Corona Daily 227: Parents Look Out

This week, the UK’s Royal College of Pediatrics and Child Health (RCPCH) warned eating disorders were on the rise among children and adolescents. This was based on a survey of forty pediatricians and child specialists in England. The number of their patients have tripled or quadrupled this year. Waiting lists are long and beds for patients in severe shortage. Children with eating disorders are appearing in advanced stages of illness. They have missed interaction with friends, teachers and doctors, any of whom may have noticed and pointed out the visible change earlier.

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The three key eating disorders are binge eating (eating too fast, too much, eating when not hungry), anorexia (fear of gaining weight, starving oneself to remain slim) and bulimia (binge eating followed by vomiting it out – some professional ballerinas are victims of bulimia).

Social media has aggravated the crisis by glorifying thinness and fitness. Forgetting that genetics also contribute to the size and shape of our bodies, many young girls fall victim to body comparison. Young boys, on the other hand, may get obsessed with a muscle-oriented body image or a six-pack abdomen. Modern teenagers know ratios like BMI (body mass index), and have weighing machines and apps to monitor them.

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Pandemic and lockdowns have made matters worse. Eating disorders are now considered a crisis in child mental health. Children are isolated with school closures, exams are postponed, sport activities cancelled, physical exercise is curtailed and replaced by increased screen time and social media. There was also an extensive media coverage further focusing on BMI and how overweight people are vulnerable to Covid-19.

UK pediatricians have identified two patient profiles in the pandemic time. One is the high achieving, ambitious, truly driven young girls. They had meticulously planned their future which is now in danger or shattered. The second type is those with personality disorders and problems with controlling their emotions.

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What symptoms should parents look out for?  (a) Child eating very fast (b) cutting food into small pieces (c) going to the bathroom or shower immediately after meals (d) hiding how much was eaten (e) significant weight loss or gain (f) avoiding meals with others (g) sudden change in diet (h) obsessive exercise (i) refusing to eat food previously enjoyed (j) use of negative comments about their bodies or other people’s bodies (k) wearing larger clothing (l) avoiding social situations (m) excessive fear of going out (n) skipping meals. (o) calorie counter apps on phones.

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Studies in the UK, USA and Netherlands suggest this crisis is widespread.  

In the USA, 9% of population (29 million) suffers from eating disorders. NEDA (National Eating Disorders Association) reported that in November, 72% more people were seeking help through online chats, as compared to previous years.

In Canada, some Olympic and Paralympic athletes became new victims of eating disorders. They had a set exercise and diet routine. With the Olympics postponed, and rigourous training halted, athletes are left confused, their diets disrupted.

Since September, there is a noticeable eating disorder spike among children in North America and Europe. To combat this crisis, school reopening should be a priority.

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This discussion is also relevant for adults. Our set routines, commute to the office and back, prime of the day spent in the office keep us away from food. Diet management is one of the lesser-known benefits of office-going.  Locked up at home, we need to be super-disciplined to manage diet, exercise and sleep. A bowl of chips can be quietly finished next to a business Zoom call. Fears about the virus and financial worries can cause retributive eating and drinking.

During new year parties, some people celebrate by binge-eating after midnight. What a way to start a New Year. If the curfew regulations can reduce indiscriminate eating while entering the new year, it will set a good tone for orderly eating in 2021.

Ravi 

Corona Daily 228: Fang Fang and Zhang Zhan

On 20 January, the 11-million strong city of Wuhan was gripped by fear. It was to face the first major lockdown of this year. A deadly, highly contagious virus had already taken fourteen lives and the state media was shifting its stance on the fatal virus with every new infection.  

Fang Fang’s first reaction was shock, followed by anger. On 25 January, the first day of the Lunar New Year, she logged on to her Sina Weibo account to write her first diary entry. It started with the words: Technology can sometimes be every bit as evil as a contagious virus. Fang Fang, 65, had had her account shut down before, not surprising in China. The first day’s post ends with the words: “Let’s see if this post is able to be uploaded.”

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In February, Zhang Zhan, a 37-year-old former lawyer, travelled 400 miles from Shanghai to Wuhan. She began going around Wuhan with her video camera and smartphone documenting what was happening on the streets. She tried to talk to people, but many refused to talk in front of the camera, requesting that it be directed at their feet instead. Police sometimes stopped Zhang asking her what she was filming and why. Zhang was not an accredited journalist. She was a street reporter, better known as a Citizen Journalist. She videorecorded the overflowing hospitals, empty shops, and the Wuhan Institute of Virology. Her filming of crematoria suggested people were cremated day and night, far more than officially reported.

