businesses and services that reopen are expected to follow social distancing norms.
Who decides what to reopen?
State governments will decide where restrictions can be eased. And several state chief ministers, including Delhi’s Arvind Kejriwal, have said that none of the restrictions will be lifted in their regions.
Mr Kejriwal said the situation in the national capital was still serious and the decision would be reviewed after one week.
India’s most populous state, Uttar Pradesh, will also see all restrictions in place, as will the southern states of Andhra Pradesh, Telangana and Karnataka.
The southern state of Kerala, which has been widely acknowledged for its success in dealing with the virus, has announced a significant easing of the lockdown in areas that it has demarcated as “green” zones.
This includes allowing private vehicular movement and dine-in services at restaurants, with social distancing norms in place. However, it’s implementing what is known as an “odd-even” scheme – private cars with even and odd number plates will be allowed only on alternate days, to limit the number of people on the road.
Young people starting out in the jobs market face a hit to their prospects that could endure years after the Covid-19-induced downturn has run its course
A generation of angry youth raises the spectre of political instability
Freelance filmmaker Anita Reza Zein had grown used to jam-packed production schedules requiring her to put in long hours and run on little sleep. Until Covid-19 struck.
Today, the talented Indonesian is suddenly free. With five projects on hold and many more potentially cancelled, she now spends her time working on a personal project, doing research for her work and occasionally going for a ride on a bicycle.
“I feel calm and patient although I’m jobless. Maybe because it’s still the third week [of social distancing] and I still have enough savings from my previous work,” said the 26-year-old, who is from Yogyakarta. “But I imagine life will become tougher in the next few months if the situation gets worse.”
Like her, millions of youths are now part of a job market in Southeast Asia that has been ravaged by the coronavirus pandemic. They are the unlucky cohort of 2020 whose fortunes have changed so drastically, so quickly.
Freelance filmmaker Anita Reza Zein now spends most of her time at home as her projects have all been frozen due to the spread of Covid-19. Photo: Anita Reza Zein
Just three months ago, many eager graduates were about to partake in a strong economy and possibly land decent pay cheques.
Today, job offers are being withdrawn and hiring halted, leading to a spike in regional youth unemployment in the short term. In the long term, the effects on the Covid-19 cohort could lead to wider social and political problems.
JOB MARKETS SHUT
The virus’ impact on economies and the job market in the region has been swift and devastating. Borders have been slammed shut, workers ordered to stay at home, and thousands of companies closed every week.
The biggest problem is the lack of certainty about how long this will last – the longer the governments keep their countries on lockdown, the worse the economic impact.
In Indonesia, for example, the virus has caused almost 2.8 million people to lose their jobs, according to the Manpower Ministry and the Workers Social Security Agency. Likewise, in Malaysia, an estimated 2.4 million people are expected to lose their jobs, going by data from the Malaysian Institute of Economic Research (MIER).
is bracing itself for a 5.3 per cent contraction in GDP for the full year, the worst since the Asian financial crisis in 1997.
“We think about seven million jobs have been lost already, and the figure will hit 10 million if the outbreak drags on for two to three more months,” said Kalin Sarasin, council member and head of the Thai Chamber of Commerce.
Lockdown for 34 million people in capital Jakarta as Indonesia fights surge in coronavirus deaths
For young jobseekers, the outbreak of the Covid-19 pandemic could hurt even more, with companies unwilling to open up new jobs for them.
“My clients who were open to fresh graduates previously have realigned searches [for candidates] who have at least one year of experience, as it’s a lot faster for someone with experience to scale up quickly and contribute,” said Joanne Pek, a recruiter at Cornerstone Global Partners’ Singapore office.
For many small and medium-sized enterprises (SMEs) such as Singapore-based restaurant chain The Soup Spoon, saving jobs – rather than recruiting – is the priority.
“We don’t want to let anyone go during this period, so we’re focused on protecting jobs,” said co-founder and director Benedict Leow, who employs some 250 workers.
THE COVID-19 COHORT
The looming economic downturn could have distinct consequences for the Class of 2020 that will outlast the economic downturn itself.
For one thing, the paucity of jobs could result in the Covid-19 cohort becoming a “lost generation” of sorts, said Achim Schmillen, a senior economist at the World Bank Social Protection and Jobs Global Practice.
“Research from around the globe shows that graduating in a recession can have significant and long-lasting impacts that can affect the entire career. In particular, it can lead to large initial earnings losses which only slowly recede over time,” he said.
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Economics professor Jeff Borland of the University of Melbourne said that international studies showed that what happened to people when they first entered the labour market would affect them for the rest of their working lives.
“Many international studies have shown that trying to move into employment during a major economic downturn cuts the probability of employment and future earnings for a decade or more.
“Why this occurs is less well-established. Reasons suggested include being forced to take lower-quality jobs, losing skills and losing psychological well-being,” he said in a piece published on The Conversation website.
Malaysia sets up Covid-19 test zones in the capital to hunt for ‘hidden’ coronavirus cases
This could create “lasting scarring” on the graduates this year, said labour economist Walter Theseira.
“If their careers start badly, it would affect their earnings for a number of years because they would lack the same experience as peers who started in a more secure position,” the associate professor of economics at Singapore University of Social Sciences said.
Shrinking salaries and the downsizing of companies mean that graduates might have to seek out professions outside their areas of study to survive, said Grace Lee Hooi Yean, head of the Economics Department at Monash University, Malaysia.
She said youth unemployment in the country, which stands at 11.67 per cent, could rise sharply.
“This looming crisis could trap a generation of educated and capable youth in a limbo of unmet expectations and lasting vulnerability if the graduates are not ready to face reality and adapt to the new challenges,” she said.
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This is fast becoming the reality for final-year medical student Rebecca K. Somasundaram, who has been left without a job due to the pandemic.
After being offered a residency programme at a top specialist hospital in Kuala Lumpur, she was notified a month ago that her placement had been made void until further notice. This has thrown the 24-year-old’s plans into disarray as she was hoping to enter the workforce soon to pay off her student debts. Her plans to get married next year have also been put on hold temporarily.
“I am in constant talks with the hospital to see if there is any way I can join them soon but seeing how things are unfolding so quickly, I am slowly losing hope,” she said.
Over in Indonesia, the pandemic will trigger job losses on a national scale. To combat this, the government would need to introduce strong fiscal measures and beef up its social protection policies, said the country’s former minister of finance Muhamad Chatib Basri.
Many people on lower incomes tend to work in the extraction industry, such as mining and palm oil, and these are the first industries hit due to the global slowdown.
“The rich will be able to brave the storm, but the poor have no means to do so,” he said.
Singapore migrant workers under quarantine as coronavirus hits dormitories
SPECTRE OF 1997
With partial lockdowns imposed in the capital of Jakarta, more needs to be done to ensure that vulnerable citizens have access to food and financial support.
Without government intervention, economic woes could soon translate into political instability, a scenario last seen in the Asian financial crisis.
In 1997, waves of discontent sparked racial riots in Indonesia that toppled the country’s long-time strongman Suharto, while in Thailand a political crisis created the conditions for populist leader Thaksin Shinawatra to rise.
