Chindia Alert: You’ll be Living in their World Very Soon
aims to alert you to the threats and opportunities that China and India present. China and India require serious attention; case of ‘hidden dragon and crouching tiger’.
Without this attention, governments, businesses and, indeed, individuals may find themselves at a great disadvantage sooner rather than later.
The POSTs (front webpages) are mainly 'cuttings' from reliable sources, updated continuously.
The PAGEs (see Tabs, above) attempt to make the information more meaningful by putting some structure to the information we have researched and assembled since 2006.
City at centre of outbreak finally able to declare itself clear of disease after months in lockdown and thousands of deaths
Risk of infection remains, however, with some patients testing positive for coronavirus that causes disease without showing symptoms
Ferries and other public transport services resumed in Wuhan last week. Photo: Xinhua
The city of Wuhan, the initial epicentre of the coronavirus pandemic, no longer has any Covid-19 patients in hospital after the last 12 were discharged on Sunday.
Their release ended a four-month nightmare for the city, where the disease was first detected in December. The number of patients being treated for Covid-19, the disease caused by a new coronavirus, peaked on February 18 at 38,020 – nearly 10,000 of whom were in severe or critical condition.
“With the joint efforts of Wuhan and the national medical aid given to Hubei province, all cases of Covid-19 in Wuhan were cleared as of April 26,” Mi Feng, a spokesman for the National Health Commission said on Sunday afternoon.
The announcement came only one day after the city discharged the last patient who had been in a severe condition. That patient also was the last severe case in Hubei province.
The last patient discharged from Wuhan Chest Hospital, a 77-year-old man surnamed Ding, twice tested negative for Sars-CoV-2, the virus that causes Covid-19, and was released at noon on Sunday.
“I missed my family so much!” Ding told Changjing Daily.
Another unidentified patient exclaimed as he left the hospital: “The air outside is so fresh! The weather is so good today!”
Wuhan faced a long journey to bring its patient count down to zero.
The city of 11 million, the capital of Hubei province and a transport hub for central China, was put under a strict lockdown on January 23 that barred anyone from entering or exiting the city without official approval for 76 days until it was officially lifted on April 8.
Coronavirus: Wuhan, Los Angeles officials discuss getting back to work after lockdown
22 Apr 2020
Residents were ordered to stay in their apartments as the city stopped public transport and banned private cars from city streets. As the epidemic worsened, more than 42,000 medical staff from across the country were sent to the city and to Hubei province to help ease the burden on the local health care system.
Wuhan was the hardest hit city in China, accounting for 50,333 of the 82,827 locally transmitted Covid-19 cases recorded in China. More than 4,600 died in the country from the disease.
On March 13, the city reported for the first time that there were no new suspected cases of the infection, and five days later there were no confirmed cases.
The number of discharged patients bottomed out at 39.1 per cent at the end of February, gradually climbing to 92.2 per cent by last Thursday.
“Having the patients in the hospital cleared on April 26 marks a major achievement for the city’s Covid-19 treatment,” the Wuhan Health Commission said in a statement.
However, having no severe cases in hospital does not mean all the discharged patients will require no further treatment as they may still need further care.
“Clearing all the severe cases marks a decisive victory for the battle to safeguard Wuhan,” health minister Ma Xiaowei told state broadcaster China Central Television on Saturday.
“Some patients who have other conditions are being treated in specialised hospitals. It has been properly arranged.”
Coronavirus: Chinese writer hit by nationalist backlash over diary about Wuhan lockdown
18 Apr 2020
Ten patients aged between 42 and 85 who have been declared coronavirus-free are still in intensive care at the city’s Tongji Hospital where they are being treated for kidney problems and other complications arising from Covid-19. Some still need ventilators to help them breathe.
These 10 patients are under 24-hour care, with 190 nurses on four-hour rotations. There are other patients in a similar condition in two other hospitals in Wuhan, according to the Hubei Broadcasting and Television Network.
However, the discharge of the last batch of Covid-19 patients does not mean that the risk of infection is gone.
The city reported 20 new cases of people testing positive for Sars-CoV-2, the official name for the coronavirus that causes the disease, but who do not yet show symptoms.
There are 535 such carriers under medical observation. Past data shows some of these asymptomatic carriers will develop symptoms, and so will be counted as Covid-19 patients under China’s diagnosis and treatment plan.
China’s coronavirus infection curve has flattened out with about 694 imported cases of Covid-19 on top of about 800 locally transmitted ones now under treatment.
The national health commission spokesman warned that people still need to be on high alert as the virus is continuing to spread around the globe, with no sign yet of a slowdown.
“[We] must not drop our guard and loosen up. [We] must discover cases in time and deal with them quickly,” Mi said, citing the continued pressure from cases imported by people returning from overseas.
“The next step will be to implement the requirements of the central government and continue to guard against imported cases and a rebound of domestic transmitted cases.”
The richest man in China opened his own Twitter account last month, in the middle of the Covid-19 outbreak. So far, every one of his posts has been devoted to his unrivalled campaign to deliver medical supplies to almost every country around the world.
“One world, one fight!” Jack Ma enthused in one of his first messages. “Together, we can do this!” he cheered in another.
The billionaire entrepreneur is the driving force behind a widespread operation to ship medical supplies to more than 150 countries so far, sending face masks and ventilators to many places that have been elbowed out of the global brawl over life-saving equipment.