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Fang Fang began posting an entry every day. This was a candid first hand account of a Wuhan resident. The simple straight-from-the-heart prose went viral. Tens of millions of Chinese readers would stay up late each night just waiting to read the Wuhan diary’s next installment. She continued to write for two months.

Michael Berry, a professional Chinese-English translator, was one such reader who decided to share the diary with the world by translating it into English.

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Zhang Zhan was uploading her video clips on WeChat, Twitter and YouTube. Twitter and YouTube are blocked in China. In February, Chen Qiushi, who had live-streamed videos from Wuhan during the city’s lockdown and posted reports on social media, disappeared. Two other independent journalists were detained. Zhang began questioning the authorities about the detentions and disappearances.

In March, China expelled thirteen journalists from the New York Times, Washington Post and Wall Street Journal. Their crime was to criticize China’s initial response to the coronavirus. Beijing said the journalists were dispatched because of US restrictions on how Chinese State media operates in the USA.

Zhang continued to do her bit, until May 2020, when she too was arrested.

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Fang Fang had planned sixty entries. On the last day, coincidentally, the government announced Wuhan would reopen on 8 April. On that day, websites in the US uploaded pre-sale information for the English edition of Wuhan Diary, written by Fang Fang, translated by Michael Berry.

In the introduction, Fang describes the whole thing to be a dream, as if the hand of God had been silently arranging everything behind the scenes.

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Zhang Zhan was in jail without being charged until November. After she announced a hunger strike, she was handcuffed and force-fed through a tube in her throat. On Monday, 28 December, she was brought to the court room in a wheelchair. She was charged for “picking quarrels and provoking troubles” (article 293 of China’s Penal Code). The court sentenced her to four years in prison. Her mother who was present, sobbed.

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I wonder why the Chinese state treated the two women so differently. Age? Or material presented - is textual matter less dangerous for the state than the visual?

In terms of quality, Zhang’s clips look ordinary. The Chinese clips are without subtitles, and in many, she simply talks facing the camera. Her viewership was small. That can’t be the reason to put her behind bars for four years.

Wuhan Diary is short, honest, readable, in a book format. That may have kept Fang Fang free, while Zhang Zhan languishes in prison.  

Ravi   

Corona Daily 229: The Year’s Biggest News Story

In April this year, the few times I ventured out on the roads, shopping bags in hand, a mask covering my face; the talk on the streets stunned me. Whether the conversation was between people I knew or strangers, there was only one topic: the coronavirus. Nobody talked any longer about cricket, Bollywood, politics, TV debates, border skirmishes, illegal immigrants – nothing, just the coronavirus.

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The Economist published a fascinating analysis in its last week’s issue. It tried to answer the question: has the covid pandemic been the biggest news story ever? The Economist was founded in 1843. The magazine has all issues available in digital form for the past 178 years. Its editors requested the New York Times to join in the research. The New York Times made its archives available from its starting year 1851.

The research analysts combed through every article published in those two newspapers by inserting keywords for each year. (Exhausting, but not impossible any more in the digital world).

Economist published its first article on the novel coronavirus on 16 January. At the end of January, covid-19 appeared on its cover. Between February and April, ten consecutive weekly issues had virus on its cover. By late March, 80% of the published stories in Economist included the word covid-19 or coronavirus.

In 2020, covid-19 related stories had a 47% share in Economist and 46% in the New York Times.

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The same analysis found that the Great Depression in the 1930s and the 2008 crash had news coverage of less than 20%. The Y2K problem was the big story of the year, but could reach only 30%. The words internet and online, although a rage in the twenty-first century, have never figured in more than 20% of the stories in any year. The fall of the Berlin wall (1989) was mentioned in less than 10% stories. Fall of the British Empire with India’s independence in 1947 was surprisingly little worthy of news. The Spanish flu’s (1918-20) coverage on both sides of the Atlantic was fairly limited.

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In the past 170 years, only two stories were bigger in The Economist.

The First World War was obviously not called that until the Second World War happened. The share of Economist stories referring to the Great War, as it was called then, reached 53% in 1915.  The Second World War was also in the news throughout, reaching 54% in 1941. Since America was an ocean away from the wars, the New York Times stories with the word “war” peaked at 39% (1918) and 37% (1942).

