Corona Daily 108: India’s Virus Surveillance: An Unfunded Story

Earlier, in the UK context, I wrote about the criticality of genomic surveillance. Identifying and quantifying each virus avatar is a key weapon in the coronavirus war. Without the virus gene sequences, vaccines were not possible.

India has a human talent pool that is among the best in the world. At least ten major labs can conduct genome detective work. On 12 May 2020, during the national lockdown, PM Modi appealed to Indians to become self reliant. In this age of globalization, talking about self-reliance is illiteracy; displayed time and again by the likes of Trump and Modi. Talking about self-reliance during a pandemic is lunacy.

Within three days, the order issued by India’s Finance Ministry referred to that speech. “In  pursuance of the Prime Minister’s address to the nation… in order to prove self-reliance…it has been decided no tender up to Rs 200 crore ($27 million) will be allowed.” The order became effective immediately, with no notice period.

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Labs analysing positive samples use specialised plastic containers and reagents, both imported from American companies such as Illumina. There are no Indian substitutes. The order banning tenders below Rs 200 crore brought to a halt most sequencing by September 2020. All labs ran out of reagents. The labs complained to the Ministry of Finance. The ministry finally exempted the labs in January 2021. Eight valuable months were wasted by a single piece of thoughtless paper.

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In December 2020, a welcome initiative brought India’s ten major labs together in a consortium with an unwieldy name INSACOG (Indian SARS-CoV-2 Genomics consortium). Detailed 18-page guidelines were issued.

The consortium had three ambitious goals: (a) Mapping the spread of the UK variant across India (b) Investigating regional outbreaks for early detection of new variants. (c) Continuous surveillance program to sequence 5% of all positive samples across India+100% of all positive samples of international arrivals.  

The analysis on positive samples would be conducted with retrospective effect. Rs 115 crore ($16 million) funding was promised. It was a well-conceived initiative.  

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Positive samples must be sent by the testing labs to one of the consortium labs. The samples need to be preserved at temperatures between -80 and -20. Many labs had destroyed the past samples. The consortium would accept only RT-PCR tests. Many states had conducted large scale antigen tests that didn’t qualify. By February, the consortium should have investigated 45,000 samples, it managed 3,500.

Sanctioned money doesn’t mean real money. Part of the money, Rs 80 crore was finally released on 31 March, the last day of the Indian financial year.

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The maximum capacity of the ten labs is 1,000 samples a day. In reality, they analysed about 100 a day. Today, India has 380,000 new cases. To keep the 5% mission of the consortium, it should analyse 19,000 samples today. But the maximum capacity is 1000 samples a day. In effect, the mission works only if the number of cases is low. India produces 2 million vaccines a day, but aims to vaccinate 4 million people daily. The case of the genomic surveillance is similar.

There has been talk about the Indian variant, a double mutant, a triple mutant. Data based on small samples is not reliable. And detective work must be accompanied by police action. The double mutant variant was detected in October 2020. It was found again in November and December. That discovery needed urgent action. By February, that variant exploded, causing a surge in Maharashtra state.

Competent genomic surveillance can track the effects of superspreader events. Wide-ranging genomic analysis could have verified and quantified the impact of the Kumbh Mela and election rallies. Instead, Indians are left with anecdotal evidence of obituaries of people returning from such events.

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Within less than a year of its self-reliance resolve, India is now looking in all directions for oxygen and other help. If the rich nations want to offer help, they should consider funding India’s genomic surveillance labs to ramp up their capacity. A large scale genome analysis in India is a global, not local, necessity.  

Ravi 

Corona Daily 109: French Humour

Last few weeks, Jean Castex, the Prime Minister of France has been getting ladies’ underwear by mail every day. Not just that, each sender shares a photo on social media, accompanied with a screenshot of a letter explaining their low-down act. Castex has already received more than two hundred lacy and non lacy panties.

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France is currently in its third nationwide lockdown. The earlier lockdowns were so strict; a Frenchman wishing to leave the house had to fill a two-page, widely infamous, “attestation”. It was denounced as a multiple choice quiz by a senator. The convoluted language made the applicants look online for the meaning of some French words. To go jogging, one had to specify the starting point, the route, state the time, and give a reason for jogging. After filling the form online, one waited for the ministry to approve, and then either print the permission or take it on your smart phone.

