Corona Virus Covid 19

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A Wuhan doctor says Chinese officials ignored her coronavirus warnings in December, costing thousands their lives
RHEA MAHBUBANI,RHEA MAHBUBANIMAR 13, 2020, 03:03 IST

doctor wuhan coronavirus

Reuters
A doctor puts on protective goggles before entering the isolation ward at a hospital, following the outbreak of a new coronavirus in Wuhan, Hubei province, China on January 30, 2020.


  • Ai Fen, director of Wuhan Central Hospital's emergency department, shared a diagnostic report with colleagues on WeChat on December 30. She was particularly concerned by the similarities between the new pneumonia-like infection and SARS, she told Chinese magazine, People.
  • A hospital supervisor criticized Ai for "spreading rumors" and forbade her from speaking about it even to her family, the South China Morning Post said.
  • Hospital staff saw person-to-person transmission long before officials acknowledged or reported it, leaving "hundreds of doctors and nurses in the dark, doing all they could to treat patients without knowing about the epidemic," the Chinese outlet Caixin reported.
  • Frontline healthcare workers at Wuhan Central Hospital were among the worst hit by the COVID-19 virus. Four among them, including whistleblower doctor Li Wenliang, have died.
  • Visit Business Insider's homepage for more stories.
A Wuhan doctor said she wishes she could rewind the clock to December when she first sounded the alarm about a new pneumonia-like virus - only to back away after being reprimanded by Chinese officials.
Ai Fen, director of Wuhan Central Hospital's emergency department, told Chinese magazine People that a colleague sent her a diagnostic report in late December of a worrying infection that mirrored severe acute respiratory syndrome (SARS), according to the South China Morning Post.
Ai shared a picture of the report on a WeChat group on December 30, and then its members circulated that photo more widely. Whistleblower doctor Li Wenliang, 34, who was silenced by Chinese officials and then died of the COVID-19 virus, was part of that group.
Ai said she also gave hospital authorities a heads-up about the virus.
"I even grabbed our hospital respiratory department director, who happened to be passing my office, and told him that one of his patients was confirmed to have been infected with a SARS-like virus," Ai said to People magazine, the Post reported.


'My mind just went blank'
The next day, hospital leaders told Ai that Wuhan's health commission had forbidden frontline medical workers from saying anything about the virus in a bid to avoid panic.
Ai said she was also censured by a hospital official, who accused her of "spreading rumors," the Post reported. She was ordered to not speak about it even to her husband and to inform her staff members that they were not permitted to publicly disclose any information about the illness.
"My mind just went blank," Ai told the magazine. "He wasn't criticizing me for not working hard … He made me feel that I alone had ruined the future of Wuhan. I was in despair."

LI WENLIANG

LI WENLIANG/GAN EN FUND via REUTERS
Li Wenliang wears a respirator mask, following the coronavirus outbreak, in Wuhan, China, February 3, 2020.


One week later, a hospital nurse, Hu Ziwei, fell sick, Ai said.
"How could I refrain from discussions with my medical colleagues knowing that a new and significant virus had emerged? I followed my intuition as a doctor so what mistakes did I make?" Ai wondered.


Evidence of human-to-human transmission
It has been widely reported that the coronavirus originated in a wet market in Wuhan, and Ai said initial patients were in some ways linked to the market. But, soon that trend changed, and more family clusters began to show up.
"If there's no people-to-people transmission, why did the patients continue to increase after the Huanan market was closed?" Ai said.
An investigation from the Chinese outlet Caixin found that more than 230 of 4,000 staff members at the Wuhan Central Hospital have contracted the coronavirus. This is the highest rate of infection at all Wuhan medical centers.
Dr. Li Wenliang died in February and was followed by other doctors Jiang Xueqing and Mei Zhongming in early March. Ophthalmologist Zhu Heping died on March 9, marking the fourth fatality among medical workers.
The hospital's deputy chief cardio-thoracic surgeon and deputy chief urologist are in critical condition, a head nurse told Caixin.


Frontline medical staff were kept 'in the dark'
A department head who asked to stay anonymous told Caixin that Chinese authorities have risked people's lives by spreading misinformation.
"The false information released by the relevant departments - claiming the disease was controllable and would not spread from human-to-human - left hundreds of doctors and nurses in the dark, doing all they could to treat patients without knowing about the epidemic," the source said. "And even when they fell ill, they could not report it. They could not alert their colleagues and the public in time despite their sacrifice. This is the most painful loss and lesson."
Doctors at Wuhan Central Hospital also pointed to other factors that put them at heightened risk, Caixin reported.

wet market

Felix Wong/South China Morning Post via Getty Images
Poultry vendor selling live chicken at wet market in Kowloon City.


To start, they were at close proximity to the South China Seafood Market, where a majority of early cases are believed to have sparked. First-generation virus infections are likely more lethal, Caixin said. Li and Mei reportedly contracted the virus from the same patient.
Also, early January saw a large number of patients come to the hospital with elevated temperatures. At the time, another local hospital was treating only those coronavirus patient who had in some way come in contact with the seafood market. All others were being shipped off to the Central Hospital where staff were not experts in contagious diseases and so got sick.

Interfering with diagnoses
Meanwhile, doctors were not allowed to report cases that they encountered.
"It's fairly easy to fill out the disease reporting form," a doctor told Caixin. "When we get cases of hepatitis B or other severe infectious diseases, we can make a diagnosis directly on the computer, fill in the infectious disease report in a pop-up window and just click OK." But "to do that, a diagnosis must be made," the doctor said.
A law enforcement official visited the hospital on January 12, Caixin reported, and told medical staff that the infectious disease forms could only be completed and submitted with guidance from experts at the city and provincial levels.
The next day, Wang Wenyong, who leads infectious disease control at Wuhan's Jianghan district disease control center, told Wuhan Central hospital to alter a suspected coronavirus report to say that patients were suffering from other illnesses.
And the district health authority, rather than collecting samples and consulting with the hospital, asked medical staff to wait, causing an ill-afforded delay, doctors said to Caixin. And all the while, patients poured in and the number of cases continued to climb.