Covid-19 is the biggest story of the year ever for the New York Times, and with the exception of the two World Wars, for The Economist.

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Newspapers are often accused of focusing on bad news. I think that is simply a reflection of human nature. When we gossip, we rarely compliment the absent people we talk about. Similarly, public fear since the start of the pandemic is often reflected in the newspapers.  

In March, tabloids often used the phrase “killer virus”. One article in The Telegraph reproduced on-the-ground reports from Wuhan: “Mask-wearing patients fainting in the street. Hundreds of fearful citizens lining cheek by jowl, at risk of infecting each other, in narrow hospital corridors as they wait to be treated by doctors in forbidding white hazmat suits. A fraught medic screaming in anguish.”

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Here is wishing that covid-19 is no longer the biggest news story in the forthcoming year.

Ravi 

Corona Daily 230: Israel Wants Selective Shoulders

On Saturday, 19 December, Israel’s PM Benjamin Netanyahu received the first vaccine shot in Israel. Israel’s “Give a Shoulder” campaign has secured four million doses of the Pfizer vaccine. Israel will issue “green passports” to the vaccinated, to allow them greater freedom of movement. Netanyahu boasted he had managed to call Albert Bourla, Pfizer’s CEO, at 0200 am to clinch the vaccine deal for Israel. (Albert Bourla is a Greek Jew).

Since 1967, Israel has occupied the Palestinian land of East Jerusalem, the West Bank and the Gaza strip. Who is going to vaccinate this population? Israeli health minister Yuli Edelstein rejected it was Israel’s responsibility- moral or otherwise. He admitted it is in Israel’s self-interest to vaccinate the neighbour who sends thousands of workers into Israel every day but said nothing will be done for non-Israelis until all 9 million citizens of Israel are first inoculated. “We can’t deny an Israeli citizen a vaccination because we want to help someone else.” he said.

The Give a Shoulder campaign includes Jewish settlers inside the West Bank, but not its 2.5 million Palestinians.

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Israel and the Palestinian Authority have struggled to contain the outbreaks. Tens of thousands of Palestinian labourers employed in Israel have transmitted the virus there and back. Israel has reported more than 370,000 cases, and 3,000 deaths. The Palestinian Authority has reported more than 120,000 cases with 1,100 deaths.

More than 25,000 Palestinian children born during the pandemic have not had their birth registered by Israel.

The Gaza strip, variously described as a concentration camp, a crime against humanity, a collective punishment, is in grim condition. Its two million residents include those in the refugee camps. Almost 86,000 Palestinians, living on average 12 per apartment, are packed within a quarter-square-mile of density, ready-made for a coronavirus explosion.

Gaza gets about 8 hours of electricity every day. It suffers daily rolling blackouts and unsafe drinking water. Power cuts severely affect hospitals and infrastructure. Its 60 ICU beds, and an emergency 38-bed field hospital are full. Supply chains are broken. WHO usually sends humanitarian help from Dubai via Jordan. Supplies of vital equipment, including respirators, are hampered.

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Palestinian leaders say they can’t afford the Pfizer vaccine ($20 a dose) or Moderna ($30 a dose) even if they were to become available. Palestinians have only a single refrigeration unit, in the oasis town of Jericho, capable of storing the Pfizer vaccine.

Russia reportedly plans to offer 4 million doses of Sputnik-V in future. Palestinians have requested UAE to share with them the Chinese vaccines. Whatever arrangements are made, Israel will be the deciding authority. The Israeli regulators must review and approve the vaccine before it can enter the Palestinian territory. Unapproved vaccines can be stopped at checkpoints.

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The Israeli citizens, including those in the occupied West Bank, will get the recognized, approved vaccines. As a humanitarian measure, Israel may allow Russian or Chinese vaccines to be delivered to the Palestinian territories. The apartheid character of the Israeli regime is further highlighted by the vaccine double standards.

The coronavirus knows no geographical or racial boundaries. Israel’s economy needs thousands of Palestinian labourers shuttling to work in Israel every day. It is naïve on Israel’s part to think the selective vaccine policy will work.

Ravi 

Corona Daily 231: Travel Nurses

Laura Liffiton, a 32-year-old nurse, worked in an overrun ICU in a crowded New York city hospital in April. In July, she flew to Arizona, where she lost four patients on her first day. In October, she travelled to Green Bay, Wisconsin. She has been sleeping only four hours a night. In different cities, she has seen overwhelmed doctors and nurses, lines of intubated and dying patients, with no end in sight to the misery of the situation.  

