Corona Daily 091: Micro-weddings and Mini-moons

Worldwide, the wedding industry is estimated to be worth $ 300 billion a year. USA’s share is some $73 billion.

The USA wedding numbers are now out. 2.13 million (2018), 2.13 million (2019), 1.11 million (2020). The wedding ceremonies that took place were sharply shrunk, budgets lowered, guest lists curtailed. The micro-weddings were followed by mini-moons instead of honeymoons. Instead of travelling abroad, couples settled for moving domestically, sometimes to a resort only a few miles away.

In 2019, the average wedding in the USA cost $25000+, most of it going to the reception ceremony. In the pandemic, nuptials took place in the family house backyard or online. The expense came down substantially, and wedding industry vendors had to adapt.  Hotels are offering elopement packages, bridal gown designers are creating shorter dresses and bakers are baking miniature cakes to be individually served.

Though there were fewer marriages, reportedly there were more than usual engagements. Couples found themselves locked in the house, or isolated away from one another; both were susceptible to realize love and get engaged. Pre-pandemic engagement rings had 1 carat stones. Now a standard engagement ring comes with a 2.5 carat diamond ($6000-$9000). Larger and more novel cuts of diamonds, including pear and heart shaped stones, are in heavy demand.

Some redirect the saved money on flowers. Instead of 200 guests, they are allowed 20. They are spending on expensive flowers, specialty arrangements and hanging installations.

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Newspapers had published scary stories of traditional weddings held courageously. In August 2020, a 55-person wedding in rural Maine spread infections across more than 200 miles, landing seven in hospital and killing seven in total. A 300-person wedding in Washington resulted in 61 cases, and 15 deaths.

When traditional wedding bookings dried up, Caroline Creidenberg began offering planned Zoom weddings. She bought a few dozen tripods, microphones and lights. There are virtual group dances, toasts and breakout rooms separated by virtual tables. The package costs $1200 excluding photo guest book ($100) and slide shows ($200).

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The Association of British Wedding Businesses reports that 36% weddings were cancelled or postponed. The £10 billion industry suffered a loss of £5.6 billion.

Nearly 80% of the world’s wedding gowns are stitched in China. Those made outside China also rely on Chinese fabrics and materials. Last year, when China closed its factories to curb the coronavirus outbreaks, brides in America and Europe were suddenly dress-less.

Next week, on 20 May, China celebrates its own Valentine’s Day. This year, more than 200,000 Chinese couples have registered for marriage licenses on that day.

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India holds 12 million weddings every year. Some couples don’t want to postpone because the auspicious date set by the family astrologer may not return in future. In Gujarat, reportedly 30,000 wedding ceremonies were cancelled. Those determined to abide by the date either married in a private ceremony or online. Shaadi.com is a popular matchmaking site. It now offers a “weddings from home” (its own form of WFH) service that provides a qualified pundit (Hindu priest), and tutorials for bridal make-up. Some Indian weddings have had hundreds of attendees online, and a live stream for thousands more.

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New York’s Governor Andrew Cuomo went one step ahead in the online wedding business, and issued an executive order named “project cupid”. This for the first time allowed couples to apply for marriage licenses online, and not turn up in person as required by law.

In parts of Asia and Africa, weddings are ruinously expensive. Some shrewd young men and women are hurrying up to marry to save on expense. They can avoid falling in debt over their weddings.

It is an excellent thought to arrange a wedding cheaply, in the backyard or online with only the immediate families present. Postpone the reception ceremony to a few years down the line. That way, money wasted in marriages that don’t last long can be saved. Wise couples would do well to follow this wedding-reception distancing practice even after the pandemic is over.

Ravi 

Corona Daily 092: Babies in Trials

This week, USA has started vaccinating 12-15 years old, just in time for their summer camps. Pfizer has received an emergency approval. There are 50 million children in America below the age of 12. What about vaccinating them?

In fact, Pfizer and Moderna have started clinical trials among younger kids. Moderna has three age groups: 6-11 years old/ 2-5 years old/ 6-20 months old. The youngest participants for either trial are six months old.