A month ago, the French parliament debated the linguistic nuances of the word confinement (lockdown). If people are allowed to go out, can it really be a lockdown? Someone suggested lockdown light (like Marlboro lights). Finally they called it confinement partiel, where several concessions would be offered.

In the third lockdown, the French are allowed to walk their dog, with 1 km as the maximum radius. But with their children, the radius is 10 km. Fairly generous, because from Paris center, you will go out of Paris if you try to cover 10 km. However, this is applicable only if you are a local with an address proof. If not, you fill the multi-quiz form before stepping out.

E-cigarette sellers, video game parlours and chocolate shops are open. But shoe shops, beauty salons, cloth stores and departmental stores are shut. Wisely, since the shoe shops are shut, shoe repair shops are allowed to operate.

Earlier, France had a 12 hour lockdown (6am-6 pm) followed by 12 hours of curfew (6pm-6am). In the third lockdown, one extra lockdown hour is granted to people, the curfew now begins at 7 pm.

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Roger Cohen, a NYT reporter in Paris describes his visit to Castorama to buy a desk lamp. Castorama is open under the lockdown laws, because its surface area is below 100,000 sq feet. But different sections are closed by red-and-white tapes like a police barricade. Because inside the hypermarket, only essential goods can be sold. Mr Cohen could buy toasters or pans of hundreds of varieties, any home stereo equipment, but not a desk lamp. At Boulanger, an electronics store, vacuum cleaners could be sold, but not refrigerators or stoves.

Florists are open, and kitchenware stores shut. Bookstores are open in the third lockdown, although they were susceptible to virus in the first. Frozen goods shops are open, but not gift shops.

When Mr Cohen asked in the shop why a desk lamp was considered non-essential, the salesman said he didn’t know. “But, of course, you can use a candle”, he said helpfully.

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Camille Chaize, the interior ministry spokeswoman, admitted the documents and rules were complex, but they were self-explanatory. One kilometer was plainly the radius in which a dog urinates, ask animal experts.

Hairdressers are now essential to boost the morale of the French people. Florists are now allowed because half of their business takes place in spring. And chocolate shops are obviously open for the Easter holidays (which are not exactly holidays). The nationwide curfew was reduced by an hour because of the clocks springing forward for summertime.

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Lingerie stores were classified as non-essential businesses. All underwear shops were ordered shut to reduce the transmission of covid-19. Angered by the regulation, the lingerie shop-owners decided to send underwear to the PM. “Florists, bookshops, hairdressers and record shops are essential. What about underwear?” The group asked. “Isn’t it a question of hygiene and protection? Isn’t it the first thing we put on in the morning to get dressed?”

France will review the lockdown regulations on 3 May. The French PM may consider making lingerie essential in the new regulations.

Ravi 

Corona Daily 110: Covid Compliance Officer (C19CO)

You probably didn’t watch the Oscar ceremony two days ago; it was the least viewed Oscar telecast in history. Oscars had appointed a ‘head of covid compliance’ - Dr Erin Bromage, professor of immunology. Instead of the Dolby Theater, the ceremony was held at the spacious Los Angeles Union (Railway) station. Vaccinated guests sat mask-less at widely spaced tables.

The protocol allowed a shorter quarantine for those who flew in by first or business class. All guests and presenters were given at-home testing kits. In all 15000 rapid tests were conducted, and vaccinations verified.

The “red carpet” was tiny. Winners walked a few steps to a small dais. Songs were not live, but pre-show, not part of the ceremony itself.

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This article is not about the Academy awards but a new job that has emerged in the pandemic: Covid Compliance Officer (technically C19CO. Sounds a bit like a virus variant). CCO is the new gatekeeper, the watchdog on film sets, events, festivals, offices, sport tournaments, clubs or universities.

Dr Linda Dahl is an ear, nose and throat surgeon. In June 2020, lockdowns forced her to shut her practice. Unemployed, a friend asked her if she would like to be a CCO for a TV production. Linda said no, and later took the job, because the studio didn’t find anyone else.