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Laura is one of the fifty thousand or so travel nurses in the USA. They work on temporary contracts, and move from city to city. For some, travelling is the motivation, for others money. Early-career nurses want to work in different places to gain experience. Those nearing the end of their careers, with little family burdens, want to use their last few years of work to increase their retirement savings. In normal times ICU and medical surgical nurses are the highest in demand.

Specialised agencies bill the hospitals and provide the “travelers”, who stay in hotels, Airbnbs or rented apartments. They usually stay in one place for three months. The three months were historically granted as a maternity leave, during which a travel nurse would replace the one on maternity leave.

When natural disasters such as hurricanes or tornadoes strike, travel nurses serve a useful function. They reach the hot spot, work in the disaster zone, and then leave.

What is happening this year is unprecedented. In November, the demand for travel nurses went up by 44%. California, Texas, New York, Florida and Minnesota are the five states with the worst shortages.

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Now, more than 100,000 Covid patients are hospitalized every day in the USA. Ordinarily a nurse, particularly in ICU, serves a maximum of two patients. Now, nurses are looking after eight. The governor of North Dakota has allowed covid-positive doctors and nurses to continue working, as long as they are asymptomatic. The University of Utah hospital has been using 36-hour shifts for nurses and the state of Iowa has run out of staff beds.

In summer, travel nurses were mainly needed to help in operating rooms on postponed cases and backlogs from the spring wave. In normal times, hospitals scrutinized the resumes to carefully select the best candidates. Now they specify only the number. Like the rush to get the vaccines, there is a rush to get the travel nurses.

The dynamic between the staff nurses and travel nurses is complicated. In a Sacramento hospital, only staff nurses were given higher quality equipment such as air-purifying respirators. With travel nurses earning substantially more, staff nurses are bound to feel upset. Some of them have left their permanent staff positions to become travelers.

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The prices for travel nurses are skyrocketing. Before the pandemic, hospitals would pay $75 an hour, now it is three times more. A traveler can earn anywhere from $5000 to $10000 a week. On top of that, now hospitals are asking for travelers for vaccination. Joe Biden wants America to give 100 million shots every month. Rural hospitals are struggling to find money to pay the high rates for travelers.

The never-ending work is risky. One organization has identified 922 frontline health workers who died of covid after helping the patients.

High pay has drawn more supply, but because this profession requires training and qualifications, there is a limit to the supply. There just aren’t enough nurses. The agencies are shuffling nurses in what they call robbing Peter to pay Paul.

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In my view, the USA needs to take the extraordinary step of expanding the travel nurse concept to nurses from overseas. Countries like India and the Philippines, with relatively fewer cases now, would be able to provide a few thousand nurses on an emergency basis.

Ravi 

Corona Daily 232: The Strange Case of Ice Hockey

Against all odds, Canada is hosting the 2021 World Junior Ice Hockey Championship in Edmonton. Starting on Christmas day, and culminating on 5 January, it will be held behind closed doors, in other words no spectators allowed. All teams are held in an Edmonton bubble with strict regulations.

This week, eight German players tested positive. Germany’s training matches against Austria (21 Dec) and Czech (23 Dec) are cancelled. Two members of Sweden are also in isolation. Two American players were sent home. Three weeks ago, Hockey Canada had to suspend its selection camp and quarantine all players for fourteen days, after two players tested positive.  

These are the under-20 players. As we know, the coronavirus has little impact on the young. Moreover, these are some of the fittest kids in the world. But ice hockey has been plagued by an astoundingly high number of cases. 29-year-old Tyler Amburgey was the coach of two hockey teams. In August, he initially caught a cold from the chill of the ice rinks. This was not unusual, he had it every year. It progressed to a headache, fatigue and shortness of breath. Thirty kids he had coached had tested positive. On the third day, 29 August, Amburgey died.

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Scientists are studying hockey-related outbreaks to learn why hockey players are getting infected so often. Several theories have been suggested.

Hockey players are sprinting the whole time on ice. This leads to heavier breathing resulting in more particles being inhaled and exhaled.

One theory is that the spaces occupied by the rinks keep the virus suspended, possibly at the height of six to nine feet above the ice. Similar outbreaks were documented at other super-cold venues like meat processing factories.

