Tag: coronavirus pandemic

What should rich countries do with spare masks and gloves? It’s the opposite of what the WHO recommends

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Most developed countries hold significant quantities of medical supplies in reserve to respond in an emergency. For example, Australia has its National Medical Stockpile, which stocks personal protective equipment, such as masks and gloves, among other items. New Zealand has its national reserve supplies.

If these supplies are not used in an emergency, such as a pandemic, they typically stay in the stockpile until their use-by date, then are sent to landfill. Surely there’s a better way, especially with some developing nations short of medical supplies. Donating surplus stock to developing countries seems an obvious solution.

Our study (University of Wollongong and Tava Olsen, University of Auckland Wollongong) looked at the likely impact of donating excess stock to developing countries dated items close to or past their labelled use-by date. We found this a viable option, even better than donating fresh items. What’s in the stockpile? In 2011, Australia’s stockpile contained about 3,000 pallets of expired stock, the bulk of which was personal protective equipment, including 98 million latex gloves.

While some of the reserves have been used during COVID, items are being restocked. So these too will likely expire if not used. For instance, we know surgical masks in the stockpile are already expiring. Similar issues have been seen in other developed countries such as the United States, New Zealand and Canada, before and during the current pandemic.

Why not donate surplus stock? This expiration and waste is in sharp contrast to the situation in some developing countries. Some are forced to reuse normally disposable items, such as surgical gloves, masks and syringes. While donation of surplus stock seems an obvious solution, donations of dated medical supplies are typically discouraged.

The World Health Organisation (WHO) recommends against it. It expects donations to arrive in another country with an expiry date of: at least one year, or half the shelf life if the expiry date is less than one year. The idea is to protect recipients from degraded or faulty stock.

We found a pragmatic option Our study modelled the impact of donating stock, in particular personal protective equipment and similar low-risk products. We did not look at donating dated vaccines or medicines, which come with higher safety risks. We found dated donations close to or recently past their use-by date was the best option. This benefited the recipient country the most, as it was least likely to push local suppliers out of business.

The next best option was donating fresh stock. The least preferable option was donating very dated stock, such as items out of date by more than a year. How could old stock be better? It’s easy to assume that donating large volumes of fresh, excess stock, still within its use-by date, would be the best option. But we showed how this can distort the local market.

Flooding the local market with free, fresh products can force local suppliers to lower their products’ market price, and make them potentially stop making or supplying these products. This discourages any further attempts to develop local supply capacity, and makes the recipient country more reliant on donations.

This may be compounded by corruption. If corrupt officials siphon donated products and sell them on the black market, this too may force local suppliers out of business. This may also drive prices up on the black market, putting an extra strain on already stretched health-care systems.

Whether or not such corruption is involved, somewhat dated supplies could enable the local supplier to stay in business and supply the country’s health-care system. What should happen next? Some surplus medical supplies are being donated. But these programs are small scale and face many restrictions and challenges.

These include a limited and unpredictable supply of donated items and relying heavily on volunteers and community partners to distribute donated stock. So donating surplus stock could be better coordinated at a larger scale.

Our evidence calls us to rethink what we do with dated donations of low-risk medical supplies. Masks, respirators, syringes and hand sanitisers from national stockpiles would be a good start. Such products can continue to be useful even when dated, especially if the products are stored well.

Indeed, even in developed countries, personal protective equipment has been distributed past its expiration date when needed during the pandemic. It would be prudent to run a pilot program to donate dated, surplus stock, possibly with a single product.

Medical suppliers could also get on board. They may be willing to pay the costs of such a donation program if it allows them to regularly restock national stockpiles and similar reserves with fresh items. Many countries were surprised at the start of the pandemic to find how much expired stock was in their reserves.

A donation program would prevent this happening again and help us better prepare for the next pandemic.

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Kerala’s nurses serving the world review their choices as they recover from the ‘Act of God’

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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“Have you seen the Pearl of Kochi? Isn’t it a beautiful tribute to all nurses?” asks Soniya Biju, a young nurse who was forced to return to Kerala from China after COVID-19 broke out.

Soniya was excitedly referring to a sculpture inaugurated in Ernakulam (Kochi)  on Thursday — International Nurses Day — to honour all nurses and health workers who have been at the forefront of the battle to save lives. The “Pearl of Kochi” depicts the Earth placed atop the sails of a ship navigating rough waters — a befitting tribute to nurses.

Today, Soniya works at a mid-sized hospital in Kerala’s Changanassery with a large portion of her savings being swiped out of her bank account to pay off her education loans. Having studied nursing at the Yangzhou University in China, she worked for a year until the deadly virus struck. She was among the batch of nurses who returned to Kerala from China in January 2020.

Soniya, who comes from a family that survived on daily wages, told News18 that her parents were always keen on making her a nurse.

“My mother would always say a nurse’s job is God’s work. They saved money for years, and mortgaged our only piece of ancestral land to pay for my studies. They were thrilled when I got a job at a Chinese hospital, but then I could not afford the airfare. I took loans against my gold chain and earrings,” she recalled.

Describing the situation in China, the nurse spoke of gruelling shifts, strenuous work and constant fear of being infected by the virus.

