Med college adopts safe method to collect swab

TNN | Apr 7, 2020, 04.10 AM IST

Trichy: Taking cue from foreign countries, Pudukottai government medical college has come up with a safe method for taking a nasopharyngeal swab from suspected COVID-19 positive patients by making use of a separate cabin.

The nasopharyngeal swab is collected from the surface of the inner nose of the patient by inserting a flexible swab. Doctors wear complete protective apron including goggle and helmet to prevent themselves from getting infected. Doctors need to change their protective gears every time nasopharyngeal swab is collected from a patient. This may lead to a shortage of protective gears as it happened in a few western countries. While protective gear costs around Rs 2,000 to 3,000 thereby making it an expensive affair, this process reduces the consumption of personal protective equipment by doctors, said Dr A L Meenakshisundaram, dean, Pudukottai government medical college hospital.

The idea of the cabin was first evolved in South Korea where the testing kiosk was created in public places calling people to volunteer for the test. It was adopted in Kerala by doctors and now has been adopted by Pudukottai government medical college hospital.

The adoption of this technique will ensure zero-infection possibility to doctors, he said. Doctors can collect the nasopharyngeal swab by extending their hands through two holes in the glass wall between them. Even if the patients sneeze or coughs during the process, it will not go inside the cabin, he said.

Three more test positive for Covid-19 in Thanjavur

TNN | Apr 8, 2020, 04.26 AM IST

Trichy: Three more people including a woman tested positive for Covid-19 in Thanjavur on Tuesday pushing the total number of people infected with the virus to 91 in the state’s central region. The positive cases include a 52-year-old man from Adhirampattinam and a 51-year-old man from Ammapettai, both Tablighi Jamaat delegates.

With the three cases, the number of total cases in Thanjavur touched 11, which includes one West Indies returnee from Kumbakonam.

In Trichy, the test results of the six more TJ delegates with Covid-19 symptoms are awaited at Mahatma Gandhi Memorial Government Hospital (MGMGH). It was expected to be released on Monday. The hospital has four more new patients with Covid-19 symptoms.

MGMGH had 30 positive cases – all of them from a Delhi event. The hospital is also providing treatment to one Covid-19 patient each from Erode, Karur, Ariyalur and Perambalur. Trichy district administration said all of them were stable.

Trichy district administration said that none of the family members/ close contacts of the 30 Covid-19 patients in Trichy showed symptoms. “I have visited Puthanatham and Thuvarankurichi areas. No family members are showing Covid-19 symptoms,” Trichy collector S Sivarasu told ToI this evening.

The collector also said that he has ordered for taking samples of a 73-year-old woman and a 20-year-old pregnant woman in the area. “I have asked the health department to concentrate on aged people and high risk people in the families of the affected people to ascertain their status,” said the collector. As on Monday, 84 patients including 69 people who attended the Delhi event tested negative.

State govt notifies Mayiladuthurai district’s formation

TNN | Apr 8, 2020, 04.30 AM IST

Trichy: The state government has issued an order notifying the formation of Mayiladuthurai district with Mayiladuthurai as capital here on Tuesday.

The order has been issued based on an announcement made by chief minister Edappadi K Palaniswami in the Assembly under rule number 110 on March 24.

As proposals received from the principal secretary, commissioner of revenue administration in this regard, a formal order has been issued stating the formation of Mayiladuthurai as the 38th district of the state by bifurcating Nagapattinam district. Bifurcation of the town was a long pending demand of people of Mayiladuthurai.

The chief minister had promised to create a new district during the inauguration of the government medical college in Nagapattinam.

As cancer care takes a hit, poor patients bear brunt

TNN | Apr 8, 2020, 04.09 AM IST

Madurai: With only a few general consultations for cancer screening coming in every day and lesser people being referred for treatment in both government and private hospitals, cancer care has been taking a hit in the lockdown. Patients undergoing chemotherapy and radiation are also facing difficulties in logistics to go for treatment, thereby remaining exposed to infection amid the Covid-19 scare.

“Hardly a few patients are coming in for general consultations in government hospitals because many can’t afford to arrange for transport. Cancer is not simple to just diagnose and start treatment. Usually, people consulting physicians with minor ailments are referred for cancer screening. In the current situation, people are not likely to visit hospitals unless it is an emergency,” said Dr M Ramesh, head, department of surgical oncology, Government Rajaji Hospital (GRH). However, doctors said that if the lockdown is not extended and at least gradually relaxed for beyond 10-15 days from now, there is nothing to be alarmed about.

Cancer surgeries continue to be performed for those requiring it in all hospitals. However, surgical oncology departments are also seeing less number of patients coming in because there are lesser referrals. “All emergency surgeries are being performed. In some cases, the surgery could be postponed if the tumour is in the initial stage and we advise management by chemotherapy. However, for cancers affecting bone, soft tissues or oral cancer, surgery is the only solution and we perform it immediately,” Dr Ramesh said.

It has not been easy for cancer patients availing of routine chemotherapy and radiation therapy, particularly for poorer sections and those from rural areas. 102 Ambulances are currently ferrying such people . Around 50-60 cancer patients have so far made use of the ambulance in Madurai district alone in the past ten days.

“No cancer patient should be stranded at his home town sick and unattended. Less toxic chemotherapy regimens with lesser hospital visits and oral chemotherapy regimens may minimize exposure of both patient and the caregiver to Covid-19 sources. Certain planned chemo schedules may be delayed, however patients requiring chemotherapy for day-to-day control of disease may continue their therapy under strict monitoring. Oncologists can also decide to postpone or modify radiation therapy depending on the clinical situation,” said Dr Krishnakumar Rathnam, head, Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre (MMHRC).

