Corona Daily 381: Cuddle Puddles

Since 2004, when two relationship coaches founded a Cuddle Party in New York, professional cuddlers and cuddling organizations have been doing good business. Cuddle parties also known as cuddle puddles or snuggle parties have girls and guys cuddling together for extended times. Usually written consent is essential before a session starts. Everyone must be fully clothed. No sexual touching is allowed. (There are other parties and clubs for that).

Cuddling allows our bodies to release a hormone called oxytocin. That in turn helps reduce blood pressure. In the absence of physical contact, people may experience loneliness, depression, anxiety disorders and stress.

Social distancing is the enemy of cuddling. Lockdowns have presumably locked down the oxytocin within us, raising our blood pressure. Cuddle parties have stopped. Now professional cuddlers are trying to arrange virtual cuddling sessions. Cuddle Sanctuary will run a virtual cuddling workshop on 30 July. Its certified professional cuddlers normally charge $80- $100 per hour for one-on-one cuddle sessions. Now they are training their clients to simulate an embrace on Zoom. Franzblau, Cuddle Sanctuary’s founder, asks clients to lie on their side with one arm stretched under their head and the other near torso. In that position, clients are requested to recall a pleasant cuddle from the past. Some cuddlers are suggesting an eye-to-eye contact on the screen. If done deeply, the eye cuddle may create an emotional togetherness to a level where oxytocin is released.

The benefits of virtual cuddling are unknown, but Cuddle up to me, Cuddlist, Lovedome, Cuddleparty are trying to make the most by charging clients in these pandemic times.  

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In Israel, the Apollonia national park has advised people to cuddle trees. Trees after all are living organisms. The park now arranges daily tours for tree-huggers, giving the word a new positive meaning.

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A group of psychotherapists conducted a study in June to find out whether sleeping in a cuddled state has any benefits. They took a dozen couples, and asked them to sleep together for a few nights, and alone for a few. Both times, through attached censors, they were subjected to polysomnography. The study found that co-sleeping allowed 10% more REM (rapid eye movement) sleep. REM is the part of our sleep where we dream. Sharing a bed improves sleep for both partners, according to the study.

My one concern with the study is that all selected couples were in an age group 18-29. What happens to older couples? I remember reading somewhere that in Buckingham palace nobody shares a bed. They visit the room of their spouse when required, but return to their own room to sleep. I wonder if Prince Charles has any problems with his REM sleep.

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One practical and useful invention of the pandemic is the Cuddle Curtains. They are essentially plastic sheets with armholes. Usually made from shower curtains, the lockdown-friendly cuddle curtains are fast gaining popularity in Europe. Particularly in nursing homes. A British plasterer Anthony Cauvin uploaded a clip showing him hugging his grandmother on Youtube.  A social media sensation, the touching video got more than eleven million views in the first week.

Ravi 

Corona Daily 382: White Flags

In August 1998, Russia was hit with its worst financial crisis. Banks became bankrupt. Inflation was a record 84%. Pensioners could buy one loaf of bread and two liters of milk with their monthly pension. I lived and worked in Moscow then. My house was only a couple of miles from the Red Square. I often took evening walks to the Kremlin and back. Once I was returning via Bolshaya Nikitskaya. It was cold and dark as it generally is during autumn.

On that relatively empty street, I saw a row of young Russian women standing. Probably in their twenties, some even underage, they stood next to each other. The display of white Russian women was half a mile long. As I learnt the going rate was $10, because the supply far exceeded the demand. Most had arrived from neighbouring suburbs or small towns, many from decent families. Lots of them would not dream of doing anything similar before the financial crisis.

That long line of young Russian women is a flashbulb memory I cannot forget. It made me understand what hunger means. It can destroy human dignity. It can make a woman solicit clients on the street for ten dollars.

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In Guatemala, for the past few months, people stand on the streets waving white flags to denote they are hungry. Passing vehicles or pedestrians can offer food or money. With 65% population in poverty, the poor have neither savings nor social security. The emergency is colour coded by flags. White is hunger, red for medicine, and black/yellow/blue signal a woman, child or elderly person in danger of violence.