“The job was back-breaking with the patients who were admitted in an extremely serious condition. We did not know Chinese and spoke largely in sign language. Many of them were not conscious. I had to take the risk of working to pay back loans and send money back home. But I finally decided to come back as my family was extremely worried about my safety, “ she said.

There were more than 23,000 Kerala students studying across 40 Chinese universities and all of them were forced to return to India. Upset with the cold response from the state and central governments on the future of medical students from China, protests were held under the banner of Foreign Medical Graduates Parents Association (FMGPA) — an association of parents of medical students in foreign countries. They have registered their grievance with the central government through an online portal — Centralised Public Grievance Redress and Monitoring System — and have yet to get a response.

“These students from Chinese universities are forced to take online classes now, but their future remains uncertain due to the non-availability of visas from the Chinese authorities,” Lekha Shankar, joint secretary of FMGPA, said.

“In order to secure jobs, practical and laboratory experience is essential and these students will not be able to undergo that training unless they return to China,” Lekha added.

“Back home, they will not get jobs if they don’t have practical training. So we are left with two options — help them go back to China or help with their training in India, even if it means they pay for it,” she added.

“We have spent close to Rs 20 lakh for my course. We have no idea whether the Indian government will accept our degrees earned through online classes. I have been earning practical experience from private hospitals near my hometown. But what guarantee do I have that it will be recognised? If it is not, we are doomed,” said Shameem Ahmed, studying with Zhengzhou University.

“The government has come up with solutions for students and nurses who returned from Ukraine; why not us?” asks Parvathy Unni, a fourth-year student from Dali University, located in the Yunnan province in China.

“I want to go back to China to complete my studies. I have no fear at all. Our university has made no decision about calling us back and the Chinese government also has no idea of what to tell us,” she said.

She explained that if students opt to study in India, they are forced to pay anywhere between Rs 8 lakh and to Rs 20 lakh per year for a government medical seat. That’s a whopping Rs 90 lakh to Rs 1 crore for a four-year course, an amount that out of reach for many.

In December 2021, in order to address the post-pandemic job loss situation, especially amongst the medical community, the Kerala government had signed an MoU with German Federal Employment Agency. This is a German government agency in charge of recruiting nurses from Kerala and providing job opportunities in the health sector in a post-pandemic world.

In a Facebook post, Kerala Chief Minister Pinarayi Vijayan said that the world is  indebted to the sacrifices and services of the medical community, who bravely stood at the forefront of the struggle against COVID-19. He called it a matter of pride that across the world — not just in Kerala — Malayalee nurses were on the frontline of the fight against the pandemic.

“The German recruitment scheme is called ‘Triple Win’, and is the first of its kind in India held under the aegis of a government. More than 10,000 job opportunities are expected to come up for nurses in Germany in the post-Covid scenario,” said Vijayan.

One of the first major records of migration of Malayalee nurses was in the 1960s, when a group of around 6,000 nurses — mostly Catholics — were summoned to Germany which faced a shortage of health staff. Europe had been facing a severe shortage of healthcare professionals and these Indian nurses began to work in Catholic hospitals. They were slowly absorbed into the medical health system and were lovingly called “Brown Angels”. The nurses began to travel to Italy, Switzerland and other countries as their skill and sincerity was well appreciated.

Hospitals in Vienna recruited nurses from Kerala in the early 1970s through a Catholic order, ‘the Queen of the Apostles’, which was founded in Vienna in 1923 for missionising in India, says a paper titled, “International Mobility of Nurses from Kerala (India) to the EU: Prospects and Challenges with Special Reference to the Netherlands and Denmark”, by Praveena Kodoth and Tina Kuriakose Jacob.

“Nurses from Kerala were pioneers in opening up a new avenue of employment for migrants in Europe, the US and the Gulf and in taking up the position of the main breadwinners of their families. As their husbands and family began to follow them overseas, they reversed the gender pattern of migration. In the early phase, (the erstwhile) Bombay was the launching pad for nurses seeking to go to the Gulf countries, the US and East Africa,” the research paper stated.

Irudaya Rajan, Founder Chairman of the International Institute of Migration and Development, explains that its not just those who come from economically backward communities that pursue education as nurses — many who are financially well off as well. He said the estimated total foreign remittances to Kerala stood at Rs 85,092 crore in 2018 — 20 percent of the state’s GDP.

“Earlier nursing was looked down upon as a profession, but today, health workers are finally being given their due.  Its not just nurses, but auxiliary nurses, like  midwives and caregivers, who are also in high demand,” the migration specialist further explained.

So, why do so many nurses from Kerala go abroad to study and work? News18 spoke to several nurses who are working in countries such as the UK, Ireland, USA, Middle East and Australia.

There are three major reasons — subsidised education with state-of-the-art facilities, dignity of labour and the possibility of permanent residency.

While a nurse who is trained in India and works in the country would earn a salary between Rs 15,000 and Rs 50,000 per month, s/he would earn twice or even thrice as much in countries like the UK, Ireland and the Middle East. The money earned helps the nurses pay off the loans taken for their education and foreign placement in a short period of time.

Jom Francis worked in Kuwait for seven years and returned to India in 2020, just after the pandemic struck. He had been earning close to Rs 15,000 before he found a job in the Middle East.