The TV production had a 300 person cast-crew. She began waking up at 4 am to check the PCR test results. If somebody was positive, it was her responsibility to contact trace and isolate the crew. Linda disapproved of the “covid theatre” that includes rapid tests, temperature screening and plastic dividers (called split bubbles) in the makeup and catering department. She insists consistent PCR testing and ventilation are the most critical. Temperature checking and wiping the doorknobs give the appearance of doing the right thing, but good filtration and ventilation actually mitigate risk.

In sports tournaments (like the current Indian cricket league) all the players are in a bubble. But in this TV production, people went home, and then the Covid Compliance officer had no control over what they did.

The budget for Covid compliance is high, 25-30% of the total budget. Linda was getting pitches for covid sniffer dogs and six-figure thermal scanners.

At Kaufman Astoria Studios, a crew member was carrying a birthday cake for his colleague. “You can’t eat it here” Linda had to say firmly. She also prohibited blowing candles or singing the birthday song. Instead people clapped.

She and other CCOs get various nicknames: covid cop, social distance nazi, quarantine queen.

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The CCOs must absorb ever changing guidance from the health authorities. New York state’s quarantine changed from zero to 14 days, and then to 7 days. One CCO warns: Our guidance today is not the same as our guidance tomorrow.

CCOs have the power to cancel a show or shooting. Orchestra vocalists and wind instrumentalists are given brown paper bags to put their masks in while performing. Breaking of any protocol as simple as this can result in a cancellation of a concert. 

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CCOs don’t need to be doctors. Some of them are from the relevant industry. Online courses ($50) for two hours give you a certificate, but there is no official accreditation. Erica DeSimone, an event producer, worked as a CCO on a set in New Jersey.

Erica sat on every pre-production meeting. She was always first on set, ensured rapid testing, marking the floors for distance, checked food was individually packed. For the next 12 hours, she walked on the set repeating three mantras: (a) Please put your mask above your nose. (b) Please step further apart. (c) How did you sneak that water bottle here?

She had assistants with super soaker squirt guns full of hand sanitiser. They walked about cleaning tables, chairs and communal areas. And the bathroom every time someone visited it.

Before taking part, all actors and crew have to sign a waiver saying they won’t sue the producer if they get Covid. So, there is a grudging respect for the job the CCO does.

Ravi

Corona Daily 111: Pandemic’s Huge Baby Bust

With couples locked down everywhere last April, the world expected a baby boom nine months later. 2021 will bring in millions of lockdown babies, cheerfully announced the social media experts.

That was a misconception. A year later, America and Europe are looking at an unprecedented baby bust. USA faces the biggest birth slump in 100 years. Brookings institute projected US births would fall by 300,000 - 500,000 this year. It’s a double whammy – covid is taking people away, and fewer babies are replacing them.

China had 11.8 million births in 2019, but only 10 million in 2020. (12% decline).

December and January statistics are out for most developed nations. Births have fallen between 7% and 22%. North America, Europe and rich Asian nations are likely to see a 15% decline in births in 2021. P&G, Nestle and Reckitt Benckiser are already revising their sales forecasts for diapers and baby formulas.

Google search provides collateral evidence. The search for ultrasound, morning sickness, Clearblue (pregnancy test) has fallen since the pandemic began.

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There are several reasons given:

Economic uncertainty and the challenges of lockdown parenting have dissuaded 34% of American women. They have either postponed the thought of children or reduced the number of children they expected to have.

The hardest virus-hit areas show the largest declines. Fear and stress resulting from a disaster can discourage pregnancies across national borders. The 1986 Chernobyl accident resulted in an unusually low birthrate in Italy nine months later.

Domestic violence made abused women choose abortion.

Levels of sexual activity have fallen. Those with young children and particularly school-age children report the largest declines in sex. There is a lack of opportunity, particularly for polyamorous active young people. Some people fear being unable to safely access pre-natal care or hospitals for deliveries.

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Will this bust be followed by a boom once the pandemic is over? Analysts look at history for clues.

Indeed, the Spanish flu pandemic, the Great Depression and the Second World War were followed by a baby boom, the last one giving us the term baby boomers. There are a few noteworthy differences, though.

In WWII, men had gone away on war. After the war, they reunited with their wives/partners and the boom happened. In the coronavirus pandemic, many couples were together, in fact locked in 24 hours.

Second, the 1918-1920 Spanish flu pandemic happened before contraceptives were born. Now in developed nations, most pregnancies are a choice rather than a surprise.

