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New Delhi, May 15: A group of doctors from the AIIMS, Raipur has recommended restrictions on the use of mobile phones in healthcare institutions amid the COVID-19 pandemic, warning that such devices can be a potential carrier of the virus and lead to infection among healthcare workers.

In a commentary published in the BMJ Global Health journal, the doctors stated that mobile phone surfaces are a peculiar 'high-risk' surface, which can directly come in contact with the face or mouth, even if hands are properly washed and one study indicates that some healthcare workers use phones every 15 minutes to two hours.

Though there have been many significant guidelines from various health organisations like the WHO and CDC focusing on prevention and control of disease, the commentary highlighted "there is no mention of or focus on mobile phones in these guidelines, including the WHO infection control and prevention guidelines, which recommends the use of handwashing".

In healthcare facilities, phones are used to communicate with other health care workers, look up recent medical guidelines, research drug interactions, understand adverse events and side effects, conduct telemedicine appointments and track patients among others, stated the document.

The document has been authored by Dr Vineet Kumar Pathak, Dr Sunil Kumar Panigrahi, Dr M Mohan Kumar, Dr Utsav Raj and Dr Karpaga Priya P from the Department of Community and Family Medicine.

"In their tendency to come in direct contact with the face, nose or eyes in healthcare settings, mobile phones are perhaps second only to masks, caps or goggles," the authors said.

"However, they are neither disposable nor washable like these other three, thus warranting disinfection. Mobile phones can effectively negate hand hygiene... There is growing evidence that mobile phones are a potential vector for pathogenic organisms," they said.

It is the need of the hour to address proper hygienic use of mobile phones in healthcare settings. In a study in India, almost 100 per cent of health workers of a tertiary care hospital used mobile phones in the hospital, but only 10 per cent of them had at any time wiped their mobile phones clean, the commentary published on April 22 said.

"The safest thing to do is to consider your phone as an extension of your hand, so remember you are transferring whatever is on your phone to your hand," Dr Pathak said.

Amidst the ongoing pandemic, two biggest mobile phone companies have uploaded their user support guidelines, saying that 70 pc isopropyl alcohol or Clorox Disinfecting Wipes can be used to gently wipe the exterior surface of phones in switched-off mode.

However, in doing so, the use of bleach or entry of moisture through any of the openings must be avoided, and any harsh chemical may damage the oleophobic screen, leading to damage in the touch screen sensitivity of the phone, the article stated.

Mobile phones are one of the most highly touched surfaces according to the Centers for Disease Control and Prevention (CDC), along with counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets and bedside tables.

The doctors recommended restriction on mobile phone usage in healthcare settings like hospital wards, ICUs and operation theatres, while advocating the use of headphones to prevent contact with the face while talking.

There should be no sharing of mobile phones, headphones or headsets of any kind. In addition, where available, the use of interdepartmental intercom facility may be promoted.

"Although hand hygiene and mobile phone use by a person are not mutually exclusive, it is high time to acknowledge the potential role of mobile phones in disease transmission cascade and to take evidence-based appropriate actions. This is especially important, given the ongoing COVID-19 pandemic," the authors said.

They said it is necessary for government agencies and the WHO to generate public awareness and to formulate suitable information, education and communication material on mobile phone hygiene, especially in healthcare settings.

AIIMS, New Delhi, Resident Doctors' Association (RDA) General Secretary, Dr Srinivas Rajkumar T said even outside health care settings, people should pay special attention to the usage of mobile phones as they carry them to all places.

"Phone and computer peripherals like keyboard, mouse, etc. should be covered with transparent plastic covers which can be cleaned without interfering with their function. Cleaning hands by soap or alcohol-based hand sanitizer before and after contact with phone and between contact with other surfaces can decrease the risk of potential transmission.

"Using a handsfree headset, dedicated operator/assistant per ward handling the communication via common line in hospitals while on duty can enable communication without compromising safety," Dr Srinivas said.

Jan 15: Amazon.com Inc Chief Executive Officer Jeff Bezos is facing a bitter welcome during his India visit this week as the country’s antitrust regulator initiated a formal investigation just hours before his arrival and trader bodies comprising millions of infuriated small store owners announced demonstrations.

