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Kasaragod, Apr 19: Kasaragod, Kerala's COVID-19 hotspot, is the only district in the southern state lacking adequate health infrastructure.

In spite of treating the highest number of COVID-19 patients in the state with meagre infrastructural facilities and even without the support of a medical college in the north Kerala district, no deaths have been reported due to coronavirus.

The state health department views the performance of M Kunhiraman and his team, consisting of Janardhana Naik and Krishna Naik, at the General hospital in Kasaragod as a success story.

"Not only did they control the situation quickly with minimum infrastructure, they also started turning out a large number of negative cases within a few weeks and creditably ensured zero mortality.

This can be showcased as a best global model," Chairman of the Information Education and Communication (IEC) Committee and Project Director Kerala State Aids Control Society, R Ramesh said.

Recalling the ordeal, Janardhana Naik said his first major challenge was the physical examination of a patient with suspected COVID-19.

"Even with the PPE kit, nobody knew how effective they were and it took a whole 30 minutes to wear them properly.

But as time passed, we got accustomed to it," he said.

The traditional method of dealing with a patient involved knowing his or her history, observation and physical examination.

For hundreds of years, the hands-on body approach has been the soul of the doctor-patient relationship -- taking the pulse, tapping on and listening to the chest, feeling lumps.

With the onset of COVID-19 all that has changed.

"In fact, the whole exercise was fraught with grave risks because everything connected with COVID-19 was new.

Doctors have to keep a distance even though the physical examination wearing a Personal Protective Equipment (PPE) is difficult.

Sounds from the body are inaudible, vision is blurred through the smog-covered goggles and a stethoscope seldom has any use," Janardhana Naik said.

It was from March 15 that the hospital started receiving COVID-19 patients, primarily from Dubai.

By the time the first person came, the hospital was ready for him.

Soon, patient numbers began to swell and in a couple of weeks they reached about 91.

From then on, it was teamwork.

Committees were formed for each and every task, including the help desk, IT, treatment, medical board, training, food, waste disposal and data maintenance.

Initially, patients had many misgivings about the hospital.

"Some were disillusioned and even aggressive. Some were not happy with the facilities the hospital had to offer.

But gradually through good treatment and counselling by a psychiatrist, who visited the hospital on alternate days, the confidence and mood of the patients changed and they became friendly with the staff," Naik elaborated.

Counselling was also given to the concerned family members of the patients.

Besides treatment, the medical staff had to spend a considerable amount of time clearing the doubts of patients.

When they got discharged some patients insisted on seeing the faces of the medical staff, who till then were anonymous entities covered from head to toe.

Some even wanted to take selfies with them.

However, the medical team politely turned down their requests and preferred to remain hidden in their work attires.

The mood of the patients also rubbed off on the doctors and hospital staff.

All the physicians and hospital staff are now more confident of dealing with contagious diseases after treating COVID-19 patients.

"Our previous experience of treating H1N1, Chikungunya and Dengue cases helped us a lot.

Words of encouragement from the Health Minister K K Shailaja, Health Principal Secretary Dr Rajan N Khobragade and Health Services Director Dr Sarita R L gave us the impetus to build up confidence.

Moreover, the field health workers did a wonderful job in containing the viral spread," Naik added.

As the number of coronavirus cases rose, the state government on April 5 deputed a 26-member medical team from Thiruvananthapuram to set up a COVID-19 hospital in the district.

They turned a block of the under construction Government Medical College as a hospital-like facility, setting up a 200 bed facility to treat coronavirus patients.

Bengaluru, Apr 18: Hours after announcing that two-wheelers will be allowed to ply and that IT/BT companies can resume operations with 33 per cent strength, Chief Minister B S Yediyurappa on Saturday took a u-turn and rolled them back, citing “public opinion” as the reason. 

Earlier in the day, Yediyurappa announced that, after April 20, there will not be any restriction on the movement of two-wheelers in areas that are not COVID-19 containment zones. Yediyurappa also said that a third of IT/BT employees will be allowed to go to the office after April 20. 

“In the backdrop of public opinion and after discussions with senior officials, it has been decided that the prohibition on two-wheelers will continue throughout the lockdown period,” a statement from the Chief Minister’s Office said. “And in the IT/BT sector, only essential services will be allowed and the work-from-home policy will continue.” 