The doses for 12-15 age group are the same as for adults. This stage of trial for the younger children is about finding the right dosage. Pfizer is giving one third of an adult dose to the babies, and scaling up age-wise. The side effects will be monitored, and development of antibodies measured. The objective is to find the optimum amount that doesn’t produce too strong a reaction, but is able to protect.

Participation in the trials is competitive. More than 3,400 have applied for the Moderna trials, but only up to 200 will be accepted. The later bigger trial where kids will be given either a vaccine or a placebo will have 7,300 kids for Moderna and 4,000 for Pfizer. If you live in the USA and have young children, you can still apply for either.

Families monitor the children’s health and side effects, are required to keep an electronic daily diary of any symptoms, and commit to one year of follow-ups either by phone or in person. They must take the children to the sites for blood draws to measure antibody response. So far, apart from sore arms and mild temporary symptoms, Moderna participants are fine.

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Parents and legal guardians must give consent. Children capable of understanding are required to agree as well. They have spent a whole year living in a pandemic; even four-year olds have given verbal consent and the reason why they want to. (e.g. They saw the grandparents take the vaccine).

Unlike adults, children’s concerns are immediate. “How much will the injection hurt?” They also worry about the blood draws. Health care workers are usually enthusiastic about their children taking part in vaccine trials.

The larger trials will begin in late summer, and continue into winter. Last year, pharma companies were lucky. A wave started, and as a result there were lots of cases among the trial participants. The trial closed early. If the USA is corona free, the trials will take a long time. If there is no virus, the vaccine receivers and placebo receivers both have the same reaction, making any conclusion impossible.

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There is a debate on the ethics of America vaccinating its youngest. Of the 583,000 corona deaths in the USA, around 300 were children under 18. Some children have suffered from long covid. Concerning as those facts are, the number of cases, hospitalizations and deaths remain small.

In flu or pneumonia, children play a large role in transmission. That doesn’t appear to be the case with covid. Studies in Iceland and Israel showed children below 10 didn’t usually get infected or transmit to others.

Instead of giving 100 million doses to the 50 million American children, the same vaccines could probably protect 50 million adults in vulnerable countries where the contagion is surging. Once the vaccines are established as safe and effective in the current trials, USA can give them to the small group of children with medical conditions, who are at higher risk. And the remaining vaccines can go to people who need them most. That is the argument of the ethicists.

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Early results available show that fully vaccinated 12-15 year olds developed substantially higher level of antibodies than 16-25 year-olds. Scientists wonder if the youngest children may produce the same or greater immune response with a lower dose.

Currently, it is correct to debate the ethics of vaccinating the youngest Americans in times of global vaccine shortage. However, as I wrote in an earlier article, a coronavirus vaccine becoming a routine childhood vaccine may be the long term solution to prevent pandemics. From that point of view, the baby trials are a welcome step in the march of science.

Ravi 

Corona Daily 093: Ten Million and Counting

Yesterday, a Russian friend from Moscow’s Ballet on Ice called. Once upon a time, I had worked as the Russian interpreter with that group. The former ballerina told me about the death of a ballet dancer, our common friend. She has been hearing about so many untimely deaths. Everyone she talks to tells her about three or four people they have lost.

I could relate instantly with her. In Bombay, every day on average I hear about someone dying from covid, a relative’s relative, a friend’s friend, my mother’s student. If 4000 Indians are falling victims to covid daily, and I know one of them, my network has to be fantastic. (Mathematically, I should know 350,000 Indians). The dark possibility is the gross undercount of deaths, both in India and Russia.

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The Economist has been systematically tracking the excess mortality data from the pandemic’s start. It has now completed a robust analysis using available reliable data. For other countries, the model uses 121 different variables to come up with the best estimates.

First the headline numbers. The total number of pandemic deaths are somewhere between 7.1 million and 12.7 million, the central number being 10 million. That is more than three times the official count.

If you look at worldometer, parts of Asia and Africa appear to have escaped the brunt of the virus. Not true according to the Economist. In poor and middle income groups, under-reporting is huge, giving a deceptive picture.

