Why Does India Have So Many COVID Cases?

Something has gone horribly wrong in India. Today, the country has reported 346,786 new cases of COVID-19 for the previous 24 hours, with 2,624 deaths – the world’s highest daily toll since the pandemic began last year. Overall, nearly 190,000 people have died from COVID in the country, while more than 16.6 million have been infected.

The new outbreak in India is so severe that hospitals are running out of oxygen and beds, and many people who have been taken ill are being turned away. New Zealand, Hong Kong, the UK and the US have either banned direct flights to and from India, or have advised citizens against travelling altogether; and the list may well get longer.

The UK’s prime minister, Boris Johnson, who is keen to secure a post-Brexit trade deal with the country, has been forced to cancel a planned trip to India this coming week and, instead, plans to meet with President Narendra Modi virtually. For a country where COVID numbers appeared to be dropping dramatically just a few weeks ago, what has gone so wrong in India?

The Indian variant, known as B.1.617, appears to be wreaking havoc in the country. Since April 15, India has been reporting more than 200,000 cases of coronavirus every day and its capital, Delhi, recently announced a week-long lockdown after a rise in cases there overwhelmed the healthcare system.

“If we don’t impose a lockdown now, we might face a bigger calamity,” Delhi Chief Minister Arvind Kejriwal said as he addressed the city on Indian television on April 19. Worryingly, bed spaces and oxygen supplies in hospitals appear to be stretched, with reports of sick patients being turned away from hospitals and social media feeds filled with distraught family members whose loved ones cannot access the healthcare they need.

On Wednesday this week, as the COVID toll was rising, Delhi’s highest court took the unusual step of publicly criticising the central government and its approach to managing the country’s oxygen crisis. The court was hearing a petition filed by Max Hospitals seeking urgent help to tide over the oxygen shortage it was facing in six of its hospitals in the capital.

“Human lives are not that important for the State it means. We are shocked and dismayed that government doesn’t seem to be mindful to the extremely urgent need of medical oxygen,” the Bench stated. “We direct Centre to provide safe passage…so that such supplies are not obstructed for any reason whatsoever,” it said. “Hell will break loose [if oxygen is not supplied].” Damning words for the government in a time of crisis.

It is not entirely clear why this surge has happened in India, but it is likely to be because of crowded events organised in the run-up to elections – President Modi himself hit the campaign trail addressing election rallies in Kerala, Tamil Nadu and Puducherry on March 30 as the upturn of cases began. Large groups and social gatherings during religious festivals have also played a part, as well as the re-opening of public spaces and easing of lockdown measures which took place gradually throughout 2020 with the final “unlocking” of restrictions happening in December 2020.

There is also much concern about the emergence of new variants of the coronavirus in India. It is thought the dominant strain in the country now is the variant which was first identified in the UK, and which has shown to be up to 60 percent more transmissible between humans. On March 25, it was further announced that a new “double mutant” variant had been detected in India, now known as the “Indian variant”. This development is what has other countries spooked.

The Indian authorities do not think this new variant has yet become the dominant COVID strain in the country, but it is likely to be contributing to the increasing numbers. Genome sequencing of the new variant has shown that it has two important mutations:

1. The E484Q mutation: This is similar to the E484K mutation identified in the Brazil and South African variants, which have also been reported in recent months. The concern is that this mutation can change parts of the coronavirus spike protein. The spike protein forms part of the coronavirus outer layer and is what the virus uses to make contact with human cells.

Once contact has been made, the coronavirus then uses the spike protein to bind to the human cells, enter them and infect them. The immune response that the vaccines stimulate creates antibodies that target the spike protein of the virus specifically. Therefore, the worry is that if a mutation changes the shape of the spike protein significantly, then the antibodies may not be able to recognise and neutralise the virus effectively, even in those who have been vaccinated. Scientists are examining whether this may also be the case for the E484Q mutation.

2. The L452R mutation: This has also been found in a variant thought to be responsible for outbreaks in California. This variant is thought to increase the spike protein’s ability to bind to human host cells, thereby increasing its infectivity. A study of the mutation also suggests it may help the virus to evade the neutralising antibodies that both the vaccine and previous infection can produce, though this is still being examined.