“My salary was around  Rs 50 thousand and helped me pay off my loans in the first six months of my arrival there. Unfortunately I had to resign and was placed on COVID duty in Bengaluru,” Francis told News18.

But his life was not all that rosy — nurses working abroad have to ensure hardships of a different kind. Francis talked about how the Kuwaiti hospital authorities would find reasons to terminate a nurse. “When we go with our medical fitness certificate from India there, we are asked to produce another one to get a job. Sometimes they claim we are unfit and send us back. Some of my friends did not even have money to return to India,” he said.

“Other times, they will to assign Indian nurses on duty, refuse leave to go back to Kerala and then terminate them if they protested. I received no increments for seven years, but managed to clear my loans,” he said.

According to EA Mohammed Shihab, state general secretary of the Indian Nurses Association, of the 5,000 nurses who pass out of 99 nursing colleges in the state, a staggering 3,500 pay to find placement abroad in Commonwealth countries and the Gulf region. Kerala has another 200 nursing schools that offer General Nursing and Midwifery (GNM) as a course, with 6,000 students graduating from them each year.

Last year, after months of agitation, nurses in Kerala were able to convince the state government to hike the minimum salary of a registered nurse employed in a 50-bed hospital to Rs 20,000 — an amount which is way below the payscale in other countries. It’s such a low pay that pushes this indispensable part of the medical community to other countries where working conditions are better, salaries higher and career more exciting.

Shahid , a male nurse from Tripura who works with a private hospital in Bengaluru, is all set to go to Dubai. He is aware of the difficulties in getting a job in a hospital but is ready for the gamble.

Like many nurses, Shahid comes from an economically backward family and has huge overheads and loans to pay. Having paid Rs 4 lakh for his nursing education , he wants to clear his debts within a year.

“Many nurses come from poor families and earn just Rs 3,000 to Rs 5,000 a month. I spent Rs 4 lakh for my nursing education and am confident that I will clear my loans in 3 to 4 months of working there,” he told News18.

Recalling his days during COVID duty, Shahid said the long hours in PPE kits and seeing death at close quarters strengthened his resolve to serve people. “The risk may be high with infections around, but the pandemic taught us many things and one of it was making us mentally stronger,” he said.

“It is about changing lives. Patients would be ill, unable to speak with their BP low or sometimes high. We chat with them, they smile and then their blood pressure stabilises. That gives me immense satisfaction. That’s the kind of good I want to do for people, “ he told this reporter.

Kottayam-based nurse Renita George was in the midst of packing when she spoke to this reporter over phone. She had been working for two years in a Chennai-based private hospital and was forced to resign as her health deteriorated due to extended working hours and lack of sleep. Recalling her harrowing days, Renita said that she would have to tend to 10 to 12 patients a day in the ICU and later be put on night shift .

“You cannot afford to sleep during your shift. I lost 11 kg and my family asked me to return. I have been selected to work in a German hospital and I am being paid thrice more than what I earned here, “ she said.

While money is one reason for nurses’ migration, another is dignity of labour. Saleena Shah is a nurse who has been working with the government medical college in Thiruvananthapuram for 33 years. She feels that nurses who take up the profession are passionate, compassionate people and it would not natter where they work as they are there to serve.

Unlike India, nurses abroad or registered nurses are empowered. Doctors consult nurses on medication for patients and also listen to their suggestions. Nurses abroad are held accountable for the health of  their patients unlike in India. where the onus is only on the doctors and nurses are reduced to mere bystanders.

“When they work in other countries, nurses can take up other specialised roles such as a nurse educator, researcher or administrator. They can become nurse practitioners as well. There is growth for a nurse if they take up higher qualifications. In India, nurses are stuck in one role,” Saleena said.

Interestingly, she spoke of a new trend where many freshly graduated nurses in India have been turning towards civil services.

“The pandemic has taught us many things. It has taught us how we can bring in hybrid education by collaborating with universities across the world and give our nurses specialised education. Our hospital had a tie up with the Karolinska Institute, Sweden. Exchange programmes will help nurses to function better,” she added.

The possibility of a permanent residency in the country they work in is an added incentive for nurses to travel across the seas. Their children also receive quality education, and countries in Europe, Canada and Australia offer them permanent residency.

Monisha Stefen left for Canada in 2010 and obtained her Canadian nursing licence. She has been working as a nurse ever since. “My family, husband and two daughters applied for Canadian citizenship and we are expecting it to be cleared soon. Our quality of life has improved so much,” she said.

Even though a career in nursing helps in achieving the dream of a ‘good life’ , it all comes at a cost. There are huge challenges in understanding the culture, language and people of the new country. English may be accepted but in Europe, knowledge of French, Italian or Spanish becomes important.

However, on a happier note, the demand for Indian nurses has shot up post COVID, says the Indian Nurses Association.

“Requests from hospitals from many countries have been pouring in seeking applicants. There are more than 10,000 applications from different  pending seeking our nurses expertise,” said an official from the Indian Nurses Association.

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Mental health may impact chances of breakthrough COVID

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Los Angeles: People who are vaccinated against COVID-19, and have a history of certain psychiatric conditions, face an increased risk of breakthrough disease, according to a study. Researchers from the University of California (UC) San Francisco, US, noted that the risk may be related to impaired immune response as well as risky behaviours associated with some disorders.