This is an indoor game. The rink is surrounded by plexiglass to prevent errant pucks and keep the game dynamic (unlike soccer which pauses once the football goes beyond the marked line). The plexiglass keeps the airflow stable, and ice cold. Ice rinks are designed so that there is little ventilation or humidity. It seems like an ideal ground for the coronavirus.

Lab experiments have shown that at 86F (30C) the airborne virus takes 52 minutes to decay, at 50F (10C), it takes 109 minutes, more than double the time.

When humidity is high, the virus attaches itself to bigger droplets and falls to the ground due to the heaviness of the humid drops. (if true, I am happy about the high humidity levels in Mumbai). When the air is dry, the droplets evaporate into small size particles and stay in the air. Lingering at a height of six feet above the ice, they can easily enter the nostrils of the hockey players. Research has also shown that in general, cold temperature and low humidity can make some people more susceptible to viruses, possibly because of lowered immunity.

I must emphasise these are theories and speculations at this stage. But the high number of cases among the ice hockey players is a fact. The tragic death of a 29-year-old coach is also a fact. Ice hockey involves vigorous physical exertion accompanied by deep, heavy breathing. During the game players frequently move from the ice surface to the bench while still breathing heavily.

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Although the International Ice Hockey Federation has cancelled most events by now, the World Junior Championship starting next week is an exception. Governors of seven American states, including New York, New Jersey and Connecticut have banned competitive hockey until the end of January.

Investigating the case of ice hockey is essential because it may offer valuable clues about the behaviour of the virus. It may explain why things are so bad in Europe and America in winter time, and so dramatically improving in hot and humid Mumbai.

Ravi   

Corona Daily 233: Executions in a Hurry

America eagerly waits for 20 January; the day Joe Biden will be sworn in. Three Americans; Lisa Montgomery, Cory Johnson and Dustin John Higgs most anxiously await the Biden inauguration, although they realise their chances of witnessing it are slim. The Trump administration has set their execution dates on 12 Jan, 14 Jan and 15 Jan respectively.

USA, Japan and India are the only three democracies that have retained capital punishment. USA executes the most. In the USA, 22 states have abolished the death penalty. Twelve other states have not executed anyone in the past ten years. Other than the states, the US federal government justice system can also impose a death penalty.

For the last 17 years, not a single federal execution had taken place. With great vigour and enthusiasm, Trump set about changing all that. In July 2019, his Attorney General announced the resumption of federal executions. This year, the virus spread is rampant in the prisons. Nationwide, more than 6000 inmates and 1700 prison staffers tested positive. But without losing focus, during the pandemic, the Trump government carried out more executions than all states combined, a first such instance in history.

As per an unwritten convention, during the transition time, the outgoing president pauses all executions. In fact, Clinton and Obama commuted some death sentences to life imprisonment. Trump broke the tradition of 125 years. Since his losing the election in November, three men have been executed, two of them last week. Trump will also have the honour of facilitating the federal execution of the first woman since 1953.

Lisa Montgomery’s life has been prolonged by the coronavirus, which by infecting her attorneys, caused the postponement of the execution date to 12 January. Dustin John Higgs, due to be executed five days before the Biden inauguration is now corona positive himself. He doesn’t even know the method of his execution.

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A three-drug cocktail delivered through a lethal injection was commonly used in the past. Barbiturate acted as a sedative and painkiller, vecuronium bromide was the neuromuscular drug and potassium chloride was added to stop the heart. The problem with lethal drugs is that no human trials can be conducted. In 2014, Oklahoma officials gave Clayton Lockett an untested cocktail of drugs that tortured him for 43 minutes.

Trump’s Attorney General announced federal executions will now use pentobarbital. This is not without problems either. Lundbeck, the European manufacturer, has not sold the drug to the US since 2011. Last year, Texas inmates injected with locally made pentobarbital writhed on the floor, screamed in pain and felt themselves burning. America can detonate atom bombs and kill 200,000 people, but it struggles to execute individuals on the death row.

Undeterred, the Justice Department last month issued new regulations that allow more methods for federal executions including electrocution and the firing squad. In case suitable killer drugs are not available, the planned January executions may happen through any of the other methods.

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Under Operation Warp Speed, correction officers are included in the first round of vaccine distribution along with health care workers. (I wonder if death row inmates are given vaccines).

Prisons continue to test death row inmates and are isolating those who test positive. Dustin John Higgs is now isolated. The priest who talks to him regularly said Higgs won’t be able to meet his relatives during the final weeks of his life.

