India coronavirus dispatch: Can 'social bubbles' contain Covid-19 spread?

Here is a round-up of articles from Indian news publications on how the country is dealing with the Covid-19 pandemic. From cancer care through the pandemic, to Mumbai’s efforts to ramp up its health infra, and how our cities turned the crisis from bad to worse — read these and more in today’s India dispatch.

Interview

How Gujarat is trying to overcome Covid-19 challenges: Gujarat has had over 18,500 Covid-19 cases, and the number of deaths in the state also continues to climb. Case fatality (deaths among those with Covid-19) stands at about 6.2 per cent, more than twice the national average of 2.8 per cent. Read this interview with Jayanti Ravi, principal secretary, health and family welfare, Gujarat, to understand why case fatality is higher, besides the state’s infrastructure preparedness and response. She gives a public health perspective, more specifically in Ahmedabad, which is facing the brunt of the pandemic. Read more

Opinion

The coronavirus pandemic has locked out cancer care: At present, we are suddenly doing little or nothing for cancer victims anywhere in the country. Cancer has many different faces, many speeds at which it progresses, and varied end results. The quick killer cancers are still the ubiquitous mouth and throat cancers, brain, breast, stomach and pancreatic cancers. Rapidly growing progressive cancers can gallop fast to kill patients within weeks or months. Untreated cancers will inevitably end up at an advanced stage where only palliative care will be possible. Read more here

A right time to shift pharma gears: While we should evidently continue funding pharmaceutical research & development, it is worth asking whether our current way of doing so is optimal. There are three main concerns. First, innovators motivated by the prospect of large markups tend to neglect diseases suffered mainly by poor people, who cannot afford expensive medicines. Second, thanks to a large number of affluent or well-insured patients, the profit-maximising price of a new medicine tends to be quite high. Third, rewards for developing and then providing pharmaceutical products are poorly correlated with therapeutic value. To address these problems, the authors of this report propose the Health Impact Fund as an alternative track. Read more here

Citizens Under Lockdown

No guidelines on exports, fishers in TN stare at uncertainty despite fishing permit: Seafood exporters from the coastal district believed that once fishermen entered the sea, business would return to normal. However, with no clarity on new export routes, exporters are bewildered over their business prospects. The fishermen of Thoothukudi, the only district to venture into sea amid the lockdown period, are getting good catches but are finding it difficult to sell the fish for the same price as before. Read more here

They survived long arduous journeys back home – but not Covid quarantine centres: On April 29, the Centre allowed movement of stranded workers. But with government-run trains and buses too few to ferry everyone, thousands were forced to make journeys spanning hundreds of kilometres on foot. But before they could really be home, many had to spend 14 days at isolation facilities, usually crumbling government school buildings, to ensure that they did not inadvertently infect others. Many who survived the arduous journeys back home are struggling to make it through their isolation periods alive. Relatives of those who have died claim this is because access to medical care in these quarantine centres is either late or inadequate. Read more here

Malnutrition could cost children’s health & lives for years after Covid crisis, experts warn: The Covid-related economic crisis could also push India further away from meeting the World Health Organization’s (WHO’s) target for reducing stunting by 50 per cent from 2012 to 2030, say experts. Maternal and child malnutrition is one of the reasons for 68 per cent under-five deaths in India. Covid-19 puts malnourished children at an ever-high risk of death, and for the children who survive, poor growth, development and learning outcomes, according to Unicef. Read more here

Managing Covid-19

Mumbai works to ramp up its health infra as it slowly surfaces from Covid lockdown: As Maharashtra slowly eases out of a two-month lockdown, civic and health officials are scrambling to ramp up health facilities in case of a fresh wave of Covid-19 infections amid several reports of patients making a run for hospital beds. The ‘unlockdown’ has seen people step out for walks, non-essential shops open up for business and private offices resume functioning with up to 10 people. However, what can complicate the crisis is the annual onset of Mumbai’s infamously harsh monsoon, during which floods submerge the city, bringing with it a horde of ailments such as malaria, dengue and leptospirosis. Read more here

How our cities turned the national Covid-19 crisis from bad to worse: Some medical researchers and urban planners have argued that the population density of cities makes them more vulnerable to a sustained local outbreak. According to Steven Goodman, an epidemiologist at Stanford University, population density, together with very good intra-city connectivity, has been the enemy in cities like New York, Chicago and New Jersey. New York’s high Covid-19 mortality seems to hold this argument up (although the mortality is lower in many of Asia’s hyper-dense cities). Read more here

Understanding Covid-19

Social bubbles – Micro-communities that could contain spread of Covid-19: Amid the pandemic, there is increasing pressure on governments to ease lockdown restrictions, especially to lift economic and psychological burdens on people. Many countries have started gradually lifting restrictions, even as their number of cases continues to rise. As a Covid-19 vaccine is still months away, questions about the methods that can be adopted to avoid the second wave of infections while easing restrictions have arisen. A new study suggests that one of the ways of effective social distancing strategies to keep the Covid-19 curve flat could be the idea of ‘social bubbles’. Read more here

Study finds a link between high blood pressure and Covid-19 death risk: A study has found that patients with higher blood pressure face twice as high a risk of dying from the Covid-19 as patients without high blood pressure. Researchers analysed data from over 2,800 Covid-19 patients who had been admitted to Wuhan’s Huo Shen Shan Hospital, exclusive to Covid patients, between February 5 and March 15. They found that 34 of these 850 hypertensive patients (4 per cent) with Covid-19 died. By comparison, 22 out of 2,027 patients without hypertension (1.1 per cent) died. That is a 2.12-fold increased risk after adjustment for factors that could affect the results, such as age, sex and other medical conditions. Read more here