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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.

Even more than three years after demonetisation and all-out efforts to make most transactions through electronic, cash is still king, as it thrives in a digital India, said fintech start-up Paytm founder Vijay Sekhar Sharma.

"While cashless economy is not possible in India, less cash economy will be in the future. Less cash is the only solution, not the elimination of cash," Sharma told IANS in an interview after unveiling an all-in-one payment gateway on Tuesday.

Asserting that it would take 5-10 years for India to make the transition to digital payments from the traditional mode of cash, Sharma, 41, said the e-payment industry benefitted more from the November 8, 2016 note ban and withdrawal of old Rs 1,000 and Rs 500 denominations.

"I think it (demonetisation) helped the industry despite lack of specific help. But the world has changed since then. It is about the scale of distribution of merchants that is what is propelling digital payments," said Sharma.

Most of the cash not only came back into circulation, but also remains as the mode of payment for the majority due to its convenience for the people used to such transactions.

Expounding Paytm's zero service charge, Sharma said the strategy is sustainable as it leads to acquiring more customers and merchants, enabling newer business opportunities.

Paytm also does not levy a service charge to small merchants for its payments services, unlike organised players like Uber.

"Though there is a monetisation model, the merchants who are small shopkeepers, become our financial services customers as they open a bank account, which is profitable."

Paytm secured a Payments Bank license from the Reserve Bank of India to offer a savings bank account, Rupay debit card and money transfer services.

"We are banking on payment services acquiring customers and merchants who avail banking, lending, insurance, wealth and software services like billing software and business ledger software services eventually," Sharma noted.

The mobile first bank services include zero balance and zero digital transaction charge accounts.

"Basically, payments, cloud, commerce and financial services are a cohort we follow. So, payments is our customer as well as merchant acquisition. If it breaks even, we are happy because other line items make more money, he affirmed.

Noting that in a market like India, one cannot price services at a premium unlike in a developed country like the US, the billionaire businessman said a consumer in a developing country would not be able to afford such a hefty charge.

Forbes ranked Sharma as India's youngest billionaire in 2017, with a net worth of $2.1 billion.

While several countries operate on the model of higher service charges, Sharma said newer business models have to be discovered in India, as customer lifecycle value is accounted for more stages than in other nations.

Asked about an upscale retailer like Zara not giving a wallet payment option during its recent end of season sale in Bengaluru, Sharma said Paytm was addressing such hiccups with its all-in-one payment solutions.

"It's an opportunity, because if the retailer has our all-in-one point of sale machine, where in they enter the amount, it shows both the Quick Response code (QR) and card payment options," he observed.

Sharma compared older swiping payment machine to feature phones and modern ones to feature-rich smartphones.

"If you notice, they look like feature phones and the modern day card machine is more a smartphone like. You can add the smatphone components, which can add the features," reiterated Sharma.

Though Paytm's all-in-one QR point of sale machine integrates the billing system, its chief executive said it was not ideal to have an independent QR feature.

Paytm has 16 million strong merchant user base, which Sharma aims to raise to 26 million base in the next one year.

Sharma has launched in this tech city an all-in-one payment gateway and Paytm Business Payments solution, which enable digital payments through multiple methods for small and medium enterprises (SMEs) and an Android point of sale machine.

With the new gateway solution, collecting digital payments through multiple methods can be achieved seamlessly while Paytm Business Payments solution enables automated vendor payments, including employee salaries and customer refunds among others.

The One97 Communications-owned Paytm aims to help SMEs streamline and digitise their business activities using its new solutions, which enhance the overall efficiency of both accepting and making payments.

Paytm has a data bank of over 200 million saved cards and bank accounts, a feature which enables partner apps to shorten transaction times and propel faster conversions while using the all-in-one payment gateway.

Complementing the two solutions, Sharma also launched an all-in-one Android point of sale machine, which can accept payments through all forms such as cards, wallets, UPI apps and even cash.

The device has a QR code that supports all contact and contactless payments, coming with integrated billing software customized solutions for different sectors such as catering, ticketing, parking and others.

The handheld Android device is equipped with an in-built printer, scanner and can also generate bills.

Valued at $16 billion, Paytm is not alone in the fiercely competitive Indian fintech space where a dozen players like PhonePe, MobiKwik, Kotak 811 and deep pocketed international giants Google Pay and Amazon Pay are in the fray.

The United States of America has bought almost the entire world's supply of remdesivir, one of just two drugs proven to treat COVID-19. 

“President Trump has struck an amazing deal to ensure Americans have access to the first authorised therapeutic for Covid-19,” said the US health and human services secretary, Alex Azar. 

“To the extent possible, we want to ensure that any American patient who needs remdesivir can get it. The Trump administration is doing everything in our power to learn more about life-saving therapeutics for Covid-19 and secure access to these options for the American people.”

The announcement implies that no other country in the world will be able to buy remdesivir for next three months at least.

The anti-viral drug patented by the US-based Gilead biotech firm is the only one approved by the European Medicines Agency (EMA) to treat patients with the novel coronavirus.

The Trump administration has already shown that it is prepared to outbid and outmanoeuvre all other countries to secure the medical supplies it needs for the US.

“They’ve got access to most of the drug supply [of remdesivir], so there’s nothing for Europe,” said Dr Andrew Hill, senior visiting research fellow at Liverpool University.

Remdesivir, the first drug approved by licensing authorities in the US to treat Covid-19, is made by Gilead and has been shown to help people recover faster from the disease. 

The first 140,000 doses, supplied to drug trials around the world, have been used up. The Trump administration has now bought more than 500,000 doses, which is all of Gilead’s production for July and 90% of August and September.