Archive for ‘the Lion City’

04/04/2020

Coronavirus latest: US deaths hit daily high as global infections cross 1 million; Singapore shuts schools and workplaces

  • The US saw 1,169 deaths in 24 hours and its infections are 20 per cent of the global total
  • China to hold day of mourning for victims; Singapore announces fifth death and school closures; Boris Johnson says he’s still ill; Angela Merkel ends quarantine
A group of nurses gather in the Bronx, New York, for a strike about the lack of personal protective equipment, on April 2, 2020. Photo: EPA-EFE
A group of nurses gather in the Bronx, New York, for a strike about the lack of personal protective equipment, on April 2, 2020. Photo: EPA-EFE
The number of confirmed coronavirus cases around the world soared past one million on Thursday and deaths topped 50,000 as Europe reeled from the pandemic and the

United States

reported the highest daily death toll so far of any country.

Despite more than half the planet imposing some form of lockdown, the virus claimed thousands more lives, with the US, Spain and Britain seeing the highest number of daily fatalities yet.
Covid-19 is currently spreading the most rapidly in the US, where there have been 243,453 infections and 5,926 deaths, according to a tally by Johns Hopkins University.

The US saw 1,169 deaths in 24 hours, the highest one-day toll recorded in any country since the global pandemic began. The grim record was previously held by Italy, where 969 people died on March 27.

Here are other developments:

Singapore shuts schools, workplaces in ‘circuit-breaking’ move

Singapore’s coronavirus case number hits 1,000 after city state reports biggest single-day spike
Singapore Prime Minister Lee Hsien Loong on Friday afternoon announced most workplaces would be shut from April 7, and schools would be closed from April 8, in its 
strictest measures yet

to battle the coronavirus pandemic.

The city state has 1,114 infections and five people have died. More than 200 have recovered.

Essential services such as food establishments, markets and supermarkets, clinics, hospitals, utilities, transport and banking services will remain open.

Coronavirus: what’s behind Singapore’s U-turn on wearing masks?

4 Apr 2020
Lee on Friday said instead of tightening measures incrementally over the next few weeks, Singapore should “make a decisive move now, to pre-empt escalating infections”.

“Looking at the trend, I am worried that unless we take further steps, things will gradually get worse, or another big cluster may push things over the edge,” Lee said, describing the new measures as a “circuit breaker”.

Medical experts say the stringent measures require the cooperation of citizens to stay at home, given that local infection clusters have ballooned from six at the end of February to more than 20 currently.

People stand behind markers as they practice physical distancing while queuing up to buy food at a Singapore supermarket on April 3, 2020. Photo: Reuters
People stand behind markers as they practice physical distancing while queuing up to buy food at a Singapore supermarket on April 3, 2020. Photo: Reuters
The Lion City has launched a website to help individuals with symptoms that might be related to Covid-19 decide whether they should see a doctor or not.
On the Covid-19 Symptom Checker website, individuals will be prompted to answer a short list of questions including their age, if they have any chronic diseases, if they have travelled outside Singapore in the past 14 days, or have been in touch with a suspected or confirmed Covid-19 case.
They will also be asked to choose which symptoms they are experiencing from a predetermined list including symptoms such as cough, difficulty breathing and the loss of taste/smell. The site will then recommend what the person should do next. This includes whether they should see a doctor or continue to monitor their symptoms.

China to hold day of mourning for Covid-19 victims

At 10am on April 4, 2020, the public will be asked to observe three minutes of silence. Photo: EPA-EFE
At 10am on April 4, 2020, the public will be asked to observe three minutes of silence. Photo: EPA-EFE
China has declared April 4 a national day of mourning for the thousands of people who have died in the coronavirus pandemic.

Flags will be flown at half-mast across the country and at embassies overseas, while all public entertainment will be halted for the day, said the State Council, China’s cabinet, on Friday.