Third, Spanish flu pandemic was a health crisis. There is no record of it devastating economies. (Also because it coincided with the First World War, it was difficult to separate the economic impact of the pandemic and the war). The Great Depression, on the other hand, was an economic crisis. The current pandemic combines a health and an economic crisis. Its impact on reduced fertility is likely to be greater.

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It is not by chance that Joe Biden has included significant incentives for children in the latest stimulus package. Every year, each American child under six will receive an allowance of $3600 and there onwards $3000 annually until the 18th birthday. America and Europe already have declining populations. They can’t afford a baby bust.

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The picture in developing and poor nations is different. UN says the pandemic has caused 12 million women in 115 countries lose access to family planning services. This may result in 1.4 million unintended pregnancies.

India’s abrupt announcement of a national lockdown last year made migrants flee to their villages. They were united with their wives. Indian migrants usually meet their families once a year, for a month or so. India has never seen so many couples together for such a long time. Access to contraception, abortion and family planning was cut off.  The data is not yet out, but India is likely to have a baby boom.

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The potential simultaneous bizarre outcome of a baby bust in rich nations and an unwanted baby boom in poor nations will further change the demographic composition of the world.

Ravi  

Corona Daily 112: Your Social Network

Dr Sheldon Cohen is a professor of psychology at Carnegie-Mellon. His specialization is studying the link between social ties and health. When the pandemic and the lockdown began, he looked at his phone. Out of the 800 contacts, he made a shortlist of 50, and ranked them according to how often he would like to interact with whom. The ranking was based on how meaningful the person was to him.

Not everyone is as systematic as Dr Cohen, but social circles are shrinking for all of us, says writer Kate Murphy in the NYT.

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Friend is a loosely used term, particularly since the birth of social media. There are people who don’t recognize their own friends from the Facebook list. Some people collect friends like my generation collected postal stamps in childhood, for eg0 satisfaction and show-off.

Certainly, in the before-mask era, we interacted with hundreds of people. Ten years ago, I went to a gym every morning, learnt ballroom dancing in the evenings, attended a writer’s club and a readers’ club every month, and socialized every Sunday with my fellow marathon runners. My life was exhausting and full of people. Now, ten years later, I am in touch with very few of those hundreds of “friends”. Most of them were activity friends – the activity over, the friendship was over.

Similarly, last few years, whenever my daughter’s school summoned us, I met the other school parents. Every now and then, we had a parents’ get-together over lunch. Since last March, my daughter’s school has been online. I have not met a single parent from the school. I am not a WhatsApp person, so that interaction is completely severed. It was situational and superficial.

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In a study, a psychologist Robin Dunbar claimed that human beings have the cognitive capacity to accommodate four to six close friends. That’s all. It is the top tier of your social network with whom you have a daily or weekly interaction.

Regular contact is important. Without that, friends can get demoted to acquaintances. Another study found that every five to seven years, we replace as much as half of our social network. Social networking is a zero-sum game. When we add a friend, another one drops out. (Of course, one may forward a message to 100 people. I don’t think belonging to a WhatsApp group by itself constitutes friendship).

The pandemic is clarifying whom we really like and dropping those with whom our relations were situational, convenient or superficial. A major reason for discontinuing relationships is the lack of meeting opportunities.

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Friendship is not always reciprocal. One study asked 84 undergraduates to score others on a 0-5 scale: I don’t know this person (0)/ friend (3)/ one of my best friends (5). They were also asked to “predict” the scores of others about them. The conclusion was that almost 50% of the friendships were not reciprocal. Only when both identified each other as “friend” (3 or above), the friendship was considered reciprocal. In Bollywood films and in real life, many of us have experienced this with love. The person we fall (deeply) in love with falls (even more deeply) in love with someone else.

It hurts our ego to accept the possibility that some of our close friends may not feel as close to us as we to them.

The pandemic year offers an acid test. If you consider someone a close friend or one of your best friends, and have had no contact with that person for a whole year, you may have been mistaken.

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Unlike Dr Cohen who made the short list at the beginning, we can now evaluate our true close social circle. If what the cognitive psychologists say is true and we can have only a handful of close friends, the pandemic has probably given us enough evidence to know who they are.