Rising discontent could have serious implications at the ballot boxes, warned Basri, who said young voters were a key voting bloc for President Joko “Jokowi” Widodo.
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In last year’s general elections, Jokowi proved a hit among the lower-educated youth who had benefited from the creation of largely unskilled jobs during his tenure.
“With more young people expected to become unemployed in the coming months, things will only get worse from here,” said Basri, who added that the country’s youth unemployment stood at almost 20 per cent in 2018.
Indonesia, which has 268 million people and is Southeast Asia’s largest economy, had 133 million workers as of last August, according to official data.
Close to 10 per cent or about 12.27 million are university graduates but among this group, about 5.67 per cent or some 730,000 were unemployed. This was higher than the country’s overall unemployment rate at that time, which was 5.28 per cent.
‘Ghosts’ deployed to scare Indonesians into staying home to slow spread of the coronavirus
GETTING IT RIGHT
Economists say, however, that all is not lost. Much will depend on policy and how governments focus on battling the virus on the public health and economic fronts. They point to Singapore, which has launched a robust response to the crisis.
On April 6, the Singapore government announced its third budget in two months to help companies and households tide over the crisis. In all, Singapore’s total stimulus package, which aims to save jobs and keep funds flowing to companies, will cost the government a massive S$59.9 billion (US$42 billion).
The Singapore government was also preparing for a labour market that would be reluctant to hire fresh graduates on a full-time basis, said Theseira.
“There are plans to implement large-scale subsidised traineeships, which may be more palatable to companies which are worried about taking on permanent headcount this year,” he noted. “As the economic situation improves, they can be converted to permanent positions.”
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While jobs were being created for fresh graduates, many would still have to temper their expectations, such as taking jobs with lower starting pay, said DBS Bank economist Irvin Seah.
“There are still some jobs to go around. There are still some companies that may need workers. But they will need to be realistic,” he said.
For instance, despite the downturn, Singapore telco Singtel expects to recruit over 300 fresh graduates for various permanent positions this year, according to Aileen Tan, the company’s Group Chief Human Resources Officer. Many of the new hires will be in new growth areas such as the Internet of Things, analytics and cloud.
The Singtel Comcentre building in Singapore. Photo: Roy Issa
Other companies that continue to hire include those in tech across the region, including e-commerce giant Shopee, food-delivery service Foodpanda and Amazon.
In Australia, Borland suggested helping young people to remain plugged into the labour market through government-funded paid internships, or even offering them loans to go for further studies and prevent a spell of unemployment.
For now, while some young jobseekers are taking a wait-and-see approach, the reality is hitting hard for others.
Final-year National University of Singapore student H.P. Tan had all but secured a job at a public relations firm last month, after three rounds of interviews.
The Faculty of Arts and Social Sciences undergraduate was rejected via an email from the agency, which said that they could no longer hire after Covid-19 started to drastically cut business.
“When I got that rejection, it was a turning point. I didn’t think I would be directly impacted,” said the 23-year-old.
“I also applied to a few other agencies but the response has been slow, so I am now freaking out at the possibility of not being able to find a job after graduation.”
Image copyright GETTY IMAGESImage caption Indore is a bustling commercial city
In early March, 40-year-old Ravi Dosi, a chest specialist in India, saw a baffling surge in patients with respiratory problems at outpatient clinics.
“There was almost a 50% jump in patients with upper respiratory issues and sore throat. They were not responding to antibiotics. Testing was still low and we didn’t really know what was going on,” Dr Dosi, who works at Sri Aurobindo Institute of Medical Sciences, a 1,156-bed private medical college in the central city of Indore, told me.
Less than a fortnight later, Dr Dosi began seeing an uptick in admissions of Covid-19 patients. Around the end of March, the hospital was receiving 28 infected patients every day.
They had dry cough, fever, and difficulty breathing. Their blood oxygen levels were low. They were reporting loss of taste and smell.
In the first wave of patients, nearly a dozen came from far-flung districts, more than 150km (93 miles) from Indore, a bustling commercial city in Madhya Pradesh state. The state has now become a hotspot, with nearly 400 confirmed infections out of the more than 6,400 infections and nearly 200 deaths across the country so far.
By the second week of April, Dr Dosi and his team of 100 doctors and nearly an equal number of nursing staff working 24/7 in three shifts, were treating 144 Covid-19 patients. (Thirty-one had been treated and sent home already.)
A total of 38 patients were in intensive care. Twenty-one of them were critical. There had been seven deaths. “We are handling the largest number of Covid-19 patients in India,” Vinod Bhandari, a surgeon and chairman of the hospital, told me.
Doctors now believe that the infection was spreading in the community long before the government admitted to it, and testing slowly ramped up. Until two weeks ago, Indian health authorities had been denying community transmission.
Image caption The hospital in Indore has more than 140 patients
Now a new study by Indian Council of Medical Research (ICMR) using surveillance data from 41 labs in the country has hinted at community transmission: 52 districts in 20 states and union territories reported Covid-19 patients. Some 40% of the cases did not report any history of international travel or contact with a known case. (The survey was based on swabs collected from nearly 6,000 patients who tested positive between 15 February and 19 March.)
Back in the hospital in Indore, the doctors are battling the surge in infections.
Three isolation wards spread over two floors floors are stacked with patients. (The hospital has earmarked 525 beds for Covid-19 patients.) Isolation wards have younger patients with mild infection, while elderly patients with more severe symptoms are in intensive care. The oldest patient is a 95-year-old man, and the youngest is a four-month-old boy.
The team of doctors handling patients includes chest specialists, anaesthetists, microbiologists, and dermatologists. There are patients with a lot of underlying medical conditions – diabetes, hypertension, even cancer – so all the specialists have been called in to help with the treatment.
Dr Dosi wakes up early, puts on protective gear – scrubs, face masks and shields, N95 masks, gowns, double gloves and shoe covers – before going on his rounds of the patients. Doctors say they are not facing a shortage of gear yet.
They are using 22 ventilators to help the critical patients breathe, and also providing oxygen supplies to others using nasal cannulas (nose prongs).
In the isolation wards, patients are given oral medication – antibiotics and hydroxychloroquine (commonly known as HCQ), an anti-malarial drug – and directed to maintain social distancing and wash their hands regularly.
Image caption The isolation wards are packed with patients
“I have never seen a challenge and crisis like this in my career. I have heard stories about an outbreak of plague in Surat [in 1994]. But this seems to be much bigger. The biggest challenge is to keep hopes alive and be positive,” says Dr Dosi.
Keeping hopes up for patients in isolation can be taxing. Three tests, say doctors, are being done for the infection – if the first test comes out positive, the patient remains in isolation for two weeks, and is tested twice on two days after the quarantine period. If the last two tests come back negative, the patient is discharged. If not, the patient has to stay in isolation for another two weeks. “It is a tough grind, mentally,” says one doctor.
For the last three weeks, Dr Dosi has been living in the hospital, away from his wife, two sons and parents. His father is a retired pathologist. They communicate via hurried video calls, between his frantic trips to the isolation wards and intensive care.
I ask him when does he expect this to “get over”, so that he can go home.