But Ma’s critics and even some of his supporters aren’t sure what he’s getting himself into. Has this bold venture into global philanthropy unveiled him as the friendly face of China’s Communist Party? Or is he an independent player who is being used by the Party for propaganda purposes? He appears to be following China’s diplomatic rules, particularly when choosing which countries should benefit from his donations, but his growing clout might put him in the crosshairs of the jealous leaders at the top of China’s political pyramid.
Other tech billionaires have pledged more money to fight the effects of the virus – Twitter’s Jack Dorsey is giving $1bn (£0.8bn) to the cause. Candid, a US-based philanthropy watchdog that tracks private charitable donations, puts Alibaba 12th on a list of private Covid-19 donors. But that list doesn’t include shipments of vital supplies, which some countries might consider to be more important than money at this stage in the global outbreak.
The world’s top coronavirus financial donors
How Alibaba compares to the top five. No one else other than the effervescent Ma is capable of dispatching supplies directly to those who need them. Starting in March, the Jack Ma foundation and the related Alibaba foundation began airlifting supplies to Africa, Asia, Europe, Latin America and even to politically sensitive areas including Iran, Israel, Russia and the US.
Ma has also donated millions to coronavirus vaccine research and a handbook of medical expertise from doctors in his native Zhejiang province has been translated from Chinese into 16 languages. But it’s the medical shipments that have been making headlines, setting Ma apart.
“He has the ability and the money and the lifting power to get a Chinese supply plane out of Hangzhou to land in Addis Ababa, or wherever it needs to go,” explains Ma’s biographer, Duncan Clark. “This is logistics; this is what his company, his people and his province are all about.”
A friendly face
Jack Ma is famous for being the charismatic English teacher who went on to create China’s biggest technology company. Alibaba is now known as the “Amazon of the East”. Ma started the company inside his tiny apartment in the Chinese coastal city of Hangzhou, in the centre of China’s factory belt, back in 1999. Alibaba has since grown to become one of the dominant players in the world’s second largest economy, with key stakes in China’s online, banking and entertainment worlds. Ma himself is worth more than $40bn.
Officially, he stepped down as Alibaba’s chairman in 2018. He said he was going to focus on philanthropy. But Ma retained a permanent seat on Alibaba’s board. Coupled with his wealth and fame, he remains one of the most powerful men in China.
Media caption The BBC’s Secunder Kermani and Anne Soy compare how prepared Asian and African countries are
It appears that Ma’s donations are following Party guidelines: there is no evidence that any of the Jack Ma and Alibaba Foundation donations have gone to countries that have formal ties with Taiwan, China’s neighbour and diplomatic rival. Ma announced on Twitter that he was donating to 22 countries in Latin America. States that side with Taiwan but who have also called for medical supplies – from Honduras to Haiti – are among the few dozen countries that do not appear to be on the list of 150 countries. The foundations repeatedly refused to provide a detailed list of countries that have received donations, explaining that “at this moment in time, we are not sharing this level of detail”.
However, the donations that have been delivered have certainly generated a lot of goodwill. With the exception of problematic deliveries to Cuba and Eritrea, all of the foundations’ shipments dispatched from China appear to have been gratefully received. That success is giving Ma even more positive attention than usual. China’s state media has been mentioning Ma almost as often as the country’s autocratic leader, Xi Jinping.
AFP
So far…
Over 150 countries have received donations from Jack Ma, including about:
120.4mface masks
4,105,000testing kits
3,704ventilators
Source: Alizila
It’s an uncomfortable comparison. As Ma soaks up praise, Xi faces persistent questions about how he handled the early stages of the virus and where, exactly, the outbreak began.
The Chinese government has dispatched medical teams and donations of supplies to a large number of hard-hit countries, particularly in Europe and South-East Asia.
However, those efforts have sometimes fallen flat. China’s been accused of sending faulty supplies to several countries. In some cases, the tests it sent were being misused but in others, low-quality supplies went unused and the donations backfired.
In contrast, Jack Ma’s shipments have only boosted his reputation.
“It’s fair to say that Ma’s donation was universally celebrated across Africa,” says Eric Olander, managing editor of the China Africa Project website and podcast. Ma pledged to visit all countries in Africa and has been a frequent visitor since his retirement.
“What happens to the materials once they land in a country is up to the host government, so any complaints about how Nigeria’s materials were distributed are indeed a domestic Nigerian issue,” Olander adds. “But with respect to the donation itself, the Rwandan leader, Paul Kagame, called it a “shot in the arm” and pretty much everyone saw it for what it was which was: delivering badly-needed materials to a region of the world that nobody else is either willing or capable of helping at that scale.”
Walking the tightrope
But is Ma risking a backlash from Beijing? Xi Jinping isn’t known as someone who likes to share the spotlight and his government has certainly targeted famous faces before. In recent years, the country’s top actress, a celebrated news anchor and several other billionaire entrepreneurs have all “disappeared” for long periods. Some, including the news anchor, end up serving prison sentences. Others re-emerge from detention, chastened and pledging their allegiance to the Party.
“There’s a rumour that [Jack Ma] stepped down in 2018 from being the chairman of the Alibaba Group because he was seen as a homegrown entrepreneur whose popularity would eclipse that of the Communist Party,” explains Ashley Feng, research associate at the Centre for New American Security in Washington DC. Indeed, Ma surprised many when he suddenly announced his retirement in 2018. He has denied persistent rumours that Beijing forced him out of his position.