This new wave in India has been devastating for the country. A coordinated response is needed between Indian states and central government to manage the supply of oxygen and essential drugs if the number of COVID-related deaths is to be brought under control. There is also a concern that we do not know the true number of deaths from COVID, as some people have died at home before they could get to hospital and many others in India, particularly in rural areas, have had difficulty accessing testing facilities.

Pressure urgently needs to be lifted off the healthcare system and the only way to do that is to ramp up the vaccination programme, strengthen social distancing procedures and re-introduce lockdown measures.

One of my passions as a doctor is being able to pass on my knowledge to the doctors of tomorrow. I have done it for years and am a senior lecturer at two UK universities.

A large part of the teaching I do involves getting my students to speak to and examine patients. This has been a challenge in the last 12 months as bringing patients into the surgery for them to see students has been too risky, and the patients that tended to have the illnesses the students needed to see were generally shielding to reduce the chances of them catching COVID-19.

Medical students have been lending a helping hand to COVID-ravaged hospitals all over the world, and their assistance has been welcomed by many. But we also need to prepare them for a world beyond COVID and, in the limited time we have with them, to ensure they are prepared for a wide range of medical conditions from the physical to the mental. But how can we do that if they were unable to see patients as normal?

Technology has been the answer. Our surgery, where I work as a family doctor in Bradford, northern England, is lucky enough to have a clinical skills lab that students can learn in. This is a room that has “model” body parts that the students can use for examination purposes.

Students can come into the surgery and, initially, hold telephone consultations with patients, speaking to real patients who ring in about their ailments. The students record a medical history by speaking to the patients and attempt to come up with a management plan which they then run past me or another doctor for approval.

Because the students cannot examine the patients physically, we then make a list of the examinations the students would have done and, once their clinic list is complete, move over to the clinical skills lab. I then ask them to practice the examination they would have done on the models. This might include a chest exam, a rectal or vaginal exam. The models can be adjusted so that each time the student uses them they will make a different examination finding, such as a new lump or abnormal breathing sounds. It really is quite clever.

Although it will never really replace the real thing, this method has allowed us to keep medical education going throughout the pandemic – something that has challenged medical schools the world over.

And now, some good news: Exercising can reduce the risks of COVID

A new study by Glasgow Caledonian University in Scotland has shown that regular exercise can reduce the risk of getting infections like COVID-19 by up to 37 percent. The researchers conducted a full-scale systematic review of 16,698 worldwide epidemiological studies published between January 1980 and April 2020, with world-renowned immunologists and epidemiologists from University College London (UCL) in the UK and Ghent University (UGent) in Belgium, as well as exercise and sports scientists from Cádiz University in Spain and a public health consultant from NHS Lanarkshire (NHSL) in the UK.

They found that doing 30 minutes of exercise which gets you out of breath and a bit sweaty five times a week strengthens your immune response to infectious diseases. It is thought that regular exercise increases the number of immune cells in the body acting on the first line of defence – the mucosal layer of antibodies. These cells are responsible for identifying foreign agents or “germs” in the body without depressing the rest of the immune system, so it’s perfectly safe and protects you against infectious disease.

We have known for some time about the benefits exercise can have for a person’s overall physical and mental health. Now, in the time of COVID, it has been shown to help boost your immune system too. So the message is clear; get outdoors and exercise if you can or to the gym if it is in keeping with your local COVID guidelines. If neither is possible, your kitchen or living room is a perfectly good place to do 30 minutes of dancing, jumping or whatever floats your boat!

Reader’s question: Is it safe to go to my hospital appointment during a pandemic?

Over the past 12 months, people have repeatedly been told that the safest place for them is home and that hospitals are busy dealing with COVID-19 patients. While that is true, it is also important to remember that other illnesses have not gone away.