In the USA, the difference between official data and the model output is only 7%. In Romania and Iran, the deaths are more than double the government figures. And in Egypt, excess mortality is 13 times bigger. Peru’s pandemic, even today, is 2.5 times worse than India’s. Nepal and Pakistan also have a suppressed covid count.

For sub-Saharan Africa, the estimated death rate is 14 times the official number.

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What sort of intelligent estimation has the Economist model made?

As a rule, in places where lots of tests come back positive, it is safe to assume that the testing focuses on those seeking medical treatment or have symptoms. Lots of infections are missed in those countries.

Serosurveys show the percent of population with antibodies.

Other indicators are the steps the governments take to curb the pandemic; the extent to which people move around physically (satellite pictures or phone data); systems of government; media freedom, demographic factors; and geographic location.

Russia, where media is controlled by the state, has excess deaths that are 5.1 times greater than official covid deaths. Instead of the 100,000 deaths that Russia reports, more than 500,000 Russians have died. That is why the Russian ballet dancer was surprised at every Muscovite knowing someone who has died.

Closure of schools is a good indication that the actual picture is worse. Indian schools have been shut for over a year. In January, when PM Modi declared victory over coronavirus, he would have reopened the schools if it was a genuine victory.

Demography matters. If two populations have the same level of health care, the one with more elderly people sees more deaths. The risk of dying from covid is 13 times greater in Japan (median age 48) than Uganda (median age 17).

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As per the model, India is seeing between 6000 and 31000 excess deaths daily, not 4000 as reported. It is in line with the epidemiologists’ estimate – between 8000 and 32000. Only in 2021, around one million Indians have already died of covid.

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The methodology of the Economist model is here. The raw data is here. You can check your country’s data here. (Sorry, India is missing).

Under-reporting for whatever reason is a menace. It means not enough ICU beds, not enough ventilators, not enough medicines, and bodies thrown in rivers.

The under-reporting countries, including India and Russia should closely look at the Economist model, and either scientifically refute it, or try to budget medical stocks for the higher figures.

Ravi 

Corona Daily 094: Indian Crisis is Global Crisis

In the last financial year, the Indian economy contracted by 8.5%. In the last twenty five years, this was the first time India plunged into recession. 2021 was expected to offer recovery; those hopes are now dashed by the onslaught of the second wave. For more than forty years after independence, India had quasi-communism, and a so-called Hindu Rate of Growth (3.5% and stagnant). Following the collapse of the USSR, India, to an extent, embraced market economy and globalisation. The pandemic threatens India’s ambitious growth plans. Not even the Hindu nationalist government would want to revert to the Hindu rate of growth. A CNN article this week points out why a crisis in India can be a global crisis.

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First, the supply chains. 80% global trade by volume happens on ships. India is a quality human resource provider for the shipping industry. Currently, couple of my neighbours, friends, and a nephew are sailing on container ships. They are either captains or chief engineers. Out of the 1.7 million seafarers, more than 200,000 are Indians. In terms of ranking, education and skills, the Indian percentage is high. Shortage of seafarers leads to disruption of supply chains. When countries outright ban flights from India, the Indian captains or chief engineers are unable to reach their ship. Alternatively, many can get stuck for months because the replacement doesn’t arrive. Last year, those cargo ships were called floating prisons. It can happen again this year.

Currently, UAE, Singapore, Hong Kong, and China have already imposed strict quarantine restrictions on vessels arriving from India.

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Second, generic medicines. The world by now knows India produces 60% of the world’s vaccines. Serum Institute of India was expected to export 200 million doses to 92 countries, the plan now blockaded by the domestic surge of cases.

India is also the largest supplier of generic (unbranded), cheap medicines. A prescription by an American doctor has 90% drugs made in India. One out of every three pills taken by an American is from India.

Now, there is a catch. India may be the world’s pharmacy, but 70% of the medicines’ raw materials come from China. For USA to get the Indian medicines, the China-India, and India-USA supply chains must function.

Two weeks ago, China’s Sichuan Airlines suspended cargo flights to India for fifteen days. Worried, India’s pharma community has written to the Indian ambassador in Beijing urging him to resolve the issue.

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Third, financial services. If other than medicines, India is not great at exporting goods, it is a powerhouse for export of services. As many as 4.4 million Indians work in IT and business process backend, most working for American or European companies.