The study, published in the journal JAMA Network Open on Thursday, found that patients over 65 with substance abuse, psychotic disorders, bipolar disorder, adjustment disorder and anxiety, faced increased risks of up to 24 per cent for breakthrough COVID. For those under 65, risks were up to 11 per cent higher than for those without a psychiatric history, the researchers said.

They tracked data from more than 2.5 lakh US Department of Veterans Affairs patients, who had completed their vaccine regimen and had at least one test for SARS-CoV-2. Just over a half (51.4 per cent) of the patients had received at least one psychiatric diagnosis within the last five years and 14.8 per cent developed breakthrough COVID, confirmed by a positive test.

ALSO READ: New rapid COVID test more sensitive, durable

“Our research suggests that increased breakthrough infections in people with psychiatric disorders cannot be entirely explained by socio-demographic factors or pre-existing conditions,” said senior study author Aoife O’Donovan from UCSF. “It is possible that immunity following vaccination wanes more quickly or more strongly for people with psychiatric disorders and they could have less protection to newer variants,” O’Donovan said in a statement.

The average age of the 263,697 participants was 66 and 90.8 per cent were male. Overall, those participants with psychiatric disorders had a 3 per cent increased risk for breakthrough COVID infections in 2021, when adjusted for both demographic factors and pre-existing conditions, compared with participants without a psychiatric history, the researchers said.

However, the risk was 24 per cent higher for over-65s with substance abuse, 23 per cent higher for those with psychotic disorders, 16 per cent higher for bipolar disorder, 14 per cent for adjustment disorder and 12 per cent for anxiety, they said. Given the greater incidence of breakthrough infections among younger people, the study showed significantly smaller effects in the under-65s group.

Risks were 10 per cent lower in participants with psychotic disorders compared to those without a psychiatric diagnosis, the researchers said. They attribute this decrease to possible lower socialisation among younger people with psychotic disorders compared with older people who “may be less socially isolated because of their greater burden of ill health and contacts with caregivers.”

The higher incidence of breakthrough infection among older participants may be due to “decreased immunological response to vaccine that has been associated with some psychiatric disorders, which may be more substantial in older adults,” said study first author Kristen Nishimi from UCSF.

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It is also possible that older adults with psychiatric disorders “may require more frequent in-person care, which could increase their interactions with the health care system,” she noted. Breakthrough risks for other non-psychiatric conditions were also calculated and adjusted for factors like obesity and smoking status, as well as other underlying conditions.

The researchers found that patients with chronic kidney disease had an increased risk of 23 per cent, compared with 20 per cent for HIV, 19 per cent for cardiovascular disease, 18 per cent for COPD and 13 per cent for sleep apnea. This shows that certain psychiatric conditions, particularly in the 65-plus group, face risks that are on a par with other conditions, said O’Donovan.

“Mental health is important to consider in conjunction with other risk factors and some patients should be prioritised for boosters and other critical preventive efforts,” she added.

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

View | The rise and fall of the COVID wave

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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As the third wave of the COVID-19 pandemic continues to grip India, experts are constantly mapping various arithmetical models and studying data to map the trajectory of the pandemic with a suggestive peak point.

India logged more than 2.64 lakh new coronavirus infections while witnessing a 6.7 percent jump in new cases during the past 24 hours, the Health Ministry said on Friday. Deaths due to COVID rose by 315, with total fatalities pegged at 485,350.

Delhi, Mumbai and West Bengal, the three COVID hotspots in the latest wave, saw marginal dips in new cases on Friday. Uttar Pradesh and Karnataka, however, saw a significant jump in numbers.

Also read: Omicron ‘practically unstoppable’, to infect almost everyone, says health expert

The highly transmissive Omicron variant was first discovered in South Africa in November. India has been mainly administering two locally-manufactured vaccines, Covishield and Covaxin, since its vaccination drive began in January 2021.

Robust Vaccination

India’s COVID-19 vaccination coverage has crossed 155.92 crore as on January 14. More than 49 lakh vaccine doses were administered till 7 pm on January 14.

India has given the first dose to over 92 percent of its eligible population. Nearly 70 percent of the eligible beneficiaries have got their second doses. Almost 3 crore 15-18-year-old children have been vaccinated.  

Over 3.14 crore adolescents, accounting for 42 percent of youngsters between 15-18 years of age, have received the first dose of COVID vaccines in about 11 days since the rollout of the vaccination drive for this category on January 3. The government aims to cover around 80-85 percent of the estimated 7.40 crore youngsters in the 15-17 years age-group by January-end.

India started giving booster doses of the COVID-19 vaccine to priority groups from January 10. Health and frontline workers and people above 60 years of age with co-morbidities are currently eligible to take the jab.

While the Omicron has taken the centre stage in the third wave, the Delta variant is also prevalent in large numbers. Experts feel that hospitalisations have been rising but the cases are not severe.

Prime Minister Narendra Modi said on Thursday that state governments should adopt the mantra of “pre-emptive, pro-active and collective approach” to beat the third wave of the pandemic, even as he emphasised that vaccination is the most potent way to deal with the pandemic.