Police commissioner warns against aimless travel on Chennai roads

TNN | Apr 8, 2020, 07.10 AM IST

CHENNAI: All bikes and cars seized for violating prohibitory orders under Section 144 of the CrPC will be released only after the ban is lifted in the state, city police commissioner A K Viswanathan said on Tuesday.

Warning residents against roaming aimlessly on the roads, he said police personnel who catch such people will deal with them strictly. There have been instances where people have been found travelling long distances, from one corner of the city to another, just for fun, he said, adding that such ‘picnics’ should stop.

In Chennai, from March 24, when the lockdown kicked in, to April 6, police have seized about 12,000 bikes from those who in defiance of the orders came out on to the streets. “As per instructions, police have so far arrested about 30,000 people for violating prohibitory orders,” Viswanathan said.

At a programme held at Periamet, Viswanathan distributed packets, each containing a sanitizer and a mask, to armed reserve police constables. The event was organized by Aranya Foundation, an NGO run by Arnav Rathore, a Class XI student and son of additional director general of police Sandeep Rai Rathore. NGO volunteers distributed at least one lakh mixed fruit sachets to police personnel on duty.

Later, addressing reporters, Viswanathan said every day hundreds of people came out on to the roads, despite the prohibitory orders, saying they had to buy essential products. “Every individual can purchase essential products within a kilometre of his/her house and it is not necessary to leave the house and go to faroff places every day. Since police are in the forefront of dealing with such people, it is necessary that they are protected with safety gear,” he said. We have received complaints that people ride far beyond the twokilometre radius on the pretext of buying groceries, he added.

Coronavirus in Tamil Nadu: Dhinakaran for extension of lockdown if needed

TNN | Apr 7, 2020, 05.37 PM IST

CHENNAI: AMMK general secretary T T V Dhinakaran on Tuesday urged the Tamil Nadu government to extend the lockdown beyond April 14, if needed, to contain the spread of Covid-19. However, he asked the government to first ensure that the interests of the poor and the needy are taken care of before taking any decision to extend the lockdown.

Expressing anguish over the increase in the number of Covid-19 cases in the state, with Tamil Nadu placed second and next only to Maharashtra over the past few days, Dhinakaran wanted the state government to make the door-to-door surveillance - for Covid-19 affected people – more efficient. “Instead of merely noting down what the people inform the health workers, the surveillance teams should be equipped with handheld devices to check the health conditions of suspected people,” Dhinakaran said.

He recalled the hardships being faced by the downtrodden societies due to the lockdown, with several homes yet to receive the state government’s Rs 1,000 dole. “Before deciding on extending the lockdown period by one or two weeks, the state government should ensure that the needs of the poor and the needy are taken care of. Further, to mitigate the problems of the affected people during the lockdown, state government should operate mobile Amma canteens for the benefit of the needy,” Dhinakaran said.

India allows drug exports, says don’t politicise issue

Paracetamol, Hydroxychloroquine Is Under Licensed Category; Govt To Monitor Their Demand Position

TIMES NEWS NETWORK

New Delhi:08.04.2020

The government has opened up export of antimalarial drug hydroxychloroquine, depending upon availability and domestic requirements, not just to the US and other “badly affected countries” but also to neighbours dependent on India.

TOI had reported on Tuesday that India has partially opened up exports of hydroxychloroquine and paracetamol, responding to a global clamour led by US President Donald Trump.

After his request for hydroxychloroquine, which he claimed could help treat Covid-19, in a conversation with PM Narendra Modi on April 4, Trump on Monday seemed to follow it up with a threat when he said that “if he doesn’t allow it to come out, that would be okay, but of course, there may be retaliation, why wouldn’t there be”?

MEA spokesperson Anurag Srivastava on Tuesday said that given the enormity of the Covid-19 pandemic, India had always maintained that the international community must display strong solidarity and cooperation and that this approach also guided India’s evacuation of nationals of other countries.

“In view of the humanitarian aspects of the pandemic, it has been decided that India would licence paracetamol and HCQ in appropriate quantities to all our neighbouring countries who are dependent on our capabilities. We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic. We would, therefore, discourage any speculation in this regard or any attempts to politicise the matter,’’ Srivastava said.

The DGFT had notified lifting restrictions on 14 drugs on Monday. On paracetamol and hydroxychloroquine, the government has decided to keep these in a licensed category and to continuously monitor their demand position. However, Srivastava said the stock position could allow Indian companies to meet the export commitments that they had contracted.

India is among the largest producers of the drug and the government believes it has enough stock for domestic use.

Covid 19 +ve person can infect 406 others: ICMR

Sushmi.Dey@timesgroup.com

New Delhi:08.04.2020

One person infected with coronavirus can possibly infect 406 others in just 30 days in the absence of a lockdown and social distancing measures, but this can dramatically come down to 2.5 people with a 75% reduction in social exposure, a recent study by the Indian Council of Medical Research (ICMR) shows.

"If one person does not follow lockdown and social distancing norms, he can infect 406 people in 30 days. However, if social exposure is reduced by 75%, then the same infected person can spread it to just 2.5 people," health ministry joint secretary Lav Agarwal said on Tuesday.

“It is, therefore, our appeal to all of you to follow the lockdown and social distancing measures. We should understand that this is a very important intervention in the management of Covid-19,” Agarwal added, citing the study to underline the importance of observing the lockdown.

At present, the mathematical component that represents the number of persons to whom an infected person can spread the disease is between 1.5 to 4 for Covid-19, Agarwal said and added that health minister Harsh Vardhan was right in stating that "social distancing is social vaccine" in managing the infection.

