Sri Lanka: Suicide bomber's family also killed in blasts

Washington, Mar 29: The number of known coronavirus US cases soared well past 115,000, with more than 1,900 dead, as President Donald Trump said on Saturday he was considering imposing a quarantine on the hard hit New York region.

American healthcare workers in the trenches of the pandemic are appealing for more protective gear and equipment to treat a surge in patients that is already pushing hospitals to their limits in virus hot spots such as New York City, New Orleans and Detroit.

Trump told reporters he could order a quarantine on three states, New York, New Jersey and Connecticut, which between them have recorded at least 64,000 infections and 895 deaths.

He also appeared to soften his previous comments calling for the US economy to be swiftly reopened. Asked whether he thought the United States would restart by Easter Sunday, April 12, Trump replied, "We'll see, what happens."

New York Governor Andrew Cuomo said he had no details on any possible quarantine order for his state, telling a briefing: "I don't even know what that means. I don't know how that would be legally enforceable, and from a medical point of view I don't know what you would be accomplishing."

He said New York was postponing its presidential primary election to June 23, from April 28.

As the crisis deepened, nurses at Jacobi Medical Center in New York's borough of the Bronx protested outside the hospital on Saturday, saying supervisors asked them to reuse personal protective equipment, including masks. Some held signs with slogans including "Protect our lives so we can save yours."

"The masks are supposed to be one-time use," one nurse said, according to videos posted online. "Now, all of a sudden the CDC (Centers for Disease Control and Prevention) is saying that it's fine for us to reuse them. These choices are being made not based on science. They're being made based on need."

One resident at New York Presbyterian Hospital said they were issued with just one mask.

"This is your mask forever. You can bring it home with you. Here's how you can clean your mask," said the resident, who asked not to be named because he was not authorized to speak to the media. "It's not the people who are making these decisions that go into the patients' rooms."

Doctors are also especially concerned about a shortage of ventilators, machines that help patients breathe and are widely needed for those suffering from COVID-19, the pneumonia-like respiratory ailment caused by the highly contagious novel coronavirus.

Hospitals have also sounded the alarm about scarcities of drugs, oxygen tanks and trained staff.

By Saturday afternoon, the US number of cases stood at 115,842 with at least 1,929 deaths, according to a Reuters tally. The United States has had the most recorded cases of any country since its count of infections eclipsed those of China and Italy on Thursday.

BLACK MARKET
As shortages of key medical supplies abounded, desperate physicians and nurses were forced to take matters into their own hands.

New York-area doctors say they have had to recycle some protective gear, or even resort to bootleg suppliers.

Dr. Alexander Salerno of Salerno Medical Associates in northern New Jersey described going through a "broker" to pay $17,000 for masks and other protective equipment that should have cost about $2,500, and picking them up at an abandoned warehouse.

"You don't get any names. You get just phone numbers to text," Salerno said. "And so you agree to a term. You wire the money to a bank account. They give you a time and an address to come to."

Nurses at Mount Sinai Hospital in New York said they were locking away or hiding N95 respirator masks, surgical masks and other supplies that are prone to pilfering if left unattended.

"Masks disappear," nurse Diana Torres said. "We hide it all in drawers in front of the nurses' station."

One nurse at Westchester Medical Center, in the suburbs of the city, said colleagues have begun absconding with scarce supplies without asking, prompting better-stocked teams to lock masks, gloves and gowns in drawers and closets.

An emergency room doctor in Michigan, an emerging epicenter of the pandemic, said he was wearing one paper face mask for an entire shift due to a shortage and that hospitals in the Detroit area would soon run out of ventilators.

"We have hospital systems here in the Detroit area in Michigan who are getting to the end of their supply of ventilators and have to start telling families that they can't save their loved ones because they don't have enough equipment," the physician, Dr. Rob Davidson, said in a video posted on Twitter.

Sophia Thomas, a nurse practitioner at DePaul Community Health Center in New Orleans, where Mardi Gras celebrations late last month fueled an outbreak in Louisiana's largest city, said the numbers of coronavirus patients "have been staggering."

In the nation's second-largest city, Los Angeles Mayor Eric Garcetti said spiking cases were putting Southern California on track to match New York City's infection figures in the next week.

New Delhi, May 14: India may witness the death of additional 1.2-6 lakh children over the next one year from preventable causes as a consequence to the disruption in regular health services due to the COVID-19 pandemic, UNICEF has warned.

The warning comes from a new study that brackets India with nine other nations from Asia and Africa that could potentially have the largest number of additional child deaths as a consequence to the pandemic.