Image copyright GETTY IMAGESImage caption Ma discussed trade with then-President-elect Donald Trump in January 2017
Duncan Clark, Ma’s biographer, is also aware of reports that Ma was nudged away from Alibaba following a key incident in January 2017. The Chinese billionaire met with then-President-elect Donald Trump in Trump Tower, ostensibly to discuss Sino-US trade. The Chinese president didn’t meet with Trump until months later.
“There was a lot of speculation of time that Jack Ma had moved too fast,” Clark says. “So, I think there’s lessons learned from both sides on the need to try to coordinate.”
“Jack Ma represents a sort of entrepreneurial soft power,” Clark adds. “That also creates challenges though, because the government is quite jealous or nervous of non-Party actors taking that kind of role.”
Technically, Ma isn’t a Communist outsider: China’s wealthiest capitalist has actually been a member of the Communist Party since the 1980s, when he was a university student.
But Ma’s always had a tricky relationship with the Party, famously saying that Alibaba’s attitude towards the Party was to “be in love with it but not to marry it”.
Even if Ma and the foundations connected to him are making decisions without Beijing’s advance blessing, the Chinese government has certainly done what it can to capitalise on Ma’s generosity. Chinese ambassadors are frequently on hand at airport ceremonies to receive the medical supplies shipped over by Ma, from Sierra Leone to Cambodia.
China has also used Ma’s largesse in its critiques of the United States. “The State Department said Taiwan is a true friend as it donated 2 million masks,” the Chinese Foreign Ministry tweeted in early April. “Wonder if @StateDept has any comment on Jack Ma’s donation of 1 million masks and 500k testing kits as well as Chinese companies’ and provinces’ assistance?”
Perhaps Ma can rise above what’s happened to so many others who ran afoul of the Party. China might just need a popular global Chinese figure so much that Ma has done what no one else can: make himself indispensable.
“Here’s the one key takeaway from all that happened with Jack Ma and Africa: he said he would do something and it got done,” explains Eric Olander. “That is an incredibly powerful optic in a place where foreigners often come, make big promises and often fail to deliver. So, the huge Covid-19 donation that he did fit within that pattern. He said he would do it and mere weeks later, those masks were in the hands of healthcare workers.”
Image copyright GETTY IMAGESImage caption Ma at an Electronic World Trade Platform event with Ethiopian Prime Minister Abiy Ahmed last year
Duncan Clark argues that Ma already had a seat at China’s high table because of Alibaba’s economic heft. However, his first-name familiarity with world leaders makes him even more valuable to Beijing as China tries to repair its battered image.
“He has demonstrated the ability, with multiple IPOs under his belt, and multiple friendships overseas, to win friends and influence people. He’s the Dale Carnegie of China and that certainly, we’ve seen that that’s irritated some in the Chinese government but now it’s almost an all hands on deck situation,” Clark says.
There’s no doubt that China’s wider reputation is benefiting from the charitable work of Ma and other wealthy Chinese entrepreneurs. Andrew Grabois from Candid, the philanthropic watchdog that’s been measuring global donations in relation to Covid-19, says that the private donations coming from China are impossible to ignore.
“They’re taking a leadership role, the kind of thing that used to be done by the United States,” he says. “The most obvious past example is the response to Ebola, the Ebola outbreak in 2014. The US sent in doctors and everything to West Africa to help contain that virus before it left West Africa.”
Chinese donors are taking on that role with this virus.
“They are projecting soft power beyond their borders, going into areas, providing aid, monetary aid and expertise,” Grabois adds.
So, it’s not the right time for Beijing to stand in Jack Ma’s way.
“You know, this is a major crisis for the world right now,” Duncan Clark concludes. “But obviously, it’s also a crisis for China’s relationship with the rest of the world. So they need anybody who can help dampen down some of these those pressures.”
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.
BEIJING, April 9 (Xinhua) — The third China International Import Expo (CIIE) plans to double the size of its medicine and medical equipment section from that of last year’s event, and nearly 60 Fortune 500 companies and industry giants have signed up for the section, an official said Thursday.
Over 80 percent of the planned area for this section has been booked, Gao Feng, spokesperson of the Ministry of Commerce, told a press briefing.
The section will display items such as drugs, medical equipment, elderly care, health food and medical services. A few companies will present epidemic control products including extracorporeal membrane oxygenation machines, invasive and non-invasive ventilators, thermometers and protective face masks, said Gao.
More than 1,000 exhibitors worldwide have signed up for the third CIIE scheduled to be held in Shanghai from Nov. 5 to 10, occupying 60 percent of the exhibit space.
The philanthropic foundations of Jack Ma and Joe Tsai, two of China’s wealthiest technology entrepreneurs, have donated 23 million face masks, 2,000 ventilators and 170,000 pieces of protective gear to New York
The donation, the biggest by private citizens to the epicentre of the global coronavirus pandemic, was described by New York Governor Andrew Cuomo as ‘really good news’
A shipment of 1,000 ventilators donated by Jack Ma Foundation and Joe Tsai Foundation, has arrived in New York. Photo: Handout
Chinese philanthropists are stepping up their donation of protective gear, essential medical and diagnostic kits to the United States, Europe and Asian countries, despite rising acrimony between diplomats and government officials looking to pin blame amid the world’s worst pandemic in decades.