Coronavirus china wuhan doctors

STR/AFP via Getty Images
A doctor examines a patient who is infected by the coronavirus at a hospital in Wuhan in China's central Hubei province.


'I would have told everyone, even though I was warned'
Now, Ai says she "really regrets" not telling more people about what she was seeing because her fellow doctors may not have died if they "could have been warned earlier," according to the Post.
"As a clinician, when I discover a very important virus, how could I not tell other doctors… I did the thing that a doctor, a normal human being would do," said Ai. "If the public could be alert for the virus since Jan. 1, then there would not be so many tragedies."
The censoring that Ai complained about continued into this week, Quartz reported, with her article being deleted from People's WeChat page.
However, Chinese WeChat users, who rallied for freedom of speech after Wenliang's passing, defied censors by writing the story backward, inserting emojis and Braille symbols, and even using a coded, so-called "Martian" language that relies on ancient Chinese characters. Translated to English and German, the article was re-shared to WeChat, only to be taken down again, Quartz found.
For her part, Ai said if she had known how the coronavirus would go on to infect more than 127,000 people and kill over 4,700 others, "I would have told everyone, even though I was warned," she said. "I have thought many times: if only time could be turned back."



A Wuhan doctor says Chinese officials ignored her coronavirus warnings in December, costing thousands their lives
 

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Coronavirus: China's netizens get creative to share censored article on whistleblower

A man working on a laptop in Beijing. Online users in China have adopted a range of creative measures to share a censored article on a whistleblowing doctor.


A man working on a laptop in Beijing. Online users in China have adopted a range of creative measures to share a censored article on a whistleblowing doctor.PHOTO: REUTERS


PUBLISHED

MAR 11, 2020, 3:52 PM SGT


BEIJING (AFP) - Online users in China have adopted a range of creative measures - including screenshots, deliberate typos, PDF files and Morse code - to share a censored article on a whistleblowing doctor.
The report features an interview with a doctor in Wuhan, the epicentre of the new coronavirus outbreak, who sounded an early alarm only to face disciplinary action.
The following outbreak has killed more than 3,150 and infected nearly 81,000 in China, as well as spreading around the world.

But the interview with Dr Ai Fen, in the March edition of China's People magazine, has been removed from the popular social media platform WeChat and netizens have complained that it cannot be shared in chat groups.
In the censored feature, Dr Ai said she was given an "unprecedented and severe rebuke" after trying to warn other doctors in December when test results from a patient came up with the results "Sars coronavirus".
Dr Ai circled the words in the report on Dec 30 and shared it, urging doctors to take precautions against the virus - and earning a reprimand from her hospital's disciplinary department.

The warning was also shared by eight physicians, who were later punished by Wuhan police for "rumour-mongering". Wuhan was placed under lockdown in late January.

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Various adaptations of the article have since been circulating online in an apparent pushback against online censorship.
These include versions written in hanyu pinyin - the system for transliterating Chinese characters into the Roman alphabet - those containing intentional misspellings, and versions where many words are replaced with emojis.1

Screenshots of a Morse code version were also being shared on social media platforms.
Chinese authorities have faced fierce criticism for not acting fast enough to curb the virus epidemic, and for reprimanding those who tried to warn others in the early days of the spread.
The death of Dr Li Wenliang - one of the doctors reprimanded by police early in the outbreak - sparked an outpouring of grief, and rare calls online for political reform and free speech in the country.
In China, it is common for social media companies to scrub content considered politically sensitive, including protests and government criticism.
Government censors had made some exceptions for political criticism when directed at local officials, who were later removed from their posts and accused of negligence.

At a press conference last month, top Chinese scientist Zhong Nanshan said China would have seen far fewer infections from the virus if it had been quicker to adopt strict control measures.



Coronavirus: China's netizens get creative to share censored article on whistleblower
 

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Online Chinese users get creative skirting censors over virus whistleblower

Online users in China have adopted a range of creative measures -- including screenshots, deliberate typos, PDF files and Morse code -- to share a censored article on a whistle blowing doctor.

March 11, 2020, 13:51 IST

(NYT photo)




(NYT photo)Beijing: Online users in China have adopted a range of creative measures -- including screenshots, deliberate typos, PDF files and Morse code -- to share a censored article on a whistleblowing doctor.



The report features an interview with a doctor in Wuhan, the epicentre of the new coronavirus outbreak, who sounded an early alarm only to face disciplinary action.

The following outbreak has killed more than 3,150 and infected nearly 81,000 in China, as well as spreading around the world.

But the interview with doctor Ai Fen, in the March edition of China's "People" magazine, has been removed from the popular social media platform WeChat and netizens have complained it can not be shared in chat groups.

In the censored feature, Ai said she was given an "unprecedented and severe rebuke" after trying to warn other doctors in December when test results from a patient came up with the results "SARS coronavirus".

Ai circled the words on the report on December 30 and shared it, urging doctors to take precautions against the virus -- and earning a reprimand from her hospital's disciplinary department.

Li's warning was also shared by eight physicians who were later punished by Wuhan police for "rumour-mongering". Wuhan was placed under lockdown in late January.

Various adaptations of the article have since been circulating online in an apparent pushback against online censorship.

These include versions written in pinyin -- the system for transliterating Chinese characters into the Roman alphabet -- those containing intentional misspellings, and versions where many words are replaced with emojis.

Screenshots of a Morse code version were also being shared on social media platforms.

Chinese authorities have faced fierce criticism for not acting fast enough to curb the virus epidemic, and for reprimanding those who tried to warn others in the early days of the spread.

The death of Li Wenliang -- one of the doctors reprimanded by police early in the outbreak -- sparked an outpouring of grief, and rare calls online for political reform and free speech in the country.