“In a couple of weeks,” he says. “The lockdown should have helped to slow down the infection.”
Dr Dosi is alluding to the strict 21-day lockdown India imposed on 24 March to halt the spread of the infection.
Image copyright GETTY IMAGESImage caption Health officials have been denying community transmission
Things are getting better, he says.
“I am getting 10 patients for admission in isolation wards, and two patients severe enough for intensive care every day now. Earlier this week, it was 50:50.”
It is possibly too early to hazard a guess about when admissions will slow down to single digits. As more people are tested, the number of patients can easily rise again.
It’s been unrelenting, Dr Dosi says.
Early, on Friday, I sent him a text to find out what was going on.
Image copyright GETTY IMAGESImage caption More than a billion people have been staying at home during the lockdown
Will India extend its rigorous 21-day lockdown to slow the spread of coronavirus beyond its end date next week? By all accounts, yes.
On 24 March, India shut its $2.9 trillion economy, closing its businesses and issuing strict stay-at-home orders to more than a billion people. Air, road and rail transport systems were suspended.
Now, more than two months after the first case of Covid-19 was detected in the country, more than 5,000 people have tested positive and some 150 people have died. As testing has ramped up, the true picture is emerging. The virus is beginning to spread through dense communities and new clusters of infection are being reported every day. Lifting the lockdown could easily risk triggering a fresh wave of infections.
A harsh lockdown is certain to slow down the disease. Virologists I spoke to believe India is still at an early stage of the infection. The country still doesn’t have enough data on the transmissibility of the virus or even how many people could have been infected and recovered to develop adequate herd immunity. (It is slowly beginning finger prick blood tests to look at the presence of protective antibodies.)
More than 250 of India’s 700-odd districts have reported the infection. Reports say at least seven states have a third of all infections, and want the lockdown extended. Six states have reported clusters of rapidly growing infections – from the capital Delhi in the north to Maharashtra in the west and Tamil Nadu in the south.
Economic fallout
Not surprisingly, the lockdown is already hurting the economy. Many of the early hotspots are economic growth engines and contribute heavily in revenues to the exchequer. Mumbai, India’s financial capital and Maharashtra’s main city, accounts for more than a third of overall tax collection. The densely populated city has reported more than 500 cases and 45 deaths, and numbers are steadily rising. Authorities say the infection is now spreading through the community. Mumbai has made wearing face masks mandatory.
Image copyright GETTY IMAGESImage caption India has ramped up testing during the lockdown
Many of these hotspot clusters are also thriving manufacturing bases. The spread of infection means that they will be under lockdown for a longer period of time.
The services industry, which generates almost half of India’s GDP, is also likely to remain shut for some more time. Construction, which employs a bulk of migrant workers, will remain similarly suspended. The unemployment rate may have already climbed to more than 20% after the lockdown, according to a report by the Center for Monitoring Indian Economy.
For the moment, economists say, the government will have to prioritise farming over everything else to ensure the livelihoods of millions and secure the country’s future food supplies.
Half of India’s labour force work on farms. The lockdown happened at a time when a bumper winter crop had to be harvested and sold, and the rain-fed summer crop had to be sowed. The immediate challenge is to harvest and market the first crop, and secure the second.
Moving trucks to pick up produce and take them to markets, with adequate social distancing and hand washing will be something the government will have to move on quickly.
“The immediate challenge is to ensure that rural India is not hit,” says Rathin Ray, an economist. “Realistically, a complete lockdown cannot be continuously maintained beyond early May. We don’t have a choice but to reopen gradually after that.”
Image copyright GETTY IMAGESImage caption India has been under a lockdown from 24 March
There is little doubt about that. For his part, SK Sarin, who heads a government advisory panel on combating the disease, says the lockdown can be only eased in a “graded manner in areas that are not hotspots” and that the hotspots remained cordoned off.
Like other affected countries, India will have to prepare itself for what Gabriel Leung, an infectious disease epidemiologist and dean of medicine at the University of Hong Kong, describes as several rounds of “suppress and lift” cycles.
During these periods “restrictions are applied and relaxed, applied again and relaxed again, in ways that can keep the pandemic under control but at an acceptable economic and social cost.”
Also, Dr Leung observes, “how best to do that will vary by country, depending on its means, tolerance for disruption and its people’s collective will. In all cases, however, the challenge essentially is a three-way tug of war between combating the disease, protecting the economy and keeping society at an even keel”.
It is now clear that shutdowns need to continue until transmission has slowed down markedly, and testing and health infrastructure has been scaled up to manage the outbreak.
Experts from the southern state of Kerala, a striking outlier that is containing the infection thanks to a transparent government and a robust public health system, say it isn’t time to lift the lockdown yet and have recommended a three-phase relaxation.
For most countries, easing the lockdown is a tricky policy choice. It sparks fears of triggering a fresh wave of infection and presents the inevitable trade-off between lives and livelihoods. French Prime Minister Edouard Phillipe, says relaxing the lockdown in his country is going to be “fearsomely complex”. In a crisis like this, according to his Dutch counterpart Mark Rutte, leaders have to “make 100% of the decisions with 50% of the knowledge, and bear the consequences.”
Image copyright GETTY IMAGESImage caption India’s financial capital, Mumbai, is emerging as a hotspot
It is going to be tougher for India with its vast size, densely packed population and enfeebled public health system. Also, no country in the world possibly has so much inter-state migration of casual workers, who are the backbone of the services and construction industries.
How will India manage to return these workers to their work places – factories, farms, building sites, shops – without a substantial easing of public transport at a time when crowded trains and buses can be a vector of transmission and easily neutralise the gains of the lockdown? Even allowing restricted mobility – allowing social distancing, temperature checks and passenger hygiene – would put considerable pressure on the public transport system.
The policy choices are fiendishly tough, and the answers are far from easy. India bungled the lockdown by not anticipating the exodus of millions of migrant workers from cities. The weeks ahead will tell whether the fleeing men, women and children carried the infection to their villages. The country simply cannot afford to make similar mistakes again while trying to relax the lockdown. Nitin Pai of The Takshashila Institution, a think tank, believes states should be left to decide on easing restrictions, and decisions “should be based on threat [of infection], which should be determined by extensive testing”.
This week Prime Minister Narendra Modi said that the “situation in the country is akin to a social emergency”. His government now needs make sure that the looming threat to the nation’s health and economic progress is tackled skilfully.
Image copyright GETTY IMAGESImage caption Staff film a tomb sweeping ceremony for a customer
People in China are paying their respects to dead ancestors digitally as the country continues to face the coronavirus outbreak.
The Qingming festival, also known as Tomb Sweeping Day, is usually a time when people visit the graves of friends and family, sprucing up the area and making offerings to their spirits.
But amid fears of another outbreak, the government has advised people to stay away and maintain social distancing.
That’s led to some cemeteries allowing people to come as long as they’ve booked a slot, while others are banning visits completely.
But other companies and burial places have turned to modern technology as they look for ways for families to continue the centuries-old tradition.
Li Quanxi, an official at Beijing’s civil affairs bureau, said: “We want to encourage people to transform social traditions amid the coronavirus outbreak.”