However, recent reports also suggest that coronavirus often infects clusters of family members and friends. These trends assume significance in India where family members often stay together and members comprise different age groups, making social distancing a difficult proposition.

WHERE TO? A family ventures out wearing masks during lockdown in New Delhi on Tuesday

Donate generously, chief minister appeals to public

Chennai:08.04.2020

Chief minister Edappadi K Palaniswami on Tuesday appealed to industrialists, leading companies, non-government organisations and the general public to donate generally to support the government’s steps to check the spread of Covid-19.

Appreciating the contribution made by several industrialists and prominent persons to the CM public relief fund , Palaniswamisaidthat₹79.74crorehadbeen donatedtillApril 6 following his first appeal on March 27. “Little drops of water make a mighty ocean,” said the CM urging everyone to contribute.

Contributions can be made by internet banking (http:/ereceipt.tn.gov.in/cmprf/cmprf.html)/debit/credit card and get receipts from https://ereceipt.tn.gov.in/cmprf/cmprf.html. It can also be done directly to the Indian Overseas Bank, Secretariat Branch,Chennai 600009,TamilNaduIndia.The SB account number is 117201000000070 and IFS code - IOBA0001172 and CMPRF PAN – AAAGC0038F. TNN

Covid +ve Thai, Indonesian tourists booked

TIMES NEWS NETWORK

Salem/Erode:08.04.2020

Police in Erode and Salem have registered cases against foreign nationals from Thailand and Indonesia for flouting visa norms. The foreign delegates had arrived in India on tourist visas and had attended and conducted religious congregations.

Erode police have registered cases against six Thailand nationals who came to the city on March 11. Police said they spent time in three mosques till March 15.

Out of seven Thailand nationals who came to the city, one person died at Coimbatore government medical college on March 16 due to renal complications, police said On March 21, doctors in Erode confirmed two people as positive for Covid-19. Later, a few others who were in contact with the Thailand nationals also tested positive, police said. “They had attended religious meetings in three mosques,” a police officer said.

Police registered a case under various sections including 269, 270, 278 of IPC along with the Foreigner’s Act 1946 and the Tamil Nadu Public Health Act 1939.

“We haven’t arrested the six people as they are being treated for Covid-19 in IRT government hospital in Perundurai,” a police officer.

In Salem, police officials registered cases against 11 Indonesian nationals under the same sections for violating visa norms.

AROUND THE STATE

Hope amid gloom as Covid +ve woman delivers baby

Team TOI  08.04.2020

There was good news amid the Covid-19 gloom when a 32-year-old woman, who tested positive on Tuesday, delivered a baby boy by caesarean section at the Raja Mirasdar Government Hospital in Thanjavur. The woman’s father-in-law, a resident of Sundaram Nagar in Thanjavur town, had returned from the Tablighi Jamaat conference in Delhi. The man and his son are now awaiting their Covid test report. Thanjavur district collector M Govinda Rao told TOI that both baby and mother were stable. “We will take swab samples for the baby tomorrow,” he said.

In Madurai, the wife and two sons of a 54-year-old Madurai man, who died due to respiratory failure after he tested positive for Covid-19, tested negative in the first confirmatory test. “The second confirmatory test will be done on Wednesday and they are likely to be discharged if they test negative again,” said Madurai collector T G Vinay. The woman and her two sons were admitted to the isolated ward in the Madurai Rajaji government hospital after they tested positive.

Meanwhile, district authorities continued with contact tracing of family members of positive patients and expanding containment zones across the state. On Tuesday, the total number of Tablighi Jamaat members and relatives, who tested positive for Covid-19, rose to 637.

On Tuesday, five persons in Madura district tested positive for Covid-19. Out of the five, one person had attended the Delhi conference while others were all close contacts of positive patients. A 49-yearold man, who tested positive, was from Elumalai, a containment zone, and was working in the milk depot of another positive patient. In the containment zones in this district, a total of 73,396 families are being monitored by 902 health department teams.

In Trichy, after five more persons tested positive, the city corporation established four additional containment zones. Trichy district on Monday recorded 13 new Covid-19 positive cases. Barricades were placed by the urban local body and city police at the entrances of streets to prevent public movement. Trichy Corporation mobilised four minitrucks to sell assorted bags of vegetables to residents in the containment zones.

Trichy collector S Sivarasu said he had ordered for samples to be taken from a 73-yearold woman and a 20-year-old pregnant woman. “I have asked the health department to concentrate on aged people and those who are at high risk in the families of the affected people to ascertain their status,” said the collector.

Except Thanjavur, Trichy, Karur, Ariyalur, Perambalur, Pudukottai, Tiruvarur and Nagapattinam districts in the region recorded no new cases. Among the eight districts, Trichy district was on top of the list with 30 positive cases.

In Coimbatore, the district administration began containment measures for the 23 cases within the corporation limits. At least 60 people have tested positive, 57 among them are Tablighi Jamaat Muslims. All their families have been quarantined in their homes. Besides these 57, two others, including a 25-year-old girl, who returned from Spain, and a 53-year-old railway engineer, have tested positive. All their families have been placed under home quarantine. Besides, around 2,000 people. who flew in from abroad, continue to be under home-quarantine.

Madras HC zooms into era of digital hearing seamlessly

Sureshkumar.K@timesgroup.com

Chennai:08.04.2020

The Madras high court is not letting Covid-19 disrupt judicial work. The HC, which is among the nation’s oldest high courts, is putting to use latest digital tools, including video conferencing app ‘Zoom’, to conduct its proceedings amid the lockdown.

Over the past fortnight, judges sitting in different places heard cases addressed by government law officers from one location and lawyers from another.