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Chronic hunger is defined as going to bed hungry. (Citizens of many rich nations have a reverse problem). 821 million in the world are chronically hungry. 265 million faring worse are on the brink of starvation. If not addressed urgently, the hunger crisis generated by the pandemic may result in 12,000 people dying of hunger every day. That is twice the number of people dying of Covid-19. United Nation’s goal of eradicating hunger by 2030 is in serious danger. UN has requested $10.3 billion to fight pandemic hunger.

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UN proposal for global ceasefire during pandemic was wilfully vetoed by USA. In the world’s hot spots, including Yemen, Afghanistan, Syria and South Sudan, the food crisis is aggravated by border and supply route closures. In Yemen, people are surviving on bread and tea. Unable to access even potatoes, they are scared of the food prices, not the virus. These four countries along with Congo, Venezuela, Ethiopia, Sudan, Nigeria and Haiti have the worst hunger crisis. Their combined population is 135 million.

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Many of us are exposed to media owned by USA or Western Europe. We look at their news, their stock markets. Don’t get fooled by those numbers. USA, EU and UK have given unprecedented aid to their citizens and companies. That creates an illusion of life returning to normal. But 86% of the global population lives outside of North America and EU/UK. Life can be very different there.

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Even in the USA, a staggering 43 million now receive food stamps. If the current $600 a week aid is not extended beyond July, another 20 million will join the queues for food. India has wisely announced free wheat, rice and pulses to 800 million till November-end.

Throughout the pandemic, the world must focus on providing free food to as many people as possible. Making people beg, or making women sell their bodies for food is inhuman. 

Ravi

Corona Daily 383: Should Schools Open or Not?

Currently, the raging debate is whether to reopen schools. Yesterday, parents and teachers jointly sued the Florida governor over the order to reopen Florida schools. England has announced every school will open on 1 September. At present, 107 countries have country-wide closure of all schools and colleges. More than a billion students are affected.

Much is written about distance learning, and the unequal access to it. The mental health of children stuck at home for months. Cancellations of exams and fear of missing an academic year. The plight of special or disabled children. Domestic violence. In poor countries, children missing free meals at schools.  

The politicians debating this issue rarely have children in mind.

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Politicians are worried about the economy. About GDP numbers, houses and cars sold, unemployment rate. For the economy to work, factories and offices must function smoothly. Transport must run. For workers to report to work, someone must look after their young children. In developed nations, the family size is small. Sometimes fathers drop the kids to school on the way to work; mothers pick them up on the way back. This arrangement works very well in normal times.

Traditionally, there are more women in nursing jobs than men. As a result, 70% of health care workers are generally women, many of them mothers. With schools shut, doctors and nurses have been unable to report to work. This was the key reason behind Sweden’s risky gambit of keeping the country open. It paid a heavy price.

More than education, it is child care that is the major political/economy issue. Not everyone can work from home. Even those who can are developing children fatigue. They are tasked with looking after children 24 hours, in some cases giving them home education. One American woman was fired because her kids were making too much noise during her business calls.

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There appears to be a consensus that the virus risk for children is low. But their ability to transmit the disease is being investigated.

In a smaller German study, 1500 children (age 14-18) and teachers from 13 schools were tested. Out of 2000, only 12 had antibodies.

South Korea this week published an important large scale study. It covered 65000 people in total. It concluded that children between 10 and 19 can spread the disease just like any adult.

England and America talk of sending the entire class or school into home quarantine if a certain percentage falls sick.  In such cases, what are the parents supposed to do? Take leave from their work? Run the risk of catching the infection from their own child?

Denmark and Norway are the only two countries that have somewhat successfully reopened schools. Israel opened and shut them again.

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Several ideas are floating around. One suggests opening up safe centers for online learning. These can be opened in empty stadiums or wedding halls. Students go there with a laptop to take online lessons, allowing parents to go to work. Meals are provided for. Teachers are not necessary, just some facilitators helping the students with seating and Wifi.

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The suggestion by the US public health seems the most sensible. In your locality (not country), if the positive test rate is 5% or below, open the schools. It means the average infection rate among those tested should not exceed 5%. Florida’s is 20%. If this standard is applied, most big cities in India and the USA should not open schools yet, no matter what anybody thinks.

