High risk involved, avoid Pakistan airspace: US tells its airlines

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

Mumbai, Feb 10: Ankita Pisudde, a resident of Hinganghat town in Wardha, was critical after sustaining 40% burns on February 3 when she was set afire, allegedly by one Vikesh Nagrale (27) while she was on her way to college.

The 25-year-old woman lecturer who was set on fire by a stalker in Maharashtra’s Wardha district last week died at a hospital in Nagpur on Monday morning, a police official said.

Ankita Pisudde, resident of Hinganghat town in Wardha, had been critical after sustaining 35 to 40% “grade III” burns on February 3 when she was set afire allegedly by one Vikesh Nagrale (27) while she was on way to her college, they said.

She was undergoing treatment at the Orange City Hospital & Research Centre here, located around 75 km from Wardha.

“Doctors at the hospital declared her dead at 6.55 a.m. today,” Hinganghat’s police inspector Satyaveer Bandiwar said.

The woman sustained deep burn injuries on scalp, face, right upper limb, left hand, upper back, neck and eyes along with severe inhalational injuries, the hospital said in a medical bulletin on Monday.

She died of “septicemic shock” after suffering from deep dermal burns along with severe inhalational injuries, respiratory distress and related complications, it said.

Around 4 a.m. on Monday, her oxygen levels deteriorated inspite of ventilator support, coupled with decreasing urine output and reduction in blood pressure, the hospital said.

As part of immediate resuscitation measures, medicines were escalated to maintain the blood pressure and all feasible steps were taken to improve the oxygen levels in blood, but the patient remained “extremely critical”, it said.

“Around 6.30 a.m., she had bradycardia and inspite of prolonged cardiopulmonary resuscitation, the patient could not be revived and was declared dead at 6.55 a.m.,” it said.

The probable cause of death was “septicemic shock”, the bulletin added.

During her treatment, she underwent tracheostomy (creating an opening in neck to place a tube into the windpipe to allow air to enter the lungs), burn dressings, debridement and escharotomies, the hospital informed.

Debridement is a medical procedure to remove dead, damaged or infected tissue, while escharotomy is a surgical procedure used to treat full-thickness (third-degree) circumferential burns.

The woman’s parents and uncle were kept informed about her deteriorating health condition and death, the hospital said, adding that the body was later handed over to police for postmortem and other formalities.

After the woman’s condition deteriorated, the hospital informed about her critical status to Maharashtra Home Minister Anil Deshmukh, Wardha Guardian Minister Sunil Kedar, Nagpur Divisional Commissioner Sanjeev Kumar, Police Commissioner Bhushan Kumar Upadhyay, Wardha Collector Vivek Bhimanwar and Wardha Superintendent of Police Basavraj Teli.

Heavy security was deployed in Hinganghat to avoid any law and order problem following her death, the police said.

Several locals, mostly women and college students, took out a march in Wardha city last Thursday, demanding death penalty for the accused.

Home Minister Deshmukh visited the hospital on Tuesday and announced that the accused’s trial would be fast-tracked.

The State government last week flew Navi Mumbai-based National Burns Centre director Sunil Keswani to Nagpur to supervise the woman’s treatment.

It has also appointed well-known lawyer Ujjwal Nikam as special public prosecutor in the case.

According to the victim’s relatives, Nagrale, who was arrested within hours of the incident on February 3, had been harassing her for quite some time.

Nagrale and the woman were friends till two years ago when she severed ties with him due to his “irrational behaviour”, the police earlier said.

A special team led by Deputy Superintendent of Police Trupti Jadhav will probe the case, the Wardha Police said last week.

From loudspeakers on the roof of a Minnesota mosque, the Islamic call to prayer echoed for the first time ever throughout a Minneapolis neighbourhood late on Thursday as the Muslim community there prepared to begin the holy month of Ramadan.

It echoed again on Friday morning and will continue five times a day during the holy month. 

The simple, short call - known as the adhan - marked an historical moment for Minneapolis and major cities across the United States, community members said. While the adhan is commonly broadcast throughout the Middle East, North Africa and other places, for many Muslims in the US, it is only heard inside mosques or community centres.

"There's definitely a lot of excitement," said Imam Abdisalam Adam, who is on the board of the Dar al-Hijrah mosque, from where the adhan will be broadcast.
"Some people see it as historic," Adam told Al Jazeera. "To the point ... that they're not doing it, able to see it in their lifetime." 

Recited by different representatives from mosques around the city, the call to prayer is expected to reach thousands in the Cedar-Riverside neighbourhood in Minneapolis, according to Jaylani Hussein, the executive director of Minnesota's Council on American-Islamic Relations (CAIR).

While Hussein says the community had discussed broadcasting the call for years, it became even more pressing this year when the coronavirus pandemic forced mosques to shut their doors and residents to stay inside. The coronavirus has infected more than 870,000 people nationwide and killed at least 50,000.
"We wanted to touch those individuals who frequent this mosque and this community," Hussein said. "If we cannot be physically together, at least this echo, this voice, this call to prayer can be an extension of us being together at this difficult time. To give some people some solace."
Ramadan - Minnesota.

The Dar al-Hijrah mosque in the Cedar-Riverside neighbourhood of Minneapolis, Minnesota [Courtesy of Abdisalem Adam] 
Ramadan is traditionally a time when Muslims worldwide regularly attend mosques for daily prayers and break their fasts together. But this year, most have been told to pray at home and forgo community iftars in favour of staying safe from the COVID-19 crisis.

Adam, the imam, said while the Muslim community is experience loss this Ramadan, they hope the call to prayer broadcast will create a "semblance of normalcy".

"With the loss of Friday prayers and the regular congregational prayers, we are hoping that this will give a sense of solace and connection to the spiritual needs of community members," he added. 

An avenue to greater investment?

The Cedar-Riverside neighbourhood is a densely populated area of Minneapolis that has historically been an entry point for many immigrants and today is home to large Somali and Oromo communities.

Ramla Bile, a Somali American who lives in a neighbourhood adjacent to Cedar-Riverside, has been active in the community for years. She welcomed the broadcast of the call to prayer, saying it will help people "feel the spirit of Ramadan in a way that is meaningful".

But she also hopes the city of Minneapolis, which provided the noise permit for the broadcast, will make bigger strides to invest in the community in even more tangible ways.

"There's been a lot of need and a lot hurt in the community in light of the COVID-19 pandemic. And then there's the ongoing conversation you've been having," she said, pointing to deep-seated Islamophobia, systemic racism and the need for infrastructure projects like sprinkler systems in high-rise buildings. 

"We need to see greater investments to support the most vulnerable members of our community," Bile said referring to the neighbourhood's elders, undocumented individuals, low-income families and others.

"Right now, we're waiting for a bailout for our micro-businesses who comprise our Somali malls, or a rent freeze for neighbourhood residents," she added.

For CAIR's Hussein and Imam Adam, they hope this Ramadan's call to prayer helps encourage other communities around the US to take similar steps.

"This will hopefully inspire others … to think about what could happen in future Ramadans and beyond," Hussein said.

Adam added that while the virus has devastated communities and upended daily life, it has also shown that "we're in this together".

"It just shows the significance of the global village and how interconnected and interdependent we are as a world community," he said. "I think that there will be a lot of change in our way of life for the better. I hope so."