In China, it is common for social media companies to scrub content considered politically sensitive, including protests and government criticism.

Government censors had made some exceptions for political criticism when directed at local officials, who were later removed from their posts and accused of negligence.

At a press conference last month, top Chinese scientist Zhong Nanshan said China would have seen far fewer infections from the virus if it had been quicker to adopt strict control measures.




Online Chinese users get creative skirting censors over virus whistleblower - ET HealthWorld
 

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Daily wage workers battle for survival in COVID-19 days
Source: PTI - Edited By: Roshneesh Kmaneck
March 25, 2020 18:00 IST

India has been put in lockdown to halt the spread of the coronavirus outbreak. People have been told to stay indoors, but for many daily-wage earners this is not an option.



IMAGE: A rickshaw puller waits for passengers on a deserted road, amid a nationwide lockdown over the highly contagious novel coronavirus in New Delhi. Daily wage earners are despairing over how they will manage their family's livelihood without any work Photograph: Yawar Nazir/Getty Images

Waging a desperate battle for survival, they are the invisible millions who eke out a precarious living as construction workers, painters, food vendors and a host of other jobs suddenly rendered redundant in these COVID-19 days.

As India grinds to a halt with a three-week nationwide lockdown in place to curtail the spread of the coronavirus, the unorganised working force on the margins of society might be the worst hit with no savings and therefore completely dependent on what they earn each day.

According to official data, there are 42 crore (420 million) people in the unorganised sector, including agricultural labourers, spread out across the sprawl that is India.
Some are migrant workers, stuck in distant corners with no transport to take them back to their villages, others are scrounging to make ends meet with no money coming in. And all are getting increasingly frantic on how they and their families will manage in the days and weeks to come.
The stories are many -- varied and yet the same, of hopes for the future dimming and dreams of prosperity receding into the unseen distance.
The bright lights of a big city had beckoned Bhupesh Kumar, a 22-year-old daily wage labourer from Bihar's Begusarai district who is now stuck in Delhi, unable to either go back home or earn a livelihood here.

"I was doing my graduation but had to come to Delhi about five months ago because my family was very poor. I was learning plastering. I have barely earned anything," he said.
Anjani Mishra, a contractor who takes on whitewash and paint jobs, has asked the five people who work for him to to return home.

"I am from Raxaul in Bihar and want to go back. But all buses and train services have been cancelled. I asked many taxi drivers to drop me to my hometown, but they are refusing as the police has sealed borders along the national capital."


IMAGE: Homeless Indians sit in the middle of a deserted road amid the lockdown in New Delhi. Photograph: Yawar Nazir/Getty Images
His story finds echo in far away Kolkata.

Manoj Barik, a construction worker the West Bengal capital, lost his job this week after the company suspended all services. His earnings of Rs 300 a day was meagre but he somehow managed to feed his family of five, including three children.
But not anymore.
"We have been asked to go back. But right now bus and train services are suspended. The contractor has stopped paying us," he said despairingly, eager to get back to his village in East Midnapore district.
West Bengal Chief Minister Mamata Banerjee on Tuesday evening announced Rs 1,000 under which labourers in the unorganised sector will get a one-time payment of Rs 1,000.

That might not be enough to see Barik and others through this crisis.
According to state government sources, Bengal has an unorganised workforce of around 90 lakh, including hawkers, rickshaw pullers, bus drivers and tea garden workers.
In Uttar Pradesh, too, the government has said around 35 lakh labourers in the state will get Rs 1,000 each as financial aid while free ration for one month will be provided to 1.65 crore construction workers.

Stuck without food and also shelter in many cases, the worries of daily wage workers on how they will feed their families are spiralling.
Most of those working in bigger cities hail from villages and said they are desperate to return because food will at least not be a problem.
"There is no work and whatever little we have saved will soon dry up if the situation continues. It is not just the disease but also about food," said Raju, a resident of Bahraich who takes up whitewashing jobs in Lucknow.
"Some of my relatives who ran fruit juice kiosks have closed their outlets and are sitting at home. There is no raw material and no customers either," he added.
Back home in his village, he said, food will not be a problem because they won't have to buy it from the market.
The anxiety finds echo everywhere.


IMAGE: Beggars seeking alms sit in a deserted market during the lockdown in New Delhi over the spread of coronavirus. Photograph: Yawar Nazir/Getty Images

A vegetable seller in Haryana's Rohtak town said his daily earnings have already been halved.
"People are uncertain about about the future. Customers are buying less because they don't know how long this will last and they need to save money," he said.
The Haryana government earlier this week announced a package of Rs 1,200 crore per month to help below poverty line and low income group like labourers, street vendors and construction workers.
"Everyday, I have to go out for work to earn something. But with restrictions on movement of people in place, how will I manage?" asked Suresh, a construction worker in Mohali in neighbouring Punjab.
"Ramdin, who belongs to Uttar Pradesh, added that he would earn Rs 8,000 to Rs 10,000 a month working at different construction sites. But that has dried up.
"I have to look after my wife and two children. All of a sudden there is no work," he said.
Autorickshaw driver Amarjeet in Panchkula Amarjeet said he is the sole bread winner of his family.
"Sitting at home without work and having to support a family is not easy. This virus has devastated lives and one can only pray that these difficult times get over soon."
Punjab Chief Minister Amarinder Singh last week announced immediate relief of Rs 3,000 each for all registered construction workers in the state.
The tales of livelihoods lost and lives in peril are heard everywhere.
In southern Tamil Nadu, like in other states, thousands of migrant workers are stranded, relying on their meagre savings or reduced to borrowing from others to make ends meet.
Chennai Corporation officials said they have housed over 1,000 migrant workers. But that is just not enough to cover them all.
A food vendor who sells puffed rice on the roadside said he is at his wits' end. "We have to earn everyday to meet our daily needs and to buy things to prepare the next day snack. It is a cycle. The lockdown is a nightmare," he said.
Tamil Nadu Chief Minister K Palaniswami has announced a Rs 3,000 crore relief package for ration card holders, hawkers and auto-rickshaw drivers.
"Inkenni rojulu ila pasthulu undalo teliyatam ledu (We don't for how long we have to suffer this)," lamented Swami Naidu, a daily wage labourer in Andhra Pradesh's Vijayawada.