Ravi

Corona Daily 384: Crowd-Sleuthing from Home

UK Met office has preserved rainfall data from 1820. It contains 3.5 million data points. Once digitized, it would vastly help improve future weather predictions and climate modeling. Unfortunately, this data was handwritten. Though scanned, even the best OCR (Optical character recognition) programmes confuse between 1 and 7, 3 and 8. By March end, expecting people to have more time in a lockdown, the Met launched a Rainfall rescue project. They expected it would take 16 weeks. A total of 65,000 handwritten pages needed to be digitized. The project was finished in only 16 days, with 16,000 volunteers contributing from home.

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Various online platforms facilitate crowd searching to solve mysteries. Find missing people. Catch criminals. Detect war crimes in Gaza. Analyze earthquakes. Estimate the damage in Syria. Identify nuclear warheads in North Korea. Citizen science projects and virtual volunteering are booming in lockdowns.

Tracelab is a Canadian non-profit platform. Their April event attracted 550 participants scrutinizing 15 cases of missing people, generating 8000 new leads. In an earlier event, one participant spent hours studying YouTube footage to discover a clip where the missing person was entering a car. Investigators had missed it. The police traced the car, and found the missing person living there.

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Europol has launched ‘Stop child abuse – trace an object’ where more than 40 million images (clothes, toys) related to child sexual abuse are available. Public is requested to trace the location/country of origin of the items. Through this platform, ten victims were identified, and two offenders successfully prosecuted.

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Hacking is not allowed. Volunteers must use information available in the public domain. But with platforms like Google Earth any satellite imagery can be sourced. With tools like Quantum GIS or Planet, that imagery can be processed and analyzed. Most of these tools are free. From your chair, you can access most satellite images of everything that is outdoors. The world now has too much electronic data, and not enough volunteers to explore it.

After the disappearance of the Malaysian Airlines flight MH 370, an area of more than 1 million sq. km needed to be explored. More than 10 million volunteers contributed to the hunt. Tomnod, a platform, had allocated a small geographical piece to each of them.

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Zoouniverse has several interesting projects any of us can contribute to, without leaving home. You can help find rural homes in Africa that have no electrical access. (By comparing images in day time and night time). A project ‘spot slavery from space’ identifies the location and scale of brick kilns in India and Pakistan. The assumption is that many workers at the kilns are bonded labourers. If you love nature, you can start tracing changes in the coastal environment by identifying marine invertebrates. If you love sound, you may want to listen to and analyse the seismic sounds of earthquakes. Historically, lady doctors and scientists have been unnamed. One photo from an earlier century shows Dr Michael Somyogi, and his five unnamed women doctor colleagues. Online volunteers have so far found the name of one of them.

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Collective effort can work miracles. Wikipedia is probably the best example of what crowdsourced projects can achieve.

The online detective work on Zoouniverse, Europol, Tracelab or Maxar will bring you neither money nor fame. But you can contribute to some good in the world. The joy and purpose of investigation is a reward for the soul. Trapped in your house, it may be an activity more fulfilling than watching Netflix or playing video games.

Ravi

Corona Daily 385: Terror in the Time of Covid

Those unhappy about masks, missing birthday parties, restricted travel may want to look at the happenings in Philippines and Columbia.

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Philippines has the fiercest and longest lockdown in the world. Its president Rodrigo Durerto, 75, declared a national emergency on 9 March. Ten days later, he declared “a state of calamity” for six months. The entire nation was placed under a General Community Quarantine. Armed forces and national police are deployed to ensure discipline. If they see any violent lockdown violators, Durerto has said, “shoot them dead”. Fake news peddlers can be imprisoned for up to 12 years and/or fined up to $ 20000.

Since March, presidential security has implemented a “no-touch policy”. Nobody is allowed to touch Durerte or any of his family members. (Punishment for doing so is not specified.)

On 3 July, the president signed into law an anti-terrorism bill. A council appointed by Durerto is now authorized to designate any individual or group as “terrorists”, arrest and detain them without a warrant or charge for 14 days, extendable by another ten. The bill also allows for 90 days of surveillance and wiretaps and punishments that include life imprisonment without parole.