Tracking the Trajectory

IIT Kanpur professor Manindra Agrawal, who has been tracking the COVID-19 curve in the country using SUTRA model, says India will witness a peak in COVID-19 infection cases soon and that the maximum number of cases are likely to be reported in bigger cities like Delhi, Mumbai, and Kolkata.

“We are still confident that the peak will occur in the last week of January, but the peak value is unclear. We need to wait till the phase stabilises,” Agarawal tweeted.

India blue curve is showing a slight inward turn. We are still confident that the peak will occur in last week of Jan, but the peak value is unclear. We need to wait until the phase stabilizes. pic.twitter.com/VrtQsjcSq7

— Manindra Agrawal (@agrawalmanindra) January 12, 2022

Agarwal, who has done a lot of modelling studies on COVID, feels that the third wave will have a very large number of cases but nearly all of them are mild. “It is better to focus the resources towards those who need treatment instead of testing a very large number of cases,” Agarwal further tweeted.

Gautam Menon, Professor of Physics and Biology, Ashoka University says: “Our models suggest a peak of between 6 lakh and 9 lakh cases across India. As a caveat, testing has remained largely static even as the test-positivity ratio had increased steeply, so we may simply not be testing enough to be able to see the underlying numbers of cases.”

Menon says that it seems well established that the Omicron wave overall was less severe than what was witnessed for the second Delta wave. “Our vaccination programme as well as the fact that the far larger fraction of Indians have been infected once in the previous waves is also a protective factor.”

Chandrakant Lahariya, consultant physician and epidemiologist based in New Delhi, says that it is very likely that in the ongoing wave, India may see a phased peak as the cases in metro, middle towns and rural cities will rise in a phased manner but in quick succession. There might be a sustained number of high cases from the fourth week of January to the second week of February with minor fluctuations before a clear decline and ebbing of the third wave.

New Drugs

The World Health Organisation (WHO) has recommended two new drugs for COVID-19, providing yet more options for treating the disease.

The first drug, Baricitinib, is strongly recommended for patients with severe or critical COVID-19. It is part of a class of drugs called Janus kinase (JAK) inhibitors that suppress the overstimulation of the immune system. WHO recommends that it is given with corticosteroids.

Also read: Decline in COVID-19 cases likely after wave of Omicron variant fades out, says Bill Gates

WHO has also conditionally recommended the use of a monoclonal antibody drug, Sotrovimab, for treating mild or moderate COVID-19 in patients who are at high risk of hospitalisation. This includes patients who are older, immunocompromised, having underlying conditions like diabetes, hypertension, and obesity, and those unvaccinated.

In another significant research, Polish scientists discovered a gene that increases the risk of dying from Covid 19.

The research from the Medical University of Bialystok estimates that the gene could be present in about 14% of the Polish population, compared with around 9% in Europe and 27% in India. It’s the fourth-most important factor in determining the severity of the illness after age, weight and gender, it said.  

A genetic test “may help to better identify people who, in the event of an infection, may be at risk of an acute disease, even before the infection develops”, said Marcin Moniuszko, a professor in charge of the study.

Follow all the LIVE coronavirus updates here

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

3 Mins Read

Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Pandemic lessons: Risks, resuscitation and resilience within the manufacturing sector

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The VUCA (Volatility, Uncertainty, Complexity and Ambiguity) world, aptly described by our keynote speaker, Bridgestone India MP Parag Satpute, has brought risk management to the centre stage in this new normal.  From merely a compliance activity to a contentious topic of discussion across boardrooms, risk management tops the agenda of every organisation the world over.  To understand the disruptions caused by the black swan event in the Manufacturing sector and its impact on supply chains,

ICICI Lombard & CNBC-TV18 organised a specially curated “Risk Masterclass 2021”. It is a special initiative under the aegis of India Risk Management Awards that recognizes India’s leading organizations that have taken the lead in managing business risks.

The session kickstarted with a context setting address by Sandeep Goradia, Head, Corporate Solutions Group, ICICI Lombard General Insurance.  He said, “As a part of the non-life insurance sector, we have always been working towards shifting our focus from being a risk transfer entity to playing a much more active role as a risk management partner.” 

Sharing some alarming statistics on cybercrime, he said, “For cyber events 2021 has actually recorded the highest incidences ever–on an average 30,000 websites are being hacked every single day and there is a cyber-attack every 39 seconds.” He welcomed Satpute to deliver his  keynote address.  Stressing on the importance of agility, Parag said, “What we have learned through this crisis is that the importance of agility and the importance of adapting to the situation very promptly will hold us in good stead during future crises also. So, this is the lesson we are taking from the COVID-19 crisis and hopefully this is what will help businesses to continue to thrive in future situations as well.”

He discussed how at Bridgestone they followed a structured approach to counter the challenges during the pandemic by deploying the 4S — secure, streamlined, sustained and shift.

Next up was an invigorating panel discussion with Industry leaders where Paromita Chatterjee, Special Correspondent, CNBC-TV18, had a conversation with Anil Chopra, Group Head–CEO, Apollo Tyres Ltd; Dinyar Manekshaw Jivaasha, Global Head & President, ESSAR; Abhay Baijal, CFO, Chambal Fertilizers; and Alok Agarwal, Executive Director, ICICI Lombard General Insurance.  Anecdotal references, insightful strategies, and contextual analogies were shared as the panelists unanimously agreed on digitisation being the driving force that kept manufacturing units well oiled and running amid the pandemonium.  