What is Qingming festival?
Qingming festival is one of the most important events in the calendar to commemorate ancestors who are no longer with you.
People clean the graves and burn items such as joss sticks and paper offerings – sometimes quite large ones – to honour the dead and transmit money and other goods to loved ones in the afterlife.
Image copyright AFPImage caption A woman burns incense ahead of the tomb sweeping festival
The tomb sweeping period falls between 28 March and 12 April.
Making offerings online
It is not completely unknown for pay their respects online, however, with the spread of Covid-19, there are now people who have no other option.
“Cloud tomb sweeping” allows people to “virtually” clean graves and make offerings to spirits.
One website providing this service is Heavenly Cemetery. On the surface, the website looks like any usual shopping site, although it also allows people to have their own memorial halls for their loved one so family and friends can join.
Relatives can light a candle, burn money and offer objects such as Chinese rice wine and beer. There is even an option for online tomb cleaning.
Media caption Watch: People pay respect to their deceased pets ahead of Tomb Sweeping Day
Funeral company Fu Shou Yuan International launched its own online tomb sweeping service on 12 March. It operates in more than 30 Chinese cities. In its first week, its website had about 87,000 visitors.
George Chen, whose grandparents are buried in Shanghai, visits their tombs every year but will be marking this year’s Tomb Sweeping Day online for the time being.
He told Shanghai Daily: “Old traditions are deeply rooted, but it is quite understandable because it is a special period. I will pay virtual respect and visit the scene once the epidemic ends.”
Getting someone to do it for you via livestream
While taking part in “cloud tomb sweeping” does mean you get to send offerings, it does not include the physical cleaning of a loved one’s tomb.
So some burial spots are now offering relatives a chance to watch a member of staff clean the tomb via a live stream. Others will send you photographs of the cleaned grave.
One cemetery in Shanghai is offering packages where a “valet sweep” starts from as little as 35 yuan (£4).
Image copyright GETTY IMAGESImage caption Staff hold a ceremony on behalf of a customer
Babaoshan funeral parlour, in Beijing, also offers live stream services.
Zhou Weihua, deputy director of the parlour, told Chinese news agency Xinhua that live streaming could become a future trend.
“Helping clients sweep tombs and holding online commemorative activities not only meets the demand in this special period but also offers more options for people to remember their deceased family members in the future.”
What about Wuhan?
China reported 3,199 deaths from coronavirus with 2,559 of those in Wuhan, where the first cases were recorded late last year.
The city is still in a lockdown which is expected to end on 8 April, and the government has announced that cemeteries will remain closed until 30 April.
Wuhan’s civil affairs department said it would make “unified arrangements to organise staff at cemeteries to hold a collective ceremony to pay tribute to the deceased”.
Image copyright JEN SMITHImage caption Jen Smith lives in Shenzhen, where it’s compulsory to wear a mask outside at all times
My Money is a series looking at how people spend their money – and the sometimes tough decisions they have to make. Here, Jen Smith, a children’s TV presenter from Shenzhen in southern China, takes us through a week in her life, as the country slowly emerges from the coronavirus pandemic.
Over to Jen…
Since being in lockdown I’ve been bingeing on Keeping Up With the Kardashians. It starts with one episode after dinner, blink, and suddenly it’s 3am. YouTube, Facebook, Google and Instagram are all banned here, so you’d think I’d be a binge-free socialite after a year and a half living in China. Well, those sites are banned unless you have a VPN – I pay $120 (£97) a year for mine, so Sunday was a late night, with a lie-in until 10.30 this morning.
I go for a run – mask and all, as it’s currently illegal to be outside without one. I make my coffee (bought in the UK), fruit smoothie (about 20 yuan, $2.82, £2.27) and cereal (80 yuan a packet) before cycling to work.
Today is a bit of a crazy day in the studio. I work as a children’s TV presenter. My company has profited from the lockdown as more children are watching the shows non-stop – meaning a rapid turnaround for us.
We shoot two shows from 2-6pm then “break” for a meeting. We discuss tomorrow’s shoot while I eat dinner – homemade aubergine curry. It is normal for the Chinese to eat breakfast, lunch and dinner at work. Normally the company gives all staff 25 yuan through a food-ordering app, and the whole company would eat together. However, because of the current social distancing, that social time is in the far distant past!
I make it home for 8pm, order some deep-fried cauliflower as a snack (45 yuan) and start the inevitable Kardashian binge.
Total spend: 65 yuan ($9.10, £7.37)
Image copyright JEN SMITHImage caption Workers often have a midday nap in the office
It’s a much earlier start (7.30am), but the same morning routine. On my cycle to work I notice that the traffic is almost back to normal – Shenzhen is inhabited by well over 12 million people, so as you can imagine rush hour is intense. This doesn’t change the fact that everywhere you go you have to scan a QR code – leaving my apartment, using the walkway by the river, and getting into the building I work in.
After a morning of shooting I eat homemade potato curry and settle down for a nap. Naptime is such a commonality in China that people store camp beds at the office. I order a coffee and banana chips (20 yuan) for a pick-me-up before the afternoon’s shooting.
It’s St Paddy’s Day so I head to the local pubs area, catch dinner at a French restaurant (222 yuan), then a few drinks (25 yuan – mainly bought by men at the bar for us) before a very tipsy cycle home.
Total spend: 242 yuan ($34, £25)
Image copyright JEN SMITHImage caption A disposable cover reduces the risk of transmitting the virus by touching lift buttons
The morning’s shoot (thankfully) was cancelled, so I nursed a hangover in bed until around 11am, at which point I had a phone meeting for a company that I do “plus-size” modelling for (for context I’m a UK size 12). I eat a bowl of cereal and order more cauliflower (45 yuan) while I watch a film.
At 2.30pm an intern picks me up, and we head to the government building to apply for a new work visa. Ironically, the image taken for my visa is Photoshopped to remove wrinkles, freckles and my frizzy hair. When I ask why this is being done for an identification document, the intern replies that the government wants it to be neat, and “the Chinese way” is to have altered photos.
I don’t argue, and have an interview before I hand in my passport. The whole process takes around two hours, so I order food to my house while on the way home (150 yuan for burger, salad and cake!) I take a taxi across town which ends up being 39.05 yuan.
The day starts at 8.30am with coffee and reading, before I get a manicure (280 yuan). My nail lady has been very worried about the state of my hands during the virus, so she spends a whopping two and a half hours treating them while I watch a film (0.99 yuan – bought by her). Because the manicure was so long I don’t have time to eat lunch before our fitness shoot, which runs from 2-5.30pm. I then have an appointment to sign into a building which I’ll shoot in tomorrow.
The building is near a supermarket called Ole (one of the only western supermarkets), and I pick up groceries for 183 yuan before heading home to cook, listen to podcasts and prep for the big day of shooting on Friday.
Total spend: 463 yuan ($64, £52.5)
Image copyright JEN SMITHImage caption Jen filming in front of a green screen – a more colourful digital background will be added later in post-production
Fridays are generally my busiest day. The way the Chinese seem to function, is a boss will say “I want this done now” and then employees rush to finish it. Generally, they will write scripts on Monday and Tuesday, discuss Wednesday, then we shoot later in the week. The poor editors, despite mandatory office hours during the week, then have to work tirelessly through the weekend to achieve a Sunday evening deadline.