At 10am, the public will be asked to observe three minutes of silence, during which sirens will blast out across the country and the owners of cars and boats should sound their vehicles’ horns, the council said.

Saturday also coincides with Ching Ming, or the Tomb-sweeping Festival, when Chinese traditionally gather to remember their ancestors.

China to stage day of mourning for the thousands lost to Covid-19

4 Apr 2020
Mainland China on Friday reported 31 new confirmed coronavirus cases, including two locally transmitted infections, the country’s National Health Commission said.

It also reported four new deaths as of Thursday, all in Wuhan, the city where the outbreak began, the commission said in a statement. The total number of infections now stands at 81,620 and 3,322 deaths have been reported from mainland China to date.

The commission said 60 new asymptomatic coronavirus patients were also reported on Thursday.

UK’s Boris Johnson still ill with virus fever

British Prime Minister Boris Johnson remains in isolation with a high temperature, more than a week after testing positive for coronavirus.

Johnson made the announcement in a video posted on Twitter on Friday, saying that even after seven days, “alas I still have one of the symptoms, a minor symptom: I still have a temperature”.

“In accordance with government advice I must continue my self-isolation,” he said.

As virus rages, British love for NHS could make or break Boris Johnson
3 Apr 2020

With coronavirus deaths still rising, the PM is anxious to drum home his message that Britons must obey government orders to stay in their homes as much as possible.

On March 23 he ordered a national lockdown, with the closure of schools, stores, restaurants and leisure facilities. Under emergency laws, police have the power to fine individuals who flout the rules and break up gatherings of more than two people in public.

Germany to crack down on people flouting physical distancing rules

Police officers ask people to disperse as they gather at a park in Berlin, Germany, on March 28, 2020. Photo: Reuters
Police officers ask people to disperse as they gather at a park in Berlin, Germany, on March 28, 2020. Photo: Reuters
People in Germany risk being fined up to €500 (US$540) for standing too close to each other from Friday, as officials crack down on people flouting rules brought in to control the coronavirus outbreak.
Chancellor Angela Merkel’s government has ordered people not leave their homes unless they have an exceptional reason such as grocery shopping, exercise or medical appointments.
Gatherings of more than two people are banned and a distance of at least 1.5 metres must be kept from others at all times.
Local governments have the power to set fines for transgressors, with city officials in Berlin saying their fines would be as high as 500 euros. Similar announcements have come from across Germany’s 16 states.
Bow ties to face masks: German firms shift gears in virus crisis
2 Apr 2020
According to figures by the Robert Koch Institute (RKI) on Friday, Germany has recorded more than 79,000 cases of the novel coronavirus, and 1,017 deaths, although RKI president Lothar Wieler warned on Friday that the actual number of casualties could be much higher.
“We won’t manage to test every single person … I assume we will have more deaths than are officially recorded,” he said.
Wieler said the mortality rate would “continue to rise” in Germany.  German minister’s suicide linked to coronavirus crisis
30 Mar 2020

Meanwhile, Merkel on Friday left her Berlin home for the first time in almost two weeks, after she was forced into quarantine following contact with an infected doctor.

Merkel was tested several times, with all tests coming back negative.

The 65-year-old leader has returned to her office, where she will continue to observe social distancing rules and lead the country via video and audio conferencing, her spokesman said.

Spain records over 900 virus deaths

Members of the Red Cross prepare food for families in need at a food bank in Ronda, Spain, on April 3, 2020. Photo: Reuters
Members of the Red Cross prepare food for families in need at a food bank in Ronda, Spain, on April 3, 2020. Photo: Reuters
Spain

on Friday recorded over 900 new coronavirus deaths over the past day, bringing the number of casualties to 10,935, in the first decline in new Covid-19 deaths in four days.

The country has the world’s second-highest death toll after Italy, but health ministry figures confirm a consistent downward trend in the rate of new cases and fatalities.