Anil shared how technology came to their rescue when 400 of Apollo’s trucks were abandoned midway during the lockdown, and with the aid of a GPS tracking mechanism they were able to avert a major crisis.  He also delved into interesting acronym coined at Apollo, called ‘DRIVE’ — discovering new sales, inventory and production optimisation, value of cash, and elimination of bad costs.   He maintained that a blended combination of offline and online is needed to stay ahead of the curve.  Speaking of digital transformation, Alok shared how ICICI Lombard ramped up their IT systems for transitioning the entire insurance process one and also ensure seamless claims clearances.  Abhay shared valuable lessons learnt during this period of trial and rightly quoted that, “Risk is like a snake in your backyard and you will not know which way it turns and bites you”.  Being in a continuous process industry, he shared how the company navigated the challenges of labour, packaging material and maintenance of the plant through the first and second phase of the lockdown.

Dinyar reprimanded companies for not taking the role of risk management seriously and emphasised the growing relevance of the digital world, which he warned is not risk averse. He said, “Strong risk management practices are the backbone of a successful company and that will distinguish people, otherwise it is like an elephant in a room and we’ll just be groping in the dark.”   He spoke at length on leveraging tech tools such as Cloud computing AI, ML, blockchain, 3D printing, predictive analysis, which will have an important play in the days ahead.

Alok explained how the play of Internet of Things (IOT) is transforming the supply chain space. Use of digital supply networks and solutions are handy tools for seamless supply chain management.  In addition, ICICI Lombard has developed a Corporate India Risk Index which measures a company across six broad risk parameters, 32 detailed risk parameters, and comparing their risk preparedness versus what is the reaction time at the time of the risk event happening. This risk index then gives a benchmark to the company against the other peers in the industry.  He also drove the importance of self-sufficiency along with awareness of world events that cause disruptions to supply chain and preparing for vendor back-ups, he stated “the buzzword Just-in-time is replaced with Just-in-case.”

Likening the pandemic to a war scenario, Alok summed up the session by stating, “We have to anticipate the risks, we have to prepare ourselves during peacetime so that during wartime we react better.”

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Omicron threat: Can’t rely on UK data to formulate booster strategy; no need to panic as yet, says Dr Gagandeep Kang

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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India’s top microbiologist Dr Gagandeep Kang today told CNBC-TV18 that the the rapidly spreading Omicron variant of COVID-19 needs to be monitored, and that there is no need to press the panic button as yet.

She said it was “reassuring” that most of the countries recording a large number of Omicron cases have reported that it does not cause a particularly severe disease. “I don’t think that we can immediately predict a doomsday scenario. We need to be careful, but not terrified,” said Dr Kang.

“Now, [the current scenario] may not necessarily mean that the virus itself is less virulent; it could mean that the virus is spreading in populations that have reasonable vaccine coverage, causing either asymptomatic or mildly symptomatic infections. If that is the case, and that continues to hold, then that is a good thing,” she added.

Also read: Omicron cases likely to rise in January; experts say need to improve testing

Dr Kang said our healthcare infrastructure is not as likely to be overwhelmed. “[The Omicron variant] is definitely something that requires caution and tracking,” Dr Kang advised.

On the need for a booster strategy, Dr Kang said the government must not rely on data from the United Kingdom, where the booster plan is based on how it was affected by the delta wave.

“The important thing to remember is that in the UK, they saw the delta wave after they had vaccinated the bulk of their population. In India, it was the other way around. People had the delta variant for the most part first before they got vaccinated. So it’s not possible for us to directly take the UK data and use that to justify boosters in India, we need Indian data to make decisions,” she said.

Also read: Hospitalisation rate lower for Omicron than Delta coronavirus variant: UK study

The microbiologist said the fastest way to formulate a COVID-19 booster dose strategy is by taking a look at vaccine efficacy.

“The fastest way to look at results that can help make decisions about boosters is to look at vaccine effectiveness data by age and by vaccine, which means that if we have had over a billion doses of vaccine given out in the country, we should know that when someone tests positive is ill or hospitalised or dies, we have their vaccination history,” Dr Kang said.

She explained that this will allows us to do what is called a “test negative design” for assessing vaccine effectiveness. “That is real world data that tells us whether vaccines are failing or not. And this is the kind of data that the rest of the world has relied on to make decisions about boosters,” Dr Kang added.

Also read: ‘Another storm coming’, WHO warns of COVID-19 variant Omicron surge in Europe

Pointing out that India does not have a vaccine mix like other countries. “In India, we do not have the mix of vaccines that other countries have. We do have AstraZeneca (Covishield) that other countries use, but we do not have another vaccine that is the equivalent of the Covaxin. There are other inactivated vaccines but none of them have the same adjuvant. So we can’t really take exactly the data from other countries and use that to make decisions,” Dr Kang said.

She emphasised that a third shot of the vaccine is a must for the immune-compromised sections of the population.   On paediatric COVID-19 vaccination, Dr Kang said we need a larger data set to initiate the drive.