In one instance, a lawyer was bike-borne when his case was ‘called’. He sought a minute — not an adjournment — parked his vehicle and addressed the court on the sidelines of a busy road. That is how urgent matters relating to the handling of the Covid-19 pandemic and some bail applications have been heard so far.

A division bench of Justice Vineet Kothari and Justice R Suresh Kumar have heard at least 10 cases so far using ‘Zoom’.

“It was very comfortable. I participated from my residence and the judges from their residential chambers,” additional advocate general P H Arvindh Pandian, who represented the state government, said.

Video-hearings first came about more than two years ago. Sitting in Madurai, Justice S Vaidyanathan heard a case argued in another part of the city via Skype. He took to Skype at the instance of the then administrative judge of Madurai bench of the court, Justice V Ramasubramaniam, now a judge in the Supreme Court.

As for the present proceedings, Pandian said the only drawback was that the judges of the division bench could not have a facility for private discussion between them. Given the emergent situation, it is not a big issue, he added.

“But, how far such digital platforms will be useful for India judiciary has to be seen in the long run,” Pandian said. All correspondence in connection with the cases from government authorities have occurred only through digital mode, he said.

“They send an email with the information needed or in some cases the documents were sent through WhatsApp. At no point was a physical visit of an officer needed,” Pandian said.

If they were to use the inhouse video-conferencing facility, judges and staff have to visit the high court premises, whereas this app just needs to be installed on their mobile phones, said officials in the office of registrar (IT).

At any given point of time not more than 40 members are on call, including the judges, law officers and advocates. But the entire hearing was seamless without any interruption. This is the first time in the history of state judiciary a private digital tool has been used to conduct hearings, officials said.

Advocate M L Ravi, who argued two PILs through the digital tool, called the experience “fantastic”. Though initially there were some connection and other problems, once every participant got used to the app, it was like a routine court hearing, he said. “There were no glitches at all. I represented for two PILs. One from my senior’s residence in T Nagar and another from my residence,” he added.

In one instance, a lawyer was bike-borne when his case was ‘called’. He sought a minute — not an adjournment — parked his vehicle and addressed the court using ‘Zoom’ app on the sidelines of a busy road

Garbage collectors get garlands

Siddharth.Prabhakar@timesgroup.com

Chennai:08.04.2020

On Sunday, when conservancy workers Shanti and Bhavani entered the Muhammed Hussain colony in Kolathur for their daily routine of collecting garbage, they were in for a pleasant surprise. Residents of two streets in the area showered them with flowers and offered them fruits as they went to their homes. Some of them were doing it from the balconies of their homes.

They were showing their gratitude to the conservancy workers who, without fail, reported for duty every day.

“We were grateful to them and wanted to express our happiness. Ideally we would have organised a feast or a felicitation ceremony, but due to the current scenario, we avoided it,” said H Chandrabose, secretary of the registered resident welfare association of the colony. The idea was mooted in a WhatsApp group of the colony. During this activity, the residents ensured they followed social distancing norms and have even created a video.

Incidentally, the conservancy workers in the street come to collect the garbage with tricycles that were donated by the same RWA 18 years ago. The civic body provides conservancy workers with travel facilities and food in these tough times, but it is appreciation from the public that they crave for, said a senior GCC official in zone-6, ( Thiru-vi-ka Nagar ), under which Kolathur falls.

In the same zone, a private construction company has been arranging lunch every day for 1,700 conservancy workers as well as some guest workers who have stayed back.

Zonal executive engineer Senthilnathan said that KLP constructions, a firm on Perambur Barracks Road, has done it for the past 10 days and would continue for the next 10 as well. “They provide either sambhar rice, tamarind rice or puri channa with a sweet,” the official said.

HAILING THE HEROES: Shanti and Bhavani being greeted with flowers at Muhammed Hussain Colony in Kolathur on Tuesday

NEWS DIGEST

Now, consult docs through video conference

08.04.2020

If you are unwell and finding it difficult to consult a doc-tor due to the lockdown, then the Indian Medical Association’s Tamil Nadu branch has a solution for you. The branch has developed and launched a telemedicine platform for video consultation of stable patients and is supported by doctors across state. The service was launched on Tuesday on the occasion of the World Health Day. The service is available from 8am to 10pm and is being offered for free till the Covid-19 ends. Patients can vis-it www.instaclinix-.com and follow simple steps to consult a doctor. After opening the site, enter basic details with complaints and submit, wait in a virtual waiting room and consult a doctor through video consultation. The doctor will also send an e-prescription through email.

Cooking food for needy:

Sabki Rasoi, an initiative started to serve freshly cooked meals to the needy, has delivered 15,720 meal packets in Chennai with the help of five partners since April 5. More details about the initiative can be had at info.sabkirasoi@indianpac.com and at 6900869008.

Daily parcel cargo trains from April 9: The weekly parcel cargo express special trains announced by Southern Railway earlier between Chennai Central and New Delhi will be made a daily special from April 9 to 14. A press re-lease said booking of parcels are open.

Man traps cobra, held: Tiruvallur forest officials arrested a man, 26, on charges of inflicting cruelty on a cobra, a Schedule I rep-tile. He was remanded to judicial custody. A forest officer said he received a video taken by a television channel in which a man, later identified as Yuvaraj of Kakkalur, is seen trapping a cobra from the wild.

#LOCKDOWN HEROES

A guardian angel for pregnant women, on call round-the-clock

Sindhu.Kannan@timesgroup.com

Chennai:08.04.2020

It was 2am on Monday when Leo Akashraj received a call informing him that the woman he had dropped at a hospital had delivered a boy. Happiness knew no bounds for the 23-year-old now seen as a guardian angel for many, especially pregnant women.