I start with mashed avocado and a hard-boiled egg before work. The morning shoot runs from 9.30-11.40am, and I have an early lunch – homemade curry again, before my regular nap time. The afternoon shoot is three hours, so I have time to pop home and shower before a live stream at 6pm. I take a taxi to and from the live stream which ends up being 28 yuan.
Total spend: 28 yuan ($3.92, £3.18)
Image copyright JEN SMITHImage caption A taxi driver has improvised a screen to reduce the risk of picking up Covid-19 from a passenger
Finally the weekend! Although things are slowly getting better in China after the coronavirus outbreak, there’s still not too much to do. So I use this time to write, play my piano and generally chill inside. Around 3pm, I venture outside to the shops to pick up some snacks (159.60 yuan) before settling in to ring my family back in the UK with a homemade cocktail – a friend of mine in Canada is doing a daily live stream, “quarantinis” where he teaches you how to make cocktails!
What’s interesting is that a lot of people have started leaving their houses again, but it is still illegal to go outside without a mask on, and temperature checks are taken everywhere. I was even refused entry to a building due to being foreign. I imagine this is because recently the only new cases are being brought in by non-Chinese travelling back to China.
Total spend: 159.60 yuan ($22, £18)
Image copyright JEN SMITHImage caption Shenzhen’s Metro system is still very quiet
It’s another slow day for me as many foreigners have not yet returned to China, so most of my friends are out of the country. I start the day by reviewing potential scripts.
This takes me to 1.30pm without realising I haven’t eaten. I decide to go for a quick run and I return to eat mashed avocado and a hard-boiled egg.
I home-bleach my hair with products bought in the UK, then head back to editing again. About half way through the afternoon I take a little break to practice Chinese. I use an app which is fantastic and free! Definitely worth everyone downloading this during social distancing so you can learn new skills!
For dinner I order online again, a three-dish meal for 160 yuan.
Lockdown may have been lifted, but shops, bars and restaurants remain empty in Beijing, showing struggle facing economic recovery
Controls have been returning in other parts of China, where cinemas and tourist attractions shut amid fears of new wave of infections
The nearly two month-long lockdown has changed the consumption behaviour of Chinese residents, many of whom have turned to home cooking to cut their spending. Photo: AFP
China’s urban lockdown may have eased, but deserted streets and stores in the capital Beijing this week suggest that for the services sector, the impact of the coronavirus outbreak could be deeper and longer than expected.
Many restaurants, cafes and pubs remained closed in the city, where vigilance remains high about a second wave of infections. Among those that were open, there were few customers to be seen.
The usually crowded Wangfujing shopping street was quiet on Wednesday, with just a few shoppers patronising what is usually the heartbeat of the city’s commerce and tourism. There were more staff than consumers at the Apple store, while everyone wore a mask. Shops along the pedestrianised zone closed their doors before sunset, but many did not open at all.
In a downtown food court, a handful of people dined during what would usually be the lunch rush hour, each restricted to their own small table to maintain social distancing, in great contrast with the usual frantic dash for seats.
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While China has largely stemmed the domestic spread of Covid-19, threats of imported cases, with the virus having infected over one million people worldwide, and asymptomatic carriers continue to hamper the recovery in China’s
A survey published on Friday showed that in March, sentiment among small service sector firms remained depressed. The Caixin / Markit services purchasing managers’ index (PMI) was 43.0 for last month, with a number below 50 meaning the sector is shrinking. “There are too few people now. We only sold about a hundred bowls of noodles, that was just half of our normal level,” said one Beijing street vendor, who had also cut many items from the menu due to insufficient demand.
A bookstore in the city centre held an official opening ceremony after a soft opening followed by a two and a half month-long forced shutdown, but received only four visitors on a morning, one of which was the South China Morning Post reporter. All four were required to go through a body temperature check and write down their personal contact details before entering.
Service sector workers said the situation was surreal and that they were worried that there was no end in sight.
“I have never seen KFC look like this,” said an employee of the fast food chain restaurant at Wangfujing, pointing to the virtually empty dining hall.
A grocer at a nearby food market continually shook her head when talking about the decline in customers, but said she felt lucky that she could come back to Beijing from her hometown before the 14-day mandatory quarantine requirement was imposed on February 14.
This situation is not restricted to Beijing. When the Chinese government reopened around 500 cinemas nationwide in March, each one attracted on average
Now, many places across China are reimposing controls amid fears of a new spike in infections, the same fear leading people to stay home instead of going to those venues which have reopened.
Shanghai has closed tourist attractions while Sichuan has again closed karaoke lounges. Cinemas have also been reclosed across the country.
President Xi Jinping said during a visit to Hangzhou last Sunday that China must remain alert. “If you want to watch a movie, rather than going to a cinema, you can watch it online,” Xi said.
Services account for 60 per cent of China’s economy and the majority of employment. The slowness of the sector’s recovery is placing huge pressure on the world’s second
at a time when manufacturers are seeing export orders nosedive.
Liang Zhonghua, chief macro analyst at Zhongtai Securities, a brokerage, said that China’s damaged consumption alone could drag economic growth down by 4.5 per cent in the second quarter.
“(Chinese) residents’ fear of the epidemic is not over,” he wrote in a note this week.
Beijing’s malls still empty after coronavirus lockdown lifted
In Beijing all travellers entering the city are required to undergo a 14-day quarantine, while mass gatherings are still forbidden.
The containment measures have stopped many migrant workers from getting back to
, if they still exist. Many local residents still choose to work from home, even though authorities had been trying to encourage people to go out and spend money.
On April 1, the traffic flow on Beijing’s subway system was 3.05 million passengers a day, less than a third of the level a year ago, according to the operator, while car traffic was still about 15 per cent less than it was last year, government data showed.
I will keep cooking for myself, even when everything goes back to normal, it is much healthier and cheaper – Beijing resident
The nearly two month-long lockdown has changed the consumption behaviour of Chinese residents, many of whom have turned to home cooking to cut their spending.
“I will keep cooking for myself, even when everything goes back to normal, it is much healthier and cheaper,” said a Beijing lawyer whose family name is Li.
The effect of this behavioural shift is borne out in the 17.9 per cent drop in retail sales in the capital over the first two months of the year, only slightly better than the nationwide drop of 20.5 per cent.
Beijing businesses have clubbed together to issue some 150 million yuan in
US death toll passes 3,000 as New York’s hospitals are pushed to breaking point
Italy extends lockdown as cases exceed 100,000; UN Security Council votes by email for first time
The USNS Comfort passes the Statue of Liberty as it enters New York Harbour on Monday. Photo: Reuters
Harsh lockdowns aimed at halting the march of the coronavirus pandemic extended worldwide Monday as the death toll soared toward 37,000 amid new waves of US outbreaks.
