Indian Army officer, two soldiers killed as China turns violent in Ladakh

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, Mar 22: The total number of coronavirus positive patients in Maharashtra has risen to 74 with 10 more positive cases reported in the last 24 hours, officials said.

Of the 10 new cases, 6 are in Mumbai and 4 in Pune, they said on Sunday.

Earlier this week, a Covid-19 patient died in Mumbai.

Jun 9: Prime Minister Narendra Modi wants all 1.3 billion Indians to be “vocal for local” — meaning, to not just use domestically made products but also to promote them. As an overseas citizen living in Hong Kong, I’m doing my bit by very vocally demanding Indian mangoes on every trip to the grocery. But half the summer is gone, and not a single slice so far.

My loss is due to India’s COVID-19 lockdown, which has severely pinched logistics, a perennial challenge in the huge, infrastructure-starved country. But more worrying than the disruption is the fruity political response to it. Rather than being a wake-up call for fixing supply chains, the pandemic seems to be putting India on an isolationist course. Why?

Granted that the liberal view that trade is good and autarky bad isn’t exactly fashionable anywhere right now. What makes India’s lurch troublesome is that the pace and direction of economic nationalism may be set by domestic business interests. The Indian liberals, many of whom are Western-trained academics, authors and — at least until a few years ago — policy makers, want a more competitive economy. They will be powerless to prevent the slide.

Modi’s call for a self-reliant India has been echoed by Home Minister Amit Shah, the cabinet’s unofficial No. 2, in a television interview. If Indians don’t buy foreign-made goods, the economy will see a jump, he said. The strategy — although it’s too nebulous yet to call it that — has a geopolitical element. A military standoff with China is under way, apparently triggered by India’s completion of a road and bridge near the common border in the tense Himalayan region of Ladakh. It’s very expensive to fight even a limited war there. With India’s economy flattened by COVID, New Delhi may be looking for ways to restore the status quo and send Beijing a signal.

Economic boycotts, such as Chinese consumers’ rejection of Japanese goods over territorial disputes in the East China Sea, are well understood as statecraft. In these times, it’s not even necessary to name an enemy. An undercurrent of popular anger against China, the source of both the virus and India’s biggest bilateral trade deficit, is supposed to do the job. But is it ever that easy?

A hastily introduced policy to stock only local goods in police and paramilitary canteens became a farcical exercise after the list of banned items ended up including products by the local units of Colgate-Palmolive Co., Nestle SA, and Unilever NV, which have had significant Indian operations for between 60 and 90 years, as well as Dabur India Ltd., a New Delhi-based maker of Ayurveda brands. The since-withdrawn list demonstrates the practical difficulty of bureaucrats trying to find things in a globalized world that are 100% indigenous.

Free-trade champions fret that the prime minister, whom they saw as being on their side six years ago, is acting against their advice to dismantle statist controls on land, labor and capital to help make the country more competitive. Engage with the world more, not less, they caution. But Modi also has to satisfy the Rashtriya Swayamsevak Sangh, the umbrella Hindu organisation that gets him votes. Its backbone of small traders, builders and businessmen — the RSS admits only men — was losing patience with the anemic economy even before the pandemic. Now, they’re in deep trouble, because India’s broken financial system won’t deliver even state-guaranteed loans to them.

The U.S.-China tensions — over trade, intellectual property, COVID responsibility and Hong Kong’s autonomy — offer a perfect backdrop. A dire domestic economy and trouble at the border provide the foreground. Big business will dial economic nationalism up and down to hit a trifecta of goals: Block competition from the People's Republic; make Western rivals fall in line and do joint ventures; and tap deep overseas capital markets. The first goal is being achieved with newly placed restrictions on investment from any country that shares a land border with India. The second aim is to be realized by corporate lobbying to influence India's whimsical economic policies. As for the third objective, with the regulatory environment becoming tougher for U.S.-listed Chinese companies like Alibaba Group Holding Ltd., an opportunity may open up for Indian firms.

All this may bring India Shenzhen-style enclaves of manufacturing and trade, but it will concentrate economic power in fewer hands, something that worries liberals. They’re moved by the suffering of India’s low-wage workers, who have borne the brunt of the COVID shutdown. But when their vision of a more just society and fairer income distribution prompts them to make common cause with the ideological Left, they’re quickly repelled by the Marxist voodoo that all cash, property, bonds and real estate held by citizens or within the nation “must be treated as national resources available during this crisis.” Who will invest in a country that does that instead of just printing money?

At the same time, when liberals look to the business class, they see a sudden swelling of support for ideas like a universal basic income. They wonder if this isn’t a ploy by industry to outsource part of the cost of labor to the taxpayer. Slogans like Modi’s vocal-for-local stir the pot and thicken the confusion. The value-conscious Indian consumer couldn’t give two hoots for calls to buy Indian, but large firms will know how to exploit economic nationalism. One day soon, I’ll get my mangoes — from them.