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| The Virus Is Coming to Myanmar, but the Pain Has Already Begun | The Virus Is Coming to Myanmar, but the Pain Has Already Begun |
| (3 days later) | |
| HLAING THARYAR, Myanmar — When he was 12, Ko Naing Lin survived a cyclone that killed his father, a small-town doctor, and at least 130,000 others in the Irrawaddy Delta of Myanmar. A life of lazy soccer games, plentiful fish curry and reprimands to finish his homework — “Now, or else what will become of you?” — ended. | HLAING THARYAR, Myanmar — When he was 12, Ko Naing Lin survived a cyclone that killed his father, a small-town doctor, and at least 130,000 others in the Irrawaddy Delta of Myanmar. A life of lazy soccer games, plentiful fish curry and reprimands to finish his homework — “Now, or else what will become of you?” — ended. |
| Today, Mr. Naing Lin’s life is being overturned again, this time by the coronavirus. It is not — yet — a matter of a spreading outbreak in Myanmar, whose health care system is on life support. The country, which borders China, has only five confirmed cases of the virus, all announced this week. | Today, Mr. Naing Lin’s life is being overturned again, this time by the coronavirus. It is not — yet — a matter of a spreading outbreak in Myanmar, whose health care system is on life support. The country, which borders China, has only five confirmed cases of the virus, all announced this week. |
| Instead, a suspension of Chinese imports is threatening the livelihoods of the roughly one in five people in Myanmar who work in the bag, shoe and garment industries. Dozens of factories have already closed, including Mr. Naing Lin’s. | Instead, a suspension of Chinese imports is threatening the livelihoods of the roughly one in five people in Myanmar who work in the bag, shoe and garment industries. Dozens of factories have already closed, including Mr. Naing Lin’s. |
| In addition, factory owners, most of whom are Chinese citizens, are using the chaotic situation to shunt unionized workers aside, labor activists said. | In addition, factory owners, most of whom are Chinese citizens, are using the chaotic situation to shunt unionized workers aside, labor activists said. |
| For hundreds of millions around the world like Mr. Naing Lin, who struggle to keep their heads above the poverty line, the economic impact of the coronavirus has so far been more shattering than the virus itself. | For hundreds of millions around the world like Mr. Naing Lin, who struggle to keep their heads above the poverty line, the economic impact of the coronavirus has so far been more shattering than the virus itself. |
| These vulnerable populations have no social safety net, no health insurance, no retirement accounts. In the thatched shack where Mr. Naing Lin lives with his mother and younger brother, there is no refrigerator to stock with quarantine provisions, only a pile of sweet potatoes and some cooking oil. | These vulnerable populations have no social safety net, no health insurance, no retirement accounts. In the thatched shack where Mr. Naing Lin lives with his mother and younger brother, there is no refrigerator to stock with quarantine provisions, only a pile of sweet potatoes and some cooking oil. |
| “There is no hope of getting a new job,” said Mr. Naing Lin, 24. | “There is no hope of getting a new job,” said Mr. Naing Lin, 24. |
| Then he broadened his judgment. “There is no hope,” he said. | Then he broadened his judgment. “There is no hope,” he said. |
| After his father’s death 12 years ago left the family without its breadwinner, Mr. Naing Lin started lifting 55-pound bags of cement on the night shift, earning barely enough to feed the family once or twice a day. | After his father’s death 12 years ago left the family without its breadwinner, Mr. Naing Lin started lifting 55-pound bags of cement on the night shift, earning barely enough to feed the family once or twice a day. |
| At age 13, he began working as a school janitor. The students slumped in their seats didn’t notice the slight shadow behind them, desperate to learn even as he mopped, swept and dusted. | At age 13, he began working as a school janitor. The students slumped in their seats didn’t notice the slight shadow behind them, desperate to learn even as he mopped, swept and dusted. |
| “I felt very small and sad,” Mr. Naing Lin said. | “I felt very small and sad,” Mr. Naing Lin said. |
| He scrimped and saved and scrimped some more. At a night school, he completed a Level One English course, receiving a laminated identity card that he still carries with him. | He scrimped and saved and scrimped some more. At a night school, he completed a Level One English course, receiving a laminated identity card that he still carries with him. |