Ravi 

Corona Daily 113: Criminalising Bladders

United Kingdom has done an excellent job with vaccinations. This month London had some days without a single covid-19 death. Weather is improving - time to go to beaches and parks. But some Brits will continue to wear masks for quite a different reason.

On 21 April, residents of Tooting officially lodged complaints demanding more public toilets. In the pandemic, public toilet access has been severely restricted. To save money, UK councils have been reducing the number of public toilets over the years, delegating the function to McDonalds, Starbucks, and other pubs and bars. This may create the ridiculous situation of having to buy a drink in order to go to the bathroom; but desperate people at least had an expensive solution. Now police patrols have a special duty to deter people from peeing and pooing in bushes, on beaches, in private spaces.

Many public toilets were closed last year because of the “covid-says-no” attitude. Newspapers talked about toilet plume in public loos. Sometimes cleaners were not available in lockdown times. Some restrooms blocked off every other urinal, a tactic that was named “social piss-tancing”.

Because the English love systems and queues, in parks certain bushes get designated as loos, and people queue up at those bushes. Two brothers have launched a website for “loo-cation” updates. People finding an open loo feed the information on the app, and people wanting to relieve themselves try to find the nearest place. A bit like finding the nearest Chinese restaurant on your Google maps.

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A pregnant woman from London developed a urinary tract infection after being unable to find a toilet on a trip to Hyde Park. Another woman suffering from a bowel condition was barred from using the loo at her local GP surgery. One woman from west London couldn’t visit her daughter’s grave as the loos on the way and at the cemetery were all shut. Another woman resorted to taking Imodium (medicine to treat diarrhea) before going shopping, and taking a laxative on returning home.

Dylan, 28, was trying to use the bushes when the park officers caught him and fined £195. When he sobbed and said he was out of work, they reduced it to £95. When he complained, the council said it’s not their responsibility to provide the public with a place to urinate. Pre-pandemic England had one public toilet per 12,500 residents.

One American professor calls it “criminalizing having a bladder”. Some American state laws specify that if the police catch people relieving themselves in public places and ticket them, they have to register as sex offenders.

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Some novel products have appeared. Peebol is a pocket sized toilet. It is a bag filled with rapidly absorbing granules, which converts urine into solid, non-odour, non-spill gel. You could quickly get inside your car, use Peebol. Then at home throw its contents, which are biodegradable, on the compost heap.

Sheewee is a device that helps women to pee standing up without exposing themselves. Its sales went up by 700%. Sales of urine funnels, adult diapers, and external catheters have all skyrocketed.

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Amazon first denied and later acknowledged their workers using glass bottles and plastic bags to relieve themselves. Lack of restrooms has become an unbearable issue for delivery workers, taxi drivers, police and others who work outside their home.

Homeless people have nowhere to go. Menstruating women have no place to change their sanitary wear. People with Crohn’s disease, irritable bowel syndrome always mentally map the toilets on the route before leaving home. Now, they have become disabled. Only those with strong bladders and bowels can venture out. Women have started dehydrating themselves before going out.

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UN has named 19 November as the annual “World toilet day”. 4.2 billion people in the world live without safe sanitation. 700 million, including 500 million in India, defecate in the open. As a result of this lack of sanitation, more than a million children under five die of diarrhea every year.

The pandemic has now made Europe and the USA more aware of this issue. In the post-pandemic action plan, access to safe sanitation must be on the first page.

Ravi 

Corona Daily 114: Hair We Share

In pandemic times, even those who are struggling financially have one asset that grows every day.

In the lockdown last year, most men and women missed their usual scheduled trip to the hairdresser. Some used the rare opportunity to grow ponytails or long hair. When salons began to open, the risk of exposure prevented people from rushing for a haircut. In the USA and UK, some women with 14 inch braids are now fully vaccinated. They are looking forward to getting rid of their burden, and head to the beach with new summer cuts.

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On Long Island, Suzanne Chimera runs a company called “Hair We Share”. She asks people to donate their long hair. Wigs made of donated hair are given free to adults and children with medical hair loss. Cancer patients undergoing chemotherapy need wigs. Wigs are expensive everywhere, a good wig with human hair can easily cost between $1000 and $3000. This expense added to the cost of the treatment is an unfair burden on a cancer patient.