The engineer, an Avadi resident who runs Pretty Lil Hearts, an NGO, receives no less than 30 calls a day and has in the past 14 days helped at least 51 women. Twenty nine of them have delivered babies.

He keeps himself and his cars – a Swift and a WagonR - ready allthetimefor an emergency. Leo is aware of the need to maintain social distancing and takes only very few people apart from a paramedic to ensure swift service.

Police tasked with enforcing prohibitory orders also don’t stop him. “They grant us permission to leave immediately on seeing the pregnant women. Moreover since it is my own car they do not question me,” says Leo.

Sometimes he receives frantic calls at midnight. “I rush to help, no matter how far the caller is from my residence,” he says, adding that he is being supported by his friend Benny.

Despite the odd hours, Leo feels happy when the couple he has taken to hospital call him up later and request him to name their child. “I feel elated,” he says.

On Monday, he recalls, he was called to take a woman to a hospital. “It was not her due date but still, the doctors praised me for reaching the hospital on time, as the woman had to be operated and the child was born within 15 minutes of us reaching there,” he says.

Jasmine of West Mogappair, the beneficiary, says they came to know of Leo from the internet. “It was a blessing for us. His service is incomparable especially during lockdown.”

Leo, who has decided to quarantine himself from his parents as he has been visiting hospitals regularly, can be reached on 9600432255/ 7358305635.

Leo Akashraj

30K download corpn’s corona app

TIMES NEWS NETWORK

Chennai:08.04.2020

Within a week of its launch, Greater Chennai Corporation’s new mobile application to geo-tag fever cases in the city has registered 30,000 downloads.

Officials said around 50 fever or cases with similar symptoms are being registered on the app every day and the corporation is monitoring the health of 1 lakh people through the app.

The application, ‘GCC Corona Monitoring’, was launched last week by corporation commissioner G Prakash. It has been created by MP Azhagu Pandia Raja, a research fellow in the ministry of housing and urban affairs, and Greater Chennai Corporation.

Residents in the city can download the application, click a photograph of a pillar in their house and send it through the application if they have fever symptoms.

There will be an option -- ‘general fever symptoms’ -- in the application for use. The location will automatically get geo-tagged on a map at the civic body’s command and control centre.

In case the number of fever cases is high, a team of doctors will be sent to the location to check on the residents. “If it is serious or someone shows coronavirus symptoms, we can take immediate action,” Azhagu said. “This is part of our efforts to contain the spread of the disease,” he added.

Azhagu said resources can be properly channelized and allocated towards particular locations in the city through the data collected.

The application can also be used to alert the corporation about a particular shop where people crowd or a gym that has been opened in violation of the lockdown.

Citizens can send a photo and the geo tag will appear at the control centre, enabling the corporation to send flying squads to disperse the crowd or take action, Azhagu said.

Residents can tag their locations on the app

Lockdown puts railway hawkers in blind alley

Shanmughasundaram.J@timesgroup.com

Chennai:08.04.2020

As governments stutter around fighting an invisible enemy, the 21-day nationwide Covid-19 lockdown announced by the PM has come as a stumbling block to the visually challenged community that lives on the outskirts of the city.

Before the lockdown, K Dharman and wife Uganthai used to sell handkerchiefs on suburban trains. They were among the 120 visually challenged who eked out a living by selling fruits and eatables on trains until the virus outbreak brought train services to a halt. “We survived the 13 days of lockdown with whatever little we had saved. We don’t have any money left and we can’t earn. We don’t know what will happen if the lockdown continues,” said 30-year-old Uganthai.

At least 120 visually challenged hawkers live in Maraimalar Nagar

Families of blind in city stare at uncertainty

Their 10-hour labour on train, with their 18-month-old on their shoulders,would getthecouple₹500 per day. The family pays₹3,000 per month as rent for their small house. “We don’t have a ration card,” said the couple.

The card would have made them eligible for free rice and other state handouts. Dharman says officials visited their area on Tuesday and collected details about the residents. “They told us they were making arrangementsto give us lunch,” he said.

For the 30familiesliving in theblind people’s tenements (Parvai attoor kudiyurippu) at Maraimalar Nagar on the outskirts of Chennai, the closure of government educational institutions has deprived them of a source of employment. A few of them used to earn a living a little less than 500 a day by repairing wooden chairs at the offices and institutions nearby.

With all sources of income drying up, the residents are losing hope with every passing day. “Government officials distributed 5kg rice and half a kilo each of dal and oil four days ago after we approached the district collector. How long will it keep a family of five to six from starvation?” says a 73-year-old member of the community.

Avg age of corona casualties is 60

Pushpa Narayan & Rema Nagarajan TNN

08.04.2020

The average age of 125 people who have died in India from Covid-19 till Monday was 60 years, data on these deaths collated by TOI from all states shows. While this is significantly lower than in other countries like Italy, where the average is closer to 80, this is due to a younger population in India than in most Western countries. Age groupwise case fatality rates (deaths as a percentage of confirmed cases) worked out on the basis of official data for 4,097 cases and 109 deaths put out on Monday confirm this.

Against an overall CFR of 2.7%, the figure for those under 40 was 0.4%, for those between 50 and 60 it was 2.4% and for those over 60 the CFR was 8.9%.

Covid victims had diabetes, hypertension

This is in line with the trend in other countries. The data collated by TOI also showed that the most common co-morbidities among those who died of Covid-19 so far were diabetes and hypertension, and in a large number of casesbothconditionswere presenttogether. This too is not unlike the rest of the world though there are variations. In China, for instance, the death rate was highest among people with heart diseases or those with lung diseases followed by diabetes and hypertension.