The 932 deaths on Friday was a smaller gain than Thursday’s 950, according to Health Ministry data. The number of confirmed cases also increased by less than the previous day, with 7,472 new infections taking the total to 117,710.

Why Europe’s hospitals – among world’s best – are struggling with virus

1 Apr 2020

Prime Minister Pedro Sanchez’s government has been struggling to bring the virus under control. Hospitals are overwhelmed, nursing homes have been especially hard hit in a nation with one of the world’s oldest populations, and the army has been mobilised.

Sanchez may extend the current four-week lockdown for another two weeks beyond April 11, Spanish media reported on Friday. The stay-at-home order limits people’s movement to shopping for food and essentials, while some workers are also allowed to circulate.

Passengers disembark from virus-hit cruise ship in Florida

The Zaandam cruise ship docked in Florida on Friday. Photo: TNS via ZUMA Wire/dpa
The Zaandam cruise ship docked in Florida on Friday. Photo: TNS via ZUMA Wire/dpa
Passengers from an ill-fated cruise were carefully freed from their cabins and allowed to disembark on Friday, following the removal of 14 critically-ill people who were wheeled off to Florida hospitals bracing for an onslaught of coronavirus patients.
The exodus from the Zaandam and its sister ship the Rotterdam, both operated by Holland America Line, was expected to continue throughout the day.
Floridians were getting off first, followed by other passengers. Buses were taking people healthy enough to travel directly to the airport, where they will board chartered flights home without going through the terminal.
Coronavirus nightmare for passengers stuck on MS Zaandam ‘death ship’
30 Mar 2020

“This is a humanitarian situation, and the County Commission’s top priority is protecting our 1.9 million residents while providing a contained disembarkation option for people on board who need to get safely home,” Broward County Mayor Dale Holness said in a statement late on Thursday.

Four people have died on the Zaandam, for reasons not yet disclosed. All told, 107 passengers and 143 crew reported flu-like symptoms during the voyage, but many have since recovered.

It was unclear when the bodies of four passengers who died on the Zaandam would be removed from the ship, which set sail on March 7, the day before the US State Department warned people against cruising during the pandemic.

South Korea’s infections top 10,000

South Korean hospital’s ‘phone booth’ coronavirus tests
South Korea

on Friday said the number of confirmed coronavirus cases in the country has surpassed 10,000, with 174 deaths linked to Covid-19, the disease caused by the new virus.

The Health and Welfare Ministry reported 86 new coronavirus infections over 24 hours to the end of Thursday, taking the total to 10,062 cases. It also logged five more deaths.

The numbers confirmed an encouraging stabilisation of numbers, which have hovered around the 100 mark for the past three weeks, a clear downward trend which began in March after numbers peaked at the end of February with over 900 cases recorded in a day.

South Korea’s virus response is the opposite of China’s – and it works

15 Mar 2020

For a fourth straight day, more new cases were recorded from Seoul and the surrounding Gyeonggi province, than in what has so far been the outbreak epicentre in the country – North Gyeongsang province and city of Daegu – with the capital area registering 34 new cases, and the latter recording 23.

Imported cases in patients recently returned from abroad also continued to increase, with 22 new infections bringing the total to 264.

Japan to give US$2,800 payouts to households

A man seen in a protective mask at Shinjuku in Tokyo, Japan, on April 2, 2020. Photo: EPA-EFE
A man seen in a protective mask at Shinjuku in Tokyo, Japan, on April 2, 2020. Photo: EPA-EFE
Japanese ruling party executive Fumio Kishida said on Friday he has agreed with Prime Minister Shinzo Abe to offer 300,000 yen (US$2,800) in cash payments per household that suffers a certain degree of income declines from the coronavirus pandemic.
About 10 million of Japan’s 58 million households are expected to be eligible for the cash programme, a key pillar of an emergency economic package that the government plans to compile possibly on Tuesday.
The relief measure will be funded by a supplementary budget for this fiscal year that the government wants to pass in parliament before Japan’s Golden Week holiday starts in early May.
Coronavirus: Tokyo’s nightlife districts linked to rise in cases
2 Apr 2020

The government will not set a household income limit for the cash handout, which will be tax free, officials said.