Joe Biden has declared he is opposed to the death sentence. If the lawyers of the three inmates manage to delay the executions beyond 20 January, the three may live a long life. To prevent that, Trump will try to be precisely punctual and efficient.

Ravi 

Corona Daily 234: Women Less Keen to Get the Vaccine?

An interesting article in yesterday’s Washington Post talks about three US surveys published this month asking Americans about their intentions to get vaccinated. Surprisingly, all three, the Pew Research, the National Geographic Survey and the Gallup poll concluded women were less likely than men to get the vaccine. In a fourth poll, the Reuters/Ipsos poll, 35% of women said they were not very or not at all interested in getting vaccinated. The NatGeo survey had the largest gender gap (men 69% likely vs women 51% likely). All four surveys were American, but the reasons could be universal.

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Cary Funk, the author of the Pew research talks about unrelated past studies. In them, men were generally very enthusiastic about new genetic technologies. Women adopted a wait-and-watch approach. It is possible, Cary Funk says, the doubting women may get vaccinated eventually, but not now.

Most trials exclude pregnant and breastfeeding women. Young women who are or want to be pregnant think about their babies as much as about themselves. In most societies, women don’t get credit for conception, but are blamed for miscarriages. This is one possible reason why many young women would stay away from the unproven vaccines.

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Ruth Faden, a bioethicist at Johns Hopkins, describes women as the guardians of the family. It is the mother, rarely the father, who makes sure the child takes the right vaccines on time. Mothers are particular about visits to the pediatrician. Their maternal instinct makes them read up on new research, and discuss it with other mothers.

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Nancy Tomes, a history professor offers a history perspective. Like Ruth Faden, she confirms women were historically responsible for protecting their families against microbe threats. Women, more than men, wear masks to protect others. But they are discerning when it comes to drugs and vaccines because most medical experience comes from a “male perspective”, medicines created by men, for men. Tomes gives the example of the early birth control pills (invented by men) that had much higher hormonal doses than needed. Women on pills complained of nausea, headaches, dizziness for which men called them hysterical.

Women were excluded from HIV drug trials. Only as late as in 1993 did the US congress pass a law, making women’s inclusion in clinical research mandatory. Light female bodies may react differently to vaccines and drugs than heavy male bodies. Women have had many reasons to distrust medical science. I earlier wrote about the syphilis experiment conducted on black men. Gynecological procedures were forced on enslaved black women.

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The incredible speed with which 95% effective vaccines have appeared has not helped. Since no long-term effects are known, I believe some women may want to wait long enough to monitor the safety record.

The Pew research also found a correlation between the possibility of covid-related hospitalization and vaccination intent. People worried about landing in hospital (and then who knows what) showed greater willingness to get the vaccine. It is well known that in this pandemic men are getting hospitalized and dying in far greater numbers than women. This could be a reason why women are less willing. The risk-benefit analysis in their mind makes the vaccine not worth the risk yet.

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The two most effective vaccines so far, Pfizer and Moderna, are based on mRNA, a new technology. The credit for its creation goes to Katalin Kariko, an American woman of Hungarian origin. The technology of another vaccine, Novavax, is invented by a team of all-women scientists. The leader of that team is Nita Patel, an Indian who emigrated to the USA.  Women like them can be invited to campaign for creating more trust in the vaccines. Vaccines are no longer made by men, for men.

Ravi 

Corona Daily 235: Antacid Shortage causes Heartburn

In April this year, developed countries faced shortages of a variety of products. Supermarket shelves were empty of toilet papers. The reason was hoarding, rather than increased use, of toilet paper rolls. Demand for hand sanitisers, masks, bottled water, thermometers suddenly shot up. They were out of stock at different times. One more product has been frequently in short supply.

Antacids.

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Heartburn occurs when acid in the stomach flows up into the esophagus (food pipe) and causes pain that moves from the stomach to the chest. For a variety of symptoms such as heartburn, acid reflux, indigestion, gases, bloating, stomach ulcers and gastritis; antacids are offered as a medical remedy. They contain calcium, magnesium, aluminum salts which work to neutralize the acids in the stomach. Antacids are sold in a variety of forms – tablets, liquids or chewable gummies. Gelusil, Eno, Gaviscon (India), Tums, Pepcid and Famotidine (USA) are well known antacid brands.