Information on co-morbidities was available for 86 people who died. This showed that more than half of them (56%) were diabetic and almost half (47%) had hypertension. Over a third of the 86 had both diabetes and hypertension. One in five suffered from asthma or lung disease. Only 16% had cardiac disease along with diabetes and/or hypertension. Renal disease too was reported in several of those who died.

Thedata does not recordhowseverely diabetic or hypertensive the person was or how serious the lung disease was. It is not possible to say, therefore, how much of a bearing the extent of pre-existing morbidities had on the probability of death. More than 40% of the cases examined had two pre-existing disease conditions, while over 17% had more than three co-morbidities. Only about a third of those who died (35%) had just one co-morbidity.

The fact that diabetes emerged as the leading co-morbidity among those felled by the disease in India is significant given the fact that an estimated 9.4%of thecountry isdiabetic--12%of the urban population and nearly 8% of rural—according to an ICMR study on prevalence of diabetes and hypertension. The same study also showed that up to 30% of the population -- 33% in urban and 28% in rural had higher than normal blood pressure levels.

While a combination of diabetes and hypertension is bad enough as a risk factor, what makes it worse is that this risk increases with age. The prevalence of hypertension was over 60% in the above 55 years age group and that for diabetes was almost 30% in the same age group.

Two more die in TN; total toll 8, cases 690

Pushpa.Narayan@timesgroup.com

Chennai:08.04.2020

Two more people died on Tuesday taking Tamil Nadu’s Covid-19 toll to eight while the number of positive cases rose by 69 to 690 (637 of Tablighi Jamaat cluster).

The state health department is yet to determine the travel or contact history of the two casualties: a 64-year-old woman in Chennai and a 45-year-old man in Vellore.

Health secretary Beela Rajesh told reporters that while the woman from Royapuram had died on Monday at the Rajiv Gandhi Government General Hospital, the announcement was made on Tuesday after her samples tested positive. In the evening, an idli seller outside the Christian Medical College, who had been hospitalized for severe respiratory distress caused by Covid-19, passed away.

In the last two days, three patients admitted to hospitals —two in RGGH and one in Vellore — with severe acute respiratory syndrome have died within a few hours of admission. The 45-year-old patient was admitted to the intensive care unit of CMC Vellore and was put on ventilator on Monday. “We don’t know if the patient was in an isolation unit. They have told us he was in a cubicle inside the ICU. He died on Tuesday at around 6pm following respiratory arrest,” the Vellore collector said.

‘One +ve person can infect 406, can limit it to 2.5 with distancing’

One person infected with coronavirus can possibly infect 406 others in just 30 days in the absence of a lockdown and social distancing measures, but this can dramatically come down to 2.5 people with a 75% reduction in social exposure, a recent study by the Indian Council of Medical Research shows. P 7

Experts revising protocol to prevent deaths

Public health authorities said they did know the travel history of the 64-year-old woman either yet. Rajiv Gandhi Government General dean Dr R Jayanthi said the woman who had fever and cough for the last four days came in with breathing difficulty on Monday around 1.15pm. “We first gave her high flow oxygen and quickly stepped up care. She was intubated and her samples were sent for Covid19 test. Doctors pronounced her dead by 2.45pm,” she said Expert committees are working to revise treatment protocols to prevent of deaths.“An expert committee comprising private and government doctors went into case sheets to revise the treatment protocols so deaths can be prevented,” she said. All people who are showing symptoms of the disease, particularly in containment areas, are isolated and tested, she said. Once rapid testing kits arrive, the state will use them for mass screening in hotspots, she added. State has added two more testing centres including the state-run medical college hospital in Erode. The state now has 19 testing centres including 12 in government, she said.

Four doctors have tested positive across the state so far and a senior neurosurgeon in Chennai is in isolation, with test results awaited.

The hospital where the neurosurgeon saw patients has been shut and all staff quarantined. One doctor has been posted at the hospital to lone after a lone patient, who suffers from cancer and was not in a condition to be shifted.

A woman doctor in Erode has recovered as has her 10-month-old. Of the other three, one has a clinic in West Mambalam. The other two are a doctor couple linked to the Tablighi Jamaat cluster.

Doctors face hard choice: Who lives, who dies?

08.04.2020

Last month, a video went viral claiming doctors in Madrid were removing people aged over 65 from ventilators, to save lives of younger Covid-19 patients. It turned out to be fake news, but a situation in which doctors have to choose between patients is not unlikely now, as the number of Covid-19 cases continues to rise.

All over the world, hospitals are under tremendous strain. There aren’t enough ICU beds and ventilators to save every critical patient. On a routine day, who gets attention first depends on the severity of their condition. You have an accident victim with signs of internal bleeding, and another with a fractured arm: the haemorrhaging patient comes first.

The corona pandemic has made the ordinary rules of ‘triage’ or patient classification meaningless. Now, there is a stream of critically ill patients. Say, you are a doctor with one remaining ventilator and three new arrivals. Whom do you save? Whom do you let die?

It’s an ethical dilemma that no doctor wants thrust upon them. That’s why general rules to deal with such situations have existed for a long time. While military hospitals often need to make use of them, this is the first global medical crisis in a long time that’s forced hospitals to dust their manuals, and medical ethicists to work on improving the existing guidance. They know that the allocation of equipment and care to patients will always be contentious, but they need to make it clear, ethical and equitable as far as possible.