Banks are encouraging staff to work from home, shifting work out of India, and extending project deadlines. Work from home is complicated because employees are falling sick, or are looking after sick relatives. Security and data protection are additional challenges. Barclays employs 20,000 people in India. In India, banks fall under essential services. Stanchart CEO said the bank has suffered disproportionate share of cases among its branch staff.

The Big Four accounting firms (KPMG, PwC, EY and Deloitte) and Accenture together employ 350,000 Indians. Ernst & Young activated its contingency plans to shift work from India to other geographies. Accenture employs 200,000 people in seven Indian cities. They also have a plan to shift functions elsewhere if necessary.

In addition to the banks and accountancy firms, Amazon, Twitter, Google, Microsoft, Zoom and Indian IT giants Infosys and Wipro have donated money, medical equipment, opened covid care centers, and offered paid sick leave to their employees.

With vaccine nationalism and superior medical infrastructure, ordinary people in America and Britain may be able to celebrate a normal summer this year. However, those engaged in business will pray for India’s recovery. Front office loses its glamour without a well-functioning back office.

Ravi 

Corona Daily 095: The More People Die, the Less We Care

The Syrian war began in 2011. Bashar Assad and his government started mass killing protestors. By 2015, nearly 250,000 died in the Syrian war, most of them civilians. There was little international interest. Those who analysed Google searches for Syria or refugees found zero searches for four years. That changed overnight when the picture of the drowned Syrian toddler (above) Alan Kurdi went viral internationally. Suddenly, the Google search for Syria and refugees zoomed. Donations to the Red Cross were greatly boosted by that single picture. Why did a single photograph manage to motivate when the death of a quarter of a million people didn’t?

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Joseph Stalin was a disgusting genocidal butcher. But he has some memorable quotes attributed to him. “One death is a tragedy; a million deaths is a statistic”, he had said.

This feeling of indifference was named “Psychic Numbing” by Dr Robert Lifton, a psychiatrist who studied this phenomenon among Hiroshima survivors.

Dr Paul Slovic, the psychology professor at the University of Oregon has devoted his career to research on this subject. He finds that our brains process situations through gut feelings, not logic. We don’t necessarily feel twice as bad when two people die, as compared to one. And as the numbers grow, numbness grows as well. We don’t notice the difference between 80 lit candles and 81. Similarly, our feelings don’t register the difference between 80 deaths and 81 deaths.

Every year, more than two million children die from diarrhea and eight hundred thousand from measles. Stalin starved seven million Ukrainians in a single year, and Pol Pot killed two million Cambodians. Did the world blink? The official coronavirus death count has passed 3 million. Will we feel any different when it crosses 5 million or 10 million? We likely won’t.

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Our capacity to feel is limited.

Many of us are willing to help a single suffering child. Studies have shown that a picture of two children brings down the desire to help. And if it is known that the child is one among thousands or millions, the charitable motive disappears. One life is valuable, but that life loses value, perceptually, if it is part of a larger tragedy. This is technically called the “compassion fade” and the “compassion collapse”.

Charities such as “Save the Children” have recognized it is better to endow a donor with a single, named child to support than to ask for a bigger cause. No matter where we live, we have probably seen a television story where a child falls deep into a narrow well or an abandoned shaft, and the live coverage of the rescue operation is watched by millions for two days. Those millions celebrate the triumph of that rescue because it is an individual story.

There is nothing new about racism in America. But the story and a 9-minute video of a white police officer fatally choking a black man by pressing his knee on him added new life to the “black lives matter” movement.

Abel Herzberg, a holocaust survivor has a famous quote: “There were not six million Jews murdered; there was one murder, six million times.”

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If three million people have died in the pandemic, what is there for us to do? We think our efforts are so puny, we end up doing nothing. This is called a “false sense of inefficacy”. It’s not correct to assume we can’t help, we can.

Awareness of the concepts of psychic numbing and compassion collapse is important. It makes us focus on individuals rather than abstract masses. Since the start of the pandemic, I have picked up two individuals in my neighbourhood, a cobbler and a car-washer. Every month, I partly compensate their monthly loss of earnings. They are happy, and I am happy. The joy of giving is no less than the joy of receiving.