What causes heartburn or acidity? The list is long: Fried and fatty foods. Acidic foods (like lemons or tomatoes). Chocolate. Alcohol. Peppermint. Caffeine. Sodas (carbonated drinks). Acidic juices. Table salt. Spicy food.

In short, any food and drink we love is liable to give us some form of acidity, indigestion or heartburn. Mental stress can also cause all of these symptoms.

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In April, as we all remember, the world was frantically conducting studies to find out what may work against the coronavirus. In a hospital, a set of researchers administered nine times the usual dose of famotidine (antacid) intravenously to covid patients. All 187 patients were in a critical stage. The crude study found out that covid-19 patients on famotidine were dying at a rate of 14%, those without at 27%. After the news of the study became public, American pharmacies like Walgreens and CVS sold all antacid stocks within two days.

Before that, on 1 April, FDA banned Ranitidine, popularly known as Zantac. It was an easy to buy, over the counter drug. Investigation showed it can cause cancer if stored for a long time before consumption. Americans were asked not to buy Zantac, and throw away whatever stocks they had at home.

Over the next few months, the pandemic stress grew. Diet composition changed dramatically. Working from home and little exercise meant extra kilos that caused heartburn and acid reflux. Under depression and a cloud of fear, people who could afford it increased the consumption of booze, sweets, comfort food, takeaway pizzas and fizzy drinks. Johnson & Johnson, makers of Pepcid, confirmed sales of Tylenol, Pepcid and other antacids grew by 30%.

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India is known as the pharmacy to the world. Antacid tablets are unusually cheap – one US dollar can buy 200 tablets in India.  Sun Pharma, Cadila, Torrent sell about 70 million tablets annually. Thanks to Trump who was busy advertising a variety of quack treatments, India managed to produce and export large quantities of hydroxychloroquine (now rejected by both FDA and WHO), paracetamol and famotidine. In October, when Trump was infected, White House confirmed he was taking famotidine along with Zinc and Vitamin D. After that announcement the sales and shortages of famotidine suddenly grew. (Don’t forget 74 million Americans voted for Trump).

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The November elections caused unbearable stress and fear about Trump not winning (Trump supporters) and fear about Trump winning (Biden supporters). With the winter wave in North America and Europe, stress levels are sufficiently high for antacids to be out of stock once again.

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Antacids may have only a short-term effect. Several stomach discomforts are aggravated by continuously thinking about them. In my view, it is better to accept the reality of the pandemic stress and lifestyle, learn to live with the heartburn, rather than get addicted to any form of antacids.

Ravi 

Corona Daily 236: Fruits of Lockdown Gardening

In 1526, the English king Henry VIII and his chief advisor, Cardinal Thomas Wolsey, reformed England’s coinage to regulate the kingdom’s economy. In that project, the Tudor king introduced gold crowns, with a difference. They bore the initials of the queen, Catherine of Aragon.

Seven years later, Henry VIII wished to divorce his wife. This desire changed the course of England’s history. Since pope Clement VII wouldn’t allow him to divorce, Henry VIII formed his own church: The Church of England. He became its supreme head. Many catholic convents and monasteries were dissolved. The king proceeded to marry Anne Boleyn, and the Royal Mint issued a new set of coins with the letter “A”.

Three years later, Henry VIII accused his wife of adultery, incest, witchcraft and conspiracy to kill him, and arranged her infamous beheading. Having gotten rid of her, he ordered the mint to produce “J” initialed gold coins, dedicated to his new wife, Jane Seymour. She died in a year’s time, in the process avoiding both a divorce and beheading.

Henry VIII married three more times, but the Mint was not able to keep pace. There is no record of this numismatic novelty for the last three marriages.

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During the April lockdown, with nothing better to do, a New Forest family in Hampshire, UK was weeding their flowerbed. All of a sudden, they discovered 63 gold coins and one silver coin from King Henry VIII’s reign. The treasure included coins with the initials of the king’s wives.  

The Museum experts have offered two possibilities. It could be a merchant’s hoard. This part of the world was wealthy. Wool trade was important. The New Forest is close to the coast, so someone involved in maritime trade could have hidden it.

The other possibility is the monasteries. When Henry VIII started dissolving or demolishing them, some monasteries and churches tried to hide their wealth in the hope of recovering it after several years. They didn’t, but some lockdown gardeners recovered the gold pot after almost five hundred years. The total value of the gold coins is more than 14,000 pounds in today’s money.