Bezos is in New Delhi for the Smbhav summit, an Amazon India event for small and medium businesses. The billionaire is scheduled to conduct a fireside chat with Amazon India chief Amit Agarwal, anchoring an event that also features Infosys Ltd. co-founder Narayana Murthy and retail billionaire Kishore Biyani, who recently sold a stake in his retail group to Amazon. Ahead of the event, Bezos paid his respects at Mahatma Gandhi’s memorial, wearing a white tunic and a rust-colored Indian vest.

The small businesses that Amazon’s CEO is hoping to endear himself to, however, are organizing in opposition. The Confederation of All India Traders announced that members of its affiliate bodies across the country would stage sit-ins and public rallies in 300 cities to raise a war cry against the world’s largest online retailer. In a letter to Prime Minister Narendra Modi last week, the confederation’s Secretary General Praveen Khandelwal alleged that Amazon, much like Walmart Inc.-owned Flipkart, was an “economic terrorist” who engaged in predatory pricing that deprived the government of tax revenue and “compelled the closure of thousands of small traders.”

India’s e-commerce market is projected to grow to $150 billion by 2022, according to a 2018 report by software industry group Nasscom and consulting firm PwC India. Competition for this rapidly expanding sector is intensifying as Asia’s richest man, Mukesh Ambani, prepares to go live with JioMart, an online shopping platform challenging Amazon and Walmart directly. The latter’s Flipkart Online Services Pvt is also delving deeper into the countryside in its pursuit for more customers. Amazon, for its part, opened a huge office complex in the southern city of Hyderabad in September, underscoring its commitment to the country.

The Competition Commission of India said it would probe the deep discounts, preferential listings and exclusionary tactics that Amazon and Flipkart are alleged to have used as anti-competitive levers. India’s trade bodies have long argued that both retail giants were flouting rules by promoting sales and discounts through their favoured sellers, many of whom they have preexisting commercial arrangements. The regulator has ordered for the investigation to be completed within two months.

Bezos last visited India in 2014 under starkly different circumstances. During that trip, the Amazon founder wore local festive garb, rode atop a festooned truck for a photo opp and presented Amazon’s Indian unit with a giant check for $2 billion. Since then, Amazon has pledged a further $3.5 billion to expand in the country.

Jan 13: India lost more than $1.33 billion to internet restrictions in 2019 as Prime Minister Narendra Modi’s government pushed ahead with his party’s Hindu nationalist agenda, raising tensions and sparking nationwide protests.

The worst shutdown has been in Kashmir, where after intermittent closures in the first half of the year, the internet has been cut off since Aug. 5 following the government’s decision to revoke the special autonomous status of the country’s only Muslim-majority state, a study said. The prologued closure was criticized by India’s highest court, which ruled Friday that the “limitless” internet shutdown enforced by the government for the last five months was illegal and asked that it be reviewed.

India imposed more internet restrictions than any other large democracy, according to the Cost of Internet Shutdowns 2019 report released by Top10VPN, a U.K.-based digital privacy and security research group. The South Asian nation recorded the third-highest losses after Iraq and Sudan, which lost $2.31 billion and $1.86 billion respectively to disruptions. Worldwide internet restrictions caused losses worth $8.05 billion, the report said.

The cost of internet blackouts was calculated using indicators from groups including the World Bank, International Telecommunication Union, and the Delhi-based Software Freedom Law Center. It includes social media shutdowns in its calculations.

India’s ministry of information and technology didn’t respond to an email seeking a response to the report’s findings.

‘Conservative Estimates’

Through 2019, India shut access to the internet for over 4,000 hours. The report added shutdowns in India were often narrowly targeted, down to the level of blocking city districts for a few hours to allow security forces to restore order. Many of these incidents were not included in the report.

“These are conservative estimates,” said Simon Migliano, head of research at U.K.-based Top10VPN. “Internet shutdowns are increasing and it shows a damaging trend.”

India’s other major internet disruptions coincided with two moves by the government that affect India’s Muslim minority. The first disruption took place in November in the states of Uttar Pradesh and Rajasthan after the Supreme Court handed a victory to Hindu groups over Muslim petitioners in a long-simmering dispute over a plot of land.

There were further disruptions in December when protests erupted against the introduction of a religion-based law that allows undocumented migrants of all faiths except Islam from neighbouring countries to seek Indian citizenship. The government enforced shutdowns across Uttar Pradesh and some Northeastern states in order to quell the protests, the report said.