Suzanne encourages potential donors to keep growing their hair before donating. In the pandemic, her donor base has increased by 230%. Men ask her how they can donate their wild, unkempt hair. The minimum length for donation is 8 inches long. With eight inches of hair, wig makers end up making a 4-6 inch wig. Majority of those needing wigs are women, who prefer long hair. Many men agreed to wait until their hair was sufficiently long.

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In the pandemic, organizations such as Hair We Share are making compromises, such as accepting grey or highlighted hair. Jerika Nguyen, 28, managed to grow hair till her haunches. Last month, she donated nine inches of her hair to Children With Hair Loss, one of the few charities that accepted her highlighted hair. Jerika compared her experience to blood donation. You give up something knowing you are going to get it back, and what you give up helps the one who receives it.

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Locks of Love, one of the better known charities, tells us that as much as 80% of the hair donated may by unusable for wigs. Many people don’t read the guidelines, and send in hair that is wet, moldy, short, gray, or too processed. This has to be thrown away.

Donors ask if they could see the photo of a person who is wearing the wig made of their hair. Usually the recipients prefer to be anonymous. Even if they allow, the logistics make it difficult to identify which hair is part of which wig. To make a nice, thick wig the manufacturers may look for 20 identical ponytails, each at least eight inches long, and combine these to make a wig.

Paul Frasca, co-founder of Sustainable Salons, in Australia, said hair donations were down almost 70% last year. But a welcome surprise this year is receiving high quality “virgin” long hair coming from men.

In India, at least Hyderabad and Mumbai have hair-wig double donation agencies.

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In China, the wig industry market is booming. USA is China’s largest export destination for wigs. Every time the Trump administration sent stimulus checks to American families, wig exports from China to the USA grew. China prefers to import human hair from India, it is cheaper. And Indians seldom dye their hair, so the quality of hair is good.

In Japan, the demand for men’s wigs has grown nearly three times during the pandemic. While no large scale study is available, wig makers believe the Zoom conferencing is responsible. Japanese men watch themselves endlessly during the Zoom call, feel restless about the image of their crown, and order a nice expensive wig before the next meeting.

Ravi                                                          

Corona Daily 115: Running on Empty Cylinders

India reported 315,000 new cases yesterday, a pandemic record. More than 2100 officially died of covid-19, an Indian record. Many deaths are attributed to the shortage of oxygen. Doctors are required to play god by choosing whom to give oxygen to and letting the others die.

On 16 April, Vijay Shrivastava, 65, a journalist, posted on twitter a photo of his oxymeter showing 52, instead of the required 90 plus. The Uttar Pradesh Chief Minister’s advisor replied asking him to provide full details. By then his oxygen level had fallen to 31. On 17 April, he died. His son said he tried to get an oxygen cylinder everywhere but couldn’t.

Yesterday, in a city of Maharashtra, at least 24 patients died in a matter of minutes when the oxygen supply to their ventilators suddenly stopped due to a leak.

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Six hospitals have gone to the Delhi High court. On 21 April, the high court judge said, “this is ridiculous. We want to know what the center is doing with regard to oxygen supply across India.”

Today, India’s Supreme Court has entered the battleground. Beg, borrow, steal but get the oxygen, a judge reportedly said to the government. The court wants the government to show the national plan for oxygen supply.

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Oxygen is used in industries. It is used in hospitals. We are familiar with oxygen cylinders traditionally used in hospitals. But there is a relatively modern technology called “pressure swing adsorption (PSA)”. Broadly speaking, this production process uses the normal air, and by applying changes in pressure separates the oxygen. This oxygen is supplied continuously to the hospital through pipes. The technology avoids the complications of storage and transport of liquid oxygen. The PSA plants are built close to a hospital or are attached to it.

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Last year, on 14 March, India declared covid-19 to be the national health emergency. It was known India was likely to experience huge shortages of beds, PPE, ventilators and oxygen. The central government decided to build 162 Pressure Swing Adsorption Oxygen plants in 162 district hospitals across the country. India then went into a national lockdown.

For reasons never explained, the tender was issued on 21 October. It took more than seven months to prepare a tender in a national emergency.