The private foundations of Jack Ma and Joe Tsai, co-founders of this newspaper’s owner Alibaba Group Holding and two of China’s wealthiest technology entrepreneurs, have donated a combined 23 million face masks, 2,000 medical ventilators and 170,000 pieces of protective gear to New York city.
The first 1,000 medical ventilators arrived today, with another 1,000 on the way, for a total donation valued at US$50 million, according to a person familiar with the matter.
Delivery of the essential materials, made possible by behind-the-scene manoeuvres by the donors and officials from both the Chinese and US sides due to import and export regulatory hurdles, highlights the role of civil diplomacy in dealing with the global public health crisis.
New York Governor Andrew Cuomo thanks the Chinese government for the 1,000 ventilators donated by Jack Ma Foundation and Joe Tsai Foundation, which arrived in New York on Saturday. Photo: Handout
The gesture comes as diplomats of both countries, and even government officials including the US president and his secretary of state, have engaged in a tit-for-tat war of words, as they attempt to pin the blame for the worlds worst pandemic in decades on each other.
Confirmed cases in the US have soared and surpassed China as the new global epicentre. In the US there are nearly 310,000 cases and nearly 8,500 people have died so far from the Covid-19 disease.
Jack Ma is a friend of mine and he’s made it very possible to get about 1,000 ventilators from China. But that was from him and my other friend [Tsai] that was really a gift – Andrew Cuomo, governor of New York
Andrew Cuomo, governor of New York, thanked the Chinese government for easing the transfer of the ventilators to the hard-hit state, the current epicentre of the coronavirus outbreak in the US.
He said the donations were “really good news”, as the state pushes up against the apex of the outbreak, which is likely to hit in about seven days.
“This is a big deal, and this is going to make a significant difference for us,” Governor Andrew Cuomo said on Saturday.
“Jack Ma is a friend of mine and he’s made it very possible to get about 1,000 ventilators from China. But that was from him and my other friend [Tsai] that was really a gift. And we appreciate it very much.”
One of the challenges in making the donation possible was the fact that the US had previously blocked China-made “KN95” standard masks, only allowing “3M N95” masks to be used. Although the two masks have different standards, they essentially have the same performance. On Friday, the US Food and Drugs Administration issued an emergency use authorisation for KN95 masks.
Alfred Wu, associate professor in Lee Kuan Yew School of Public Policy at National University of Singapore, said that what China is doing with its so-called masks diplomacy is very clear. “But given the emergency situation in New York, whatever channel – private or public sources – the equipment comes from, should not matter, especially those for medical workers,” he said.
Separately, the western state of Oregon has also said that it would send 140 ventilators to New York.
The state, like other areas of the US, is facing shortages of medical gear, including masks and ventilators.
“We are not yet at the apex. We are getting closer,” Cuomo said, adding that this was good as it gave the authorities more time to prepare.
A tweet from New York Governor Andrew Cuomo thanking the Chinese government for the 1,000 ventilators donated by Jack Ma Foundation and Joe Tsai Foundation. Photo: Twitter
Cuomo said 113,704 people in New York have tested positive for the coronavirus, with 15,000 having been hospitalised The state’s death toll saw a significant spike on Saturday to reach 3,565, up from 2,935 the previous day.
The White House has been criticised for not better coordinating the supply of medical goods to states, who are competing with each other on the open market.
NUS’ Wu said that tussle between the federal and state governments in the US on key decisions on acquiring medical supplies was not helping the fight against the pandemic. “Unlike in China, where the central government has the say over local governments, in the US, when it comes to public health provision, the power belongs to the state,” he said.
Meanwhile, Cuomo acknowledged that he asked the White House and others for help negotiating the ventilators.
Trump said he would like to hear a more resounding “thank you” from Cuomo for providing medical supplies and helping quickly to add hospital capacity.
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.
Coronavirus: as Malaysia braces for third wave, doctors make their own face masks
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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.
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.
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The Jack Ma Foundation has also launched an online platform for doctors and nurses around the world to share knowledge on fighting the virus. “One world, one fight,” it said in a tweet.
Associate Professor Jeremy Lim from the global health programme at the Saw Swee Hock School of Public Health said it was crucial for countries to work together.
“Viruses don’t respect borders. Countries have to share information and help each other as we are only as strong as the weakest link. Any country can become a reservoir of disease and the world may then be forced to endure a ping-pong of outbreaks over and over again.”
And the advice of Lee, at Singapore’s Ministry of Health? “Practise good hygiene and wash hands regularly.”
Indonesian medical staff administer mass testing for Covid-19 in Bekasi, West Java. Photo: AFP
SINGAPORE, A CASE STUDY
Amid this sharing of advice, it is often Singapore that is held up as an example to replicate. Despite the country grappling with a rising load of Covid-19 patients, most of whom have recently returned to the city state from abroad, its health care system has continued to run smoothly. Doctors say this is because it has been preparing for a pandemic ever since Sars caught it by surprise. During the Sars outbreak, health care workers accounted for 41 per cent of Singapore’s 238 infections.
Consequently its hospitals swung into contingency planning mode early on in the coronavirus outbreak, telling staff to defer leave and travel plans after its first cases emerged.
Meanwhile, its hospitals swiftly split their workforces into teams to ensure there were enough workers if the outbreak worsened, and to ensure workers got enough rest.
Singapore has 13,766 doctors, or 2.4 doctors for every 1,000 people. That compares to 2.59 in the US, 1.78 in China and 4.2 in Germany. Places like Myanmar and Thailand have fewer than one doctor for every 1,000 people.