Also read: Omicron thrice more transmissible than Delta; increase bed capacity, adopt containment measures: Govt to states

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Apple shuts 8 retail stores in US and Canada amid surge in COVID-19 cases

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Amid the rapid spread of the Omicron variant of COVID-19, tech giant Apple has temporarily closed eight retail stores in the US and Canada, Bloomberg reported.

The iPhone maker has closed stores in Dadeland (Miami, Florida), The Gardens Mall (Palm Beach, Florida), Lenox Square (Atlanta, Georgia), Cumberland Mall (Atlanta, Georgia), Highland Village (Houston, Texas), Summit Mall (Fairlawn, Ohio), Pheasant Lane (New Hampshire) and Sainte-Catherine (Montreal, Canada) since Tuesday.

The Cupertino-based company generally closes retail stores when around 10 percent of its employees test positive for the coronavirus.

Earlier, Apple had shut nine other stores in Maryland, Florida, Texas, Ohio, Hawaii and Ottawa (Canada). The shops reopened a short while later, except the one on Lincoln Road in Miami Beach, the Bloomberg report said. Similarly, Apple had shut down its store in Charleston, South Carolina, in August.

The company had earlier said it tests its employees on a regular basis and reopens stores only after testing each employee again.

“We regularly monitor conditions and we will adjust our health measures to support the well-being of customers and employees,” Bloomberg quoted Apple as saying.

First detected last month, the Omicron variant of COVID-19 now accounts for at least 73 percent of all new cases in the US, Reuters reported.

According to a Reuters tally, the US has seen a 26 percent rise in the average number of cases in the past seven days and 83 percent since the beginning of December.

US President Joe Biden said his administration would assist the states in battling the fresh wave of infections by increasing the vaccination capacity, distributing 500 million COVID-19 tests for free and mobilising military medical personnel if required, AFP reported recently.

Meanwhile, Apple has started limiting number of people in its retail stores to maintain social distancing and made it mandatory for all to wear masks across all stores in the US. It has also installed plexiglass dividers in its retail stores to protect employees.

To mitigate the risk of visiting a store, Apple is offering incentives for ordering online. The company has started an offer to get products in most metro cities delivered for free booked within a period of two hours. The offer will be open till December 24.

Sources

https://www.reuters.com/business/healthcare-pharmaceuticals/holiday-travel-plans-flux-americans-weigh-omicron-risk-2021-12-22/

https://www.livemint.com/news/world/us-to-deploy-military-personnel-to-fight-omicron-if-needed-11640081216298.html

https://www.livemint.com/companies/news/apple-temporarily-shuts-eight-stores-as-covid-cases-surge-among-employees-11640237727303.html

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

View | Omicron fears have just gotten worse; what lies ahead?

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The number of Omicron cases in the country crossed the 100 mark on Friday, triggering fresh fears of a third wave.  According to the Union Ministry of Health and Family Welfare, Omicron cases have been reported from 11 states and Union territories so far.

Maharashtra, with 32 cases, has added the most to the national tally, data from the ministry showed. Delhi, with 22 cases, had the second highest number of cases.

The government also issued advisories to avoid unnecessary travel and crowded spaces. Ever since Omicron became a ‘variant of concern’, guidelines were issued for states to take precautionary measures. On a daily basis, trajectory across the world, along with the emerging evidence, is being analysed to identify actions to be taken on priority.

Global threat

The number of daily Omicron cases around the world is increasing rapidly, particularly in the UK, Denmark, Norway, and South Africa. The countries with a surge in Covid cases are also reporting a high incidence of the Omicron variant.

The World Health Organisation (WHO) had recently warned that the Omicron variant spreads at a rate not seen with any other variant. 

“Currently, 77 countries have reported cases of Omicron, but the reality is that the variant is probably in most countries, although it has not yet been detected,” said the Director-General of the WHO, Tedros Adhanom Ghebreyesus, at a press conference.

The variant’s global spread suggests it could have a major impact on the COVID-19 pandemic, and the time to contain it is now, before more Omicron patients are hospitalised, Ghebreyesus said.

“We should not dismiss Omicron as mild. Even if Omicron does cause severe disease, the number of cases could once again overwhelm health systems. Based on current limited evidence, Omicron appears to be spreading at a faster rate not seen with any other previous variant. Emerging data from  South Africa suggests increased risks of infection with Omicron,” says Poonam Khetrapal Singh, Regional Director, WHO South-East Asia.

Vaccination vibrancy

The government needs to make a quick reassessment of its strategies and speed up the vaccination programme.   It is however not very clear whether the vaccine is effective against the variant or not.

A new study by Columbia University says the Omicron variant is “markedly resistant” to vaccines, and boosters might not do much to help, spelling bad news for the country as Omicron spreads and COVID-19 cases rise nationally.

“A striking feature of this variant is the large number of spike mutations that pose a threat to the efficacy of current COVID-19 vaccines and antibody therapies,” said to the study. 

The WHO on Friday issued an emergency use listing to Covovax, Serum Institute of India’s version of Novavax Inc’s Covid-19 vaccine. The agency said that Novovax’s own vaccine is currently under assessment by the European Medicines Agency, and will complete its own assessment of this vaccine once the EMA has issued its recommendation.