Millions affected by the pandemic is a numbing concept. But any of us can help an identified one or two people. When you want to, help as soon as possible. Compassion also has a shelf life and an expiry date.

Ravi 

Corona Daily 096: Licence to Hug

The UK is the happiest nation today.

British are the most law abiding people in the world. And British lawmakers make detailed, fact-figure-and-distance based, precise laws clarifying every human act allowed or disallowed in this pandemic time.

Yesterday, Boris Johnson announced the single biggest step on the roadmap: People can now hug. After a year, hugging will be legal. (Hang on, don’t rush forward so quickly.) Hugging is allowed from Monday, 17 May. Just a little more restraint before you spread your arms.

Yesterday; England, Scotland and Northern Ireland reported zero coronavirus deaths. Wales reported four. In Wales, hugging may not be possible from 17 May, but that point awaits clarification.

Johnson, while making the delightful announcement, urged people to use caution and common sense before hugging. “Whoever I hug, I can assure you, it will be done with caution and restraint”, he said. He clarified hugging remains a matter of personal choice, which probably means it is not mandatory to hug simply because it is now lawful. The licence to hug has venue limitations. In shops, pubs, restaurants and offices, social distancing norms remain intact. Hugging there is not allowed, unless you know some technique of hugging by leaving a gap of one meter plus between the hugger and the huggee.

From 17 May, 30 people, including the bride and groom, will be allowed to attend a wedding. Downing Street confirmed all guests must sit at the tables, and dancing and hugging is not allowed. The same people can hug at home, exercising due caution and common sense, but not at the wedding. A new hashtag #whataboutweddings is trending on social media today.

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Health minister Nadine Dorris on BBC Breakfast said friends and families would be allowed to hug, but called for cautious optimism.

Professor John Bell from Oxford University agreed the country was in a strong position to move ahead with hugging. “I think we’ll still probably go steady, but perhaps a bit faster” he told Good Morning Britain.

Minister Michael Gove said government wanted to see “friendly contact” and “intimate contact” between family and friends.

Catherine Noakes, an airborne infection specialist from Leeds University was a spoilsport. She said we should hug in moderation. She offered valuable tips for moderate hugging: Ask yourself - who are you hugging? Are they close family? Friends? Whoever you hug, don’t do it frequently. Let every unavoidable hug be short. Avoid face-to-face hug. Wash hands with soap before hugging. And please keep the mask on while hugging.

Dr Hilary Jones agreed with Professor Noakes. Hugs should be short, selective. “hug your children, grandchildren, not promiscuous hugs we are talking about here, not hugging everybody, not getting too close for too long.” He warned.

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A couple of scientists have suggested a brief hug, ensuring not to breathe towards the other person. Maybe both can turn their faces behind while hugging. However, if you choose to hug, enjoy it, advise the same scientists.

Chief scientific advisor Sit Mark Walport said on radio that the UK has 35% unvaccinated adults, 60% with only one dose and the truth is that the virus has not gone away. Sir Walport would like you to remember this while hugging.  

Experts have clarified that like with anything in life, consent is key. Asking someone “may I hug you” before hugging would be polite. You can simply say “what about” and widen your arms, before judging the non-verbal signals from the other party as to whether mutual physical contact is acceptable or not.

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The point missed by many foreign readers is that the British have never been known as huggers. They are happy to acknowledge the presence of another person with a quiet nod, or at best a droopy handshake. Thanks to the coronavirus pandemic, for the first time, they get a license and encouragement from the government to hug. The coming months will show how heartily they embrace this newly acquired licence.

Ravi 

Corona Daily 097: Back to Prison

In April 2016, Gwen Levi's sisters applied to President Obama for clemency.

Gwen was 70, suffering from lung cancer. Her 90 year old mother was unlikely to see her again. Since Gwen is black, her family perhaps thought they had a good chance of presidential pardon from Obama. Obama didn’t grant the pardon, perhaps fearing criticism of racial favoritism.

With the pardon rejected, everyone knew Gwen would never return home. Even if she survived the lung cancer, her release date is 2033 when she would be 88 years old.