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Last week, ABS-CBN, the largest broadcaster of Philippines was made defunct. Functioning over 25 years, watched by 60 million viewers, the broadcaster’s fault was its independent views. In more than a dozen court cases, its executives were charged with labour abuse, tax evasion, and biased reporting. Its chairman Gabby Lopez III was born to Filipino parents in the USA. This fact was used to accuse ABS-CBN of foreign ownership. All its TV and radio stations have been shut, its 11000 employees rendered unemployed.

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Despite the longest lockdown, Philippines has 67,000 cases and 1830 deaths. On 13 July, it saw the biggest rise with 3000 infections and 162 deaths in a single day.

This week Durerto has introduced a new plan called “care strategy”. It requires the national police to conduct house-to-house searches. Infected people without an individual bathroom, or with an old person or a pregnant woman in the house will be forcibly relocated to isolation facilities. Citizens have been asked to report suspected people to the police.

The plan has been compared to the drug war tactics Durerto had earlier employed. In the four years as president, he ran a campaign that left 27000 dead.

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On the other side of the Pacific, armed groups are dictating curfew conditions in Columbia. A proxy civil war has been going on in that country for the past fifty years. A Marxist-Leninist guerrilla group “FARC” aimed to overthrow the government. It financed its operations by kidnapping, drugs, extortion and illegal gold mining. That group has disarmed in 2016 and become a political party. But many of its ex-members have formed armed gangs across the country.

These groups, through whatsapp and pamphlets, are imposing their own curfews and lockdowns, more draconian than the government’s. National Liberation Army (ELN) in Bolivar announced they were forced to kill people in order to preserve lives, because the population didn’t respect the orders. At least ten civilians have been killed for breaking curfews or drinking in a bar. Motorcycles that moved during curfew were burnt. Armed groups always seek social and territorial control; the pandemic has provided them with a perfect opportunity. Despite all efforts, Columbia has 190,000 cases and 6500 deaths.

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Perhaps it is better to fall victim to Covid-19 in a democracy where discipline and rules are flouted, than survive in a land of terror.

Ravi  

Corona Daily 386: The Man in the Burqa

Ichamati is a trans-border river flowing through India and Bangladesh. The Rapid Action Battalion (RAB) is Bangladesh’s elite anti-terror/anti-crime unit. At 4 am on 15 July, several armed RAB men lay hidden and watching on the Ichamati’s bank. This was one of several porous points where smugglers ferry citizens fleeing to India. Kolkata is merely 80 km from here. Today was the ninth day of a nationwide manhunt.

At 5 am, a smart army man with night-vision binoculars spotted a black burqa. The Afghani burqa covers everything, including the face. The woman in the burqa looked stout, her walk indelicate. And she walked alone. Four RAB men quickly surrounded her, guns loaded and aimed. The voice gave it away. The removal of burqa revealed a mustachioed man wearing a helmet and bullet-proof vest, carrying a loaded revolver.  

Shahed Karim alias Mahammad Shahed, age 42, is the chairman of two hospitals in Dhaka. His impressive visiting card says he is the chairman of eleven business organizations, editor of a daily newspaper, and on the ruling Awami League’s international affairs committee.

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On 7 July, Italy suspended flights from Bangladesh. The day before, several passengers on Biman (the Bangladeshi airline) had tested positive upon arrival in Rome. Four days later 377 of them were deported and the Italian authorities banned Bangladeshis from entering Italy until 5 October. More than 100,000 Bangladeshis work in Italy, a lot of them concentrated in Lazio, a region near Rome. Italy has started conducting mandatory testing for all 30,000 Bangladeshis in Lazio.

Japan and South Korea also suspended all flights from Bangladesh with immediate effect.

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Shahed Karim, chairman of the two Regent Hospitals in Dhaka, has been working tirelessly since March. On one hand, he agreed with the government to provide free testing and care. On the other, he charged TK 4000-TK 8000 ($50-$100) per test.

Many workplaces require a fresh test certificate for a worker to rejoin. Readymade garment factories require all employees to carry a negative certificate. Last year, a large community of 12 million Bangladeshis working abroad had sent back $19 billion. Many of them trapped in Bangladesh were itching to go back. They needed test certificates before travelling abroad.