The state government has promised Rs 1,000 per family for the likes of Naidu but that money will come only after April 4.
In Kerala, Beena Baburaj, a CITU leader in Ernakulam district, said about 14 lakh people seeking jobs under MGNREGA scheme are in a dire condition due to the lockdown.
"Being jobless is very painful particularly at time of such difficulties. We don't see a silver lining of hope ahead," said Doly, 52, an MGNREGA worker in the state
In Hyderabad, too, all construction worker has been stopped and all workers confined to their camps.

And in Puducherry, 55-year-old Elumalai who makes a living ferrying goods on his tricycle said he has been rendered jobless and penniless.
Chief Minister V Narayanasamy had announced the setting up of a separate fund to which he and his ministerial colleagues would contribute their one month's salary.

Daily wage workers battle for survival in COVID-19 days
 
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Workers in Gujarat leave for homes in Rajasthan on foot
Source: PTI - Edited By: Roshneesh Kmaneck
March 25, 2020 14:55 IST

In the wake of the coronavirus outbreak and the 21-day nationwide lockdown, thousands of migrant workers from Rajasthan working in different parts of Gujarat have started walking back to their native places in the absence of any transport facility.


IMAGE: Migrant workers along with their children walk home to Rajasthan amid the 21-day lockdown. Photograph: Amit Dave/Reuters
Gujarat Police have been trying to convince them to abide by Prime Minister Narendra Modi's appeal to avoid travelling.
https://www.rediff.com/news/interview/lockdown-is-okay-more-important-are-tests-tests/20200324.htm
A Congress leader from Ahmedabad has asked the party-led government in Rajasthan to arrange some transportation after these workers reach the Gujarat-Rajasthan border near Shamlaji town of Arvalli district, also known as the Ratanpur border.


Radheshyam Patel, a native of Rajasthan's Dungarpur district and working in Ahmedabad, said there is no point in staying here without any income.
"Most of us work here at tea stalls or food joints. Since everything is shut, our employers have asked us to come back only after things get normal, as they don't have money to pay us. Since buses and other modes of transport are not available, we have decided to walk to reach home," he said.
Patel was part of a 50-member group that started its journey on foot on Tuesday night from the city's Naranpura area to reach the Ratanpur border, a distance of around 150 km.
"I know there is the threat of virus, but we are helpless. How would we survive without any income for three weeks? We don't have money to pay to our landlord. It's better we move back to our native places," said Mangi Lal, who belongs to Rajasthan's Udaipur district.

He was part of a group of 100 people who left from Gujarat's Mehsana district to return to their homes.


IMAGE: Many labourers began their journey on foot after their employers and landlords asked them to leave. Photograph: Amit Dave/Reuters


Inspector General, Gandhinagar Range, Mayanksinh Chavda said police is providing food packets and water to the migrant workers on humanitarian grounds.
"We are trying our best to discourage these migrant workers from moving to Rajasthan. This will defeat the purpose of lockdown," he said.
"Since they are desperate to reach their homes, we are providing them food and water during their journey. We are also taking action against the factory owners who have not done enough to keep these workers here," Chavda said.
Gujarat Migrant Workers' Congress president Ashok Punjabi claimed that over 50,000 workers left on foot from Ahmedabad alone to reach their homes in Rajasthan.

"I spoke to Rajasthan Chief Minister Ashok Gehlot yesterday about this issue. I urged him to arrange bus service for migrants once they reach the Ratanpur border," he said.
Many migrant labourers started their journey on foot from as far as Surat, as they have been asked by their employers and landlords to leave, said Punjabi.


Workers in Gujarat leave for homes in Rajasthan on foot
 

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'Getting food is a major concern than coronavirus'
By Uzmi Athar
March 27, 2020 14:55 IST

'All the hotels and restaurants from where I used to eat have been shut. I used to beg but now there is no one to give me alms too'



IMAGE: Homeless people and daily wagers eat food at a government shelter during the nationwide lockdown amid coronavirus pandemic near Nigam Bodh ghat in New Delhi. Photograph: Manvender Vashist/PTI Photo

"Self-quarantining ourselves is a luxury homeless like us cannot afford," believes 68-year-old Rupa who has been living on the streets of Delhi-NCR for as long as she can remember.
Rupa, currently living near a Noida metro station, says she does not understand everything happening around her -- whether it is empty roads or closure of most shops -- but what she does realise is that there is a disease which has forced people to stay indoors.
"But self-quarantining ourselves is a luxury homeless like us cannot afford," she said.
Asked if she worries about being infected with the virus, Rupa casually replies that she has seen worse and for her it is nothing more than a flu.

"Getting food is a major concern for me not this (coronavirus)," she said.
"I went to a shelter home but I got scared that I will catch some other disease there," said Rupa who refused to give details of the shelter home where she was taken.

At some distance, Ghanshyam, another homeless in his late 40s, explains how procuring food has been the biggest challenge for him in the past few days.
"My worry is not that of the disease but of getting food. All the hotels and restaurants from where I used to eat have been shut. I used to beg but now there is no one to give me alms too," he said.
India is under the biggest lockdown in its history with all 1.3 billion people asked to stay home for three weeks in view of the coronavirus outbreak, which has claimed 17 lives and infected over 700 people around the country.


