Showing posts from category: Public health,
Courting Controversy in Coronavirus Country: Belgium and El Salvador
As countries try to deal with an epidemic that is novel to the world of public health, with no tried-and-true templates to follow, there have been various quite differing approaches to the COVID-19 crisis. Some of these approaches have inevitably roamed into the realm of the controversial and polemical, polarising people at home and abroad. In previous blogs 7dayadventurer.com has sketched the go-it-alone path adopted by Sweden✱,〘Two Antithetical Approaches to the COVID-19 Crisis: A Controversial Outlier Versus a a Low-key Over-achiever (10-May-2020)〙and the denialist response of President Bolsonaro to the epidemic in Brazil〘Covid/Ovid 2020: Crisis (Mis)Management – How the World’s Leaders are Responding? (02-Apr-2020) 〙.
Belgium’s unenviable record – with an asterisk This blog turns the spotlight elsewhere, on to an unlikely duo, two vastly dissimilar countries whose strategies towards the pandemic have proved controversial, each in it’s own way. Belgium, a small European state, has surprised and shocked many observers by its prominence on the table of world’s worst affected countries. The country has recorded 815 deaths per million of population (as at the 1st of June), easily the worst per capita toll in “First World” Europe (next closest Spain, 580/one million). Although Belgium has some distinguishable factors which contribute it its fatality rate—the country and especially the capital Brussels is the sixth-most dense in Europe, and Brussels has a very international and mobile population, a high number of Belgians reside in nursing homes (accounting for more than half of the disease’s victims)✬—there’s another (statistical) factor that goes a good way to explaining why there has been 9,580 recorded victims of the disease⊡. Belgium counts both the deaths confirmed as resulting from coronavirus and the deaths which are suspected to have been caused by the disease (most countries do not include this second category in their official COVID-19 counts)✪. (“Is Belgium the world’s deadliest COVID-19 country or just the most honest?’, (Bevan Shields), Sydney Morning Herald, 01-Jun-2020, www.smh.com.au).
🔺 Belgians returning home to a coronavirus-hit country
In defence of over-counting
Belgian virologist Prof Steven Van Gucht has deflected criticism of both Belgium’s numbers and its method of calculating corona casualties, commending Belgium for its honesty in selecting the more inclusive determination of the death toll. Van Gucht has argued that “public health shouldn’t be a political game or a contest on who is doing better than someone else”, adding that other governments not being honest with the public about the true scale of their outbreaks will be caught out on it later. Not everyone in Belgium applauds such transparency and honesty with the corona data, some within the kingdom’s business leadership have expressed alarm than the methodology used to ‘inflate’ mortality and morbidity numbers may have a deterrent effect on tourists returning to Belgium once the economy reopens (Shields).
(Source: www.graphicmaps.com/)
El Salvador’s tough stand on lockdown transgressors part of a worrying authoritarian trend? Pre-existing conditions in the Central American country of El Salvador have dictated the government approach taken to coronavirus. El Salvador’s high incidence of both gang activity and homicide prompted president Nayib Bukele (at 38 youthful and very social media savvy, eg, >1.9 M Twitter followers) to act hard and fast. Bukele’s government took a preemptive approach to the outbreak, schools and colleges were suspended and a state of emergence declared before the country had recorded its first confirmed case of the virus. Borders were closed, public gatherings in excess of 500 people banned, anyone caught driving cars without a sanctioned reason were detained at confinement centres for a 30-day period. Quarantine-breakers have been dealt with, summarily and harshly. Towns in El Salvador deemed to not be complying with the president’s strict lockdown orders have been cordoned off by the police, barring public egress [‘Savior or Strongman? El Salvador’s millennial president defies courts and Congress on coronavirus response’, (Patrick Oppman), CNN, 21-May-2020, www.edition.cnn.com].
(Source: El Salvador Presidency via Reuters)
The new Salvadoran president has gone particularly hard on the country’s street gangs, the maras, who he fears would take advantage of the state of emergency to increase their criminal business activities when the security forces were busy policing the lockdown measures. Most controversial has been Bukele’s treatment of gang prisoners during the crisis – shockingly dehumanising images have emerged of large numbers of half-naked convicts shackled and huddled together in tight-knit formation (with zilch regard for social distancing), resembling a great amorphous mass of “human cargo” [’El Salvador’s president accused of using coronavirus to bolster autocratic agenda’, (Patrick J Mc Donnell & Alexander Renderos), Los Angeles Times, 01-May-2020, www.news.yahoo.com].
Recently Bukele has copped a lot of flak for the way he’s handled the crisis, including from labour organisations decrying the draconian quarantine measures as abuses of human rights. The legality of his actions has been questioned as has the increasing militarisation of the regime [‘One Year After Taking Charge, Nayib Bukele Faces Severe Criticism for Handling of COVID-19′, (Zoe PC/ Tanya Wadhwa), News Click, 03-Jun-2020, www.newsclick.in/].
El Salvador’s ‘hip’ president: taking a selfie before his speech at the UN 🔻
Shades of the White House
As an outsider—both as the son of an immigrant family from the Middle East and from a minor centre-right party which sits outside the political establishment traditionally dominated by the two main parties in El Salvador)—the president has deliberately attempted to work outside the mainstream including the National Assembly (NA) to achieve his aims. And he’s not adverse to employing military muscle to intimidate opponents⌽ while also reaching out to El Salvador’s impoverished with cash and food handouts (to buttress his personal popularity with the social base). Political opponents in the NA have accused Bukele of using the pandemic to consolidate an authoritarian regime, and of seeking to violate the national constitution (Oppman). The similarities seemingly extend to shared personal traits. President Bukele has disclosed his prophylactic use of hydroxychloroquine, while referencing Trump’s use and endorsement of the drug. The El Salvador authorities have managed to hold the death toll thus far to 53 (06-Jun-2020) at the cost of drastic restrictions on individual liberties.