Surprisingly, there is also a small market for “positive” certificates. That includes the poorest, keen to get into government quarantine to enjoy free meals for two weeks. Also some “essential” servicemen who need an official document to not work.

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Shahed Karim satisfied everyone, and speedily. His hospitals took swabs of 10,500 people. Of those, at least 6300 were given reports without any tests. Graphic designers and IT experts formed part of his team. They scanned and forged the genuine certificates. Shahed targeted long queues, and also gave ads on social media. His customers were happy at the quick service, and a quick negative report. At the Rome airport, many Bangladeshis who tested positive were carrying those negative certificates given by Shahed Karim’s hospital.

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Shahed Karim is not the only one. Dr Sabrina Husain, a government cardiac surgeon, and chairman of JKG health, and her husband were arrested on 12 July. More than 2000 fake certificates were found in their computers.

In a population of 165 million, Bangladesh has 202,000 cases so far. After arresting the criminal syndicates, the country will need to refresh the scoreboard.

*****

Ravi

Corona Daily 387: America’s Good Doctor

Dr Anthony Fauci is the most recognized name in the field of epidemics and immunology. Students wanting to pursue epidemiology as a career should study his fascinating biography.

A leading expert of infectious diseases, he has served in Public Health for over 50 years. He has advised Reagan, two Bushes, Clinton, Obama and Trump. For 20 years (1983-2002), he was the thirteenth most cited from among 3 million academicians. He has more than 1200 papers published. Since 1978, he has held 33 visiting professorships, given over 500 major lectureships, received 31 honorary degrees, 130 awards and honors, served on 41 editorial boards. He earns $400,000 a year, more than Vice-president Pence. Since 1984, he has headed the National Institute of Allergies and Infectious Diseases (NIAID). As its head, he handles a budget of $5.89 billion.

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A Brooklyn boy, both sets of his grandparents migrated from Italy. His father owned a pharmacy. His mother and elder sister worked at the counter. Little Tony delivered prescriptions on a bicycle. An academic topper, he was also the captain of the Regis High school basketball team. His height (5’7’’) meant basketball was a short career. Till today, and he is 79 now, he has a toy-sized net in his office, which he uses to relieve stress. He runs or brisk walks 3.5 miles every day. The school taught him precision of thought, and economy of expression, qualities evident when one watches him on television.

His undergrad degree was classics and philosophy with pre-med. He studied Latin for four years, Greek for three and French for two. One summer, he was a volunteer to build a new library in the Cornell medical institute. During lunch, he peeped into the auditorium, and wondered what it would be like to study there. When confronted by a guard, Tony proudly said he planned to attend this institute next year. The guard laughed ‘Right kid, and next year I am going to be the Police Commissioner.’

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The following year, he was admitted to Cornell and in 1966 qualified as a Doctor of medicine. For years, he worked as a physician and teacher of clinical medicine. (Yesterday, I mentioned epidemiologists better have a back-up. This is the best back-up. Medical doctors are never unemployed). How did Dr Fauci become an expert in epidemics?

On 5 June 1981, he received a report that described a healthy young man dying of a strange pneumonia. More reports followed, describing the death of 26 men, all gay. “It was the first time in my medical career,” says Dr Fauci, “I actually got goose pimples. I no longer dismissed it as a curiosity. There was something very wrong here. This was really a new microbe of some sort, acting like a sexually transmitted disease.”

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One of Dr Fauci’s greatest achievements was PEPFAR (President’s Emergency Plan for AIDS relief), 2003. George Bush launched it, Dr Fauci designed it. He visited several African countries personally. The program for saving Africans and Caribbeans shows what good America can do. PEPFAR has so far spent $80 billion, provided therapy to 15 million infected people, averted 2.2 million HIV infections, and provided care for 6.4 million vulnerable children.

Dr Fauci has helped fight AIDS, anthrax, SARS, 2009 Swine flu, MERS, Ebola, influenza and now Covid-19.