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Born in 1945, Gwen is one of the thirteen children raised by her mother. The father didn’t live with them, Gwen rarely saw him. At 25, she married a man who had three children from an earlier marriage. The couple had three children of their own.  Gwen looked after all six.

In 2000, she was arrested as part of a group selling a kilo of heroine. That crime carries a minimum punishment of ten years. The prosecutors tried to cut a deal, called plea bargain, with her. She should testify against her co-conspirators to get a lighter sentence. Not known whether she had good lawyers, and whether she understood the contractual agreement with the prosecution.

When she stood in the court to testify, one of the co-conspirators was her son. Her testimony would incriminate him. Gwen refused. The prosecution reminded her of her plea bargain obligation. She still refused. This turned out to be as serious a crime as the selling of heroine. Her co-conspirators got lower sentences than her, even those carrying guns. Gwen was not accused of any violence. She was sentenced to 400 months, which is more than 33 years in prison. Among developed nations, America has harsher sentences. It is a rare democracy that regularly executes people. In several cases, Blacks have got longer sentences than Whites for the same crime.

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The clemency letters were rejected in 2016. Four years had passed. Gwen’s mother had turned 94. And coronavirus entered America. Prisons were a dangerous area. Prison staff along with inmates was getting infected and dying. It was decided that 25,000 inmates would be transferred to home confinement.

Gwen Levi qualified under the CARES act. She was 75, was in cancer remission, posed no danger to anyone, her crime was non-violent, her conduct in prison was excellent, her disciplinary record spotless. In prison, she advocated for senior inmates, and trained to become a service dog handler. Her sisters were willing to accommodate her in their home. Gwen was keen to become part of society. In June 2020, she was finally going home.

She still needed to wear an ankle monitor, and give her work schedule regularly. However, she joined her sons, held her grandchildren, hugged her mother and sisters. Her bed and toilet were not in the same room any more. This is what rehabilitation was, Gwen thought.

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Donald Trump had shown his bloodthirstiness by executing three people during his last days despite knowing Biden intended to cancel their executions. Five days before Trump left office, his justice department issued a memo confirming that all released prisoners should be sent back to prisons when the pandemic in the USA ends. Gwen must go back to prison at some point, and serve out her remaining sentence till 2033.

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Out of the 25,000 prisoners sent home due to the pandemic, only 21 have violations that sent them back to prison. This is a high success rate. Male inmates who couldn’t find work are raising their children, while their wives work. Others are taking care of their parents. All of them must go back to prison, once the pandemic ends.

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Last month, 28 congress members urged Biden to reverse the “Trump administration’s cruel and misguided decision” saying a return to prison would harm families and waste tax dollars. People like Gwen were not told they would have to return to prison. Forcing them to do so would be cruel and devastating.

Gwen in her interview says she thought she was already rehabilitated. President Biden has a chance to prove her right.

Ravi

Corona Daily 098: The Black Blinding Fungus

India’s BBC correspondent reports on his interaction with Dr Akshay Nair, an eye surgeon from Mumbai. Yesterday, Dr Nair operated on a 25 year old girl who had recovered from covid three weeks ago. She was diabetic. The ENT specialist had inserted a tube in her nose, and was trying to remove tissues infected with mucor, a rare but deadly fungus. In the three hour surgical procedure, in order to save her life, Dr Nair had to remove her eye.

In April, Dr Nair saw forty patients with mucormycosis. Eleven of them (28%) had to have an eye removed.

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Mucormycosis, informally known as the Black Fungus, usually infects the sinuses and via the eyes rapidly moves to the brain. Patients typically have a stuffy and bleeding nose, swelling of and pain in the eye, drooping of eyelids, blurred vision. Black patches of skin can form around the nose. Mucor can grow behind the eye, and compress the optic nerve.

Suddenly, Indian newspapers are filled with reports of black fungus patients from around the country. The numbers are small by Indian standards, but that was the case when coronavirus started. Awareness is useful before things get out of hand.