These plants are relatively inexpensive. The 162 plants would cost Rs 200 crore ($27 million). They were going to be financed by the PM-CARES fund, an opaque instrument that uses the photo of the prime minister, government website domain, but is kind of private, not open to public scrutiny. Indians had donated Rs 3,000 crore ($400 million) to that fund in the first four days. Money, therefore, was not a problem to build the oxygen plants.

The website of the PM-CARES fund, till today, doesn’t mention how the collected funds have been allocated. It doesn’t mention the plan to build the PSA oxygen plants.

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Scroll, an independent online newspaper carried out an independent investigation by calling the potential hospitals. They called over 60 hospitals across 14 states, and found that only 11 units were installed, and five were operational.

After Scroll’s article was published, India’s health ministry hurriedly issued a series of tweets. They confirmed that out of 162 planned oxygen plants, 33 have been installed. Before May-end, the plan is to install another 47.

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India has now gone into management by crisis mode. Production and supply need to match. A big state like Madhya Pradesh has no oxygen manufacturing. More cryogenic tankers will need to be produced. Their production can take up to four months. Though an oxygen exporter, India plans to import 50,000 MT of oxygen. The logistics of import and distribution around the country are challenging. Industries have been asked to divert oxygen to hospitals.

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Journalist Shrivastava who died on 17 April lived seven km from the Shyama Prasad Mukherjee Civil hospital. It was one of the 162 hospitals waiting for the oxygen generation plant. Had it got one as was planned a year ago, Mr Shrivastava might be alive today. Along with thousands of others.

Ravi 

Corona Daily 116: Haredi Jews: Out for Change (Yotzim)

21 year old Racheli Ohayon worked in a Jerusalem phone center. She was raised in an ultra-orthodox household. Even at work, she wore the most conservative black dress, and strictly observed the religious directives, no matter how stifling. With the onset of the pandemic, she was off work, crammed in the house with seven siblings. She had a lot of time to think. With what was happening around her, she realized rabbis were no doctors. In a few weeks, she took a decision, the most shocking in the Haredi community, to quit the community and go out in search of a secular lifestyle.

Racheli had attended an ultra-orthodox girls’ school where the only history taught was Jewish history. Her school had computers, but they were not linked to the internet. Chief Rabbis had prohibited it. She had never seen a movie, and never worn a pair of jeans. For the first time, she bought a smartphone and started browsing Google and listening to music on YouTube. She joined the local library in Petah Tikva and started reading secular literature, novels which were off-limits for her. Earlier, Racheli had thought Haredim were special and different people. She found out she was not different. She feels her decision to leave was absolutely right.

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In the Haredi community, marriages are arranged. Dedi Rotenberg and his wife Divan had one such marriage. They soon realized both felt this particular type of religion was suffocating them. In 2020, they took the decision to move out of Bnei Brak for a secular life in the south of Israel. Dedi said it took him many months to adapt to his new friends and neighbours. Their slang, the subject matter were different. For a few weeks, he had no idea what people were talking about, though they shared a common language.

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They are called Yotzim (those who leave). In the ultra-orthodox community, there is no question of being able to stay at your home after giving up the orthodoxy. In extreme cases, parents of those who leave sit shiva, meaning observe the traditional mourning as if their children were dead.

Many leavers don’t wish to abandon Judaism, but are seeking individualism, and freedom to make their own choices in life. But leaving their family, community and lacking any secular education, they are not equipped to adapt to the new world. As mentioned yesterday, Haredi boys are not taught math, science or English. Many of them study Torah full time and rely on government aid. Most Haredi women work in low-grade jobs to support their families. They are responsible for raising the large number of children as well.

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There are two major organizations in Israel that take care of the leavers: Hillel and Out for Change.

Hillel empowers the leavers to build meaningful self-determined lives. Their dedicated staff provides full assistance during the first critical 3-5 years in the transition period. They  offer hotline and drop-in services, counselling and treatment, transitional housing, housing subsidies, education and employment help, free legal aid, emergency shelter, care for single parents and children.

During the pandemic, Hillel noted a 50% increase in the number of leavers. Experts attribute the increase to a breakdown of supervision and routine, disillusionment with the community leaders, a rise in internet use, and more time for questioning and self-discovery.