India currently has the highest vaccination rate in the world. The average daily doses administered in the country is 74.31 lakh, which is 4.8 times more than that in the United States and 12.5 times more than in the United Kingdom

The country has so far administered 82.82 crore first doses and 53.72 crore second doses. More than 136 crore doses have been administered in the country, which is 2.8 times the total doses administered in the USA (48.6 crore)

The epicentre

On November 26, the WHO designated B.1.1.529 a variant of concern (VOC) because of preliminary evidence of a detrimental change in COVID-19 epidemiology. As a variant of concern, it was named Omicron. 

In early November, scientists in South Africa identified the variant in a patient with COVID-19 from Botswana, a country that borders South Africa. Subsequently, the variant was detected in South Africa

According to WHO, Omicron has a large number of mutations, including more than 30 genetic mutations of the spike protein. The spike protein of SARS-CoV-2 is targeted by some of the currently approved COVID-19 vaccines; mutations in the spike protein therefore need to be closely monitored. 

Some mutations have previously been associated with increasing transmissibility and making it easier for the virus to bind and attach to cells.

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

COVID-19 vaccination: Doctors say not enough evidence yet to make case for booster dose

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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India has recorded over 22,400 new cases in the last 24 hours, the number of new infections has been hovering around the 20,000 mark for the past few days with a slight increase or decrease. Active cases have fallen by over 2,400, while recoveries have risen by 24,600. The single-day death toll now stands at over 300.

If we take a look at the pace of vaccination, it has lost momentum once again with just 43 lakh doses administered yesterday. The seven-day average for vaccination has also slipped to 58 lakh doses. As things currently stand, over 19.7 percent of the population has been fully vaccinated, and 51.6 percent has received at least one dose. The gross vaccination tally is now nearing 93 crore doses.

Global vaccine makers have started to seek approval for booster doses following studies that show immunity waning a few months after vaccination. The US is allowed the use of the third dose of Pfizer’s vaccine to people above the age of 65 and those at high risk of severe COVID-19 infection.

Also Read: COVID-19 pandemic cut life expectancy by years: Study

Johnson and Johnson has sought the FDA approval to allow extra shots of its vaccines. Apart from the US, Israel, UK and Germany are big countries that have allowed a third booster dose in Israel has even added booster dose mandatory for a complete COVID passport. However, the WHO said increasing global vaccination coverage should remain the top priority. It also has added that there is limited evidence on any widespread need for a booster dose.

Meanwhile, the Indian Council of Medical Research (ICMR) has not approved a booster dose in India so far. The question we are asking is should the government consider a COVID vaccine booster shot for those who are immune-compromised or for frontline workers? Is there evidence to consider waning immunity as being a real threat because just last week, there were reports of 30 medical students at Mumbai KEM hospital who had tested positive for COVID-19?

To discuss this in-depth, CNBC-TV18 caught up with experts, Dr Hemant Deshmukh, Dean, Mumbai’s King Edward Memorial Hospital; Dr Lancelot Pinto, epidemiologist and consultant pulmonologist, Mumbai’s PD Hinduja Hospital and Dr Rahul Pandit, Director Critical Care, Fortis Hospitals. Dr Pandit is also a member of the Maharashtra Covid Task Force.

Also Read: COVID-19 pandemic panic: Impacting individual’s travel decisions

Dr Deshmukh said what we had observed in the last entire week is that we were planning to have offline classes for the MBBS students in larger halls, “But unfortunately, what happened with the students is they dine a lot, they party a lot, they study a lot together and this creates a closed environment where a lot of students come together, discuss a particular topic in medicine and this is how probably the COVID virus has been transmitted from one person to the other.”

“The person responsible for this outbreak was only a single student, and he was probably had acquired infection somewhere outside KEM and this kind of transmission of the virus, which has happened within the campus is probably because of one index case and we got almost 31 patients tested positive. More than 90 percent of these students were isolated,” he added.

When asked about the status of vaccination of these students, Dr Deshmukh said out of these 31 who are tested positive, only one person did not get the vaccination. The others were vaccinated fully that is both doses were covered and the last dose that most of the students had taken was about two weeks back.

Dr Pinto said, “I don’t think anyone has convinced absolutely that we need to get booster doses right away. Three criteria need to be met to get booster doses. Number 1 whether we know that the possibility of infection increases with time since the second dose, and there is reasonable evidence to suggest that that is the case that breakthrough infections more commonly occur in those who were vaccinated a long time ago versus those who were vaccinated recently. Second is what percentage of these breakthrough infections tend to be severe, and we do believe that most of them still tend to be mild, even though a significant amount of time has passed since the second dose. The third is whether giving the booster will actually reduce the probability of severe infections in those who do get infected. We need all these criteria to be met before implementing a booster programme.”

“However, when it comes to frontline workers, we must also be cognizant of the fact that even if the infection in the frontline worker is mild, the frontline worker might be in touch on a regular basis with a lot of immunocompromised patients, and we don’t want to expose them to that infection. So there is a strong argument to preventing infections in frontline workers, even though these infections might be of a mild nature,” stated Dr Pinto.

Meanwhile, Dr Pandit said, “I don’t think the data is convincing enough right now to actually go and ask for a third dose or a booster dose what most of us call it for either frontline workers or for people who have got an immunocompromised state.”

For the entire discussion, click on the video

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow