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| As India Loosens Its Strict Lockdown, Coronavirus Deaths Jump Sharply | As India Loosens Its Strict Lockdown, Coronavirus Deaths Jump Sharply |
| (about 2 months later) | |
| NEW DELHI — Part of India’s success in blunting the spread of the coronavirus had been a fierce lockdown that was zealously obeyed. | NEW DELHI — Part of India’s success in blunting the spread of the coronavirus had been a fierce lockdown that was zealously obeyed. |
| But in the last few days, the government has loosened up the rules, drawing people into the streets. And now the dangerous contagion appears to be spreading more aggressively. | But in the last few days, the government has loosened up the rules, drawing people into the streets. And now the dangerous contagion appears to be spreading more aggressively. |
| The doubling rate of infections — the amount of time it takes for the number of coronavirus cases to double — has dropped from around 12 days to 9.5. The daily death rate has shot up from a few dozen in mid-April to more than 100 now. | The doubling rate of infections — the amount of time it takes for the number of coronavirus cases to double — has dropped from around 12 days to 9.5. The daily death rate has shot up from a few dozen in mid-April to more than 100 now. |
| This is still a long way from the devastating toll that the United States and several European countries have been enduring. The total number of reported infections in India is around 50,000, giving it a much lower per capita case rate than many other countries. | This is still a long way from the devastating toll that the United States and several European countries have been enduring. The total number of reported infections in India is around 50,000, giving it a much lower per capita case rate than many other countries. |
| But a tour of Delhi shows how much has changed just this week. | But a tour of Delhi shows how much has changed just this week. |
| The streets of working-class neighborhoods that last week were deserted are thronged with people. Bicycle rickshaws dart in and out of traffic. Pedestrians flow down the sides of the road. Most wear masks, as required, but many wear them off their chins with their noses and sometimes even their mouths exposed. | The streets of working-class neighborhoods that last week were deserted are thronged with people. Bicycle rickshaws dart in and out of traffic. Pedestrians flow down the sides of the road. Most wear masks, as required, but many wear them off their chins with their noses and sometimes even their mouths exposed. |
| At liquor stores, which reopened Monday for the first time in six weeks — the government was desperate for liquor tax revenue — there is nothing close to social distancing. Instead, there is utter chaos. | At liquor stores, which reopened Monday for the first time in six weeks — the government was desperate for liquor tax revenue — there is nothing close to social distancing. Instead, there is utter chaos. |
| Police officers try to beat back the crowds with long sticks, but it’s no use. The crowds just keep growing, with lines at stores sometimes stretching nearly a mile. At one shop in Delhi on Tuesday, hundreds of men converged to buy whiskey, pushing and shoving to get closer to the front, crumpled bills in their fingers, wild looks in their eyes. Many packed so close to each other that they rested their hands on the sweaty backs of people in front of them. | Police officers try to beat back the crowds with long sticks, but it’s no use. The crowds just keep growing, with lines at stores sometimes stretching nearly a mile. At one shop in Delhi on Tuesday, hundreds of men converged to buy whiskey, pushing and shoving to get closer to the front, crumpled bills in their fingers, wild looks in their eyes. Many packed so close to each other that they rested their hands on the sweaty backs of people in front of them. |
| As the heat rises — it hit 104 degrees in New Delhi a few days ago — people who live in cramped quarters, sometimes eight to a room, are finding it unbearable to stay indoors as the government has ordered. So they spill outside. They mingle in the streets. They gather. | As the heat rises — it hit 104 degrees in New Delhi a few days ago — people who live in cramped quarters, sometimes eight to a room, are finding it unbearable to stay indoors as the government has ordered. So they spill outside. They mingle in the streets. They gather. |
| “There’s no police around, nobody is enforcing the lockdown, people are out everywhere,” said an exasperated Delhi shopkeeper who goes by one name, Mehtab. | “There’s no police around, nobody is enforcing the lockdown, people are out everywhere,” said an exasperated Delhi shopkeeper who goes by one name, Mehtab. |
| The virus’s hot spots are India’s crowded urban areas, especially New Delhi, the political capital, and Mumbai, the business capital. About a third of all reported infections are from these two cities, each home to around 20 million people. | The virus’s hot spots are India’s crowded urban areas, especially New Delhi, the political capital, and Mumbai, the business capital. About a third of all reported infections are from these two cities, each home to around 20 million people. |
| In Mumbai, the police officers enforcing the lockdown seem exhausted, and withdraw from neighborhoods at night. | In Mumbai, the police officers enforcing the lockdown seem exhausted, and withdraw from neighborhoods at night. |
| “Every night when the police leave, the people get out as if there is a party,” said Rakhi Jadhav, a local representative in eastern Mumbai. | “Every night when the police leave, the people get out as if there is a party,” said Rakhi Jadhav, a local representative in eastern Mumbai. |
| Dharavi, one of Mumbai’s biggest slums, where a million or so people are squeezed into less than one square mile of shacks and narrow alleyways, is emerging as a serious concern. At least 600 residents there have been infected and it’s nearly impossible to socially distance. People live face to face and share communal toilets, often dozens of people using just one. | Dharavi, one of Mumbai’s biggest slums, where a million or so people are squeezed into less than one square mile of shacks and narrow alleyways, is emerging as a serious concern. At least 600 residents there have been infected and it’s nearly impossible to socially distance. People live face to face and share communal toilets, often dozens of people using just one. |
| Across the city, people are watching Dharavi closely. Officials are beginning to worry they might not have the resources they need to prevent a much wider outbreak. | Across the city, people are watching Dharavi closely. Officials are beginning to worry they might not have the resources they need to prevent a much wider outbreak. |
