Coronavirus Reads, Digest 2
Doctors urgently need protective equipment, and hospitals are getting overwhelmed. Also, are lockdowns going to be the new normal?
It’s Saturday, March 28th.
India, day 4 of the lockdown continues and COVID-19 cases rise above 900. Unfortunately, doctors have started to contract the virus from patients and fall sick, in Mumbai, 3 doctors have tested positive and one has died.
In yesterday’s newsletter, I had discussed how critical it is for healthcare workers to have adequate protection to fight the virus and treat patients. In Italy, 45 doctors have died after testing positive for the virus.
Rohini Mohan reported a disturbing account of a doctor who has fallen sick, after he was not even allowed to use a mask to treat patients because of fears of shortages, and that this is happening in several government hospitals.
“Protective Gear Shortage Makes Indian health workers vulnerable to coronavirus.”
The lockdown is not enough, experts say. Testing must be urgently ramped up. In the Hindustan Times, Partha Mukhopadhyay argues a four-fold approach, including: “randomised testing of people in dense urban settlements using voter lists,” and in light of the rampant migrant worker movement, “randomised testing of migrants who have returned home to smaller towns or villages from the larger cities.”
Importantly, he notes that “Just 56 districts — 25 in Uttar Pradesh, 20 in Bihar, three in West Bengal, two in Karnataka and Uttarakhand and one each in Odisha, Rajasthan, Jharkhand, and Maharashtra — account for half the male inter-state migration.” Monitoring these districts for outbreaks and doing surveillance testing will be important.
Read the full piece as he explains how this can be logistically executed. Locking down is not enough. Ramp up testing, by Partha Mukhopadhyay, Hindustan Times
And the company Maruti Suzuki has released a statement saying they will work to scale up production of ventilators to 10,000 a month. Many other Indian corporate houses have followed suit, including Tata Trust to help in funding and manufacturing PPE, testing kits and facilities.
In a New York Times Op-Ed, economist and epidemiologist Dr. Ramanan Laxminarayan says India has 3-4 weeks to prepare infrastructure, ICU facilities, and a testing apparatus.
What India Needs to Fight the Virus, The New York Times
Scientific and medical breakthroughs
In the U.S., the FDA has approved a new rapid test from Abbott Laboratories, which is supposed to detect the novel coronavirus within minutes. It works by detecting the virus RNA in a patient, and is being lauded for its accuracy levels. The company has said it will produce 5 million tests in April, but it’s not coming for use in India yet.
India is set to have a domestic made working test kit from Mylab Discovery. The kits are being manufactured in Pune, and were developed by a team led by virologist Minal Dakhave Bhosale in 6 weeks. Ms Bhosale is also making headlines as she delivered this project right on deadline before giving birth to a baby girl.
BBC’s Geeta Pandey reported the story: The woman behind India's first testing kit.
And in New York City, experimental treatment is beginning to use blood plasma containing antibodies from survivors to treat those who are still hospitalized and seriously ill.
Blood Plasma From Survivors Will Be Given to Coronavirus Patients, By Denise Grady, The New York Times
More symptoms of the virus
And doctors are finding that the SARS-CoV-2 coronavirus also can cause myocarditis, an inflammation of the heart, which led patients to think they were having a heart attack, only to discover they had COVID-19.
A Heart Attack, No It Was the Coronavirus, By Gina Kolata, The New York Times
The NYT reported a few days ago the loss of smell is an important potential symptom of COVID-19, even in people with no symptoms. If you lose your sense of smell, you should isolate immediately if not already doing so, doctors recommend.
Harvard Medical School researchers are proposing why and how the novel coronavirus can attack certain cells in the nose, detailed in this Bloomberg story: “Have Coronavirus and Can’t Smell?”
As healthy, younger people get sick and have such varying symptoms, many are wondering, why do some people get more severely affected by this virus than others? If it’s not underlying health conditions and age, what else? Another factor that scientists are explaining is something called viral load, the amount of the virus one is exposed to.
Dr. Siddhartha Mukherjee in an essay in The New Yorker, “How Does the Coronavirus Behave Inside a Patient?” explores some of these questions, “can we quantify the increase in the risk of infection as people are exposed to higher doses of the virus? Is there a relationship between that initial “dose” of virus and the severity of the disease—that is, does more exposure result in graver illness?”
And as we look to the future, a more realistic expectation: Are lockdowns going to be the new normal until there’s an approved vaccine?
9) In The Atlantic, Timothy McLaughlin writes, “Get Used To It, This Lockdown Won’t Be the Last.”
Societal crises:
The millions of Indian migrant workers trying to move out of cities after their livelihoods were disrupted are getting some much delayed solutions. Tens of thousands showed up to the Anand Vihar bus terminal in Delhi today after state governments allocated buses. Painful accounts from workers included this one in The Wire:
“I work in Haldiram’s, Sector 63, Noida. We get our salaries on the 10th of every month. Our owner did not tell us whether we will get anything this month or not. I have no money left. We used to eat at the Haldiram’s outlet where I worked but it has been shut for more than 10 days now. I have no one here who would look after me if I get infected. So I am leaving,” said Mukesh Kumar, a young worker who has to go to Madhubani, Bihar.
10) Read the full ground report in The Wire including photographs of chaotic scenes. By Ajoy Ashirwad Mahaprashastha and Anuj Srinivas
And here are two expert accounts on the social cost of this crisis and how to more humanely address the needs of marginalized and lower income groups in India:
11) Pratap Bhanu Mehta writes in The Indian Express that the lockdown was necessary. However, the government needed a better plan to manage the human cost, and now needs to use this period to rapidly build up health infrastructure.
12) P. Sainath writes about how the economic stimulus plan is not enough for the lower income groups and expounds on measures that should be taken for laborers and farmers.
Witness the exhaustion of medical workers in Italy in this photo essay in The Atlantic. These photographs by Alberto Giuliani document doctors and nurses in Pesaro the moment they take off their masks and protective equipment at the end of their shift. Most of them have been working grueling hours for weeks on end in the ICU.
American hospitals are also at risk of becoming overburdened. Using data from the Harvard Global Health Institute, these Interactive maps from the Boston Globe show how hospitals in Massachusetts and the New England area (my hometown) could be overwhelmed over time. You can enter your zip code and see for yourself.
12) How Overwhelmed Could New England Hospitals Become? By Saurabh Datar and Szu Yu Chen
Stigma and COVID-19
Every patient is a victim of this disease, and not a perpetrator or criminal. Yet in some communities, the fear that someone could be more susceptible to the virus has led to discrimination. In India, there was a move to evict doctors and nurses who were treating patients.
13) In New York Magazine’s The Cut: It is Not Shameful to Have the Coronavirus, by Katie Heaney
The most vulnerable to becoming severely ill are the elderly, and those with underlying health conditions.
14) Louise Aronson asks, “is the reality that elders are most likely to get ill and die from COVID-19 affecting the way countries—particularly the U.S.—are responding to the pandemic?” Ageism Is Making the Pandemic Worse, The Atlantic
And while there’s deep anxiety and concerns about the economic cost of the pandemic, you might be interested to know that travel influencers are having a tough time right now too.
15) India's Top Travel Influencers Reveal How Coronavirus Has Upended Their Lives, The Huffington Post India