IMAGE: A homeless man collects water from a leaking pipe as others sit on the ground. Photograph: Manvender Vashist/PTI Photo

Ghanshyam said he has been surviving by eating food from the garbage since the lockdown was announced and is worried that if the situation persists this source too would deplete.
The Uttar Pradesh government on Thursday directed officials to start community kitchens to provide food to the poor and migrant labourers amid the lockdown imposed to check the spread of coronavirus but daily wager Ramesh has his doubts over its effective implementation.
"How do we reach these kitchens, if we walk we will be stopped and questioned by the police. How do we reach there?" asked Ramesh who used to work as a daily wage worker at a construction factory but lost his job ever since the lockdown and has been living on the streets since last then.
According to the 2011 census, India is home to 17 lakh homeless people who also happen to be particularly vulnerable to COVID-19 because of their exposure.
Leilani Farha, United Nations Special Rapporteur on adequate housing, said approximately 1.8 billion people worldwide live in homelessness and grossly inadequate housing, often in overcrowded conditions, lacking access to water and sanitation -- making them particularly vulnerable to contracting the virus, as they are often suffering from multiple health issues.
She urged States to "take extraordinary measures" to secure the right to housing for all to protect against the pandemic.
"By ensuring access to secure housing with adequate sanitation, States will not only protect the lives of those who are homeless or living in informal settlements but will help protect the entire world's population by flattening the curve of coronavirus,” the UN expert said.


IMAGE: A daily wager receives food at a government shelter amid the nationwide lockdown near Nigam Bodh ghat in New Delhi. Photograph: Manvender Vashist/PTI Photo

The government and medical professionals have advised everyone to 'stay at home' and wash hands as much as possible.
"Washing our hands regularly is also something not easy for us. Where do we get the soaps from or even clean water," Ramesh asked.
"We have seen a lot in our lives, slept hungry on many nights but never we have witnessed such a situation. We are not sure what is coming next for us and what should we do to protect ourselves. All the steps advised whether it is quarantine or washing our hands is for rich people not for people like us who neither have roof over our heads nor food in our stomachs," he added.
Bharat Gopal, Senior Consultant Pulmonologist and Director National Chest Centre, said maintaining hygiene and social distancing is the key to fight this disease.
"However for those unfortunate homeless people where do they go. On top of it they are the fragile part of our population – the most vulnerable. Though the government is making efforts to provide food and shelter, awareness and the need for staying away from each other would be the key," Gopal told said.




"Areas to wash hands should be made available to these people too. The NGOs can teach them the correct technique and if these people also learn the hygiene – this enemy (coronavirus) would teach us the biggest lesson and actually save the whole population in future from so many other diseases," he added.


'Getting food is a major concern than coronavirus'
 

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'May die of corona later. We'll die of hunger before'
By DIVYA NAIR
March 27, 2020 09:15 IST

After being rendered jobless post the nationwide lockdown, several autorickshaw drivers in Kalyan, Maharashtra, appeal to the prime minister and state authorities to consider them among daily wage labourers and include them in the relief package.
Rediff.com's Divya Nair reports.


https://www.rediff.com/news/column/india-has-no-defence-against-coronavirus/20200325.htm
Jhanvi Patil with her mother

IMAGE: Daughter of an autorickshaw driver, Jhanvi Patil, 14, is visually and mentally challenged since birth.
After the lockdown, her mother, seated beside her, is concerned how the family will manage expenses and medicines with no income. Photograph: Divya Nair/Rediff.com
Four years ago, when Prime Minister Narendra Damodardas Modi announced on national television that all Rs 500 and Rs 1,000 currency notes would be invalid, it had caused huge inconvenience to several sections of the society.
Some time in 2017, E R Bhaan Raghunath Patil, who worked as a security guard at a housing society in Mumbra, a suburb in Thane district, had to resign his job because the apartment complex where he had worked for 27 years kept delaying his salary citing demonetisation.

Patil, who was 47 and did not have a formal education, could not afford to sit at home.
"I took a loan and put whatever savings I had to buy a rickshaw. After driving around for 12 to 14 hours, I would make Rs 500 a day out of which Rs 150 would be spent on fuel and maintenance," says the 51 year old from Kalyan whose eldest daughter Jhanvi, 14, is visually and mentally challenged since birth.
Since March 15, 2020, Patil is jobless and the family is struggling to keep up with daily expenses.
"My daughter doesn't have an Adhaar card, because for biometric, you need a retina scan and fingerprint ID, both of which are not possible to be recorded in Jhanvi's case. Without an Aadhar card, she cannot avail any facilities or services offered by the government," says Patil.
"She gets anxiety attacks and her medicines cost Rs 1,000 and above every fortnight. We used to send her to a special facility in Wada where she was taken care of for a monthly cost of Rs 5,000. But with the virus scare, they have sent her home and she is not comfortable here," says Jhanvi's mother, a homemaker.
"I have to pay rent and hafta for the rickshaw. My younger son's school fee is Rs 400 per month. If I am not allowed to ride a rickshaw, where do I get the money from?" asks the worried father.
Patil shares his many concerns in the video below:


Like Patil, as many as 25 families who live in Hirani chawl, Kumbhar chawl and Guma Patil chawls in Kalyan East are worried about how the lockdown, especially the next 21 days will affect the health and futures of their kids and families.
According to Bapu Chatur, vice-president, Rickshaw Drivers Owners Association, Kalyan East, the state government should try and include rickshaw drivers under the daily wage category and consider waiving off taxes on loans and announce relief on food and essentials so that no one starves and dies due to lack of jobs and incomes.
Watch him address the problems faced by families of rickshaw drivers in the video below:

Sanjay Tukaram Pande


Sanjay Tukaram Pande, 47, above, has been riding a rickshaw for 22 years now. He has two sons -- the eldest is in first year of college pursuing a bachelor of financial markets degree, while the youngest is in Class 11.