Passion is as important as education. Dr Fauci is the most famous epidemiologist, because he got goose pimples on reading the strange pneumonia deaths caused by an unknown microbe.

Ravi

Corona Daily 388: How does one become an Epidemiologist?

Grubhub, an American online food delivery company, recently hired an epidemiologist to advise them on how to safely deliver meals. Several companies worldwide are hiring qualified epidemiologists as consultants. The concepts of social distancing, masks and soap hand-wash were introduced by epidemiologists, not by politicians. What is this profession about? If a child wants to become an epidemiologist, how does he go about it?

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The Greek words epi(upon), demos (people), logos (study) combine to make epidemiology. Essentially it is the study of how often diseases occur in different groups of people and why. Epidemiologists investigate outbreaks, identify the viruses, identify ways of their transmission, and engage in constant surveillance of an epidemic.  

Epidemiology falls under the umbrella subject Public Health. Public health focuses on preventing disease, medicine focuses on treating disease. (That is one reason why it is easier for governments to cut budgets on public health. Like cutting budgets on firefighting by saying there was no fire recently).

Any child wanting to pursue the career of an epidemiologist must love Science and Math. He/she will be required to handle messy, complex data. Design, conduct and assess studies and surveys. Must be detail oriented and willing to work in a lab. Also determined, persistent, adaptable and resilient. When working in an international setting, diplomacy is essential. Communication, particularly written, is important. Job survival may depend on how well they write reports asking for grants. Epidemiologists who love their profession describe it as part detective, part prophet.  

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A typical day begins by reading ProMed to see the latest disease outbreaks around the world. Then work on a grant or a research proposal. This is followed by analyzing data and preparing presentations for the next international conference. The nine-to-five job is filled with meetings and discussions. Field work and emergencies can happen at irregular hours.

With a bachelor (4 years), masters (2), and PhD (3-5), and work experience, one can become a Doctor in Epidemiology by the age of 32-35. Oxford now offers MSc in global health science and epidemiology. In the USA, centers for disease control and prevention (CDC) run a two year specialized program in applied epidemiology.

Qualified candidates get jobs with governments, federal agencies, laboratories, hospitals or pharma companies. In the USA, an average annual salary is $71,000, with the salary range $50,000 - $120,000 per annum.

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Until now, young epidemiologists had read about pandemics only in history books. An epidemic curve and testing form two major chapters in textbooks. Now epidemiologists are excited they can apply their learning in real life. They can finally be useful to the world as they are expected to be. People are turning to them with hope to learn about the future.

The New York Times interviewed 511 epidemiologists asking their views on when we can fly, hug, shake hands, dine out, attend a wedding etc. It is an interesting read.

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In the past, epidemiologists were advised to have a back-up profession. When you are at the mercy of politicians like Trump, your employment is not secure. In 2018, it was projected this profession would grow by 5.3% between 2018-2028. Depending on the length and severity of the current pandemic, the projections may change. The demand for epidemiologists may skyrocket.

They may even get upgraded to Pandemiologists.

Ravi

Corona Daily 389: The Dishwashing Lady

57-year old Mary Daniel from Florida is the founder and chief executive of ClaimMedic – a small company that helps people deal with their health care bills. The company kept her busy. She drove across Jacksonville to meet customers every day.

From 3 July, she has taken up the job of a dishwasher with Rosecastle at Deerwood. This is a residential facility for senior citizens, retired or suffering from dementia or other disorders. The dishwashing job will pay Mary $9 per hour.

Before joining, she had to subject herself to a detailed background investigation, biometrics check by FBI and the Florida police. She underwent a 26-hour training on various subjects. She attended an induction and orientation program that explained how to interact with residents. Her dishwashing job didn’t require much of it, but it was all part of the eligibility requirement.  

She gave Covid-19 tests a few times, and fortunately was negative each time. Also a TB and a drug test. A 20-hour video training included information on infectious diseases.

Having legally qualified to do the job, Mary has started scrubbing dishes, mopping floors, cleaning the kitchen. This is the first time she has taken up a manual job.  