I have found that many of my patients are not attending their appointments for other conditions because they are worried about catching COVID or think their illness is not as important as coronavirus. Hospitals and GP surgeries all over the world have gone out of their way to make large parts of their buildings COVID-free. This means that they can be used for non-COVID-related services and staff working there will not be crossing over to cover COVID wards or clinics. So, if you receive an appointment to attend a clinic or hospital service, it is really important that you do go.

Source: Why does India have so many COVID cases? | Coronavirus pandemic News | Al Jazeera

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Related Links:

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Will Coronavirus Cancel Christmas

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It’s August, which means we’re officially one month away from Walmarts and Costcos setting up their fake plastic tree displays in the great American tradition of Christmas creep. Hallmark’s Keepsake Ornament Premiere, which happens annually in July for some reason, has already whizzed us by. Starbucks’ red cups return in less than 100 days, according to this tracker that has no business existing.

But for once, it’s hard to get annoyed about the obscenely premature airplay of “Jingle Bells” in CVS. This year, the holidays loom as the unspoken “but what about—” when epidemiologists discuss the likelihood of a second wave of the COVID-19 pandemic this fall. It’s hard to imagine Thanksgiving and the winter holidays without family or travel, but in the midst of an unchecked pandemic, it’s even scarier to think about carrying on as normal.

The United States is alone among peer nations in having endured record-high cases of coronavirus throughout the summer, despite this time of year typically being the low season for infectious disease transmission. That makes the coming winter look “Dickensianly bleak” indeed, according to a chilling new report this week in STAT; short of serious intervention, the peaks this winter could be even higher than those this spring. And that’s on top of the regular cold and flu season, which can tax hospitals even when there isn’t a pandemic. “I think November, December, January, February are going to be tough months in this country without a vaccine,” Michael Osterholm, the director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, told STAT.

Wishfully thinking the pandemic will be resolved by the holidays is also naïve; a vaccine likely won’t be widely available until the middle of 2021 in a best-case scenario. In case you need further confirmation to check your jolly: the Radio City Rockettes, for the first time in their nearly 90-year history, have preemptively canceled their Christmas shows.

Without careful planning, you can see how the holidays have the potential to be a disaster. “We know that the biggest risk of spread for this virus is when meaningful numbers of people gather indoors for any extended period of time,” Ashish Jha, the director of the Harvard Global Health Institute, told The Atlantic. Hmmm, does that sound like something people tend to do as part of the celebration of a particular food-centric November holiday?

But an indoor gathering like a family dinner doesn’t only endanger grandma and grandpa; epidemiologists say it has the makings of a superspreader event. From a health and safety standpoint, Jha added that even having “people over in my house for two hours on a Sunday morning in December” seems unwise — much less hosting Thanksgiving or Christmas dinner.

Factor in out-of-town travel, and the outlook gets even grimmer. We already know that the exodus of people from New York City in March helped fuel outbreaks in….

Read more: The Week – Health

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7 Tips to Manage Freelancers Efficiently in a Post-COVID-19 World

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It comes at no surprise that most businesses are shifting to on-demand workforce to optimize costs, survive and thrive in a post-COVID-19 world. Although a contingent workforce existed for many years, very few businesses relied primarily on independent contractors and freelancers. Contract roles were mostly available either to highly skilled management consultants and experts or to seasonal workers.

However, the COVID-19 pandemic has changed the workforce dynamics as millions of people have been laid off and businesses have to look for alternative solutions to remain competitive. Hiring freelancers and gig workers on-demand has become a preferred option even for more traditional businesses. However, managing freelancers, remote workers and independent contractors is never seamless and requires processes, planning, and reliable vendor management and freelance management services.

Some industries like software development, e-learning, digital marketing, video production, online events management, hospitality, tourism and more are likely to permanently shift to contingent workforce. As managing freelancers has its own specifics, the following seven tips can be helpful to all companies that are planning to hire more gig workers, remote workers, and freelancers in the future.

1. Analyze your hiring needs.

If some roles had been strictly reserved for full-time employees working in an office environment, now these roles may be suitable for remote workers and freelancers. To identify roles that can be transformed into contract jobs and freelance gigs, the hiring managers need to ask themselves “How critical is this role for the business?’’ If the role is of utmost importance to the business, consider keeping it as a full-time role or offer a retainer to freelancer or independent contractor who has always delivered quality work.