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✱ Sweden‘s top epidemiologist has now conceded the government’s laissez-faire approach was seriously flawed – with a status quo of 43 fatalities per 100,000 people and Sweden finding its borders with its Scandinavian neighbours remaining firmly closed [‘Top epidemiologist admits he got Sweden’s COVID-19 strategy wrong’, (Bloomberg), National Post, 03-Jun-2020, www.nationalpost.com]
⊡ as at 06-Jun-2020
✬ some countries simply don’t count deaths occurring in nursing homes in their COVID-19 tallies, the UK only belatedly included them later in the crisis
✪ if Belgium applied the same criteria as most countries the recorded number of deaths by COVID-19 would be around half of what it is
⌽ such as deploying the army inside the Legislative Assembly as ‘bouncers’ [‘Nayib Bukele’s military stunt raises alarming memories in El Salvador’, (David Agren), The Guardian, 16-Feb-2020, www.theguardian.com]
The Pandemic’s “Holy Grail”, the Elusive Vaccine: For the “Global Public Good” or an Inward-looking Assertion of Vaccine Nationalism?
At this point in the war on COVID-19 there are over 120 separate vaccination projects—involving Big Pharma, the public sector, academe, smaller biotech firms and NGOs—all working flat out worldwide trying to invent the ‘magical’ vaccine that many people believe will be necessary to bring the current pandemic to an end. While nothing is guaranteed (there’s still no cure for the HIV/AIDS virus around since the Eighties), the sheer weight of numbers dedicated to the single task, even if say 94% of the efforts fail, there’s still a reasonable chance of success for achieving a vaccine for coronavirus✱ [“Former WHO board member warns world against coronavirus ‘vaccine nationalism’”, (Paul Karp), The Guardian, 18-May-2020, www.theguardian.com].
(Source: CEPI)
If and when the vaccine arrives, will it get to those in greatest need? The way the coronavirus crisis has been handled between nations so far doesn’t exactly give grounds for optimism. Collective cooperation on fighting the pandemic has been sadly absent from the dialogue. We’ve seen the US attack China over coronavirus’ origins with President Trump labelling it the “China virus” and the “Wuhan virus”, and China retaliating with far-fetched accusations of America importing the virus to Wuhan via a visiting military sporting team, and the whole thing becoming entwined in a looming trade war between the two economic powers❂.
(source: www.socioecomonics.net)
The advent of COVID-19 has introduced us to terms such as “contact tracing”, “social distancing”, “covidiot” and the like, but recently we‘ve been hearing a new term thrown about, one with more ominous implications – “vaccine nationalism”. As the scattered islands of scientific teams continue the hunt for the “silver bullet” that presumably will fix the disease, there is a growing sense that the country or countries who first achieve the breakthrough will adopt a “my nation first” approach to the distribution of the vaccine. There are multiple signs that this may be the reality…the US government has launched the curiously named “Operation Warp Speed”, aimed at securing the first 300 million doses of the vaccine available by January 2021 for Americans [‘Trump’s ‘Operation Warp Speed’ Aims to Rush Coronavirus Vaccine’, (Jennifer Jacobs & Drew Armstrong), Bloomberg, 30-Apr-2020, www.bloomberg.com]. In the UK Oxford University is working with biopharma company AstraZeneca to invent a vaccine that will be prioritised towards British needs.
(Source: IndiaMart)
A “vac race” Not to be outdone, China, operating through Sinovac Biotech, is at the forefront of testing potential cures for COVID-19. The pressing need for a vaccine to safeguard its own population aside, Beijing’s rationale includes a heavy investment in national pride and the demonstration of Chinese scientific superiority (cf. Trump’s motivation). The Sino-US rivalry over finding a cure for the pandemic has been compared to the Cold War era ”Space Race” between the US and the USSR (Milne & Crow). A political war of superpower v superpower on a new battlefield…noted as bring part of a longer trend of the “securitisation of global health “ where the health objective increasingly has to share the stage with issues of national security and international diplomacy (E/Prof Stuart Blume, quoted in ibid.).
An environment of competition in lieu of collaboration Even prior to the start of serious talk about the vaccine, the coronavirus crisis was provoking an “everyone for themselves”, non-cooperative approach. With the onset of equipment shortages needed to combat the virus outbreak, an international bunfight developed over access to PPE (personal protection equipment). 3M masks destined for Germany were intercepted by the White House and re-routed to US recipients; French president, Emmanuel Macron, seized millions of masks that were on route to Sweden; Trump purportedly tried to buy CureVac, a German biopharma company working on the vaccine [‘Why vaccine ‘nationalism’ could slow the coronavirus fight’, (Richard Milne & David Crow), Financial Times, 14-May-20320, www.ft.com/]. India (under Hindu nationalist Modi), the world’s largest supplier of hydroxychloroquine (touted as a cure for the virus), withheld it from being exported. As part of this neo-protectionism of the corona medical trove, more than 69 countries banned the export of PPE, medical devices and medicines [‘A New Front for Nationalism: The Global Battle Against a Virus’, (Peter S Goodman, Katie Thomas, Sui-Lee Wee & Jeffrey Gettleman), New York Times, 10-Apr-2020, www.nytimes.com].
Politics and economics over science and global health? Will narrow self-interest and economic advantage prevail? Will Big Pharma sell the virus panacea to the highest bidders? A zero-sum game in which those who can’t afford the cost fall by the wayside? There are precedents…the distribution of the H1N1 vaccine for the 2009 Swine Flu was predicated on the purchasing power of the higher-income countries, not on the risk of international transmission [‘The Danger of Vaccine Nationalism’, (Rebecca Weintraub, Asaf Britton & Mark L Rosenberg), Harvard Business Review, 22-May-2020, www.hbr.org/]. The availability of the vaccine is seen as integral to restarting the global economy (Milne & Crow).
The eclipse of multinationalism? With WHO in the eyes of some international players seemingly tarnished by its relationship with China, and by Trump’s undermining of its effectiveness by threatening to withdraw American support, multilateralism is on the back foot. There have been some attempts to stem the tide, CEPI (Coalition for Epidemic Preparedness Innovations’)▣, with a mission of promoting a collective response to emerging infectious diseases, is trying to advance both the development of coronavirus vaccines and equitable access to them (http://cepi.net/).
Getting to an “equitable distribution” of the vaccine As CEPI recognises, and is committed to redressing, there is no formal mechanism in existence for fairly distributing vaccines for epidemics…one step being taken is to try to get an equitable distribution strategy accepted by the G20 nations. The only way forward to ensure that allocation is fair and prioritised according to needs is through a coordinated global effort (Milne & Crow; Weintraub eg al).
The fear is thus well founded that if and when a vaccine is discovered and developed, the richer nations will secure a monopoly over it and prevent it getting to poorer nations where it would be urgently needed by the elderly, the immunocompromised and the “first responder” health workers. There are many who hope fervently that a different scenario will be played out, that a more enlightened type of self-interest will prevail. This would require the wealthier countries seeing the bigger picture – the danger that if they don’t redistribute the cures, the outcome will be an adverse effect on the global supply chain and on the world‘s economies. As Gayle Smith (CEO of “One Campaign“, a Washington-based NGO fighting extreme poverty) put it: it is in the richer countries‘ own interests ”to ensure that the virus isn’t running rampant in other countries” (Milne and Crow). “If an international deal can be reached“, CEPI CEO Dr Richard Hatchett said, ”Everyone will win, if not, the race may turn into a free-for-all” with the losers in plain sight [‘Why the race for a Covid-19 vaccine is as much about politics as it is about science’, (Paul Nuki), The Telegraph (UK), 10-Apr-2020, www.telegraph.co.uk].
(Source: www.euroweeklynews.com)
PostScript: Its no done deal! – reining in the wave of vaccine optimism Even some of the scientists working on developing a vaccine are less than sanguine about the prospects. As immunologist Professor Ian Frazer (UQld) explains: there is no model of how to attack the virus. Trying to come up with a vaccine for upper respiratory tract diseases is complicated due to “the virus landing on the outside of you”, as we have seen with the common cold. What’s needed is “an immunise response which migrates out to where (the coronavirus) lands” [‘No vaccine for coronavirus a possibility’, (Candace Sutton), News, 19-Apr-2020, www.news.com.au].
_______________________________________________________________________________ ✱ a matter of getting “the maximum shots on goal” as Jane Halton, a former member of the WHO board, put it ❂ with Trump aided and abetted in this mission by Peter Navarro (who Bloomberg calls “Trump’s Trade Warrior”) enthusiastically leading the charge in the undeclared trade war with China ▣ with funding from the Bill and Melinda Gates Foundation
Coronavirus and Age Vulnerability: The Riddle of Japan
Both the medical experts and the empirical evidence on the ground tell us that the elderly are the cohort in the community most susceptible to COVID-19. The Office of National Statistics (UK) calculates that people aged 80 and over have >59% risk of dying from coronavirus (www.ons.gov.uk/). The pandemic’ age bias skewed against older populations is one explanation, in the absence of much hard data, put forward to explain the African continent’s current low rate of mortality due to the virus – overall 111,812 confirmed cases and only 3,354 deaths (as at 25-May-2020) [‘Coronavirus in Africa tracker’, BBC News, www.bbc.co.uk/]. The percentage of the African population aged under 25 is 60% (in sub-Saharan Africa the number over 65 is only 3%)[‘Coronavirus in Africa reaches new milestone as cases exceed 100,000’, (Orion Rummler), Axion, 22-May-2020, www.axios.com].
And if we needed any more empirical proof of the salience of the age factor, there is the tragic example of Italy’s corona-toll. 32,785 dead✤ from COVID-19 in a country with the oldest population in Europe. Nearly 58% of the country’s deaths in the pandemic have been Italians aged 80 and over [Statistica Research Department, (22-May-2020), www.statista.com/].
With Italy’s grim corona-death tally falling disproportionately heavily on the country’s senectitude, you would think that it would not bode well for Japan which has the world’s highest percentage of older people (28.2% aged 65 and more) [Population Reference Bureau, www.pbr.org/]. When you add in other demographic factors relevant to Japan, this would seem doubly ominous for the “land of the rising sun” – a population of >126 millions on a land area of 377,944 sq km, including the mega-city of Tokyo✪ with its notoriously packed commuter trains. On top of all these is Japan’s proximity to China, the virus’ original causal point.
(Source: www.quora.com)
Japan, unpropitious conditions for avoiding an global epidemic? With such cards stacked against it, worried Japanese health officials might have feared a catastrophe eventuating on the scale of that befalling the US, Italy and UK. And Japan has not come out of the pandemic unscathed but the result-to-date (25-May-2020)—16,550 confirmed cases and 820 deaths—is much better than many comparably sized and larger countries. Of course, Japan’s public health authorities are very mindful, as is every country, of being swamped by a second wave of the coronavirus.
(Photo: www.english.kyodonews.net)
How has Japan done as well as it has?
Good question! The Japanese themselves can’t really explain how they’ve managed to escape a major outbreak of the virus⌧. WHO has called it a “success story”, but it’s one that continues to mystify. In so far as explanations were forthcoming from Japan’s health ministry, it was attributed at least in part to a raft of cultural factors. First, hygiene and cleanliness is something ingrained in the Japanese psyche, Japanese people tend not to shake hands and hugs others, preferring to bow as the form of greeting. Second, the practice of wearing face masks was already the norm in Japan ante-COVID-19 (the Japanese go through 5.5bn a year, averaging 43 per head of population) [‘Most coronavirus success stories can be explained. Japan’s remains a ‘mystery’’, (Jake Sturmer & Yumi Asada), ABC News, 23-May-2020, www.abc.com.au; ’How Japan keeps COVID-19 under control’, (Martin Fritz), DM, 25-Mar-2020, www.dm.com].
Other cultural factors Other suppositions put forward to explain the Japanese success include the practice of inoculating young children with BCG vaccinations, which according to its advocates give Japanese people a basic immunity which helps their defence against coronavirus. Physiology was also cited as a factor in guarding against the disease, the low obesity of Japanese is thought to help, as is the Japanese diet (eg, natto, a soybean yoghurt, is thought to boost the immune system) [‘’From near disaster to success story: how Japan has tackled coronavirus’, (Justin McCurry), The Guardian, 23-May-2020, www.msn.com/; ‘Has Japan dodged the coronavirus bullet?’, Richard Carter & Natsuko Fuhue, Yahoo News, 14-May-2020, www.au.news.yahoo.com; Sturmer & Asada].
(Photo: www..Forbes.com)
The “Diamond Princess” In addition to all of the domestic factors hindering Japan’s fight against COVID-19, an external element exacerbating the early outbreak in Japan was the debacle of the “Diamond Princess” cruise ship. When the international ship docked at Yokohama in February, the Japanese authorities injudiciously prevented healthy passengers and crew on-board from disembarking during the quarantine – with no separation made between well and contaminated passengers, and no self-isolation of the sick! This led to a blow-out of virus contamination which eventually infected 712 passengers, creating the first big cluster of coronavirus outside of Wuhan [‘How lax rules and missed warnings led to Japan’s second coronavirus-hit cruise ship’, (Ju-Min Park), The Japan Times, 07-May-2020, www.japantimes.co.jp].
A cautious reaction from politicians, one eye on the XXXII Olympiad? Let’s look in detail at what Japan did – or didn’t do! When the disease first arrived, the government took a cautious approach to tackling the virus. Borders initially remained open and Chinese visitors were still allowed into the country in huge numbers, 89,000 came in February (after the first outbreak), which was on top of the 925,000 who visited during January! Prime Minister Abe came in for a lot of flak, some including a former PM, Yukio Hatoyama, accused him of holding off from going full-tilt against the pandemic so as to preserve the Tokyo Olympics event (Fritz). Critics railed against a lack of leadership from the Abe government, criticising its failure to appoint anyone to take firm control of the crisis, and that those efforts to counter the virus were hamstrung by the multiplication of bureaucratic silos [‘A Japan divided over COVID-19 control’, (Hiromi Murakami), East Asia Forum, 08-Mar-2020, www.eastasiaforum.org].
Lockdown-lite, testing-lite The Abe government’s belated state of emergency saw sport suspended and schools closed, but overall only a partial lockdown was imposed✺, many businesses, restaurants were permitted to stay open, albeit with reduced hours. Citizens were asked to stay home but compliance was only on a voluntary basis, with no surveillance technology deployed and no punitive action taken against anyone failing to adhere to the government’s request.
(Image: www.japantimes.co.jp)
Targeted testing
It was in testing that Japan adopted a very different crisis approach to most of the leading western countries. Rather than going for high volume, it deliberately tested under capacity. By mid-May it had tested a mere 0.185% of the country’s population, averaging two tests per 1,000 people, cf. Australia, >40 per 1,000 (Sturmer & Asada). It was highly selective, only those with serious virus symptoms were tested. The rationale for such a low-testing regime was concern for the capacity of widespread testing infrastructure, by limiting testing this would lighten the load on testing centres. Rather than mine-sweep the country with testing, the Japanese pursued a strategy of targeting virus clusters as they were identified to pinpoint the sources of the infection [‘Has Japan found a viable long-term strategy for the pandemic’, (Kazuto Suzuki), The Diplomat, 24-Apr-2020, www.thediplomat.com; Gramenz].
Consequently, Japanese medical experts concede that the official counts may be well short of the reality, which puts a rider on the country’s achievement. Even with a smaller number of cases Japan found itself lacking in IPUs (only five per 100,000 people cf. 35 in the US) , there was also a shortage of PPE as well as face masks which were rationed out only two per household (and derided as “Abe-no masks”). This calls into question the faith that the Japanese placed in the robustness of the nation’s health system [‘Japan’s Halfhearted Coronavirus Measures Are Working Anyway’, (William Sposato), Foreign Policy Magazine, 14-May-2020, www.foreignpolicy.com]⊚.
Self-complying social distancing? Social distancing, a nightmare to try to enforce in people-dense Tokyo, was not a major focus for authorities. This was largely left to the goodwill of the individual, aided by some subtle social shaming – government workers walking through Tokyo nightlife areas with signs asking people to go home (Sposato). In any event the authorities’ measures were only partly effective – Japanese people continue to flock to the cherry blossom spring events in large numbers. Where social distancing was more manageable was in shutting off obvious potential hotspots, closed spaces with poor ventilation (karaoke clubs and pubs), crowded places with many people people in the immediate vicinity and other close, intimate contact settings (Suzuki).
Cherry blossom time: no voluntary social distancing here (Photo: www.bloomberg.com)
Tokyo transport
Tokyo’s mass transit network is a petri dish in-waiting for coronavirus, but it appears that preventive measures (some pre-planned) have lessened the impact on public health. Tokyo business working hours have been staggered and large companies like NEC started to adopt telecommuting and teleworking, as well as a big increase of people riding bikes to work occurring. Consequently, transits at Tokyo’s central station on May 18th was down by 73% on the corresponding day in 2019 [‘Remote possibilities: Can every home in Japan become an office?’, (Alex Martin), The Japan Times, 23-May-2020, www.japantimes.co.jp].
(Image: Getty Images/AFP. P Fong)
Most pundits and observers conclude that Japan, with its ageing population and all its drawbacks and encumbrances, has (so far) warded off the worst of the pandemic. With no “silver bullet” in sight, we are left to speculate whether that they have achieved this outcome by sheer good luck, by good judgement, by the personal habits and cultural traits (especially hygiene) of its citizens, or by a combination of all of the above (McCurry).
Endnote: Low tester, early starter Another Asian country which has mirrored Japan’s pattern of choosing not to test in high volumes is Taiwan. The Taipei China republic, commencing measures to counter the virus as early as anyone did, had tested only 2,900 people per million of population (Worldometer, as at 20th May), but it’s mortality rate (deaths per million) was only 0.3 (total of seven deaths) compared to Japan which was 6.0 per million.
˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚˙˙˚
✤ as at 25-May-2020
✪ the largest metropolis prefecture in the world, around 14 million people
⌧ Japan’s health officials had themselves projected a worse-case scenario of up to 400,000 deaths (Gramenz)
✺ to be fair, there are constitutional impediments in Japan that prevent the declaration of a full, European-style lockdown (McCurry)
⊚ a Kyodo news poll indicated that 57.5% of people were unhappy with the government’s handling of the emergency. In so far as Japanese people have given credit to the success, it has gone to medical experts for efficiently managing Japan’s cluster tracing and containment efforts, rather than to Abe who many view with distrust based on its past track record [‘Time to Give Japan Credit for its COVID-19 Response’, (Rob Fahey & Paul Nadeau), Tokyo Review, 18-May-2020, www.tokyoreview.net]
Flying’s Future Shock: Anticipating the Great Reset
All the travel and aviation pundits say commercial flying—when it does finally get airborne again—will never be the same again. There are so many imponderables and unknowns about the enigmatic future of airline travel, the cup of endless speculation nonetheless runneth over.
No one, inside the industry or out, knows when international flights will resume normal services. Like everything else it hinges on containing, and ultimately on subduing the pandemic (the “holy grail” of the vaccine?). When it does happen and things return to ‘normal’, we know it will be a ‘new’ normal…so let’s concern ourselves now with what it might look like?
What’s on the cards at airports in the future? Airports will need to design or augment existing health and safety measures to stack up to the new requirements. Airlines will be trying to minimise the risk of human-to-human contagion, which’ll probably mean touchless check-ins and more utilisation of self-service E-ticketing machines, thermal scanning of body temperature, increasing use of biometrics. The imperative of social distancing will still be with us, airports will have to adhere to the safety edicts of keeping everyone 1.5m apart from everyone else. But will this be feasible, or even partly attainable? Airports are people magnets, people come en masse – to fly, to work, to farewell other people and to welcome others on return.
A pessimistic prognosis with very little “blue sky” Will we end up seeing airports despairingly throwing their hands up in the air and saying it’s all too much? If the prescribed public health measures include things like wiping down the handles of every piece of baggage and all the trays as they go through the scanner, that will add intolerable delays to an already tortuously long process for people at peak-travel times (‘Air Travel Is Going to Be Very Bad, for a Very Long Time’, (James Fallows), The Atlantic, 11-May-2020, www.theatlantic.com). The CEO of one of the world’s busiest airports, London’s Heathrow, is on record as stating that social distancing will be impossible to maintain✱ (‘COVID-19 and travel: Heathrow boss says social distancing “impossible” in airports’, (Neil Callanan), Traveller, 04-May-2020, www.traveller.com.au).
Will passengers turn up at the luggage check-in fully decked out in hazmat suits, smelling like they’ve been dipped by their heels in a vat of disinfectant? Will face masks, already in common use, gloves and even face shields, be mandatory for everyone in airports? Attaining standardised practice in these and other aspects of the changing landscape of flying, is a long way off happening.
(Source: www.theweek.in)
A Covid-19 health pass? Strict health screening for incoming passengers at international borders in the coronavirus age is a given, but future travellers may need to present new documents along with their international passport. Flyers may need some kind of “proof of good health” to travel internationally – much like the certificate you need now to show you’ve had the required inoculations to enter certain regions prone to yellow fever, malaria, etc. Alternately, these “immunity passports” may be used to record negative coronavirus test results❅ (‘Face masks, blood tests and onboard janitors. Flying’s about to feel very different’, (Karen Gilchrist), CNBC Traveler, 17-May-2020, www.cnbc.com; ‘The era of peak travel is over’, (Sarah Khan), Vox, 22-Apr-2020, www.vox.com).
Social distancing on planes, an oxymoron? If we turn to the aircraft flights themselves, how will they work? Some of the world’s international carriers are considering removing the middle seat in jets (as a temporary move only) to enhance space between passengers⊞. Ryanair is the first carrier to outlaw toilet queues, passengers are now required to raise their hand to request a toilet visit.
Transforming seats into anti-virus shelters Airplane designers are exploring the possibilities of converting the present flying “sardine tins” into spaces that observe social distancing. ‘Janus’ seats are one option advocated by the Italian company Aviointeriors…a double-S shaped configuration which juxtaposes passenger seats in an opposing direction to each other. Passengers are also separated by a high transparent thermoplastic shield or screen. The company had an alternate design which retains the standard seating configuration but attaches a separating perspex screen to each seat (‘Aviointeriors proposes post-COVID-19 Janus seats’, (John Walton), Runway Girl Network, April 2020, www.runwaygirlnetwork.com). The designs are still in testing stage but one drawback is that glass dividers adds another hard surface to passenger space which may be infected by contaminated droplets. the view of Peter Harbison, CAPA Centre for Aviation chairman emeritus, is that the removal of middle seats won’t be sufficient to ensure the social distancing requirement on airplanes, that the outcome is not realistically attainable.
(Image: Aviointeriors S.p.A.)
Hermetically-sealed flying? Clearly, the level of on-board hygiene will need to ramped up post-corona. There’s talk about having cleaners on-board during flights, to target the plane’s tactile zones such as toilet doors. One objective airlines will definitely aim for is minimalism, they’ll want to radically pare back the on-board fringe items. Touchscreen entertainment might disappear, pre-packaged meals left on seats prior to boarding to avoid contact, the end of free drinks, etc (Gilchrist).