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Mary’s husband, Steve, used to work as an orange juice salesman. A very sociable person as salesmen are expected to be. At 59 years of age, he prematurely developed Alzheimer’s. Mary took care of him. In July 2019, when it became impossible to leave him alone at home, Mary moved him to the care centre Rosecastle at Deerwood. He was healthy, moved around the center, chatted with people, and continued to recognize Mary, his companion of 24 years. After Mary finished her ClaimMedic work, she would visit him, watch TV with him, help him get ready for bed each night, and lovingly tuck him in bed before driving home.

On 11 March, Mary was told she can’t visit the center any more. Florida governor’s order prohibited visitors to all care homes.

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Through March, April and May, Mary tried everything. She reached out to the governor’s office more than a 100 times, but received a mechanical response pointing to the order. She promised to wear a full PPE before going to see her husband. The governor’s office refused.

She tried window visits. When she stood on the street outside Steve’s room, a thick glass separated them. Steve cried. With dementia, he couldn’t understand why Mary comes to the window, tries to talk, and instead of meeting him, walks away to her car. She stopped for fear of making it worse for him. Facetime didn’t work either.

She wrote to the director of the care center. Could she volunteer please? Could she bring a therapy dog? Could she get a job at the center – any job?

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After more than 100 days of separation, Mary heard about the dishwashing vacancy. She jumped at it. After working, she would be able to see her husband. That was the perk.

On 3 July, after washing the kitchen, she went to Steve’s room. Steve recognized her even with her mask on. Mary, he said, and hugged her. Both of them cried. Later they watched TV. Mary made his bed, and tucked him in.

Ravi

Corona Daily 390: Data Slower than the Disease

Yesterday’s New York Times has a report that sounds fictional, but is not. Set in the USA, year 2020, the report narrates the various ways in which test data is transmitted and processed.

Across America, coronavirus test results arrive at the public health departments by phone, email, post (!), and more commonly, fax. Fax complies with the American privacy standards for health information. The Austin city office receives 1000 faxes every day, many of them duplicate. Some are sent to the wrong address. If sent through a server to a computer, the health department prints the report for someone to manually enter it in a database later.

Fax machines are so overwhelmed, they frequently run out of paper. Office floors are overrun with paper. Washington State called 25 members of the National Guard (a military unit) to enter data manually.

Nationally, 80% of the results are missing demographic information, and half don’t have addresses. The Trump administration has stated that laboratories should report patients’ age, race, and ethnicity, but the rules will come into force only August onwards. Laboratories should also furnish patients’ address and phone number, but this is optional.

When reports come in duplicate, on the fax pages on the floor, the department employees, if physically present, pick the pages up. Most records come only with the patient’s name and birth date. With the address and phone missing, employees start calling the provider or going through directories.

The doctors, labs, and health authorities have different systems; they don’t talk to one another. (Like one Apple charger not fitting another Apple device.) Information is expected to move from the doctor to the lab to the public health authority and back to the doctor. It doesn’t always. Errors are possible when dealing with blurry printouts and analog data.

Many health offices get the necessary information about a test result 11 days after the test. By which time the patient has managed to infect hundreds. Health officials are advising people to assume they are positive, since the faxing system makes the process nearly as long as quarantine itself.

The report has a beautiful quote from a Health department director. “The data is moving slower than the disease.”

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In a 2017 interview, Barack Obama admitted this to be the biggest failure of Obamacare. His administration had desperately tried to get doctors to move from paper to digital, but couldn’t. $27 billion were pumped in to improve the medical system buried under mountains of paperwork. A special HITECH act was passed in 2009. Many American hospitals have some sort of electronic medical system in place, but they can’t transfer the data to another hospital outside their system. In countries like the UK or Canada, a patient has a unique ID number, which makes aggregating data easier. In the mid-1990s, the USA congress passed laws preventing the federal government from creating new ID numbers.

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UK’s National Health Service (NHS) was, until two years ago, the world’s largest buyer of fax machines. By the end of 2018, with more than 11,000 machines in use, the health secretary said he was ashamed of this backwardness. By sheer chance, NHS was ordered to get rid of all fax correspondence and go digital by 31 March 2020. In India, I don’t recall seeing a fax machine in the last ten years.

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Before a national rollout of 5G, the USA may be better off getting rid of their fax machines.

Ravi