| “How are you?” Mr. Naing Lin said, in English. “My name is Naing Lin.” | “How are you?” Mr. Naing Lin said, in English. “My name is Naing Lin.” |
| He wanted to take Level Two, but the class was too expensive. | He wanted to take Level Two, but the class was too expensive. |
| So Mr. Naing Lin went to Hlaing Tharyar, an industrial zone on the outskirts of Yangon, Myanmar’s biggest city. He got an ironing job at a textile factory, the lowest rung on a short ladder. Once more, he studied at night, learning how to fix the machines in the factories that were proliferating here, employing more than a million people in a country of 50 million. | So Mr. Naing Lin went to Hlaing Tharyar, an industrial zone on the outskirts of Yangon, Myanmar’s biggest city. He got an ironing job at a textile factory, the lowest rung on a short ladder. Once more, he studied at night, learning how to fix the machines in the factories that were proliferating here, employing more than a million people in a country of 50 million. |
| If his father had lived, Mr. Naing Lin might have become a doctor, too. But his job as a mechanic at least provided for his mother and his brother, who has Down syndrome. Mr. Naing Lin earned $175 a month. | If his father had lived, Mr. Naing Lin might have become a doctor, too. But his job as a mechanic at least provided for his mother and his brother, who has Down syndrome. Mr. Naing Lin earned $175 a month. |
| His mother bought extra thatch to reinforce their home’s roof, so it wouldn’t leak during the monsoons. He bought a smartphone. | His mother bought extra thatch to reinforce their home’s roof, so it wouldn’t leak during the monsoons. He bought a smartphone. |
| Then, this month, his factory’s Chinese boss made an announcement. Its supply chain had been severed in February, when Myanmar closed the land border with China because of the coronavirus epidemic there. Nearly all raw materials for Myanmar’s textiles industry come from China; even if the pipeline opens up again, manufacturers expect a slowdown in global demand. | Then, this month, his factory’s Chinese boss made an announcement. Its supply chain had been severed in February, when Myanmar closed the land border with China because of the coronavirus epidemic there. Nearly all raw materials for Myanmar’s textiles industry come from China; even if the pipeline opens up again, manufacturers expect a slowdown in global demand. |
| Mr. Naing Lin was unemployed, and he was far from alone. | Mr. Naing Lin was unemployed, and he was far from alone. |
| “We fear that the virus comes with the imports from China,” said Ma Hnin Thazin, a representative of the Industrial Workers Federation of Myanmar. “But we also fear that so many people are losing their jobs.” | “We fear that the virus comes with the imports from China,” said Ma Hnin Thazin, a representative of the Industrial Workers Federation of Myanmar. “But we also fear that so many people are losing their jobs.” |
| Even before the coronavirus hit, factories in Hlaing Tharyar had been roiled by a series of strikes, as workers clamored for basic rights. For example, they wanted free bandages for injuries from sewing machines, which they said occurred daily. | Even before the coronavirus hit, factories in Hlaing Tharyar had been roiled by a series of strikes, as workers clamored for basic rights. For example, they wanted free bandages for injuries from sewing machines, which they said occurred daily. |
| At a duffel-bag factory down the street from where Mr. Naing Lin worked, 196 workers staged walkouts over a 13-day period in February because the foul-tasting drinking water was making them sick. | At a duffel-bag factory down the street from where Mr. Naing Lin worked, 196 workers staged walkouts over a 13-day period in February because the foul-tasting drinking water was making them sick. |
| “It is very hot when we work,” said one of them, Ma Thandar Myint. “The water was yellow, and I had to pinch my nose when I drank it.” | “It is very hot when we work,” said one of them, Ma Thandar Myint. “The water was yellow, and I had to pinch my nose when I drank it.” |
| When Ms. Thandar Myint and hundreds of her co-workers were laid off this month because of the coronavirus shutdown, her severance was docked because she had participated in the strike. | When Ms. Thandar Myint and hundreds of her co-workers were laid off this month because of the coronavirus shutdown, her severance was docked because she had participated in the strike. |