These potential child deaths will be in addition to the 2.5 million children who already die before their fifth birthday every six months in the 118 countries included in the study.

The estimate is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health published in the Lancet.  

This means the global mortality rate of children dying before their fifth birthday, one of the key progress indicators in all of the global development, could potentially increase for the first time since 1960 when the data was first collected.

There were 1.04 million under-5 deaths in India in 2017, of which nearly 50% (0.57 million) were neonatal deaths. The highest number of under-5 deaths was in Uttar Pradesh (312,800 which included 165,800 neonatal deaths) and Bihar (141,500 which included 75,300 neonatal deaths).

The researchers looked at three scenarios, factoring in parameters like reduction in workforce, supplies and access to healthcare for services like family planning, antenatal care, childbirth care, postnatal care, vaccination and preventive care for early childhood. The effects are modelled for a period of three months, six months and 12 months.  

In scenario-1 marked by 10-18% reduction of coverage of all the services, the number of additional children deaths could be in the range of 30,000 plus over three months, more than 60,000 over six months and above 120,000 over the next 12 months.

Coronavirus India update: State-wise total number of confirmed cases, deaths on May 13

The numbers sharply rose to nearly 55,000; 109,000 and 219,000 respectively for scenario-2, which was associated with an 18-28% drop in all the regular services.

But in the worst-case scenario in which 40-50% of the services are not available, the number of additional deaths ballooned to 1.5 lakhs in the three months in the short-range to nearly six lakhs over a year.

The ten countries that could potentially have the largest number of additional child deaths are Bangladesh, Brazil, Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and Tanzania.

In countries with already weak health systems, COVID-19 is causing disruptions in medical supply chains and straining financial and human resources.

Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and due to the fear of infection among the communities. Such disruptions could result in potentially devastating increases in maternal and child deaths, the UN agency warned.

Munbai/New Delhi, May 4: India expects bad debts at its banks could double after the coronavirus crisis brought the economy to a sudden halt, a senior government official and four top bankers said.

Indian banks are already grappling with 9.35 trillion rupees ($123 billion) of soured loans, which was equivalent to about 9.1% of their total assets at the end of September 2019.

"There is a considered view in the government that bank non-performing assets (NPAs) could double to 18-20% by the end of the fiscal year, as 20-25% of outstanding loans face a risk of default," the official with direct knowledge of the matter said.

A fresh surge in bad debt could hit credit growth and delay India's recovery from the coronavirus pandemic.

"These are unprecedented times and the way it's going we can expect banks to report double the amount of NPAs from what we've seen in earlier quarters," the finance head of a top public sector bank told Reuters.

The official and bankers declined to be named as they were not officially authorized to discuss the matter with media.

India's finance ministry declined to comment, while the Reserve Bank of India and Indian Banks' Association, the main industry body, did not immediately respond to emails seeking comment.

The Indian economy has ground to a standstill amid a 40-day nationwide lockdown to rein in the spread of coronavirus cases.

The lockdown has now been extended by a further two weeks, but the government has begun to ease some restrictions in districts that are relatively unscathed by the virus.

India has so far recorded nearly 40,000 cases of the coronavirus and more than 1,300 deaths from COVID-19, the respiratory disease caused by the coronavirus.

'RIDING THE TIGER'

Bankers fear it is unlikely that the economy will fully open up before June or July, and loans, especially those to small- and medium-sized businesses which constitute nearly 20% of overall credit, may be among the worst affected.

This is because all 10 of India's largest cities fall in high-risk red zones, where restrictions will remain stringent.

A report by Axis Bank said that these red zones, which contribute significantly to India's economy, account for roughly 83% of the overall loans made by its banks as of December.

One of the sources, an executive director of a public sector bank, said that economic growth had been sluggish and risks had been heightened, even ahead of the coronavirus crisis.

"Now we have this Black Swan event which means without any meaningful government stimulus, the economy will be in tatters for several more quarters," he said.

McKinsey & Co last month forecast India's economy could contract by around 20% in the three months through June, if the lockdown was extended to mid-May, and growth in the fiscal year was likely to fall 2% to 3%.

Bankers say the only way to stem the steep rise in bad loans is if the RBI significantly relaxes bad asset recognition rules.

Banks have asked the central bank to allow all loans to be categorized as NPAs only after 180 days, which is double the current 90-day window.

"The lockdown is like riding the tiger, once we get off it we'll be in a difficult position," a senior private sector banker said.