The financial side With all the uncertainty of what’s in store for future travel, one thing that will definitely change is the economics of travel. From the consumer side, if airlines resort to removing seats, therefore capping the passenger load of a jet, it’s hard to imagine how that will not result in a ticket price hike. IATA has estimated that with aircrafts only two-thirds full, average fares would jump up to between 43 and 54 per cent✪. Airlines have reckoned that they need to fill 77 per cent capacity of the aircraft just to break even (Gilchrist). Travel industry pundits have indicated that most leisure travellers won’t be willing to pay more if the option of affordable travel is taken away (‘Social distancing on planes during coronavirus: Middle seat won’t stay empty for long’, (Dawn Gilbertson), Traveller, 04-May-2020, www.traveller.com.au).
Some industry insiders have predicted the end of over-tourism, reasoning that for financial reasons or because of the new layers of bureaucracy required, travellers will be less inclined to travel as frequently as before the crisis, and with it will we see the demise of the jet-setting lifestyle and the addictive travel pilgrim. It may be too premature to make such a dramatic call, the 9/11 terrorist attacks put many people off international flying, but not permanently, the industry bounced back its pre-2001 level eventually, and this is an industry that employs over 10 per cent of the global workforce (Khan).
Certainly though, for the foreseeable future, tourists will probably think twice about venturing to the world’s most heavily populated destinations (Venice, Rome, Paris, New York, London, Dubrovnik, the Pyramids of Giza, the Acropolis, the Great Wall, etc.). A whole new generation of ‘agoraphobes’ may decide to avoid travelling during the peak season and seek out the less-travelled, remoter locations to holiday.
A respite from the ecological ‘footprint’ for Venezia and Plaza San Marco (Source: www.sites.middlebury.edu)
Business travel to recede? Another matter to ponder is whether business travel will be reduced when the Covid-19 dust settles, will professionals and business folk still travel O/S to exotic locations for conferences? The lockdowns and restrictions of the last few months meant that the overwhelming majority of conferences went virtual. Administrators are no doubt discovering that they can just as meaningfully conduct business meetings by Skype or by video-conferencing, without the need for everyone to be in the same room together. If so, this may well have a negative knock-on affect for economy class tickets (which are subsidised by business and first class) (‘How Much of Airlines’ Revenue Comes From Business Travelers?’, www.investopedia.com).
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✱ we have recently witnessed that once beaches have been reopened to the public, it is virtually impossible to police distance restrictions on packed beachfronts
❅ Emirates have taken a different tact, trialling a rapid “10-minute” blood test at the departures gate (insiders have questioned whether this would be feasible to implement at high-volume times (Gilchrist)
⊞ operators already indicating they will move to vacant middle seats include Southwestern, Delta, American and Qantas – the Australian carrier later reneged on this claiming the risk of Covid infection on an aircraft was minimal (‘Qantas passengers angered after airline reintroduces the middle seat’, 20-May-2020, www.news.com.au/)
✪ that said, some airlines may, for the immediate period, offer travellers discounted fares and deals to reignite interest in overseas travel … “struggling operators (will) incentivize flyers to return to the skies” (Gilchrist)
The Kerala COVID-19 Template: How to Lead in the Fight against a Pandemic
When the coronavirus pandemic eventually reached India, it was always going to pose a challenge of epic proportions for a country of 1.3+ billion people, with such a dense population domiciled in such close quarters, and with a widespread underbelly of poverty. The Spanish flu of 1918 inflicted a death toll on India in the many millions, something no doubt in the back of the minds of public health officials. So, two or three months into the crisis, on paper, India’s COVID-19 record, on paper, doesn’t look as frightening as many other nations. As at 17-May-2020, so far it has had a shade under 91 thousand confirmed cases and a total of 2,872 deaths (www.worldometers.info).
(Photo: Indranil Mukherjee / Agence France-Presse – Getty Images)
There is a perception within medical circles however that these figures don’t portray the full extent of the outbreak. India’s urban areas are packed with masses of people living face to face, beset with poor sanitation conditions, up to 100 people sharing the same toilet in some cases, adding up to a recipe for catastrophe in plague time. Obtaining a test for coronavirus in India has tended to not be straightforward, thus the level of testing has lagged woefully behind what is desirable, eg, by well into March India was averaging only five tests per ten lakhs (= one million) people, compared with South Korea which had managed 4,800 per ten lakhs.
Too many migrant workers waiting for too few buses to take them home after the lockdown was announced (Photo: Yawar Nazir – Getty Images)
Containment measures have been far short of perfect, and with some glaring omissions…there has been passive resistance to the lockdowns from sceptical Indians, and the ban on public gatherings has from time to time been skirted round (some ‘scofflaw’ political parties continue to hold mass rallies). Although India’s borders were closed fairly promptly, some have been critical of the procrastination of Indian leaders’ during the crucial early days of the crisis, one Indian epidemiologist characterised it as a “let’s wait till tomorrow” attitude [‘India Scrambles to Escape a Coronavirus Crisis. So Far It’s Working’, (J Gettleman, S Raj, KD Singh & K Schultz), New York Times, 17-March-2020, www.nytimes.com]. This early reticence to act emanated from Delhi. The Modi BJP government, initially seemingly more concerned with the impact on India’s under-performing economy, issued no public health warnings or media briefings at the onset of the pandemic [‘What the world can learn from Kerala about how to fight covid-19’, (Sonia Faleiro), MIT Technology Review, 13-Apr-2020, www.technologyreview.com].
(www.anayahotels.com)
Kerala, leading from the periphery Kerala is one state that these general criticisms of Indian public health efforts against COVID-19 cannot be levelled. The small southwestern Indian state is one of the most picturesque parts of the land with its coconut trees and irenic and serene back-waterways. Known as a tourist mecca, Kerala, population 35 million, is more affluent than many parts of India (GDP per capital GB£2,200). 20% of India’s gold is consumed here, and it produces over 90% of the country’s rubber. Literacy is nearly 20% higher than the overall Indian average, and life expectancy too, is higher (www.holidify.com). All of these were contributing factors buttressing Kerala’s capacity to cope with the disease when it came.
