BBC

9th March 2020

Coronavirus: Death toll jumps again in Italy's 'darkest hour'

Italy's coronavirus death toll has jumped by 97 to 463, as Prime Minister

Giuseppe Conte described the outbreak as the country's "darkest hour".

The number of confirmed infections in Italy also increased to 9,172, up from

7,375 on Sunday, official figures show.

Italy is the worst-hit country after China, with cases of the virus confirmed

in all 20 Italian regions.

Earlier on Monday, six inmates died amid riots at prisons across Italy after

authorities suspended all visits.

Italy's government has pledged to further increase spending to offset the

economic impact of the outbreak as the country struggles to adapt to the

most restrictive limits on movement since World War Two.

Up to 16 million people in northern Italy now need permission to travel

under quarantine rules.

In an interview with La Repubblica newspaper on Monday, Mr Conte said:

"These days, I have been thinking about the old speeches of [Winston]

Churchill - it is our darkest hour but we will make it".

The coronavirus causes the Covid-19 disease. In severe cases, patients have

pneumonia, severe acute respiratory syndrome, and multiple organ failure

that can lead to death.

What happened at the prisons?

The trouble began in the northern city of Modena after inmates at the

Sant'Anna prison were told that all visits had been suspended.

Three people were reported to have died at the prison, while a further three

died after being transferred from there.

It is thought that at least two of the dead lost their lives to drug overdoses

after they raided a prison hospital for the heroin substitute methadone.

At San Vittore prison in Milan, detainees set fire to a cell block on one of the

facility's six wings, then climbed onto the roof through windows and started

waving banners, officials said.

At a prison in the southern city of Foggia, about 20 inmates managed to

break out of the building during protests. Many were quickly recaptured,

Italy's Ansa news agency reported.

There were also riots at several other prisons in northern Italy and at

facilities in Naples and the capital, Rome.

How is the government responding?

On Monday, Mr Conte said the government would pump in more money to

mitigate the impact of the outbreak.

He also said Italy would overcome the virus if people followed the rules,

adding that the sacrifices required were for the good of all.

Milan quarantine resident: "It's really important to be responsible in this

moment"

Italy is also seeking measures at EU level.

On Monday morning, the main share index in Milan, the industrial

powerhouse at the heart of the worst-affected area, opened down more than

8%.
What are the restrictive measures?

The strict new quarantine measures will last until 3 April, the government

says.

They affect a quarter of the Italian population, and centre on the rich

northern part of the country that powers the economy.

The restrictions apply to Lombardy and 14 other provinces: Modena, Parma,

Piacenza, Reggio Emilia, Rimini, Pesaro and Urbino, Alessandria, Asti,

Novara, Verbano Cusio Ossola, Vercelli, Padua, Treviso and Venice.

The UK Foreign Office advises against all but essential travel to these areas.

All schools and universities in the area are shut, as well as museums,

cinemas and swimming pools.

The government says only those with a serious work or family reason that

cannot be postponed will be allowed in or out of the quarantine zone.

Passengers departing on flights, except temporary visitors, will have to

justify themselves, as will all those arriving by plane.

There are controls at train stations to check temperatures.

Cruise ships are forbidden to dock in Venice.

The health system is under immense strain in Lombardy, a northern region

of 10 million people where Milan is the main city. Regional hospitals are

running short of beds and treating patients in corridors.

The health ministry says the average age of deaths from the coronavirus is

81.4 years.

Italy has one of the world's oldest populations. The virus is particularly

dangerous for the elderly and those with underlying health conditions.

World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus has

praised Italy for making "genuine sacrifices".

Until Sunday only about 50,000 people in northern Italy had been affected

by quarantines.

On Sunday, we drove up to the edge of the exclusion zone. We were

expecting to see roadblocks or controls in place and we didn't see anything

at all.

Cars were going in both directions. It seemed as though the control of this

restricted zone was quite loose, and that was a bit difficult to understand.
Is this simply too big an area to control and close off in the heart of Europe,

or are the restrictions gradually coming into place?