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“The objective is that you can run essential services with the greatest amount of security. Make sure functional units have redundancy built in, and are separate from each other. It depends on what you feel is sufficient to carry on services if one team is affected, factoring in rest periods and some system of rotation,” said Chia Shi-Lu, an orthopaedic surgeon.
The key is to ensure a good doctor-to-patient ratio and ensure there are enough specialists for the critical work, such as doctors and nurses who can provide intensive care, and know how to operate mechanical ventilators or machines to pump and oxygenate a patient’s blood outside the body.
At the emergency department where paediatrics emergency specialist Jade Kua treats Covid-19 cases in addition to regular emergencies, doctors are split into four teams of 21. Each team takes alternate 12-hour shifts and does not interact with other teams.
“We are in modular teams so the teams move together. So you and I would both do morning, off, night, off, morning off. Together. And then the other teams would do the same and we don’t intermingle,” said Kua.
US now has world’s most coronavirus cases, surpassing China
Chia, who works at the Singapore General Hospital, said doctors had been split up according to their functions.
“We try not to meet at all with the other teams as much as possible. We’ll just say hi from across the corridor. Meals are the same. All our cafeterias and everything have got social distancing spaced in already,” said Chia, who is also a member of parliament and chairs a shadow committee on health.
Chia said the health care system could also tap on doctors in the private sector.
Not every country has a plan like this. Last year’s Global Health Security Index by the Economist Intelligence Unit found that 70 per cent of 195 countries scored poorly when it came to having a national plan for dealing with epidemics or pandemics. Almost three in 10 had failed to identify which areas were insufficiently staffed. In India, with a population of 1.3 billion, only about 20,000 doctors are trained in key areas such as critical care, emergency medicine and pulmonology.
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In contrast, Singapore published its first Influenza Pandemic Preparedness and Response Plan in June 2005 and has since honed it to a tee. Hospitals regularly war-game scenarios such as pandemics or terrorist attacks and the simulations are sometimes observed by the Ministry of Health, which grades the performance and recommends areas for improvement.
The plan also covers the need to stockpile equipment to avoid the sort of shortages many countries are now facing, another lesson inspired by Sars when masks, gloves and gowns were in short supply.
In a pandemic preparation paper published in 2008, Singapore public health specialist Jeffery Cutter wrote that Singapore’s stockpile was sufficient to cover at least 5 to 6 months’ use by all front-line health care workers.
During the Covid-19 outbreak, it has also told citizens to not wear masks so it can conserve supply for medical staff.
Having enough protective gear has reassured Singapore’s health care workers such as Kua, a mother of six who blogged about her experience fighting Covid-19. Kua said: “I’m safe and my family is safe.”
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SOMETHING YOU CAN’T GUARD AGAINST
Despite the many positives to emerge from the Lion City, its health care workers are struggling with another problem: discrimination.
While in France, Italy and Britain, residents cheer health care workers from their windows, in Singapore health care workers are seen by some people as disease carriers.
“I try not to wear my uniform home because you never know what kind of incidents you may encounter,” said one Singapore nurse. “The public is scared and wearing our uniforms actually causes quite a bit of inconvenience. One of my staff tried to book a private-hire car to the hospital for an emergency and she was rejected by five drivers.”
There is a similar stigma in India, where the All India Institute of Medical Sciences has appealed to the government for help after health workers were forced out of their homes by panicked landlords and housing societies.
“Many doctors are stranded on the roads with all their luggage, nowhere to go, across the country,” the institute said in a letter.
Lim, from the Saw Swee Hock School of Public Health, said the worst human impulses and “every man for himself” attitudes could emerge in crises and “that is exactly why governments have to step in”.
Discrimination could affect both the performance and motivation of health care workers, Lim warned.
Meanwhile, when health care workers are infected, it creates a “triple whammy” threat.
“It means one fewer professional in an already-strained system, another patient to care for and, potentially, a team of colleagues who need to be quarantined,” said Lim.
“We must do everything possible to keep our health care workforce safe and free from Covid-19.” ■
NEW YORK (Reuters) – The number of U.S. coronavirus infections climbed above 82,000 on Thursday, surpassing the national tallies of China and Italy, as New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages of supplies, staff and sick beds.
With medical facilities running low on ventilators and protective masks and hampered by limited diagnostic testing capacity, the U.S. death toll from COVID-19, the respiratory disease caused by the virus, rose beyond 1,200.
“Any scenario that is realistic will overwhelm the capacity of the healthcare system,” New York Governor Andrew Cuomo told a news conference. He described the state’s projected shortfall in ventilators – machines that support the respiration of people have cannot breathe on their own – as “astronomical.”
“It’s not like they have them sitting in the warehouse,” Cuomo added. “There is no stockpile available.”
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At least one New York City hospital, New York-Presbyterian/Columbia University Medical Center in Manhattan, has begun a trial of sharing single ventilators between two patients.
While New York was the coronavirus epicenter in the United States this week, the next big wave of infections appeared headed for Louisiana, where demand for ventilators has already doubled. In New Orleans, the state’s biggest city, Mardi Gras celebrations late last month are believed to have fueled the outbreak.
Louisiana Governor John Bel Edwards said New Orleans would be out of ventilators by April 2 and potentially out of bed space by April 7 “if we don’t flatten the infection curve soon.”