“If we set an income limit, we would have to check individual incomes, which would take a lot of time,” Yasutoshi Nishimura, minister in charge of economic and fiscal policy, told a press conference. “Instead of that, we’ll come up with an unprecedented way (to judge who should receive cash).”

Nishimura said recipients will be limited to those who are facing livelihood difficulties, and that civil servants, politicians and major corporate executives who have not been significantly affected by the economic impact of the virus outbreak, for example, will be excluded from the scheme.

Japan weighs cost of Tokyo lockdown and Wagyu beef coupons for households

31 Mar 2020

Abe said the government will provide cash “as soon as possible” not only to households but also to small-and mid-sized business operators that have seen their revenues drop.

Abe has said the package to tackle the coronavirus will be larger than the 56.8 trillion yen emergency package compiled in April 2009 following the previous year’s global financial crisis.

Indonesian Muslims banned from travelling home for Eid al-Fitr

A police officer in a coronavirus helmet sprays disinfectant at a motorcycle in East Java, Indonesia, on April 3, 2020. Photo: AP
A police officer in a coronavirus helmet sprays disinfectant at a motorcycle in East Java, Indonesia, on April 3, 2020. Photo: AP
Islamic scholars in Indonesia on Friday issued an edict to forbid people from travelling home for Eid al-Fitr, the festival marking the end of the Muslim fasting month of Ramadan, as the country recorded nearly 2,000 infections during the 
The fatwa was issued by the Indonesian Council of Ulema a day after President

Joko Widodo

decided to allow millions of Muslims to travel to celebrate Eid in their hometowns next month, despite fears that they could spread the Covid-19 disease.

“The virus spreads very easily. Doing something like that at a time of a pandemic is haram [forbidden],” the council’s sectary general Anwar Abbas said.
Eid al-Fitr is expected to start on May 23, depending on the sighting of the new moon.
Indonesia frees 18,000 prisoners as virus death toll surges to 170
2 Apr 2020

Indonesia confirmed 196 new infections on Friday, bringing the total number of cases to 1,986.

The death toll rose to 181 after 11 new deaths, making Indonesia the the country with the highest number of fatalities in Asia outside China.

The State Intelligence Agency warned that the outbreak in Indonesia could peak in June with more than 105,000 cases.

Thailand’s night curfew to begin; people banned from making virus pranks

An officer checks the temperature of a passenger in a bus at a health checkpoint in Bangkok, Thailand, on April 3, 2020. Photo: AP
An officer checks the temperature of a passenger in a bus at a health checkpoint in Bangkok, Thailand, on April 3, 2020. Photo: AP
Thailand will on Friday night begin a daily nationwide curfew to try to curb the spread of the coronavirus.
The 10pm-4am curfew, which will run indefinitely, is the latest measure by the government to curb gatherings and have people stay at home as much as possible.

Exceptions include those people transporting medical supplies and health workers travelling to and from work, Prime Minister Prayuth Chan-ocha said.

“We prioritise health over freedom,” Prayuth said. “We might not feel as comfortable as before, but we all need to adapt for survival and have social responsibility, so that we can make it through this crisis.”

In a televised address, Prayuth also asked all Thai citizens abroad to “delay” returning to 

Thailand

until after April 15 in a bid to stop imported cases.

Thai king remains in Germany during pandemic, prompting criticism online
23 Mar 2020

Thais have also been banned from making public gatherings, in an order signed on Friday by defence forces chief General Pornpipat Benyasri.

The order prohibits people from public gatherings, carrying out activities, or gathering for unlawful purposes in a manner that risks spreading the coronavirus.