According to sources, the u-turn came following opposition from Yediyurappa’s Cabinet colleagues. “If I was in the meeting, I’d not have allowed it,” a minister said. Only Home Minister Basavaraj Bommai and Revenue Minister R Ashoka were in the meeting Yediyurappa held earlier in the day. The Opposition also stemmed from the fact that there was no need to make decisions on the lockdown when the Cabinet was scheduled to meet on April 20, sources said. 

The incoordination was apparent on Friday when Deputy Chief Minister CN Ashwath Narayan, the IT/BT minister, said 50 per cent of employees in the sector will be permitted to work while Yediyurappa said this would depend on the number of cases reported in the coming days. 

Other announcements made by Yediyurappa remain unchanged.

“Places, where COVID-19 cases are reported, will be identified as containment zones. In such containment zones, an incident commander will be appointed and given magisterial power. Teams comprising the police and health department officials will oversee the lockdown,” Yediyurappa said. “Lockdown will be much more stringent in these areas and no one will be allowed to step out. Essential supplies will be delivered home.”

According to Bommai, there were 32 containment zones in Bengaluru and ‘hotspots’ have been identified in eight districts.

With an eye on restarting economic activities, the government will allow construction work and industries. “In urban areas, construction work will be allowed to start wherever construction workers have the facility to stay on site,” Yediyurappa said. “The manufacturing sector in rural areas and industrial units located in the special economic zones (SEZ) and townships in urban areas will be allowed to function,” he said.

Stating that inter-state travel will be prohibited, Yediyurappa said the districts of Bengaluru Urban, Bengaluru Rural and Ramnagara will be considered as one only for the movement of industrial workers.

Asked about liquor sale, Yediyurappa said a decision will be taken after May 3. The government has already prohibited liquor sale till April 20 midnight.

Global oil markets remained under intense pressure on Tuesday, with Brent crude dropping below $20 per barrel for the first time in 18 years while other major benchmarks across the world tumbled. 

Brent, the international crude marker, slipped to $18.10, indicating that markets see no immediate let-up to the collapse in oil demand that sent some US oil benchmarks plunging under $0 for the first time on Monday, leaving producers paying for buyers to take their oil away while available storage is scarce.

Coronavirus has sent the oil sector into a state of crisis, with lockdowns implemented by authorities to smother the outbreak slashing demand for crude by as much as a third.

Contracts for the US benchmark West Texas Intermediate for delivery next month tumbled as low as minus $40 a barrel on Monday. Analysts at Citi warned that “if global storage worsens more quickly, Brent could chase WTI down to the bottom”.

The collapse in the May WTI contract was partly a technical product of the fact that it expires on Tuesday, meaning trading volumes were low and making the contract for June delivery more noteworthy, analysts said. That contract held above $20 a barrel on Monday but slid as much as 42 per cent on Tuesday to trade at lows of $11.79, suggesting the blowout in the May contract was more than a blip and that the entire global oil market faced challenges.

Goldman Sachs analysts said the June contact was likely to face downward pressure in the coming weeks, pointing to the “still unresolved market surplus”.

“As storage becomes saturated, price volatility will remain exceptionally high in coming weeks,” they said. “But with ultimately a finite amount of storage left to fill, production will soon need to fall sizeably to bring the market into balance, finally setting the stage for higher prices once demand gradually recovers.”

Warren Patterson, head of commodities strategy at ING, said it was likely that “storage this time next month will be even more of an issue, given the surplus environment”.

“And so in the absence of a meaningful demand recovery, negative prices could return for June,” he added.

European equities traded lower, partly dragged down by weaker energy stocks. The continent-wide Stoxx 600 was down 1.9 per cent, with its oil and gas sub-index dropping 3.3 per cent. In London the FTSE shed 1.7 per cent, while Frankfurt’s Dax slid 2.3 per cent. 

Equities were also broadly lower in Asia, with futures tipping US stocks to fall 1 per cent when trading in New York begins later.

On Wall Street overnight, the S&P 500 closed down 1.8 per cent, partly because of weakness in energy shares, but also due to increased pessimism over the time it will take for countries to emerge from lockdowns.

In fixed income, the yield on the 10-year US Treasury fell 0.03 percentage points to 0.585 per cent as investors retreated to the safety of the debt.