Take the situation above: one hospital may decide to save the youngest of the three patients, arguing that they have had the least time to live, and an early death would be most unfair to them. This is a perfectly valid philosophical position, but another hospital might decide to save whoever has the best chance of survival. In Germany, for instance, triage does not take a patient’s age into consideration.

What if one of the patients is 19, another is 40 but in good health otherwise, and the most likely to survive, and the third is a nurse, whose recovery could help many other patients live. This time, many hospitals would choose to save the nurse for society’s good.

That’s the main difference between triage in an emergency (accident victims) and a crisis (stream of Covid-19 cases). During an emergency, doctors aim to do their best for the patient before them, but in a crisis, the goal shifts to doing the greatest good for the greatest number. And this ordinarily means taking steps to ensure that the greatest number of patients survive.

If you have advanced liver disease or a serious heart condition, saving you becomes less important because you might occupy a bed for three weeks and still not make it while a fitter patient would. Doctors call it ‘success-oriented’ allocation of resources. It means, in a crisis, taking someone off the ventilator is not only justifiable but ‘just’ if the next patient has better odds of survival. There’ll never be a perfect algorithm for triage. Will you save a 30-yearold mother who has Covid-19 and breast cancer, or her bachelor brother, aged 40, who has only Covid-19? Will you save 10 octogenarians (higher success rate) or five teens (more years to live)? Which choices serve society best?

Sometimes, even ethics and philosophy throw up their hands. Then, it’s time for a lottery.

— Text: Abhilash Gaur

For more: Undark, DW, Politico & The New England Journal of Medicine

GREATEST GOOD FOR THE GREATEST NUMBER: In a pandemic, doctors focus on saving the maximum number of lives by allocating resources to patients with the best chances of survival

WhatsApp puts limit on forwards to curb viral misinformation

Digbijay.Mishra@timesgroup.com

Bengaluru:08.04.2020

Popular messaging platform WhatsApp said it has now put new restrictions to forward messages to just one person or group amid rising cases of misinformation around coronavirus. The Facebook-owned messaging platform said the limit kicks in once a message has been previously forwarded 5timesor more.

WhatsApp, which has 400 million users in India--its largest market, has one of the strongest viral effects in terms of messages or videos quickly reaching a score of people in India. People aware of the company’s plans said this has been in the works for a few months and it now has implemented it globally, when people are spending more time on the app and are often receiving information related to coronavirusthatis not verified.

Fullreportonwww.toi.in

Emirates, Etihad resume flights

07.04.2020

Dubai: UAE carriers Emirates Airline and Etihad Airways have resumed limited passenger flights two weeks after authorities grounded airlines as part of wider shutdowns to combat coronavirus. The flights are open to foreign citizens who wish to leave the UAE but no incoming passengers are allowed. AFP

Swiggy raises Rs 325 crore

New Delhi  07.04.2020

Food ordering and delivery platform Swiggy on Monday said it has raised an additional amount of $43 million (over Rs 325 crore) as part of its ongoing Series-I funding round. The size of the round now stands at $156 million.

In February 2020, Swiggy raised $113 million (over Rs 805 crore) in the funding round led by existing investor Prosus N.V. along with participation from Meituan Dianping and Wellington Management Company. Along with existing investor Tencent, new investors Ark Impact, Korea Investment Partners, Samsung Ventures and Mirae Asset Capital Markets have participated in the latest fund raise. PTI

Activist heckled for ignoring ‘switch off lights’ appeal

07.04.2020

Pune: A social activist here in Maharashtra has alleged that he and his family were heckled and termed as “anti-national” by a neighbour after they did not switch off lights at 9 pm on Sunday in response to Prime Minister Narendra Modi’s appeal. Siddharth Prabhune took to Twitter to express his grievance and said his family did not switch off lights as he was unwell. His wife Trupti Prabhune said they did not lodge a police complaint in the matter as the security personnel are already busy enforcing the lockdown. PTI

Spitting corona patient to be booked for bid to murder

07.04.2020

Telangana TODY

Shimla: A coronavirus positive patient spitting on someone will be booked on charge of attempt to murder, Himachal Pradesh Director General of Police SR Mardi said. He said such an incident was reported from a hospital in the hill State. “And in case any person gets infected thus and dies of Covid-19, a case of murder would be registered against the accused patient,” he said. He said that 52 persons have disclosed their recent foreign and inter-State travel history to the Himachal Police after his warning on Sunday. ANI

Critical Time

Fight against Covid to be long: PMModi says India’s efforts have set example to world, drawn praise from WHO and leaders abroad

Prime Minister Narendra Modi addressing party workers through video conference on Bharatiya Janata Party’s 40th foundation day, in New Delhi on Monday. — Photo: ANI

Today, the nation’s goal, mission and resolve are one, and this is to be victorious in this battle against coronavirus pandemic — Narendra Modi , Prime Minister

PTI

New Delhi

India’s battle against the coronavirus pandemic will be a long one, Prime Minister Narendra Modi said on Monday while exhorting people to not feel tired or defeated and expressing confidence the country will emerge victorious in its fight. Addressing BJP workers on the party’s 40th foundation day, Modi also responded to the Opposition’s criticism about his government’s measures against Covid-19, asserting that India’s efforts have set an example for the world and drawn praise from the World Health Organisation and leaders abroad.

“This is going to be a long fight. We don’t have to tire or feel defeated. We have to win in this long battle. We have to emerge victorious. Today, the nation’s goal, mission and resolve are one, and this is to be victorious in this battle against the coronavirus pandemic,” the Prime Minister said.

India is among the countries which understood the seriousness of Covid-19 and launched a comprehensive and timely exercise to combat it, he said, adding that the country took one decision after another and worked to implement them on the ground. Opposition leaders, including Congress’ Rahul Gandhi, have claimed the Central government did not respond in time to the virus.