"Ever since news of the virus was out, we have not been able to move out of our homes. One of our friends was beaten up badly by the constables and he is in the hospital. You can imagine how the family must be coping with these extra expenses," says Pande.
"First, they robbed us of our daily income. Then they stopped us from stepping out. How do they expect us to survive? We have loans to pay and expenses to meet. We are answerable to our families. They are dependent on us for food and basis needs."
"If the government doesn't do anything, we'll have no other option but to commit suicide. We may or may not die of corona. But we will die of hunger first."


'May die of corona later. We'll die of hunger before'
 

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'How can there be social distancing in slums?'
By VAIHAYASI PANDE DANIEL
March 24, 2020 09:57 IST

About 9 million people in Mumbai live in areas where homes are hardly two metres apart.
Vaihayasi Pande Daniel/Rediff.com reports on the lurking dangers in the city's slums in the times of the coronavirus.



*IMAGE: A metro train moves past a cluster of houses at the Asalpha slum in Mumbai. Photograph: Francis Mascarenhas/Reuters


When Rediff.com spoke to several general practitioners, who have clinics near Mumbai's slum localities, or whose patients come from the lower economic classes, they didn't have answers on how social distancing could be effected in the slums.
Says Dr Vivek Korde, a GP from Sewri, south central Mumbai, with a laugh: "How it can work? We cannot just think of it!"
General practitioner Dr Prakash Tathed has a clinic in the Grant road area of south Mumbai and sees patients from all backgrounds.
"Social distancing in Mumbai is very difficult, because you may stop the vehicles, you may stop the local trains, But what about those places where people live in a jhoppadpattis (shanties)?" asks Dr Tathed.
"They are so close together, you can't have a ten-inch distance also," adds Dr Tathed. "That's very difficult. Thankfully, still, it has not gone in that area. But when it will go, we cannot know. It will be seen after 15 days or so."


*IMAGE: Migrant workers rest inside their one room dwelling in Mumbai. Photograph: Danish Siddiqui/Reuters

A doctor working at suburban government hospital, who did not wish to be named, says: "Social distancing I don't think at a lower middle-class level will have much effect. For example, my domestic worker, her two sons are not going to work. She lives in a single room ten by ten. They have no choice but to be close to each other."
"Social distancing can't be done. It is mainly meant for the middle or upper middle class."

IMAGE: Multi-storey slums in Mumbai. Photograph: Danish Siddiqui/Reuters

Dr Sanjay (named changed), a former BMC doctor, says that in many municipal wards the lanes are very narrow and allow the passage of one person at a time.
"They throw everything into the galli and someone has to go and remove the garbage. And there's old drainage. Now you will find multi-storey slums. One, second, third floor. It's really difficult in multi-storey slums."
As per recent estimations, Mumbai now has a population of 22 million* and about 41 per cent of that live in slums.
Hence, approximately 9 million people in Mumbai live in areas where homes are hardly two metres apart.

And water may be scarce.
And isolation close to impossible.


IMAGE: People gather to fill drinking water from a common municipal tap at a slum area in Mumbai. Photograph: Punit Paranjpe/Reuters


But Dr Deven Naik, who has a practice in the Parel area, south central Mumbai, did have a thought on how social distancing might be achieved.
"The thing is that the people are living in such proximity that it is hard to isolate then at their place. What we are talking about is quarantining them at their home. That won't be possible in slums, or small chawls, where nine to 10 people live in one 10 by 10 room," explains Dr Nairk.
"So the government should think of taking the suspected cases (from the slums) and isolate them elsewhere. I don't have any idea how it can be done. But they can take the schools or grounds," Dr Naik adds.
"They have to make some makeshift arrangements for people living in such proximity like chawls and slums and all that. They can't be relied upon to isolate themselves in their homes, where basic facilities like toilets are not in their homes," says Dr Naik.
"They have to go somewhere outside for that. The concept of quarantine will not work there in those areas."



IMAGE: A child takes a bath in a slum in Mumbai. Photograph: Danish Siddiqui/Reuters


While speaking about this problem, which is not just specific to Mumbai, Dr Roopa Mankaikar, who also practices in Parel, tentatively offers the hope that people living in close, crowded, quarters may have stronger immunity in any case.
Says Dr Mankaikar: "They may be already having immunity against bad viruses because already they are living in such a poor hygienic condition. That may help us or not. I don't know. Might be possible."
She is also concerned about the doctor dispensaries inside these packed areas.
"Clinics are also very small in slums. Hardly four feet area around. Very difficult... For them to go to the hospital and check for this swab, it is not possible for everybody."
Dr Korde adds, with a touch of grim humour: "We can only pray to god and god is not there. We are helpless people. We cannot take any measure which China could take. Italy can take. We cannot take in our metro city. This is a mega city, something more than mega city."
In addition to social distancing, the other government directives are about containment and isolation of those with travel history and tips on washing hands.
For those living in slums is the use of a sanitiser or multiple washing of hands feasible?
The verdict on this is mixed.
The government hospital doctor says her domestic help, and the people who she sees from poorer areas, had sanitiser before she did.
"All my three bais are using sanitiser and they are using masks. They are doing it because all the time it is coming on the television. Television is a strong influencer."
These doctors say too that most slums have enough water available.
Dr Sanjay, the former BMC doctor, confirms: "Mumbai has a good supply of water."
Dr Tathed is of the opinion that it's more about explaining how to wash hands.
"Practically everybody is having phones. Everybody has mobile phones. Even those working as housemaids they also have WhatsApp and all this info is being disseminated to them. About washing hands and wearing masks."


IMAGE: High-rise residential buildings are seen behind a slum in Mumbai. Photograph: Danish Siddiqui/Reuters


But Dr Korde, who now works as an activist, says he won't say it's not possible, but has more to add: "We are very irresponsible people. (Thursday) I went to a stationery store to buy a pen refill. That fellow was literally wiping his nose with his hand and with those hands he gave me the refills. I scolded him."
But people are hygienically not literate.
"You ask them to wash their hands. They will wash their hands for five seconds. They should understand that this is necessary for their life! The overall view is that nothing will happen to us."