| But if the job were offered to her again, she would take it, she said. | But if the job were offered to her again, she would take it, she said. |
| “It’s a bad job, but it’s a job,” Ms. Thandar Myint said. “If I gave it up, 10 people would want to take my place.” | “It’s a bad job, but it’s a job,” Ms. Thandar Myint said. “If I gave it up, 10 people would want to take my place.” |
| Updated June 12, 2020 | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| In a statement, the factory’s Chinese owners spoke of deep debts and said there had been no choice but to close down. | In a statement, the factory’s Chinese owners spoke of deep debts and said there had been no choice but to close down. |
| Over the years, hundreds of thousands of people from Myanmar have moved to neighboring countries to work as undocumented manual laborers or household staff. With Southeast Asian nations closing their borders to ward off the pandemic, many of those workers have rushed back to Myanmar. At just one bridge between Thailand and Myanmar on Monday, more than 10,000 migrant workers were lined up to get home. | Over the years, hundreds of thousands of people from Myanmar have moved to neighboring countries to work as undocumented manual laborers or household staff. With Southeast Asian nations closing their borders to ward off the pandemic, many of those workers have rushed back to Myanmar. At just one bridge between Thailand and Myanmar on Monday, more than 10,000 migrant workers were lined up to get home. |
| For weeks, Myanmar government officials dismissed warnings that the virus could consume the country, claiming that its dietary habits and tropical climate inoculated it. Myanmar’s health care spending is among the lowest in the region; its second largest city, Mandalay, has only about 50 ventilators, according to suppliers. | For weeks, Myanmar government officials dismissed warnings that the virus could consume the country, claiming that its dietary habits and tropical climate inoculated it. Myanmar’s health care spending is among the lowest in the region; its second largest city, Mandalay, has only about 50 ventilators, according to suppliers. |
| “I was as happy as if I had discovered gold when I found three masks at my home,” said U Khaing Toe, an assistant surgeon at Yangon General Hospital. “There are no masks for us at the hospital.” | “I was as happy as if I had discovered gold when I found three masks at my home,” said U Khaing Toe, an assistant surgeon at Yangon General Hospital. “There are no masks for us at the hospital.” |
| The five coronavirus cases confirmed so far in Myanmar involve patients who were recently overseas, and the influx of returning migrant workers has catalyzed government action after weeks of denial about the virus. As of Wednesday, all people returning from abroad were subject to a 14-day quarantine in a government-designated facility. | The five coronavirus cases confirmed so far in Myanmar involve patients who were recently overseas, and the influx of returning migrant workers has catalyzed government action after weeks of denial about the virus. As of Wednesday, all people returning from abroad were subject to a 14-day quarantine in a government-designated facility. |
| Myanmar has tested only about 320 people for the virus. | Myanmar has tested only about 320 people for the virus. |
| Back in Yangon, Mr. Naing Lin studied a government poster with tips on how to prevent the coronavirus: washing hands with running water, social distancing, wearing masks. (The country’s de facto civilian leader, Daw Aung San Suu Kyi, has appeared in a video that shows her vigorously scrubbing her hands with a bar of pink soap.) | Back in Yangon, Mr. Naing Lin studied a government poster with tips on how to prevent the coronavirus: washing hands with running water, social distancing, wearing masks. (The country’s de facto civilian leader, Daw Aung San Suu Kyi, has appeared in a video that shows her vigorously scrubbing her hands with a bar of pink soap.) |
| Mr. Naing Lin laughed. Outside, crowds of laid-off workers milled around, holding hands, comforting each other. | Mr. Naing Lin laughed. Outside, crowds of laid-off workers milled around, holding hands, comforting each other. |
| Mr. Naing Lin’s shack doesn’t have running water, nor can he afford a mask. Social distancing is not feasible in a slum. He shook his head. | Mr. Naing Lin’s shack doesn’t have running water, nor can he afford a mask. Social distancing is not feasible in a slum. He shook his head. |
| “If this disease comes to Myanmar,” he said, “we will all be finished.” | “If this disease comes to Myanmar,” he said, “we will all be finished.” |
| Saw Nang contributed reporting. | Saw Nang contributed reporting. |