Modi, who stressed on the need for wearing “face covers” outside the house, listed measures like the thermal screening of international passengers, evacuation of Indian nationals abroad and barring flights from certain countries and ramping up of medical infrastructure taken by his government. The government, he said, took “proactive” decisions with help from experts and executed them in cooperation with States. “The speedy and holistic manner with which India acted has drawn praise not from within the country but also from the WHO,” the Prime Minister said and added that India played a “key role” in the holding of SAARC and G-20 meetings.

Heads of different countries have appreciated India, he said, noting that it has been coordinating with different nations and he himself has been in touch with some of them. However, the Prime Minister also made it clear that India is in for the long haul in the battle against the pandemic which has wreaked havoc in many countries, including deaths in thousands in developed nations like the US, Italy and France.

He described the seriousness and maturity shown by people during the lockdown as “unprecedented”. Nobody could have imagined that people will show such discipline and sense of service in a huge country like India, he said, adding that the nation’s collective strength was on display on Sunday evening.

Referring to Sunday’s exercise in which millions of households across the country switched off their lights and lit diyas, candles or turned on mobile torches, he said it prepared Indians for the long fight ahead.

“All sections of society; the rich and poor, the literate and illiterate, and people of various age groups, all joined hands to show this collective strength of 130 crore Indians. It further strengthened our resolve in this fight against the coronavirus,” Modi said.

Javadekar clears air on lockdown

New Delhi  07.04.2020

Amid apprehensions that the lockdown period may be extended due to the rising number of coronavirus cases across the country, Union Minister Prakash Javadekar on Monday said that the government would announce its move at the “right time”. As only eight days are left until the end of the lockdown on April 14, the Minister said the government would take any decisions considering the interest of the people amid the Covid-19 crisis that has left 111 people dead and over 3,851 active cases across the country.

“We are monitoring the world situation every minute and therefore decisions are ultimately taken in the nation’s and people’s interests. That decision will be declared whenever the right time is there,” he said.

Meanwhile, Maharashtra Health Minister Rajesh Tope said no one should be under the impression of complete lifting of lockdown in the State after April 15. "The situation between April 10 to 15 will be closely analysed before taking a decision," he said.

Scare near ‘Matoshri’

Meanwhile Covid-19 has apparently reached the doorstep of Maharashtra Chief Minister Uddhav Thackeray's private residence 'Matoshri' in Bandra.

A tea-vendor selling tea near the VVIP home was found Covid-19 positive, sending the State and health officials in a tizzy. The number of cases rose to 781 with 33 people more people testing positive. ANI

Coronavirus Threat

UP may extend lockdownEven if one case remains, lifting of lockdown will not be right as work done so far will go in vain, say officials

Joint Police Commissioner Naveen Arora inspecting the Qaisar Bagh area as police sealed it after receiving 12 Jamaati positive cases from the mosque, in Lucknow on Monday. — Photo: ANI

PTI

Lucknow

As the number of Covid-19 cases breached the 300-mark in Uttar Pradesh on Monday, Additional Chief Secretary (Home) Awanish Awasthi said it is impossible to say if the lockdown in the State will be lifted after April 14.

His remarks come a day after Uttar Pradesh Chief Minister Yogi Adityanath said the lockdown, which was imposed to contain the spread of coronavirus, will be lifted on April 15. He had also called for a mechanism to ensure crowding doesn’t take place, else all efforts will go to waste.

“Since the number of coronavirus cases has gone up markedly in the past couple of days, it would not be right to say that the lockdown will be lifted after April 14. If even one case remains, lifting it would not be right as the entire work done so far to control the virus would go in vain,” Awasthi said.

“At this preliminary stage it is impossible to say if it will be lifted after April 14. It will take time,” he said. Awasthi said the number of coronavirus infections in the State climbed to 305 on Monday and Tablighi Jamaat members accounted for more than half of these cases.

“The total count of positive cases rose to 305 on Monday. Of the 27 fresh cases reported on Sunday, 21 are linked to the Tablighi Jamaat,” he said, adding that eight Tablighi Jamaat members tested positive in Sitapur, five each in Lucknow and Shamli, and one each in Bijnor, Kanpur and Prayagraj.

As many as 159 of these 305 cases are linked to the Tablighi Jamaat, he said. At least 9,000 people had participated in a congregation at the Tablighi Jamaat’s Markaz in Nizamuddin area last month after which many travelled to various parts of the country.

“Our priority is to first take up the treatment of patients who have tested positive and then those who came in contact with them, besides tracing the chain of other contacts,” Awasthi said. He said the list of contacts of Covid-19 patients has also grown manifold.

Wherever cases have come to light, police have acted fast to ensure strict compliance of the lockdown, he added.

Uttar Pradesh has so far reported three coronavirus deaths, one each from Basti, Meerut and Varanasi. At least 21 patients have recovered and been discharged from hospitals.

Yogi sets up integrated Emergency Control Centre

Lucknow: UP Chief Minister Yogi Adityanath on Monday inaugurated an integrated Emergency Control Centre at Shastri Bhawan here to provide expeditious relief to people, ranging from information about anti-Covid hospitals and quarantine centres to the food to the poor.

Adityanath said the control room will play an important role in running an anti-corona campaign in the state without any discrimination and would help authorities provide essential services and the state's welfare scheme benefits to needy persons. He also said in emergency, the control room will act as a backbone for relief works, a statement issued by the UP government said.

Instructions have been issued to all district magistrates to set up similar control rooms and appoint nodal officers to man them their respective districts in 24 hours, the statement said. PTI