| “Testing labs, beds, facilities — they are all being overburdened with asymptomatic and mildly infected patients,” said Pradip Awate, an epidemiologist and chief surveillance officer in Maharashtra state, home to Mumbai. | “Testing labs, beds, facilities — they are all being overburdened with asymptomatic and mildly infected patients,” said Pradip Awate, an epidemiologist and chief surveillance officer in Maharashtra state, home to Mumbai. |
| Six weeks ago, India’s prime minister, Narendra Modi, imposed a strict nationwide lockdown for India’s 1.3 billion people. Mr. Modi ordered Indians to stay in their homes, and his government shut down just about everything from schools and offices to railroads and the country’s airspace. Even the borders separating India’s states were sealed. | Six weeks ago, India’s prime minister, Narendra Modi, imposed a strict nationwide lockdown for India’s 1.3 billion people. Mr. Modi ordered Indians to stay in their homes, and his government shut down just about everything from schools and offices to railroads and the country’s airspace. Even the borders separating India’s states were sealed. |
| Many Indians obeyed the rules, wary of catching the virus and not trusting India’s beleaguered health care system to save them. | Many Indians obeyed the rules, wary of catching the virus and not trusting India’s beleaguered health care system to save them. |
| But as the weeks have dragged on, the economic costs have piled up and people are becoming more desperate. Many Indians live hand-to-mouth on the equivalent of a few dollars a day, and countless millions have been thrown out of work. Endless streams of migrant workers have trudged hundreds of miles back to their villages, hoping to rely on their families and farms to survive. | But as the weeks have dragged on, the economic costs have piled up and people are becoming more desperate. Many Indians live hand-to-mouth on the equivalent of a few dollars a day, and countless millions have been thrown out of work. Endless streams of migrant workers have trudged hundreds of miles back to their villages, hoping to rely on their families and farms to survive. |
| Updated June 24, 2020 | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | |
| 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. | |
| 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. | |
| 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. | |
| 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 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. | |
| Many out-of-work laborers are still marooned in India’s cities with no source of income and no way to feed their families except for meals provided by charities or the government. | Many out-of-work laborers are still marooned in India’s cities with no source of income and no way to feed their families except for meals provided by charities or the government. |
| With the pressure building, the central government and many states loosened up the lockdown rules this week, allowing small wedding ceremonies to resume, buses to operate and many businesses to open, including salons, pet shops and electrical stores. | With the pressure building, the central government and many states loosened up the lockdown rules this week, allowing small wedding ceremonies to resume, buses to operate and many businesses to open, including salons, pet shops and electrical stores. |
| So now Indians are wondering if the easing of the lockdown has led to the surge in reported infections or if this is the right time, with cases already rising, to allow people to interact more easily. The increase in reported infections could also be from an increase in the number of tests, from about 20,000 in late March to more than a million today. India has reported just one positive case for every 25 tests, compared with one infection for every six tests in the United States. | So now Indians are wondering if the easing of the lockdown has led to the surge in reported infections or if this is the right time, with cases already rising, to allow people to interact more easily. The increase in reported infections could also be from an increase in the number of tests, from about 20,000 in late March to more than a million today. India has reported just one positive case for every 25 tests, compared with one infection for every six tests in the United States. |
| Still, Dr. S.D. Gupta, a public health expert and a member of the government’s Covid-19 task force, said testing would need to ramp up significantly to capture the full scope of India’s coronavirus outbreak. | Still, Dr. S.D. Gupta, a public health expert and a member of the government’s Covid-19 task force, said testing would need to ramp up significantly to capture the full scope of India’s coronavirus outbreak. |
| States like Tamil Nadu and Gujarat are witnessing sharp jumps in the number of cases. Officials in West Bengal have been accused of sitting on higher-than-usual mortality figures. In Punjab, the rate at which new cases were doubling dropped from 18 days to four this past week, largely because of an aggressive outbreak among religious pilgrims returning from Maharashtra, India’s worst afflicted state. | States like Tamil Nadu and Gujarat are witnessing sharp jumps in the number of cases. Officials in West Bengal have been accused of sitting on higher-than-usual mortality figures. In Punjab, the rate at which new cases were doubling dropped from 18 days to four this past week, largely because of an aggressive outbreak among religious pilgrims returning from Maharashtra, India’s worst afflicted state. |
| Dr. Gupta said it was difficult to say whether India was in the midst of experiencing a dangerous upward trajectory of new cases. But he warned that the country’s growth curve of new infections had still not peaked. With so many asymptomatic patients unaware of their status, he said, officials needed to remain especially vigilant as more restrictions were eased in the coming weeks. | Dr. Gupta said it was difficult to say whether India was in the midst of experiencing a dangerous upward trajectory of new cases. But he warned that the country’s growth curve of new infections had still not peaked. With so many asymptomatic patients unaware of their status, he said, officials needed to remain especially vigilant as more restrictions were eased in the coming weeks. |
| “What we are seeing is the tip of the iceberg,” he said. “Unless we do testing, we will never know how many cases we have. That’s a problem.” | “What we are seeing is the tip of the iceberg,” he said. “Unless we do testing, we will never know how many cases we have. That’s a problem.” |
| Suhasini Raj and Hari Kumar contributed reporting. | Suhasini Raj and Hari Kumar contributed reporting. |