Local vulnerabilities to the epidemic Kerala was coronavirus “ground zero” for India’s very first patients. Three students returning from Wuhan were tested positive and hospitalised (in all 70% of the state’s total virus patients have come from outside India). Certain preconditions pertaining to the state exacerbated the risk of disease outbreak, including a large number of Keralite migrant workers in the Gulf states, a huge expat population (working in Kerala from other Indian states), porous borders, and an early summer monsoon season (contributing to Kerala’s high rate of annual communicable diseases) [‘Coronavirus: How India’s Kerala state flattened the curve’, (Soutik Biswas), BBC News, 16-Apr-2020, www.bbcnews.com].
Preparation and planning Kerala was prepared for COVID-19 before the onset of the disease. The earlier Nipah viral outbreak (NiV) In Kerala (2018) proved a good trial run for the health service, giving the local authorities an opportunity to iron out chinks in it. Kerala’s communist-left coalition government had established a strong social welfare foundation, investing in the state’s infrastructure with a focus on health and education, and on tackling the state’s poverty✺. [‘How the Indian State of Kerala flattened the coronavirus curve’, (Oommen C Kurian), Guardian, 21-Apr-2020, www.theguardian.com].
Minister Shailaja (Source: www.manoramonline.com)
Shailaja ‘Teacher’, a woman with a plan When the epidemic arrived in Kerala, the proactive state health minister KK Shailaja took charge. With the full backing of Kerala chief minister, Pinarayi Vijayan, she had already organised a rapid response team to focus on targeted clusters, and liaised with the provincial councils. Kerala adopted the WHO protocols of test, trace, isolate and support. Rigorous contact tracing was employed, utilising detailed “route maps”. Testing of suspected carriers was decisive, with a quick, 48-hour turnaround of the result [‘Kerala has best coronavirus test rate in the country, but is it enough?’, (Vishnu Varna), The Indian Express, 01-Apr-2020, www.indianexpress.com], allowing them to move quickly on to the quarantine phase. 17,000 people were quarantined under strict surveillance, the poor without quarantine facilities were placed in improvised isolation. Recovered patients were duly released back into the community. Quarantine compliance was achieved through an admixture of phone monitoring (>340,000 calls and a neighbourhood watch system [‘The coronavirus slayer! How Kerala’s rock star health minister helped save it from Covid-19’, (Laura Spinney), The Guardian, 14-May-2020, www.theguardian.com; Kurian]. One of the sternest challenges, very early on, came from the district of Pathanamthitta. A family returning from Italy tested positive, but refused to disclose their movements upon return to Kerala. The civil servant in charge of the district, PB Nooh, and his team, worked round this obstacle by accessing the family’s GPS phone data, allowing them to trace all of their contacts (almost 300 people!). Nooh’s staff then tested the contacts for infection, thus shutting down the risk of the virus being exponentially transmitted to others in the community, ie, “breaking the chain” (Faleiro).
The coronavirus certainly didn’t miss Kerala, one-fifth of all Indian cases of the disease have occurred in the state. Under Shailaja, Kerala hit the ground running, before the end of January, screenings of arrivals at all four of the state’s international airports was introduced. The government imposed a lockdown even before the national lockdown was called…schools, malls, cinemas, public gatherings, were closed down, and the lockdown was stricter and longer than the national one (Kurian). Face masks were distributed to slum dwellers. Planning was precise and focused, a state stimulus package of Rs20,000 crore was directed towards the economic and medical crises.The medical task force was mobilised (doctors on leave were recalled, others asked to delay their leave). Those suffering hardship included migrant workers from other states were provided with free lunches by the state.
Communication with citizens informing them about all aspects of the crisis was clear and consistent (“Break the Chain” campaign which emphasises public and personal hygiene). Accordingly, community participation, both voluntary and active, was forthcoming. Some Keralites made accommodation available (including vacant homes in some instances) to those in need when requested to by the government [‘The Kerala Way of Tackling a Pandemic’, Times of India, 20-Mar-2020, www.timesofindia.com].
The Kerala government’s campaign against the virus has been aided by the polity’s decentralised nature of it’s structures. The coordination achieved allows the local councils to follow through on a lot of the public health measures needed to be implemented in the crisis (Biswas). The result of all this detailed planning and effort by Kerala – 587 confirmed cases and only four deaths and apparently no significant community transmissions (17-Apr-2020).
The state of Kerala and Shailaja ‘Teacher’ (so known because her occupation before entering politics was that of science teacher) are not resting on their laurels, being very mindful of the chance of a second wave of COVID-19 due to impending factors—Prime Minister Modi’s anticipated ending of the national lockdown, which will trigger a mass return of Kerala’s migrant workers based in the Gulf, and the approach of the tropical wet season in Kerala (June) [‘Kerala Lays Down Specific Plans To Tackle Monsoon Amid COVID-19 Pandemic’, NDTV, 15-May-2020, www.ndtv.com]. Minister Shaijala has been making preparations for such an event, many of the state’s teachers have been retrained as nurses to cope with a new upsurge in virus hotspots (Spinney).
EndNote: No time for Kerala complacency but a most worthy blueprint on offer The threat of new clusters emerging in Kerala remains very real, especially coming from outside, with a spike as recent as this past Friday—imported from neighbouring Tamil Nadu and Maharashtra as well as from overseas—reminding Shailaja and Co that the battle’s still far from won. Nonetheless, for elsewhere in India and beyond, there are lessons from Kerala‘s formidable achievement to be had from the state’s “nimble-footed, community-oriented, cautiously-aggressive approach” to the outbreak [Kurian; ‘Kerala reports 11 new Covid-19 cases’, (Ramesh Babu), Hindustan Times,16-May-2020, www.hindustantimes.com].
₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪₪
✺ the Kerala government is Marxist in ideology but pragmatic in practice, it’s policies are moderately social-democratic, with a highly-privatised public health system (Kurian)
What Happens to the World’s Airplanes After they are Grounded During the Pandemic?
I think most people, outside the industry, think the answer to this question would be “not a lot”. Unfortunately for the airlines, being grounded, being not able to utilise their assets to realise revenue, is only the start of the problems. In April it was estimate by the industry researcher Cirium that there were over 16,000 commercial passenger aircraft no longer flying – around 62% (the numbers would not have decreased since then) [‘Here’s What You Do With Two-Thirds of the World’s Jets When They Can’t Fly’, (Anurag Kotoky, David Stringer & Ragini Saxena), Bloomberg, 17-Apr-2020, www.bloomberg.com]. The severity of the blow to the airline industry internationally can hardly be understated, coming soon after IATA (International Air Transport Association) predicted (in December 2019) a US$29.3bn net profit for 2020 [http://airlines.iata.org].
The norm under coronavirus: flights with a handful of passengers (Photo: Jennifer Flowers / AFAR
Put simply, while the primary income from the airlines’ raison d’être, the loss of paying passengers, dries up, the fixed costs, the invariables, don’t go away for both the airports and the airlines. Let’s take the airports first, they make look deserted when you glimpse images of them on the internet or television, but they haven’t closed down altogether, they haven’t morphed into ghost towns. Airports still have infrastructure and most still run at least a limited service of domestic flights, and on the international scene, though closed for tourism, emergency flights still happen. So, with people and the coronavirus still around, the airports need upkeep. Surface cleaning with virus and bacteria killing disinfectants, hand-sanitising stations, etc.
A Californian “desert dormitory” for grounded jets (Photo: Mark Ralston / AFP via Getty Images)
The immediate problem for airlines in the Covid-19 crisis is where to put the multitude of grounded jets. The optimal place, leaving other considerations aside for a minute, is determined by climate. Aircrafts on the ground, exposed to the elements for any significant length of time, will do best in a dry climate with low humidity. This places the major airlines of Eastern Asia with their wetter, steamier climes at a disadvantage. Conversely, Australia’s great interior continental deserts are a favourable location. QANTAS and some other international airlines have accordingly parked their jets in Alice Springs (Central Australia)✫. In America [‘Parking in a pandemic: Grounded planes scramble for storage space’, (Paul Sillers), CNN, 22-Mar-2020, www.cnn.com]. Similarly, in America, US airlines have sought out long-term storage facilities in the hospitable desert environments of western USA [‘What It Takes for an Airline to Ground Its Fleet Amid Coronavirus’, (Jessica Puckett), Conte Nast Traveler, 31-Mar-2020, www.cntraveler.com].
Delta jet, Pinal Airpark (reliever airport), Arizona (Photo: Rebecca Sasnett, Arizona Daily Star)
A lot of European airlines are not so lucky, forced to use the local airports in Europe where some of the runways have been decommissioned to make way for the grounded planes. Aircraft parking in some of the European hubs can also be exorbitantly expensive, charging up to US$285 an hour (although the cost varies greatly from location to location). Sometimes the remotely located (long-term) storage facilities are referred to as aircraft ‘boneyards’❈ [‘Aircraft Boneyards, MRO & Storage Facilities in Europe’, Airplane Boneyards, www.airplaneboneyards.com].
Thwarting the nesting birds (Photo: Reuters / Elijah Nouvelage)
When happens with the planes taken out of service and parked? Although not in current use, they still have to be maintained so that they are ready when the airways open up again. Planes are subjected to regular, heavy mechanical maintenance checks, the hydraulics and the flight control system needs to be finely monitored. When the aircrafts are being stored long-term, the process followed has been described as a kind of ”aeronautical embalming” (Sillers) – fluids require to be drained (to prevent rusting of the landing gear), as the jets are housed al fresco everything needs to be covered and/or protected – the engine intakes and exhaust areas, external instruments, the tyres, the windows, the entire airframe (to prevent corrosion). Maintenance staff also have to check the planes for bird-nests and incursion from insects (grilles are sometimes affixed to keep birds outs). Every two weeks the wheels need to be rotated and the batteries reconnected (Sillers; Kotoky et al). Yes, it’s true to say that aircraft maintenance and storage firms are busy at the present time.
To try to offset, at least partly, the crippling hit from of the coronavirus crisis, the loss of multi-billion dollars by the industry, some airline companies have switched their (unused) passenger jets to become freight-carriers (in addition to using their usual freighters). Scoot, for instance, in February commenced bi-weekly hauls from Singapore to Nanjing and Guangzhou transporting air cargo only. Cathay Pacific carries freight on passenger-less flights from Hong Kong to three Chinese cities∅ [‘Airplanes Without Passengers Start Coronavirus Recovery’, (Will Horton), Forbes, 10-Mar-2020, www.forbes.com].
EndNote: In March, even after extensive international flight restrictions had come into effect, a number of airlines were still undertaking their scheduled flights with zero passengers on board. One of the reasons for such a seemingly nonsensical practice was to abide with EU regulations which require the airlines to fulfil their allotments or risk losing the flight slots [‘Why Airlines Are Flying Empty Ghost Planes’, ((Caroline Delbert), Popular Mechanics 11-Mar-2020, www.popularmechanics.com].
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✫ north of five billion dollars’ worth of aircraft enjoy the arid air of Alice Springs Airport (from SilkAir 737s to Singapore 380s) [‘How expensive will air travel be after the Covid-19 crisis?’, (Cynthia Drescher), CNN, (14-May-2020), www.cnn.com]
❈ quite apt for housing a lot of the older, less-efficient planes, which will be retired and either be sold-off or used for parts and then scrapyarded
∅ there’s precious little upside for the airline industry at the moment, but one positive for the jets still in the air is the record low world oil prices at the present