IMAGE: Residents fill water in a Mumbai slum. Photograph: Danish Siddiqui/Reuters

Dr Naik has another take.

According to him, since water is stored in drums in slum homes, water can easily get contaminated and washing of hands not a workable or fool-proof solution.
"Water is a very big problem. They don't have water. They just fill up some water in drums and all that. You can't expect them to wash hands frequently."
"Washing your hands at a tap (is different from) washing your hands from a drum; it can contaminate the whole source of water... And water scarcity also an issue in these areas."
Dr Sanjay had a concern about washing of masks as opposed to hands.
"People don't know how to decontaminate the mask or the cloth masks. They don't understand what is the protocol for decontaminating this mask or the cloths they are using for protection... Most people are using the mask and throwing it."
And the accumulation of discarded masks, all over the place, could be an additional health hazard in Mumbai, he points out.
A certain degree of segregation of the people of the slums from wealthier classes, for their own safety, is considered another more radical but safer option.
Covid-19 is a disease that is travelling from higher economic stratas to lower ones, where folks are less equipped to deal with it.
Creating a distance for the poor from this "imported" disease is suggested.
Or as Dr Tathed puts it: "We should restrict people to their locality only."


IMAGE: Residents in Dharavi, north central Mumbai, one of Asia's largest slums. Photograph: Danish Siddiqui/Reuters



Dr Roopa has noticed that city residents are giving their domestic help a break: "Near my clinic there are many high rises. People (in those buildings) have told their maids don't come."
Says Dr Korde: "We always blame poor people that they bring TB (tuberculosis) and this and that. And that because of them we are suffering. Now the rich people are giving suffering to the poor."
"The best thing the government can do for the poor and people living in slum areas, they should provide them adequate rations, all required things, the government should take care of all those families for a month and lock them to their home only," says Dr Korde.
"At the same time all other people should be locked in their houses for at least for three weeks. That's the only way!"



IMAGE: A municipal worker fumigates a slum area to prevent the spread of dengue fever and other mosquito-borne diseases in Mumbai. Photograph: Shailesh Andrade/Reuters

Dr Naik concurs: "You have to supply them with their essentials. They are daily wagers. So if they are not going to work, they are not going to earn."
"They should be) provided with one month rations. Supplies kept near their homes so they won't have to come out."
After quarantining these areas, Dr Naik suggests daily checks.
Municipal workers, he says, are anyway going to homes in slums checking if there are cases to be isolated.
"Workers are going to homes and asking whether you have cold or cough. They are doing it on a daily basis now."


IMAGE: A girl jumps rope in Dharavi. Photograph: Danish Siddiqui/Reuters
The former BMC doctor says surveillance is something the municipal corporation is very good at and "locking people into their domain" is a step that should be considered.
"We can track any patient at any moment. We have a massive infrastructure and massive outreach. We have a very good slum-based networking," he adds.
Dr Naik -- who is thinking of giving separate timings in his clinic for those with cough, cold and fever -- believes that that his patients from poorer backgrounds have quite clearly understood how serious the disease.
But that is not necessarily an ideal situation.
Often confusion follows.
"There is confusion in everybody's mind, like including me, about what the government is doing and how it is going to stop it and what is the future of these people," says Dr Naik.
"The amount of information being bombarding on the people is leading to panic. And we don't have anything to do for this panic. That that can lead (for those living in the slums) to a lethargy of: What will happen, will happen, if you don't have a measure of control for a thing."
"Bhagwan dekh lega kya karna. Jo sabka hoga humara hoga. Kya karein? (God will look after us, what happens to everyone will happen to me too, so why worry?)"
The fatalism arises, says Dr Naik, because of their situation, especially among daily-wage earners.
More prosperous people have all kinds of facilities available to them and the ability to stockpile groceries and lockdown.
"They don't have the facilities to lock themselves in their houses," says Dr Naik.
"They are totally dependent on the government. And (their) god."

Source: Mumbai Population 2020 (Demographics, Maps, Graphs)
*Kindly note all images only posted for representational purposes.




'How can there be social distancing in slums?'
 

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India has no defence against coronavirus
By AAKAR PATEL
March 25, 2020 12:21 IST

One third of all Indians live in one room. Another one third lives in 2 rooms.
They cannot self quarantine or isolate and if infected they will pass it on to others.
It is impossible for India to control an epidemic, notes Aakar Patel.



IMAGE: People travel in a crowded bus in Kolkata, March 23, 2020, to return to their villages before the start of the lockdown imposed by the West Bengal government to limit the spread of the coronavirus. Photograph: Rupak De Chowdhuri/Reuters

The population of India in the first census of 1872 was 206,162,360.
Meaning 20.61 crore on the subcontinent, including what is today Bangladesh and Pakistan.
In 1881, this rose by 23% to 25.38 crore.
Some of this was due to an increase in population and some due to the increase in territory controlled by the British, which kept expanding over the years.
In 1911, the population grew by 7% over the decade to 31 crore. However, in 1921, after 10 years it remained at 31 crore.
Why did the population not grow over an entire decade? The answer is an H1N1 virus which is called the Spanish Influenza.
This was an epidemic like the coronavirus and it killed off the entire population growth of a decade in India.
Around 1.5 crore people and most likely more than that were killed by it.