“It’s not conjecture, it’s not some flimsy theory,” Edwards told a press conference. “This is what is going to happen.”
About 80% of Louisiana’s intensive care patients are now on breathing machines, up from the normal rate of 30-40%, said Warner Thomas, chief executive of Ochsner Health System, the state’s hospital group.
Scarcities of protective masks, gloves, gowns and eyewear for doctors and nurses – reports abound of healthcare workers recycling old face masks, making their own or even using trash bags to shield themselves – have emerged as a national problem.
“Our nurses across the country do not have the personal protective equipment that is necessary to care for COVID patients, or any of their patients,” Bonnie Castillo, head of the largest U.S. nurses union, National Nurses United, told MSNBC.
In an ominous milestone for the United States as a whole, at least 82,153 people nationwide were infected as of Thursday, according to a Reuters tally from state and local public health agencies. China, where the global pandemic emerged late last year, had the second highest number of cases, 81,285, followed by Italy with 80,539.
At least 1,204 Americans have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, Reuters’ tally showed.
MORE BEDS NEEDED
For New York state, Cuomo said a key goal was rapidly to expand the number of available hospital beds from 53,000 to 140,000.
New York hospitals were racing to comply with Cuomo’s directive to increase capacity by at least 50%. At Mount Sinai Hospital’s Upper East Side location, rooms were being constructed within an atrium to open up more space for beds.
At Elmhurst Hospital in New York’s borough of Queens, about a hundred people, many wearing masks with their hoods pulled up, lined up behind barriers outside the emergency room entrance, waiting to enter a tent to be screened for the coronavirus.
The city coroner’s office has posted refrigerated trucks outside Elmhurst and Bellevue Hospital to temporarily store bodies of the deceased.
Deborah White, vice chair of emergency medicine at Jack D. Weiler Hospital in the city’s Bronx borough, said 80% of its emergency room visits were patients with coronavirus-like symptoms.
A ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.
Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy told reporters such bioethical discussions “haunted him” but were unavoidable.
Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Detroit.
Brandon Allen, 48, was buying groceries in Detroit for his 72-year-old mother, who has tested positive and was self-quarantining at home.
“It’s surreal,” Allen said. “People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it.”
RECORD UNEMPLOYMENT CLAIMS
Desperate to slow virus transmissions by limiting physical contact among people, state and local governments have issued stay-at-home orders covering about half the U.S. population. A major side effect has been the strangulation of the economy, and a wave of layoffs.
The U.S. Labor Department reported Thursday the number of Americans filing claims for unemployment benefits last week soared to a record of nearly 3.28 million – almost five times the previous weekly peak of 695,000 during the 1982 recession.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said warmer weather may help tamp down the U.S. outbreak as summer approaches, though the virus could re-emerge in the winter.
“We hope we get a respite as we get into April, May and June,” Fauci said on WNYC public radio.
Washington state Governor Jay Inslee said he may extend a stay-at-home order tentatively set to expire April 6, encouraged by what he called a “very modest improvement” in the Seattle area.
Washington experienced the first major U.S. outbreak of COVID-19 and has been among the hardest-hit states. As of Thursday the state reported about 3,200 cases and 147 deaths.
In California’s Coachella Valley, a region rife with retirees who are especially vulnerable, 25 members of the state’s National Guard helped a non-profit distribute food to people stuck in their homes, as most of the regular volunteers are senior citizens.
More than 10,000 troops have been deployed in 50 states to provide humanitarian aid during the pandemic.
MADRID (Reuters) – Spain’s coronavirus death toll jumped by 738 overnight to exceed that of China, where the disease originated, as the country struggled to cope with an accelerating health crisis and another senior government minister was diagnosed with the virus.
With 3,434 fatalities, Spain now has the second highest number of deaths globally after Italy’s 6,820. Nursing homes across the country have been overwhelmed by cases and a skating rink in Madrid has been turned into a makeshift morgue.
Police stood guard on Wednesday outside the rink, normally a popular venue for children’s birthday parties, as hearses arrived at the building.
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Broad avenues in Madrid and Barcelona were virtually deserted, as were towns and villages across Spain, while fire engines and tractors sprayed disinfectant to clean streets.
Authorities began to carry out mass testing for public workers in a requisitioned fairground in Madrid, one of the worst-hit regions.
Spanish medical staff, who themselves account for thousands of infected cases, have taken out lawsuits against the government, complaining of the lack of basic protective equipment like masks, scrubs and gloves.
The Spanish army has asked NATO for ventilators, protective gear and testing kits, Armed Forces Chief Miguel Villarroya said on Wednesday.
The government had ordered 432 million euros ($467 million) worth of masks, gloves, testing kits and ventilators to be delivered over the next eight weeks, with the first large batch expected this week, Health Minister Salvador Illa said.
In an example of how companies are changing assembly lines to produce medical products, a shoe factory in northern Spain has switched to making simple protective masks – first for its own personnel and then for distribution.
“Now we are working hard to … make something a little more sophisticated for it to reach medical use,” Basilio Garcia, chief executive of the Callaghan shoe factory, told Reuters.
Spain is on Day 11 of a 15-day nationwide lockdown which is likely to be extended to 30 days. Schools, bars, restaurants and most shops are shuttered. Social gatherings are banned. People are confined to their homes.
“We have achieved a near total reduction in social contact,” health emergency chief Fernando Simon told a news conference, adding that Spain was nearing the peak of the epidemic.