The tough measures that have confined some two-fifths of the globe’s population to their homes were broadened. Moscow and Lagos joined the roll call of cities around the globe with eerily empty streets, while Virginia and Maryland became the latest US states to announce emergency stay-at-home orders, followed quickly by the capital city Washington.
In a symbol of the scale of the challenge facing humanity, a US military medical ship sailed into New York to relieve the pressure on overwhelmed hospitals bracing for the peak of the pandemic.
France reported its highest daily number of deaths since the outbreak began, saying 418 more people had succumbed in hospital.
Spain, which announced another 812 virus deaths in 24 hours, joined the United States and Italy in surpassing the number of cases in China, where the disease was first detected in December.
On Tuesday, mainland China reported a rise in new confirmed coronavirus cases, reversing four days of declines, due to an uptick in infections involving travellers arriving from overseas.
Mainland China had 48 new cases on Monday, the National Health Commission said, up from 31 new infections a day earlier.
All of the 48 cases were imported, bringing the total number of imported cases in China to 771 as of Monday.
There was no reported new case of local infection on Monday, according to the National Health Commission. The total number of infections reported in mainland China stood at 81,518 and the death toll at 3,305. Globally, more than 760,000 have been infected, according to official figures.
Here are the developments:
Hospital ship arrives in New York
New York’s governor issued an urgent appeal for medical volunteers Monday amid a “staggering” number of deaths from the coronavirus, saying: “Please come help us in New York, now.”
The plea from Governor Andrew Cuomo came as the death toll in New York State climbed past 1,200 – with most of the victims in the big city – and authorities warned that the crisis pushing New York’s hospitals to the breaking point is just a preview of what other cities across the US could soon face.
Cuomo said the city needs 1 million additional health care workers.
“We’ve lost over 1,000 New Yorkers,” he said. “To me, we’re beyond staggering already. We’ve reached staggering.”
The governor’s plea came as a 1,000-bed US Navy hospital ship docked in Manhattan on Monday and a field hospital was going up in Central Park for coronavirus patients.
New York City reported 914 deaths from the virus as of 4:30pm local time Monday, a 16 per cent increase from an update six hours earlier. The city, the epicentre of the US outbreak, has 38,087 confirmed cases, up by more than 1,800 from earlier in the day.
Coronavirus field hospital set up in New York’s Central Park as city’s health crisis deepens
Gloom for 24 million people in Asia
The economic fallout from the coronavirus pandemic will prevent almost 24 million people from escaping poverty in East Asia and the Pacific this year, according to the World Bank.
In a report released on Monday, the Washington-based lender also warned of “substantially higher risk” among households that depend on industries particularly vulnerable to the impact of Covid-19. These include tourism in Thailand and the Pacific islands; manufacturing in Vietnam and Cambodia; and among people dependent on “informal labour” in all countries.
The World Bank urged the region to invest in expanding conventional health care and medical equipment factories, as well as taking innovative measures like converting ordinary hospital beds for ICU use and rapidly trining people to work in basic care.
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Indonesia bans entry of foreigners
Indonesia barred foreign nationals from entering the country as the world’s fourth-most populous country stepped up efforts to contain the spread of the coronavirus pandemic.
The travel ban, to be effective soon, will also cover foreigners transiting through the country, Foreign Minister Retno Marsudi said after a cabinet meeting in Jakarta Tuesday. The curbs will not apply to holders of work permits, diplomats and other official visitors, she said.
The curbs on foreign citizens is the latest in a raft of measures taken by Indonesia to combat the deadly virus that’s sickened more than 1,400 people and killed 122. President Joko Widodo’s administration previously banned flights to and from mainland China and some of the virus-hit regions in Italy, South Korea and Iran. The president on Monday ordered stricter implementation of social distancing and health quarantine amid calls for a lockdown to contain the pandemic.
Indonesia has highest coronavirus mortality rate in Southeast Asia
First US service member dies
The first US military service member has died from the coronavirus, the Pentagon said on Monday, as it reported another sharp hike in the number of infected troops.
The Pentagon said it was a New Jersey Army National Guardsman who had tested positive for Covid-19 and had been hospitalised since March 21. He died on Saturday, it said.
Earlier on Monday, the Pentagon said that 568 troops had tested positive for the coronavirus, up from 280 on Thursday. More than 450 Defence Department civilians, contractors and dependents have also tested positive, it said.
US military has decided to stop providing more granular data about coronavirus infections within its ranks, citing concern that the information might be used by adversaries as the virus spreads.
The new policy, which the Pentagon detailed in a statement on Monday, appears to underscore US military concerns about the potential trajectory of the virus over the coming months – both at home and abroad.
School to resume in South Korea … online
South Korean children will start the new school year on April 9 with only online classes, after repeated delays due to the outbreak of the new coronavirus, the government said Tuesday.
Prime Minister Chung Sye Kyun said that despite the nation’s utmost efforts to contain the virus and lower the risk of infection, there is consensus among teachers and others that it is too early to let children go back to school.
The nation’s elementary schools, and junior and senior high schools were supposed to start the new academic year in early March, but the government has repeatedly postponed it to keep the virus from spreading among children.
The start was last postponed until April 6, but has now been delayed three more days to allow preparations to be made for online classes.
The nation now has 9,786 confirmed cases in total, with 162 deaths.
Italy extends lockdown as cases exceed 100,000
Italy’s government on Monday said it would extend its nationwide lockdown measures
against a coronavirus outbreak, due to end on Friday, at least until the Easter season in April.
The Health Ministry did not give a date for the new end of the lockdown, but said it would be in a law the government would propose. Easter Sunday is April 12 this year. Italy is predominantly Roman Catholic and contains the Vatican, the heart of the church.
Italians have been under lockdown for three weeks, with most shops, bars and restaurants shut and people forbidden from leaving their homes for all but non-essential needs.
Italy, which is the world’s hardest hit country in terms of number of deaths and accounts for more than a third of all global fatalities, saw its total death tally rise to 11,591 since the outbreak emerged in northern regions on February 21.
The death toll has risen by 812 in the last 24 hours, the Civil Protection Agency said, reversing two days of declines, although the number of new cases rose by just 4,050, the lowest increase since March 17, reaching a total of 101,739.
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Women stand near the body of a man who died on the sidewalk in Guayaquil, Ecuador. Photo: Reuters
Ecuador struggles to collect the dead
Ecuadorean authorities said they would improve the collection of corpses, as delays related to the rapid spread of the new coronavirus has left families keeping their loved ones’ bodies in their homes for days in some cases.
Residents of Guayaquil, Ecuador’s largest city, have complained they have no way to dispose of relatives’ remains due to strict quarantine and curfew measures designed to prevent spread of the disease. Last week, authorities said they had removed 100 corpses from homes in Guayaquil.
But delays in collecting bodies in the Andean country, which has reported 1,966 cases of the virus and 62 deaths, were evident midday on Monday in downtown Guayaquil, where a man’s dead body lay on a sidewalk under a blue plastic sheet. Police said the man had collapsed while waiting in line to enter a store. Hours later, the body had been removed.
More than 70 per cent of the country’s coronavirus cases, which is among the highest tallies in Latin America, are in the southern province of Guayas, where Guayaquil is located.