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Another gardener found a mystery hoard of 50 gold South African Krugerrands from the 1970s, worth about 75,000 pounds. This was discovered in a Milton Keynes garden. How the coins ended up there will be determined by the coroner.

The British museum has said more than 47,000 treasures were unearthed in pandemic times. They include a unique Roman furniture fitting with the well-preserved face of the god Oceanus and a medieval forgery of a bishop’s seal matrix. In Herefordshire, one resident dug out a snake-shaped belt hook from the post-medieval period. Another local found a late medieval ring on top of a molehill.

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England has a law about “Treasures”. If you find something in the garden, or anywhere else, that contains gold or silver, and is at least 300 years old, you must report it to the coroner of the district within 14 days. Not doing so can attract an unlimited fine or 3 months of prison. On the other hand, you may get a share of the reward, if you are the finder and had the permission to be on the land and acted in good faith. (Archeologists are not entitled to any reward, because it is their job).

England now wants to expand the definition of treasure to include other items. For the benefit of society, it is important the items land up in museums rather than private collections. In Scotland, you must hand over whatever you find, and the authorities decide whether it can be considered a treasure trove.

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Those who live in city apartments have little chance of digging in the lockdowns. I suggest they clean the house in the lockdown. It is surprising how many treasures one comes across during the cleaning.

Ravi 

Corona Daily 237: Displaced People of the Developed World

The Sydney opera house has reopened. Nearly 40,000 spectators attended Sydney’s rugby league grand final. India and Australia are playing cricket in front of filled stands. Australian workers are being urged to return to their offices.

Australia is considered a real pandemic success story. However, at least 36,875 Australians wouldn’t agree with that assessment.

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In February, Kate and David Jeffries travelled with their infant son from Perth to Canada to care for David’s elderly mother. She was diagnosed with ovarian cancer. Today, ten months later, the Jeffries are still stranded in Canada.

Desalyn Bowyer, 40, moved from Sydney to Hong Kong last December for work. Her office allowed her to return to Sydney every two weeks to spend time with her kids. She has not met her children since February. In July, her father died. She couldn’t attend the funeral.

Yuvraj Krishna, a four-year-old boy with autism is stranded with his mother in India. His mother had air tickets to return to Sydney in April. She checks the booking sites three times a day. Yuvraj’s case is concerning. He has missed his therapy sessions since March, and has lost his faculty to speak. A therapist attributed that to his closeness to his father. His father, Rahul, alone in Sydney, is now on medication for depression and high blood pressure.

Australians are stranded in Canada, USA, Europe and India. They are the displaced people of the developed world.

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The Australian economy depends a lot on China. That could be one reason why Australia took the coronavirus very seriously right from the start. Their closing of the borders was draconian. Since 20 March, residents need a permit to leave or enter the country.

Arrivals are capped. Anyone flying in to Australia has been subjected to a 14-day quarantine at their own expense in specified hotels. The arrivals are therefore limited by the capacity of quarantine hotels. The weekly cap has slowly gone up to 8000 now. In January, 2.3 million people flew into Australia. In September, only 16,720.

Mr Den Heten, one of the stranded Australians started a website removethecap.com. It visually conveys the trauma and delays experienced by Australians trying to return home. The website already has stories of 2831 families from 170 countries.

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Several flights were cancelled. Those that operated offered only first class or business class tickets. An America or Europe ticket to Australia would cost $15000. Some airlines played the game of selling tickets for flights that were cancelled, and then taking months to process the refunds. To add to it, every person arriving must pay $3000 for quarantine. Desperate Australians offered to wear electronic ankles at home instead. That suggestion was rejected.

Since July, stranded Australians should register themselves at DFAT (department of foreign affairs and trade). Unless notified, they can’t leave for Australia. The number of stranded is of those who have registered. Every month the number grows because more people register. In India alone, 10000 are reportedly stranded.

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The right to enter your own country is considered a human right. In 1980, Australia signed the International Covenant guaranteeing such a right. Separation of children from parents is considered another breach of human rights.

Australia’s Prime Minister Scott Morrison has promised to get back all stranded Australians by Christmas. That is now unrealistic. Many Australian homes will have empty chairs at Christmas gatherings. The problem is now compounded. Those stuck in North America or Europe are unable to leave their houses because of the new lockdowns. They are unable to make it to the international airport.

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If Australia is a pandemic success, it has come at a high price. It is the only place in the developed world whose citizens are displaced as a result of the actions by their own government.

Ravi