This approach can ensure a high quality of work and motivation. On the other hand, all roles that are not critical to the business can be transformed into part-time roles or contract jobs and assigned to freelancers and independent contractors.

2. Develop a pool of freelancers.

Working with people who have demonstrated their skills and delivered high quality work over and over again is the right way to go. At the same time, project managers need to have sufficient information about the projects these freelancers have worked on before and to be able to contact them if there is a new project that requires a similar skillset and expertise. Often, being able to demonstrate that you have sufficient resources is what’s needed to win a new project over the competition.

3. Select a Freelancer Management System.

If more than 10 percent of your workforce consists of freelancers and gig workers, you will most liekly need a Freelancer Management System to be able to keep track of completed and ongoing projects, have access to historical information, manage project budgets, assign freelancers to new projects, approve payments and much more. A checklist will help a lot in your selection process. Answers to questions like “How many freelancers will I be managing in the next three years?”, “Will I manage both freelancers and remote workers across multiple geographies?”, “Do I need integrations with project management and time tracking software?”, “Do I need automated billing and invoicing?”, etc. will help you to select the Freelancer Management System that’s is addressing the needs of your business.

This can help with eliminating duplicate payments as well. Imagine that 10 freelancers are working on the same project but each of them is working on a different task, has different deadline and is paid a specific pay rate. This is the reality for many digital marketing, design, and creative companies. If the payments are managed via Excel spreadsheets and payment approvals happen via emails, duplicate payments are inevitable.

Enterprise solutions like SAP Fieldglass and Oracle HCM are usually not an option for small- and medium-size businesses (SMBs) due to the high integration and maintenance costs. Luckily, there are affordable alternatives like Transformify that have been specifically designed to address the needs of SMBs.

4. Source freelance talent quickly and efficiently.

Working with a pool of freelancers over and over again is great, however from time to time you will have to hire new people. As hiring needs highly depend on business growth and customer acquisition, it is hard to predict the skills set that will be required to win the next customer or the next project. Trying to source freelancers via various job boards, freelance marketplaces and the like is time-consuming and the results are often far from those desired. The best solution is to have a Freelancer Management System integrated with an ATS (Applicant Tracking System) to be able to quickly source, hire and manage freelancers ad hoc.

5. Know your talent pool.

Historical information about the freelancers who have worked on similar projects is invaluable when starting a new project on a tight budget and challenging deadline. Imagine that you have interviewed seven freelancers for a similar project in the past, three were shortlisted and one got the job. Wouldn’t be great to be able to easily check who those three shortlisted freelancers were and contact them immediately to check if they are available?

6. Manage project budgets.

Often, project planning and project execution are not aligned. There are tasks that have been overlooked and not budgeted at all, skills that are missing and people who become unavailable out of a sudden. It is common for freelancers to work on more than one project at the same time. Being able to move costs from one bucket to another while staying within budget is invaluable. Poor budget management may turn a promising project into a loss generating project.

7. Keep an eye on time-tracking reports.

As freelancers are often paid per hour, project managers need to be able to identify any unusual deviations in time tracking reports. If the same task was taking 10 hours in the past, why is it taking 30 hours now? Team velocity is also important as sometimes team members may happen to be times less efficient than the average for the team. If inefficiencies and overbilled hours are not identified on time, this inevitably will lead to lost productivity, tension in the team and increased costs.

The gig economy was on the rise even prior to COVID-19 lockdowns and massive layoffs. As businesses had no other option than to adopt remote working and work from home policies, going forward more and more companies will rely on contingent workforce and freelancers.

Lilia Stoyanov

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Let’s talk about how COVID-19 is affecting Freelancers, Contract workers, and Self-Employed workers around the world. Over 22 million Americans OR roughly 13.5% of the labor force have filed for unemployment in the last 4 weeks. This is the largest rise in claims since the Labor department started tracking the data in 1967. This pandemic has brought to light the issues with Freelance benefits such as affordable insurance, retirement, and qualifying for unemployment.
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