The number of coronavirus cases increased by a fifth overnight to 47,610 on Wednesday. The total number could be much higher as the government reported 130,000 sick leaves associated with the virus, encompassing workers who are either infected or in preventive isolation. The number does not include retirees.
Aside from the devastating health impact, the lockdown has dealt a punishing blow to the Spanish economy, with tens of thousands of workers temporarily laid off as sectors like retail, tourism and manufacturing grind to a halt. One of Spain’s biggest employers, El Corte Ingles, said it would temporarily lay off 22,000 workers at its department stores.
At Malaga airport in southern Spain, a gateway to the Costa del Sol tourist region, thousands of travellers waited for flights home, many sleeping on seats or on the floor.
The Bank of Spain said on Wednesday that there had been severe disruption on the economy since early March and a sharp contraction in consumer spending.
China is now making more than 100 million masks a day, up from 20 million before the coronavirus outbreak, and may start to export more to other countries
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China was producing 116 million masks per day of February 29, including a mix of disposable and high-end masks like the American-designed N95 model worn by President Xi Jinping on his trip on Tuesday to Wuhan. Photo: Xinhua
The Liu family factory has been making diapers and baby products in the Chinese city of Quanzhou for over 10 years, but in February, for the first time, it started making face masks, as demand soared spectacularly due to the coronavirus outbreak.
The business – which employs 100 people in the Southeastern Fujian province – has added two production lines to make up to 200,000 masks a day.
And while the decision was primarily commercial, “encouragement” from the Chinese government – in the form of subsidies, lower taxes, interest-free loans, fast-track approvals for expansion and help alleviating labour shortages – made the decision an obvious one, said Mr Liu who preferred only to give his family name.
“The government is advocating an expansion in production,” Liu said. “With faster approvals, producers need to prioritise the government’s needs over exports.”
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The factory is one of thousands of refitted pop-ups around China making masks and other protective equipment for the first time, part of a massive industrial drive to respond to the spread of the coronavirus.
Before the outbreak, China already made about half the world’s supply of masks, at a rate of 20 million units a day. That rose to 116 million as of February 29, according to China’s state planning agency, a mix of disposable and high-end masks like the American-designed N95 model worn by President Xi Jinping on his trip on Tuesday to Wuhan, the epicentre of the outbreak.
This exponential jump is the result of a wartime-like shift in industrial policy, with Beijing directing its powerful state-owned enterprises to lead the nationwide mask-making effort, and the country’s sprawling manufacturing engine following their lead.
For me, this is the big advantage of China, the speed Thomas Schmitz
“For me, this is the big advantage of China, the speed,” said Thomas Schmitz, president of the China branch of Austrian engineering giant Andritz, which has seen a big uptick in demand for its wet wipe-making machines in recent weeks, also due to the virus. “When you need to run, people know how to run, and this is something which has been lost in other countries since their industrial heydays.”
Chinese oil and gas major Sinopec upped production of mask raw materials such as polypropylene and polyvinyl chloride in January. This week, it set up two production lines in Beijing to produce melt-blown non-woven fabric, intended to make four tonnes of the fabric each day, which can then be used to produce 1.2 million N95 respirators or six million surgical masks a day.
The maker of China’s new J-20 stealth fighter jet, Chengdu Aircraft Industry Group, repurposed part of its factory to design a mask production line, according to local media reports. The SichuanDaily said 258 of the company’s engineers spent three days fast-tracking development of an assembly line with more than 1,200 components.
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More than 2,500 companies in China have reportedly started making masks, among them 700 technology companies including iPhone assembler Foxconn and smartphone makers Xiaomi and Oppo, in an extraordinary mobilisation of resources.
The result resembles “the war effort” in the middle of the last century in the United States and western Europe, but arguably no other nation could undergo such a transformation so quickly today.
It is a reminder of what can happen in a centrally-planned economy with a strong manufacturing base, but also brings into sharp focus some of the geopolitical issues which have characterised China’s at-times difficult relationship with the rest of the world, particularly the European Union and US, over the past couple of years.
China’s dominance in manufacturing has become all the more evident as the rest of the world scrambles to shore up their own dwindling medical supplies, leading many to wonder why the world is so dependent on it for vital supplies.
The lesson for Washington is not that we need to emulate the Chinese economic model, but rather that we need to better steward the industrial base in key sectors Rush Doshi
The Italian government, which is dealing with the highest number of coronavirus cases and deaths after China, is to take shipment of 1,000 ventilators, 2 million masks, 100,000 respirators, 200,000 protective suits and 50,000 testing kits from China.
Italian foreign minister Luigi Di Maio said after a phone call with Chinese counterpart Wang Yi, they had agreed the export deal in the same week that European neighbours France and Germany banned masks from being exported because of low domestic supplies.
The Italy export deal showed that “China is emerging as a global public goods provider as the US proves unable and unwilling to lead,” said Rush Doshi, the director of the China Strategy Initiative at the Washington-based Brookings Institute think tank.
“China’s ability to produce what is needed to fight coronavirus is not simply a product of its economic model – it’s also a product of its industrial capacity,” Doshi said. “The US once had this capacity too, but it has lost important parts of it. The lesson for Washington is not that we need to emulate the Chinese economic model, but rather that we need to better steward the industrial base in key sectors.”