Dr Shailesh Kolhatkar is a practising head and neck cancer surgeon in Nagpur. During the last twenty years, he operated on just 11 patients with black fungus. In the last two months, he is performing three to four surgeries every day. Similar stories are happening in several states. The Gujarat government has set up a special ward for mucormycosis, and bought 5000 vials of the expensive injection Amphotericin B for Rs 3.12 crore ($450,000). It can happen at any age, but most common is 35-65 years.

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Diabetic patients are in the high risk category. Mucor attacks people with uncontrolled sugar.  It rarely happens to non-diabetic patients, unless their immunity is severely compromised by AIDS or cancer.

The main reason behind a black fungus infection is man-made. Covid patients are given dexamethasone or other medicines that suppress immunity. Steroids have a tendency to increase blood sugar levels even in non-diabetics.

If such patients are exposed to wet surfaces, the chances of mucormycosis grow. Some covid patients are put on oxygen support, which has a humidifier containing water. If the water leaks from the humidifier, or general hygiene is not good, the fungus has ideal conditions to infect.

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This is a fast-moving disease with high mortality. It takes only a few days for the fungus to reach the brain.

If detected early, an anti-fungal intravenous injection costing $50 has to be administered daily for eight weeks. The total cost of the treatment is beyond the budget of an average Indian.

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In terms of prevention, doctors say it is important to keep the sinuses open. That can be done by applying steam. Diabetic covid patients should watch their sugar levels. Hygiene is important. Oxygen cylinders when required must be clean. Humidity can increase the risk. Black fungus is an invasive disease.

The most important preventive measure is to focus on the use of steroids. Some covid patients graduating from WhatsApp University are themselves opting for steroids when not necessary. The general advice is not to take steroids for the first five-six days of covid infection. Steroids should never be given in mild cases. The doses and duration of life-saving steroids must correspond to the severity of covid.

The medical community in general is trained to offer strong medical interventions. In covid times, there is little opportunity for doctors to diagnose and treat each patient individually. Indian standards seem to be more relaxed than in America and Europe. Recognising this, the Indian medical body issued altered guidelines in April. They recommend reduced uses of steroids based on the covid severity.

Not only for covid, but for any disease if, god forbid, you or your loved ones land in a hospital, you must always insist on knowing what medicines are administered. That is a patient’s right. Even for patients in the ICUs, that right should not be surrendered.

If the cure for Covid makes the patient blind, the virus can’t really be blamed for that.

Ravi   

Corona Daily 099: The Great Unwashing

As an Indian who lives in hot, humid, dirty, polluted Bombay; who gets drenched in sweat after a morning run; who after returning from a visit to the crowded vegetable market first rushes to wash up; who is among the privileged Indians to have access to water round-the-clock; I found the newspaper reports from North America and Europe shocking.

In the pandemic, people are taking fewer showers. Some Brits and Americans, displaying their names and photos in leading national newspapers, say that before the pandemic they were showering every day. Now they shower once a week.

In a major survey by the UK government, 17% of the population said it is showering less. Younger people, between 18 and 24, have a higher percentage of unwashing: 27%. In total, 28% are using less or no deodorants. 45% of generation Z and 40% of millennials are skipping deodorants. 30% of Britons are less inclined to put on fresh clothes. 25% have cut down on hair-washes. Women are delaying hair-washes twice as much as men, presumably because they have more hair to wash.

 The survey also includes stats about reduction in change of underwear and socks, but I will leave the more curious readers to probe those stats on their own.

Teenagers in America and Europe are dodging showers. After children reach a certain age, parents can’t force them to shower. Currently, that age seems to be nine.

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The less-washing people have made several observations. Many are happy they have one less thing to do. Ms W, 49, says she began thinking deeply about why she was showering every day before the pandemic (a truly philosophical question). Another lady, a school teacher said with British candidness that she takes a weekly shower, but washes essential parts at the sink. Her youngest kids at school would tell her if she didn’t smell good. Now they are learning remotely. Zoom hasn’t yet introduced a function where you can smell the person on screen. One man actually said he doesn’t shower until he smells.

Another person showers only when he leaves the building. In full lockdown, that person showered only once a month. He claims he started feeling grimy only after twenty-five days or so.