Out for Change offered leavers the option of formal registration, so as to legalise their status with the authorities. The labor and social affairs ministry recently began defining ex-haredim as a special category eligible to receive vouchers for special vocational training courses. During the pandemic, though traumatized by the break-up from the family, more than 1300 leavers signed up.

This was something that the rabbis had feared. This was one of the reasons why they were insistent on keeping the religious schools open no matter what. A leading rabbi said boredom leads to sin and puts girls in severe spiritual danger.

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Under a different name, and different religion, each country has such communities whose decrepit old male leaders trap its members into extreme orthodoxy. Israeli organisations such as Hillel and Out for Change are good role models that show how to bring those people back into civilization.

Ravi 

Corona Daily 117: Haredi Jews: State within a State

The Israel-Palestine hostility is well known. A lesser known conflict is the one between secular Israelis and Israel’s Haredi Jews. Haredim are ultra-orthodox, custodians of traditional Judaism. They consider themselves to be the truer Jews. They believe in the strictly orthodox Rabbi leaders, many of whom are above 90, and in the Torah, Hebrew Scriptures.

David Ben-Gurion, the founding prime minister of Israel, had the difficult job of negotiating between the proposed secular state and the Haredi community. From Ben-Gurion to Netanyahu, every prime minister has pandered to the community for political support. To please them, Ben-Gurion exempted them from military service, made Saturday the official weekly holiday, made kosher food mandatory in state canteens, and forbade civil marriages in Israel. Haredi communities are allowed to run Yeshiva, their own religious schools, funded by the state, which don’t teach core subjects like mathematics, science or the English language.

Nearly half of Haredi males choose not to work at all, relying on state funding and philanthropic aid to feed their large families. About 42% of Haredim live below the poverty line.

Haredi Jews make up 13% of the Israeli population. But the percent will grow because Haredi women have on average 6.6 children, secular women 2.2.  60% of Haredi Jews are under 20, at least ten years younger than the national average. Believe it or not, many Haredim call Israel an anti-Semitic state.

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The coronavirus pandemic reveals and highlights many conflicts. Since the first lockdown, Haredi Jews refused to wear masks. Religious schools continued teaching when all other schools were shut. Yaakov Litzman, Israel’s health minister a year ago, is himself a Hasidic Jew. When Netanyahu first ordered a shutdown of public gathering places including yeshivas and ritual bathhouses, Litzman persuaded Netanyahu to exempt the Haredim from the general lockdown. He argued that there was a higher law to consider. Netanyahu agreed because another election was looming in a few months.

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 Bnei Brak, just east of Tel Aviv, is a concentration of Haredi Jews. It is the poorest and most densely populated city in Israel.

Last April, it became clear Bnei Brak enjoyed no divine protection from covid-19. The crowded study halls in the yeshivas and jam packed ritual public baths turned Bnei Brak and other Haredi concentrations into hot zones.

Keeping kosher in quarantine was a challenge. The Israeli government tried to isolate coronavirus patients by carrying them in ambulances to designated hotels. The residents of Bnei Brak refused to be evacuated. They demanded written proof that food in the hotels would be kosher as certified by their trusted rabbi.

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On 31 January, during Israel’s third lockdown, Rabbi Meshulam Dovid Soloveitchik, 99 years old, died of covid. He was the head of an elite school for ultra-orthodox Jews. A grand funeral was arranged. Later on the same day, Rabbi Yitzchok Scheiner, 98 years old, also succumbed to the virus. Another mass procession followed through Jerusalem.

Chaim Kanievsky, 93 years old, is another prominent rabbi. He refused to shut the religious schools and reportedly said: we don’t care what the law says, we are not going to obey.

Earlier the secular and Haredi communities lived as if on two islands, each in their areas, rarely mixing. Bnei Brak was closed for Sabbath, and a Gay Pride parade could happen in Tel Aviv. The infectious disease showed Israel has no islands, everyone is connected and can affect one another.

Haredi Jews are 13%, but had 36% of the infections. One out of every 100 ultra-orthodox Jew over 60 died from covid, three and a half times more than the general population. This was not a chance event. London has 23,000 ultra-orthodox Jews. In London, the community had 64% infections, one of the world’s highest rates of covid-19 infection. UK average was 7%.

What was the positive impact of the pandemic on some of the younger Haredi Jews? I will discuss that tomorrow.

Ravi