The frustration is felt acutely by Michael Einhorn, president of medical equipment distributor Dealmed-Park Surgical in New York, who has been trying to source stock from China for weeks, “but cannot get straight answers” from vendors.
Einhorn said he placed an order with a private seller in China’s virus-stricken city last week, but that the goods had not been shipped.
“Everyone is running out here, people are panicking in hospitals and we want to be able to help our most important customers,” Einhorn said. “We are dealing with hospitals that do not have products, how in the United States of America in 2020 did this happen?”
With the number of confirmed coronavirus cases in China falling daily, it is not inconceivable that the sort of export deal struck with Italian leaders becomes commonplace, although for now, it deal can be chalked up as a significant public relations coup for Beijing.
The World Medical Association is unable to specify how many masks are required to supply frontline medical staff in virus-hit areas, but said that “this crisis should be a wake up call for politicians and societies to make the necessary investment in emergency preparedness and to look into the vulnerability of our supply chains”.
Australian-listed manufacturer Eagle Health announced on Friday that it had installed production lines at its Xiamen factory in southern China to make 300 million masks a year and said it had already received orders from China and would be securing further larger orders internationally.
The group, which normally makes products including amino acids, protein supplements and lozenges in China, said it would prioritise meeting the large domestic demand, but was aware of an impending global shortage.
Eagle Health has already commenced production of its first order of 3.2 million medical masks for the Yiling Hospital Management Group in China, a process which will take 10 days. It has other smaller orders from Chinese government agencies and expects to receive more orders outside China.
The decision to make more masks came from increased demand. These are opportunities. The global demand for high quality masks will be significant Xu Gang
“The decision to make more masks came from increased demand. These are opportunities,” said chief executive Xu Gang. “The global demand for high quality masks will be significant. Imagine when the schools open. The situation will take some time to peak.”
Last week, the Australian Dental Association said supplies of masks at many practices were expected to run out within four weeks. The Australian government has since arranged a supply of 54 million masks for both the dental and medical industries.
At the same time, the US only has 1 per cent of the 3.5 billion masks it would need to counter a serious outbreak, Bloomberg reported.
While China has no quota on the volume of masks that had to be hived off for local consumption, the government has said domestic demand needs to be prioritised.
Businesses are free to export but overseas demand has yet to explode like it has in China, said Fujian factory owner Liu.
Wendy Min, sales director of Pluscare, a manufacturer based near the virus’ epicentre in Hubei province, said her company is making 200,000 masks per day, much of which are sold to the government, with exports still restricted by partial lockdown of workers and cargo transport.
“We previously exported to Europe, South America and other parts of Asia,” Min said. “But at the moment we can’t export. We are trying to discuss this with the government, but we cannot wait any more – we have to export soon.”
Min said that while she was receiving countless cold calls up until last week from people in China looking for masks, these have stopped, perhaps unsurprising given the abundance in supplies becoming available.
An influx of Chinese-made masks, though, is likely to be welcomed in other virus-stricken parts of the world.
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Miguel Luiz Gricheno, CEO of Brazilian mask manufacturer Destra, said that his company is making 30,000 masks a day, but cannot meet local demand due to a lack of supplies, including the non-woven fabric from which masks are made.
“In disposable masks, most Brazilian companies are paralysed due to the lack of raw materials,” Gricheno said. “With the arrival of the coronavirus in Brazil, the demand has increased a lot but the main raw material comes from abroad.”
However, a short-term supply fix will not answer underlying questions about how so many countries found themselves in such dire straits,meaning the geopolitical fallout of the coronavirus will be extensive.
Decades of weak industrial policy helped elect US President Donald Trump, who said he would bring manufacturing jobs back to America at China’s expense. While he has waged a bruising two-year trade war with China in response, the current situation shows just how difficult it will be to change the global manufacturing processes, which are so heavily controlled by China.
One of the great flaws of globalisation is that everyone wanted things cheaper, but did you compromise your health care infrastructure in the process? Stephen Roach
“In the guise of trying to improve efficiency and create value for price-sensitive consumers, we’ve created a global production network that is very difficult to unwind,” said Stephen Roach, a professor of economics at Yale University and a veteran China watcher. “One of the great flaws of globalisation is that everyone wanted things cheaper, but did you compromise your health care infrastructure in the process.
Reuters reported that Trump is considering invoking the emergency provisions of the Defence Production Act, which would allow the government to instruct companies to alter production to help address the domestic shortage of medical supplies like masks. If a company is producing 20 per cent N95 masks and 80 per cent standard masks, the White House could order them to rejig the ratio, an unnamed official said.
The New York Times reported on Wednesday that the White House is preparing an executive order that would allow the government to buy medical supplies from overseas in the hope that it will incentivise companies to make them within the US.
But these changes still do not give Trump the sort of sweeping powers enjoyed by Chinese counterpart Xi.
“When you have a pluralistic, democratic situation that Trump is overseeing, it becomes more unwieldy” to take the steps necessary to address a crisis situation, said Harry Broadman, chair of the emerging markets practise at the Berkeley Research Group and a senior US government official in the 1980s and 1990s.
“That is why I think Trump looks at Xi with envy, because he doesn’t have to deal with a disparity of views or democratic interests,” Broadman said. “I think Trump is at heart a bilateral guy, as you saw with the phase one [US-China] trade deal and the state-to-state purchases. That is why he likes dealing with [Russian President Vladimir] Putin and Xi, because each of them can move mountains. I think Trump is very envious of that ability.”
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