It also bans any act that aggravates people’s suffering and pranks to spread the virus. Family gatherings at residences and civic activities carried out according to safe social distancing guidelines are allowed.

Violation of the order carries a maximum penalty of two years’ imprisonment and a fine of 40,000 baht (US$1,215).

Pakistan’s mosques remain open amid shutdowns

Coronavirus: In Pakistan food aid is distributed to the poor in Karachi
Mosques in Pakistan were allowed to remain open on Friday, when adherents gather for weekly prayers, even as much of the country had shut down.
Pakistan, with 2,450 confirmed coronavirus cases and 35 deaths, has been sharply criticised for moving too slowly to curb large gatherings.
Prime Minister Imran Khan was relying on restricting the size of congregations attending mosques and advice to stay at home from religious groups like the country’s Islamic Ideology Council.
Coronavirus: Pakistan quarantines pilgrims returning from Iran
4 Mar 2020

However, some provinces had issued their own lockdown orders to prevent Muslims from gathering for Friday prayers.

In southern Sindh province, a complete lockdown was being enforced from noon until 3pm, the time when the faithful gather for prayers. Anyone found on the streets would be arrested, according to the provincial local government minister in a statement.

In eastern Punjab province, where 60 per cent of Pakistan’s 220 million people live, checkpoints had been set up in major cities stopping people from congregating.

Tunisia ‘robocop’ enforces virus lockdown

The PGuard robot patrols the streets of Tunis, in Tunisia, on April 1, 2020. Photo: EPA-EFE
The PGuard robot patrols the streets of Tunis, in Tunisia, on April 1, 2020. Photo: EPA-EFE
Tunisia’s interior ministry has deployed a police robot to patrol the streets of the capital and enforce a lockdown as the country battles the spread of coronavirus.
Known as PGuard, the “robocop” is remotely operated and equipped with infrared and thermal imaging cameras, in addition to a sound and light alarm system.
In images and a soundtrack posted on the interior ministry’s website last month, PGuard calls out to suspected violators of the lockdown: “What are you doing? Show me your ID. You don’t know there’s a lockdown?”
The PGuard robot checks the exit permit of a citizen in Tunis on April 1, 2020. Photo: EPA-EFE
The PGuard robot checks the exit permit of a citizen in Tunis on April 1, 2020. Photo: EPA-EFE
Tunisia has been under night-time curfew since March 17 and authorities imposed stricter lockdown orders from March 22.
Fourteen people have died from coronavirus in Tunisia, where 455 confirmed cases have tested positive for the disease.
The robot’s Tunisian creator Anis Sahbani said the machine was first produced in 2015 essentially to carry out security patrols and it also operates autonomously through artificial intelligence.
The robot, built by Sahbani’s Enova Robotics firm, costs between 100,000 and 130,000 euros (US$100,000 and $140,000), and has been selling mostly overseas to companies for security uses.

France death tally passes 5,000

A cashier runs a store counter covered up with a plastic barrier in Paris, France, on April 3, 2020. Photo: Xinhua
A cashier runs a store counter covered up with a plastic barrier in Paris, France, on April 3, 2020. Photo: Xinhua
France

reported a jump in coronavirus deaths on Thursday as the country included fatalities in some nursing homes for the first time. Still, a decline in intensive-care admissions suggest the country’s lockdown is starting to slow the pace of the outbreak.

The health ministry reported 471 new hospital deaths from the coronavirus on Thursday. In addition, it reported 884 deaths in a partial count from nursing homes, bringing the total number to 5,387. Nursing homes were not previously included in the statistics.
France is the third-hardest hit country in

Europe

in number of deaths, behind Italy and Spain. The number of confirmed cases is now at 59,105.

Italy reported another 760 fatalities on Thursday. Its death toll, already the world’s highest, now stands at 13,915. Total infections, including recoveries and deaths, have reached 115,242.
Spain reported 950 more deaths from the coronavirus, the most in a single day, taking the total to 10,003.