The flu came to India from Europe, where it broke out in military hospitals towards the end of the first world war.
We don't know how it originated, but it is possible that it was transferred from birds or animals being slaughtered for the armies's messes.
Indian regiments which fought for the British empire returned to Bombay after Germany surrendered in 1918 and the fighting ended.
They brought the virus with them, just as those coming from abroad have brought the coronavirus.
Many nations had fought the war including the United States and so the returning soldiers took the disease around the world.
It is thought that 25% of the world's population was infected and probably killed around 10% of those infected.
These are very high rates of both transmission and of fatality and that is what we are faced with in the coronavirus.
The problem with a new virus is that it has no cure.
There is no medicine that can be taken and it has the ability to spread very rapidly as we are seeing in India today.
Person A is infected and may or may not show symptoms, s/he passes them on to the people s/he has been near, and they pass the virus on to the people they come in contact with.
And all this happens in the same day.
There is no decrease in the lethality of the virus as it passes from one person to another and the virus does not dilute.
There are ways in which the chain of the spreading can be halted and that is to end contact between all people as far as possible.
This ensures that those who are infected have the time for the disease to pass through their system.
Some survive and others will not. But the isolation ensures that even those who are infected keep the disease to themselves.
The point of isolation is not the benefit of the patient, but the others around him.
China halted the spread of coronavirus through lockdowns of entire cities.
People were banned from travelling outside their homes.
The government ensured that food was supplied to each home by trained people.
In Europe, it is not possible for democratic States to order or enforce absolute shutdowns like China.
This is the reason that the spread of the virus in Italy and now Spain is faster and the death rate higher than in China.
Of course, Europeans have been practising social distancing and self quarantine as we have seen in the videos, but this is not as effective as a total lockdown.
On Friday, March 20, in Italy (which has a population of less than Gujarat) 627 people died and another 6,000 cases of Coronavirus infection were recorded.
Just in one day. And unless the chain is broken, or the virus itself mutates into something less infectious and less lethal, the infection spreads exponentially.
We are familiar with exponential growth through the story of the man who asks the king to give him one grain of rice for the first square of the chessboard, then double it with each square.
That sequence produces 1,2,4,8,16,32,64,128,256,512,1024 and 2048 by just the 12th square.
Now assume that these are people and the 1 represents the first infected person entering the country.
By the time you reach the 64th square, everybody has been infected except a few.
This is what will happen with coronavirus.
The fact is that India has no defence against coronavirus.
One third of all Indians live in one room. Another one third lives in 2 rooms.
They cannot self quarantine or isolate and if infected they will pass it on to others.
It is impossible for India to control an epidemic. We do not have the State capacity of China to deliver food by trained and protected individuals to each home and order everyone to stay at home.
That will not happen in India.
We also do not have the healthcare to save those who will be infected and can be saved medically because we do not have the capacity there either.
India spends 4 times on defence what it does on health.
Last year, the government gave only Rs 3,200 crore to Ayushman Bharat (what is called Modicare).
We spent Rs 59,000 crore only on 36 Rafale fighters.
India has 70,000 hospital beds and only a few ventilators.
Those infected who might be able to be saved in another country will die in India.
This is a fact and we will learn of this very soon as we confront a disease that will kill not in numbers alone but a fraction of the population.
The world will notice that India cannot spread the contagion and there will be consequences of that which we shall soon see and they will not be good for us.




The good thing about India, which perhaps no other country has, is our fatalism.
We are so accustomed to extreme deprivation, misery and loss that there will be no revolution, no social upheaval as hundreds of thousands of people will die.
Those of us that survive this plague will carry on just as the survivors of the Spanish Influenza did a century ago.


India has no defence against coronavirus
 

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MHA asks states to use disaster relief funds to help migrants
Source: PTI - Edited By: Utkarsh Mishra
March 28, 2020 20:48 IST

The Centre on Saturday asked the state governments and Union Territory administrations to utilise the State Disaster Response Fund (SDRF), to which Rs 29,000 crore has been allocated for the next fiscal, for providing food and shelter to migrant workers hit by the 21-day lockdown.


IMAGE: Ram Avtar, 60, with his family walks along with other groups of migrant workers as walk to their native places amid the nationwide complete lockdown. Photograph: Ravi Choudhary/PTI Photo

Joint Secretary in the Ministry of Home Affairs Punya Salila Srivastava said the central government has also asked the states and UTs to set up camps for migrant workers fleeing cities and carry out their health check-ups.

Srivastava said the home ministry has asked the state governments and UT administrations to utilise the SDRF money for providing food and temporary shelters to the unorganised sector workers affected by the lockdown.
"Under the SDRF, whatever allocation is there in the current year, for the next year a total of Rs 29,000 crore has been allocated to the states under the SDRF. Therefore, there are enough funds with the states under the SDRF.

"We hope that with this fund, the states and UTs will be able to help the migrant workers," she said at a press conference in New Delhi.
Srivastava said Union Home Secretary Ajay Bhalla has written another letter on Saturday asking them to set up camps for migrant workers and provide them food and shelter.
The states and UTs were also told to communicate about the availability of free food and accommodation to migrant workers through the public address system, volunteers and other mode of communications, she said.
The home secretary on Friday in his letter to chief secretaries also had emphasised on the issue of the difficulties being faced by the unorganised sector workers. The DGPs of the states were also told the same.
"The home ministry is constantly in discussions with the states and UTs on the issue of migrant workers," she said, adding, steps should be taken so that the migrants would get information about these facilities.
On the availability of essential commodities during the lockdown, the joint secretary said the home ministry, along with the states and UTs, is constantly monitoring the movement of essential commodities and enforcement of the lockdown.
Asked about the issue of price rise in some parts of the country, she said the states and UTs are monitoring the situation and taking action wherever such incidents are coming into knowledge.
"The home ministry has already allowed cargo movement so that no such incident takes place," she said.
On the question of some migrants facing difficulties in paying rent to house owners, Srivastava said it was a very important issue and that the central government has been insisting that migrant workers should remain wherever they are.




"Instructions were also given to convey this to the employers. State governments are aware about this issue and taking action," she said.
Asked about the possibility of migrant workers carrying the disease, Srivastava said the home secretary in his letter specifically talked about providing accommodation to the migrants workers along with health check-ups so that their health parameters are known regularly.


MHA asks states to use disaster relief funds to help migrants
 
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