Panama to restrict movement by gender
The government of Panama announced strict quarantine measures that separate citizens by gender in an effort to slow the spread of the novel coronavirus.
From Wednesday, men and women will only be able to leave their homes for two hours at a time, and on different days. Until now, quarantine regulations were not based on gender.
Men will be able to go to the supermarket or the pharmacy on Tuesdays, Thursdays and Saturdays, and women will be allowed out on Mondays, Wednesdays and Fridays.
No one will be allowed to go out on Sundays. The new measures will last for 15 days.
Police in Kenya use tear gas to enforce coronavirus curfew
Remote vote first for UN Security Council
The UN Security Council on Monday for the first time approved resolutions remotely after painstaking negotiations among diplomats who are teleworking due to the coronavirus pandemic.
The Security Council unanimously voted by email for four resolutions, including one that extended through April 2021 the expiring mandate of UN experts who are monitoring sanctions on North Korea, diplomats said.
The UN mission in Somalia was also prolonged, until the end of June, and the mission in Darfur until the end of May – two short periods decided due to uncertainty over the spread of the pandemic.
The Council also endorsed a fourth resolution aimed at improving the protection for peacekeepers.
The resolutions are the first approved by the Security Council since it began teleworking on March 12 and comes as Covid-19 rapidly spreads in New York, which has become the epicenter of the disease in the United States.
Congo ex-president dies in France
Former Republic of Congo president Jacques Joaquim Yhombi Opango died in France on Monday of the new coronavirus, his family said. He was 81.
Yhombi Opango, who led Congo-Brazzaville from 1977 until he was toppled in 1979, died at a Paris hospital of Covid-19, his son Jean-Jacques said. He had been ill before he contracted the virus.
Yhombi Opango was an army officer who rose to power after the assassination of president Marien Ngouabi.
Yhombi Opango was ousted by long-time ruler Denis Sassou Nguesso. Accused of taking part in a coup plot against Sassou Nguesso, Yhombi Opango was jailed from 1987 to 1990. He was released a few months before a 1991 national conference that introduced multiparty politics in the central African country.
When civil war broke out in Congo in 1997, Yhombi Opango fled into exile in France. He was finally able to return home in 2007, but then divided his time between France and Congo because of his health problems.
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EU asks Britain to extend Brexit talks
The European Union expects Britain to seek an extension of its post-Brexit transition period beyond the end of the year, diplomats and officials said on Monday, as negotiations on trade have ground to a halt due to the coronavirus pandemic.
Europe has gone into a deep lockdown in a bid to curb the spread of the disease, with more than 330,000 infections reported on the continent and nearly 21,000 deaths.
In Britain, Prime Minister Boris Johnson and his health minister have both tested positive for the virus and the prime minister’s senior adviser Dominic Cummings – one of the masterminds behind Britain’s departure from the EU earlier this year – was self-isolating with symptoms.
London and the EU have been seeking to agree a new trade pact by the end of the year to kick in from 2021, even though the bloc has long said that such a time frame was extremely short to agree rules on everything from trade to security to fisheries.
The pyramid of Khufu, the largest of the Giza pyramid complex. Photo: Reuters
Great Pyramid in Egypt lights up in solidarity
Egypt’s famed Great Pyramid was emblazoned Monday evening with messages of unity and solidarity with those battling the novel coronavirus the world over.
“Stay safe”, “Stay at home” and “Thank you to those keeping us safe,” flashed in blue and green lights across the towering structure at the Giza plateau, southwest of the capital Cairo.
Egypt has so far registered 656 Covid-19 cases, including 41 deaths. Of the total infected, 150 reportedly recovered.
Egypt has carried out sweeping disinfection operations at archaeological sites, museums and other sites across the country.
In tandem, strict social distancing measures were imposed to reduce the risk of contagion among the country’s 100 million inhabitants.
Tourist and religious sites are shuttered, schools are closed and air traffic halted.
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Saudi king to pay for all patients’ treatment
Saudi Arabia will finance treatment for anyone infected with the coronavirus in the country, the health minister said on Monday.
The kingdom has registered eight deaths among 1,453 infections, the highest among the six Gulf Arab states.
Health Minister Tawfiq Al Rabiah said King Salman would cover treatment for citizens and residents diagnosed with the virus, urging people with symptoms to get tested.
“We are all in the same boat,” he told a news conference, adding that Crown Prince Mohammed bin Salman was overseeing containment efforts “night and day”.
Denmark eyes gradual reopening after Easter
Denmark may gradually lift a lockdown after Easter if the numbers of coronavirus cases and deaths remain stable, Prime Minister Mette Frederiksen said on Monday.
The Nordic country, which has reported 77 coronavirus-related deaths, last week extended until after Easter a two-week lockdown to limit physical contact between its citizens that began on March 11.
The number of daily deaths slowed to five on Sunday from eight and 11 on Saturday and Friday respectively. Denmark has reported a total of 2,577 coronavirus infections.
“If we over the next two weeks across Easter keep standing together by staying apart, and if the numbers remain stable for the next two weeks, then the government will begin a gradual, quiet and controlled opening of our society again, at the other side of Easter,” Frederiksen said.
Throughout the world, overworked health care professionals are being infected with Covid-19, yet the Lion City has kept numbers low
Preparation, planning, patient ratios and protective equipment have all played a part. Still, even the best gear cannot guard against discrimination
Medical staff walk to the National Centre for Infectious Diseases building at Tan Tock Seng Hospital in Singapore. Photo: AFP
Uncooperative patients, long hours and a lack of protective equipment are hampering health care workers across the world as they take the fight to the coronavirus, leading many to fall sick themselves.
In Malaysia, a pregnant woman who did not disclose that her father was infected tested positive after giving birth, leading to the shutdown of the entire hospital for cleaning. In the Philippines, nine doctors have died, two of whom had dealt with a patient who lied about her travel history.
In Spain, where more than 5,400 health care workers have been infected, accounting for about 14 per cent of the country’s patients, there are no longer enough workers to care for patients.
In Italy, which has more than 69,000 patients, the virus killed a doctor who had no choice but to work without gloves.
In the United States, which has surpassed China to become the world’s most infected nation with more than 83,000 people testing positive for Covid-19, hospitals are being overrun with patients.
Health care staff in the country say patients are packed into emergency wards and intensive care units (ICUs), further raising the risk of infections. They also report shortages of ventilators, face masks, gowns and shields.
The US Centres for Disease Control and Prevention on March 7 released interim guidelines saying health care workers exposed to the coronavirus could be asked to return to work as long as they wore face masks and were not showing symptoms, if their employers had no other manpower available.
Malaysian health workers at Kuala Lumpur International Airport. Photo: AFP
A REASON FOR OPTIMISM
However, amid all the gloom, Singapore’s experienceis being held up as a reason for optimism. The city state has reported more than 630 cases of infection, all of which are being treated in hospital, yet only a handful of its health care professionals have been infected. What’s more, even these cases, according to Vernon Lee, director of communicable diseases at the Ministry of Health, are thought to have been infected outside the health care setting.
Experts suggest this has been more than just luck, pointing to a case in which 41 health workers were exposed to the coronavirus in a Singapore hospital yet evaded infection.