India plans staggered exit from lockdown

Indian policemen in Hyderabad, India, wear virus-themed helmets for a campaign to raise awareness at preventing the spread of the coronavirus on April 2, 2020. Photo: AP
Indian policemen in Hyderabad, India, wear virus-themed helmets for a campaign to raise awareness at preventing the spread of the coronavirus on April 2, 2020. Photo: AP
India will pull out of a three-week lockdown in phases, Prime Minister Narendra Modi
 said on Thursday, as officials battle to contain the country’s biggest cluster of coronavirus infections in the capital, New Delhi.
The shutdown, which has brought Asia’s third-largest economy to a shuddering halt, had been due to end on April 14.
Modi ordered India’s 1.3 billion people indoors to avert a massive outbreak of 
coronavirus

infections, but the world’s biggest shutdown has left millions without jobs and forced migrant workers to flee to their villages for food and shelter.

After violence, Indian police try humour to enforce virus lockdown
2 Apr 2020

He told state chief ministers that the shutdown had helped limit infections but that the situation remained far from satisfactory around the world and there could be a second wave.

“Prime minister said that it is important to formulate a common exit strategy to ensure staggered re-emergence of the population once lockdown ends,” the government quoted him as saying in a video conference.

India has had 2,069 confirmed infections, of whom 53 have died, low figures by comparison with the US, China, Italy and Spain. But the big worry is the 

emergence of a cluster in Delhi

because of a gathering held by a Muslim missionary group last month that has spawned dozens of cases across the country, officials said.

Five-minute virus tests ‘may give inaccurate results’

A Chinese drug and diagnostic firm has cautioned that the slew of new test kits that promise to detect the coronavirus in just a few minutes may not be as accurate as conventional kits, a potential setback for countries seeking to rapidly test their citizens.

“Such rapid testing is not as accurate as the traditional nucleic acid test that takes about two hours to turn out results,” Wu Yifang, Shanghai Fosun Pharmaceutical Group’s chief executive officer, said. The drugmaker also has a swift testing technology but it’s working on making the results more accurate, according to Wu.

Coronavirus nightmare of China’s ‘recovered’ patients

2 Apr 2020
Abbott Laboratories unveiled a coronavirus test on March 28 that can confirm if someone is infected in as little as five minutes. Shenzhen Bioeasy Biotechnology has been supplying its version of rapid testing kits to the European Union even before getting regulatory approval in China for domestic use.
The faster and easy-to-deploy diagnostic kits seemingly save time and resources for nations under pressure to widen their testing efforts. But there have been reports of faulty kits, like those bought by Spain and the Czech Republic.
Shenzhen Bioeasy, which sold thousands of test kits to Spain, said in a statement on March 27 that false results could be due to improper use of its kits or faulty specimen collection.

Trump tests negative again

US President Donald Trump was was first tested last month after coming into contact with a Brazilian official who later tested positive. Photo: UPI/Bloomberg
US President Donald Trump was was first tested last month after coming into contact with a Brazilian official who later tested positive. Photo: UPI/Bloomberg
US President Donald Trump on Thursday was tested again to determine whether he had been infected by the coronavirus, and the test came back negative, the White House said.

A letter from Trump’s doctor, Sean Conley, said Trump had undergone what was a second test for coronavirus. He was tested last month after coming into contact with a Brazilian official who later tested positive.

Trump to urge Americans to wear masks when outside

3 Apr 2020

Conley said in a letter released by the White House that Trump was tested with a new, rapid point-of-contact test and the result came back in 15 minutes.

“He is healthy and without symptoms,” Conley said.

Trump said Americans should wear protective face masks if they wish. “If people want to wear them, they can” he said. Scarves work just as well, he said.