One interviewee says that with no one around except his flatmate, he doesn’t see the point in keeping clean.

Three in five people said they are using much less makeup in the pandemic, reducing the need for daily showers.

While reading the stories, I remembered a Swiss boy at my voluntary camp in Poland. The year was 1987, Polish summers were cooler. This boy arrived at a two week-camp only with a toothbrush. As an Indian, that was my first introduction to how customs can differ. The boy wearing the same t-shirt and shorts for a fortnight had chosen me as his roommate.

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Donnachadh McCarthy, 61, a Londoner, said showers are relatively new, a twentieth century phenomenon. Earlier, Britons had a bath once a week, usually on Sunday nights, and for the rest of the week washed only armpits and privates. Later, indoor plumbing improved, giving the middle class more access to running water. You were rich if you could bathe every day.

Some health experts call the daily showers aesthetic, unnecessary, commercialized by soap and shampoo companies, and even counterproductive. Washing with soap daily can strip the skin of its natural oils and leave it feeling dry.

Climate advocates love the concept of washing once a week, which they call environmentally friendly, practical and freeing. An eight minute shower uses 65 liters of water, according to the water research fund. (And a running bath ten times more).

The reduction in dating and overall sexual activity has also had its impact on the washing habits.

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Pandemic is clarifying which part of grooming we do for our own sake, and which for others. Men are shaving less. All are wearing formal clothes less. Women are giving up bras.

It seems, daily showering was another activity some people largely did for the sake of others.

Ravi 

Corona Daily 100: The Giving Wall

Miami is a former mining town with a population of 13,000 in Oklahoma State.

28 year old Jennifer White should be admired for her courage to open The Dawg House in September 2020, right in the middle of the pandemic. She sells hot dogs with extra meat, cheese, bacon, three-egg omelettes, and other hot meals.  

As if the coronavirus was not enough, Miami was hit with blizzards just like neighbouring Texas in February. The town was without power for a couple of days. The local mayor helped get homeless people into church shelters.

Jennifer wanted people in her community to be fed whether they had money for a meal or not. She came up with the idea of the giving wall. She put a sign near the entrance inviting her customers to buy receipts for extra meals and post the receipts on the café’s walls.

The mayor was the first to buy an extra meal and post the receipt on the wall. As the word spread, the café wall was filled with receipts within eight hours.

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Poor hungry people may not have money, but they have dignity.

They can simply come to the café, in an unobtrusive way pull off a receipt from the wall, sit at a table and get served a hot meal. The waiters are trained not to distinguish between guests who pay money, and those who pay with wall receipts. No questions asked. Tipping is not necessary. But some donors, who buy extra meals, attach one or two cash dollars as a tip to the prepaid receipt.

This infectious idea has spread to other towns such as Grove and Vinita in Oklahoma. Zack’s café has a notice that says: “If you are hungry or know someone who is… these tickets have been paid for in advance by previous customers. Please grab a ticket and eat!” The local church in Grove put up receipts worth $100 on the church wall.

Lasay Castellano, a nursing student who until recently worked as a manager of Zack’s café, said the diner serves about 600 people a day. She has been taping up receipts throughout the day for the last two months.

At Montana Mike’s, the general manager said she answered a call from a person from Chicago. He read the story about the giving wall, and wanted to purchase several meals and add them to the wall. He had never been to Oklahoma, but he loved the concept and wanted to be a part of it. People like him can keep the idea going, felt the manager.

In all these places, some people who were the beneficiaries of the giving wall, have now regained their lost jobs. They have come back to the same cafes, and bought an extra meal themselves.

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Jennifer White says among all the people who were the recipients of the free meals at The Dawg House, one family stood out. A couple and four daughters had quietly taken the receipts and sat at a table. “They were just so sweet, and their parents were beyond grateful and thankful.” Jennifer said. “They seemed like they had a lot going on and got to sit for an hour or so to just have a meal, have fun and laugh, and not worry about how much they were having to spend.”

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From each according to ability, to each according to need, a slogan by Karl Marx was dismissed as idealistic, impractical, and not consistent with human nature. Yesterday’s bicycle man and the giving wall stories suggest that human nature is still capable of being humane.

Ravi