The workers had all come within two metres of a middle-aged man with Covid-19 who was being intubated, a procedure which involves a tube being inserted into the patient’s trachea. The procedure is seen as being particularly hazardous for health workers as it is “aerosol generating” – patients are likely to cough.
The workers had not known at the time that the man had the virus and all were quarantined after he tested positive. However, on their release two weeks later, none of them had the virus.
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The case has come to widespread attention partly because the workers were wearing a mix of standard surgical masks and the N95 mask, which doctors see as the gold standard as it filters out 95 per cent of airborne particles.
The conclusion, published in The Annals of Internal Medicine this month, was this: “That none of the health care workers in this situation acquired infection suggests that surgical masks, hand hygiene, and other standard procedures protected them from being infected.”
Surgeon and writer Atul Gawande mentioned the case in an article for The New Yorker on how health care workers could continue seeing patients without becoming patients. He said there were things to learn from Asia and that some of the lessons came out of the “standard public health playbook”. In other words, there is much to be said for social distancing, basic hand hygiene and cleaning regimens.
A health worker in protective gear walks into a quarantine room at a hospital in Banda Aceh, Indonesia. Photo: AFP
COMING TOGETHER
With critical supplies running short in many countries, experts say it is increasingly vital that countries share both knowledge and resources.
To this end, China has been donating personal protective equipment to places including the Philippines, Pakistan and Europe. China’s richest man Jack Ma is donating 1.8 million masks, 210,000 Covid-19 test kits and 36,000 pieces of protective clothing to 10 countries in Asia.
At the same time, doctors are encouraging the Western world to learn from Asia.
Infectious diseases expert Leong Hoe Nam said that being “bitten by Sars” (severe acute respiratory syndrome) in 2003 had prepared Asia for Covid-19, while Western countries were not similarly prepared and hence lacked sufficient protective equipment.
He pointed to how about 2,000 health care workers had fallen sick in China early in the outbreak because workers did not initially have protective gear. The trend reversed as equipment became available.
“Once the defences were up, there were very few health care workers who fell sick at work. Rather, they fell sick from contact with sick individuals outside the workplace,” he said.
Malaysia is a case in point. While it has reported 80 health care workers falling ill, most are thought to be community infections.
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In a webinar organised by Caixin Global on Thursday night, Peng Zhiyong, an intensive care specialist at Zhongnan Hospital of Wuhan University, shared how they managed a shortage of personal protective equipment early on in the outbreak by rationing workers to two sets of gear per shift.
Meanwhile, in the Philippines, doctors from Manila’s Chinese General Hospital held a video conference call with doctors in Zhejiang to learn from China’s experience of treating Covid-19 patients.
Crowdsourcing platforms have also been created to share advice. The Brigham and Women’s Hospital in Boston has released guidelines for treating critically ill patients and its website includes information from Chinese doctors.
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The Jack Ma Foundation has also launched an online platform for doctors and nurses around the world to share knowledge on fighting the virus. “One world, one fight,” it said in a tweet.
Associate Professor Jeremy Lim from the global health programme at the Saw Swee Hock School of Public Health said it was crucial for countries to work together.
“Viruses don’t respect borders. Countries have to share information and help each other as we are only as strong as the weakest link. Any country can become a reservoir of disease and the world may then be forced to endure a ping-pong of outbreaks over and over again.”
And the advice of Lee, at Singapore’s Ministry of Health? “Practise good hygiene and wash hands regularly.”
Indonesian medical staff administer mass testing for Covid-19 in Bekasi, West Java. Photo: AFP
SINGAPORE, A CASE STUDY
Amid this sharing of advice, it is often Singapore that is held up as an example to replicate. Despite the country grappling with a rising load of Covid-19 patients, most of whom have recently returned to the city state from abroad, its health care system has continued to run smoothly. Doctors say this is because it has been preparing for a pandemic ever since Sars caught it by surprise. During the Sars outbreak, health care workers accounted for 41 per cent of Singapore’s 238 infections.
Consequently its hospitals swung into contingency planning mode early on in the coronavirus outbreak, telling staff to defer leave and travel plans after its first cases emerged.
Meanwhile, its hospitals swiftly split their workforces into teams to ensure there were enough workers if the outbreak worsened, and to ensure workers got enough rest.
Singapore has 13,766 doctors, or 2.4 doctors for every 1,000 people. That compares to 2.59 in the US, 1.78 in China and 4.2 in Germany. Places like Myanmar and Thailand have fewer than one doctor for every 1,000 people.
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“The objective is that you can run essential services with the greatest amount of security. Make sure functional units have redundancy built in, and are separate from each other. It depends on what you feel is sufficient to carry on services if one team is affected, factoring in rest periods and some system of rotation,” said Chia Shi-Lu, an orthopaedic surgeon.
The key is to ensure a good doctor-to-patient ratio and ensure there are enough specialists for the critical work, such as doctors and nurses who can provide intensive care, and know how to operate mechanical ventilators or machines to pump and oxygenate a patient’s blood outside the body.
At the emergency department where paediatrics emergency specialist Jade Kua treats Covid-19 cases in addition to regular emergencies, doctors are split into four teams of 21. Each team takes alternate 12-hour shifts and does not interact with other teams.
“We are in modular teams so the teams move together. So you and I would both do morning, off, night, off, morning off. Together. And then the other teams would do the same and we don’t intermingle,” said Kua.
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Chia, who works at the Singapore General Hospital, said doctors had been split up according to their functions.
“We try not to meet at all with the other teams as much as possible. We’ll just say hi from across the corridor. Meals are the same. All our cafeterias and everything have got social distancing spaced in already,” said Chia, who is also a member of parliament and chairs a shadow committee on health.
Chia said the health care system could also tap on doctors in the private sector.
Not every country has a plan like this. Last year’s Global Health Security Index by the Economist Intelligence Unit found that 70 per cent of 195 countries scored poorly when it came to having a national plan for dealing with epidemics or pandemics. Almost three in 10 had failed to identify which areas were insufficiently staffed. In India, with a population of 1.3 billion, only about 20,000 doctors are trained in key areas such as critical care, emergency medicine and pulmonology.
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In contrast, Singapore published its first Influenza Pandemic Preparedness and Response Plan in June 2005 and has since honed it to a tee. Hospitals regularly war-game scenarios such as pandemics or terrorist attacks and the simulations are sometimes observed by the Ministry of Health, which grades the performance and recommends areas for improvement.
The plan also covers the need to stockpile equipment to avoid the sort of shortages many countries are now facing, another lesson inspired by Sars when masks, gloves and gowns were in short supply.
In a pandemic preparation paper published in 2008, Singapore public health specialist Jeffery Cutter wrote that Singapore’s stockpile was sufficient to cover at least 5 to 6 months’ use by all front-line health care workers.
During the Covid-19 outbreak, it has also told citizens to not wear masks so it can conserve supply for medical staff.
Having enough protective gear has reassured Singapore’s health care workers such as Kua, a mother of six who blogged about her experience fighting Covid-19. Kua said: “I’m safe and my family is safe.”
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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.
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