NRA sues NY governor over closure of gun stores

A pedestrian pushes a stroller as people wait in line outside a gun store to buy supplies on March 15, 2020. Photo: Reuters
A pedestrian pushes a stroller as people wait in line outside a gun store to buy supplies on March 15, 2020. Photo: Reuters
The National Rifle Association (NRA) sued New York Governor Andrew Cuomo for closing gun shops during the coronavirus pandemic, saying the restriction is unconstitutional and leaves citizens defenceless while prisoners are being released early as a result of the crisis.
Cuomo’s March 20 executive order that included firearms retailers as non-essential businesses, which must close is a “pointless and arbitrary attack on the constitutional rights of New York citizens and residents,” the NRA said in a complaint filed late Thursday in Syracuse, New York.
New York ordered most businesses to close to prevent the spread of the virus, but deemed grocery stores, liquor stores, pharmacies and restaurants that do take-out as essential and allowed them to remain open.
The New York lawsuit follows similar action the NRA took in Northern California, where it sued several cities including San Jose for ordering gun stores to close.

Corona beer producer halts brewing

The Mexican brewer of Corona beer said on Thursday it was suspending production because of the health emergency in the country over the Covid-19 pandemic.

Grupo Modelo said the measure was in line with the Mexican government’s order to suspend all non-essential activities until April 30 to slow the spread of coronavirus.

“We are in the process of lowering production at our plants to the bare minimum,” the company said in a statement, adding it would complete the suspension in the following days.

Mexico’s government has said that only key sectors such as agribusiness will be able to continue to function.

US stops issuing passports, except in emergencies

The US State Department will not be processing new passports and renewals except for emergency cases because of the coronavirus pandemic, the agency’s website said.

“Due to public health measures to limit the spread of Covid-19, effective March 20, 2020, we are only able to offer service for customers with a qualified life-or-death emergency and who need a passport for immediate international travel within 72 hours,” said a March 27 online statement.

How elite US university students brought coronavirus home from campus

3 Apr 2020

Passport applications received on or before March 19 will be processed.

Travellers who paid extra for expedited service can expect to receive their passport in the next two to three weeks.

If you applied in-person at a passport agency or centre before March 19, the agency will contact you about getting your passport.

Source: SCMP

29/03/2020

Why are there so few coronavirus infections in Singapore’s health workers?

  • 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
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
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.

Coronavirus: as Malaysia braces for third wave, doctors make their own face masks

27 Mar 2020

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
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.
Coronavirus: Doctor explains the proper way to wash your hands and put on a face mask

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.

Why Singapore’s coronavirus response worked – and what we can all learn

27 Mar 2020

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
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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SOMETHING YOU CAN’T GUARD AGAINST
Despite the many positives to emerge from the Lion City, its health care workers are struggling with another problem: discrimination.
While in France, Italy and Britain, residents cheer health care workers from their windows, in Singapore health care workers are seen by some people as disease carriers.
“I try not to wear my uniform home because you never know what kind of incidents you may encounter,” said one Singapore nurse. “The public is scared and wearing our uniforms actually causes quite a bit of inconvenience. One of my staff tried to book a private-hire car to the hospital for an emergency and she was rejected by five drivers.”

There is a similar stigma in India, where the All India Institute of Medical Sciences has appealed to the government for help after health workers were forced out of their homes by panicked landlords and housing societies.

“Many doctors are stranded on the roads with all their luggage, nowhere to go, across the country,” the institute said in a letter.

Lim, from the Saw Swee Hock School of Public Health, said the worst human impulses and “every man for himself” attitudes could emerge in crises and “that is exactly why governments have to step in”.

Discrimination could affect both the performance and motivation of health care workers, Lim warned.

Meanwhile, when health care workers are infected, it creates a “triple whammy” threat.

“It means one fewer professional in an already-strained system, another patient to care for and, potentially, a team of colleagues who need to be quarantined,” said Lim.

“We must do everything possible to keep our health care workforce safe and free from Covid-19.”

Source: SCMP

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