We've seen pictures from inside the restricted cities, and the streets are very

deserted, but we're not seeing police checkpoints as such.

But perhaps this is going to be stepped up in the coming days because there

are even penalties of three months in prison or a fine of €206 (£179; $235)

for breaking the rules.

The real fear is that, in the hours between the quarantine being announced

and it coming into effect, people have gone from more infected areas in the

north down south.

There are healthcare facilities in southern Italy, far less developed than those

here in the north, that are going to seriously struggle.

What is the situation elsewhere?

The number of infections worldwide is now more than 111,000, with about

3,890 deaths.

China, which has recorded the highest number of fatalities, reported just 40

new cases of Covid-19, the lowest since 20 January.

 Although this indicates that the spread there is slowing, senior officials

warned against reducing vigilance.

In other developments:

 South Korea officials reported the lowest daily increase in two weeks

 Iran confirmed 7,161 infections and 237 deaths, however the real

figures are feared to be much higher

 In France, two more lawmakers tested positive, officials said on

Sunday

 In the US, the number of confirmed cases exceeds 500

 A cruise ship that was barred by Malaysia and Thailand over

coronavirus fears will be allowed to dock in Singapore

// TRUE TYPED COPY //

 BBC

20th March 2020

Coronavirus: Why is India testing so little?

BY- Soutik Biswas

We have a simple message to all countries - test, test, test," World

Health Organisation (WHO) head Tedros Adhanom Ghebreyesus told

reporters in Geneva earlier this week.

He was alluding to the coronavirus outbreak, which has killed more

than 10,000 people and infected nearly 250,000 in at least 159 countries.

"All countries should be able to test all suspected cases, they cannot

fight this pandemic blindfolded," he said.

With 182 reported infections and four deaths so far, is India taking this

advice seriously? Is the world's second-most populous country testing

enough?

The jury is out on this one. India had tested some 14,175 people in 72 state-

run labs as of Thursday evening - one of the lowest testing rates in the

world. The reason: the country has limited testing. So, only people who have

been in touch with an infected person or those who have travelled to high-
risk countries, or health workers managing patients with severe respiratory

disease and developing Covid-19 symptoms are eligible for testing.

Why is a densely populated country with more than a billion people

testing so little? The official assumption is the disease has still not

spread in the community. As early "evidence" health authorities say

826 samples collected from patients suffering from acute respiratory

disease from 50 government hospitals across India between 1 and 15

March tested negative for coronavirus. Also, hospitals have not yet

reported a spike in admissions of respiratory distress cases.

"It is reassuring that at the moment there is no evidence of community

outbreak," says Balram Bhargava, director of the Indian Council of

Medical Research (ICMR). He believes Mr Ghebreyesus's advice is

"premature" for India, and it would only "create more fear, more

paranoia and more hype".

Media captionDr Ramanan Laxminarayan: "India's going to be the

next hot spot for this epidemic"

But experts are not so sure.

Many of them believe India is also testing below scale because it fears that

its under-resourced and uneven public health system could be swamped by

patients. India could be buying time to stock up on testing kits and add

isolation and hospital beds. "I know mass testing is not a solution, but our

testing appears to be too limited. We need to quickly expand to restrict

community transmission," K Sujatha Rao, former federal health secretary

and author of But Do We Care: India's Health System, told me.

On the other hand, say virologists, random, on-demand testing will

create panic and completely strain the feeble public health

infrastructure. Increased and targeted "sentinel screening" of patients

suffering from influenza and diagnoses in hospitals across the country

can provide a better idea of whether there is community transmission,

they say. "We need focused testing. We cannot do a China or Korea

because we simply don't have the capacity," a senior virologist told me.

In many ways, it is all about India trying to battle a pandemic with

limited resources. Experts talk about the country's success in defeating

polio, combating small pox, successfully controlling the spread of

HIV/Aids, and more recently H1N1 with rigorous surveillance, sharp

identification of vulnerable people, targeted intervention, and an early

engagement with the private sector to prevent disease spread.

Yet, coronavirus is one of the deadliest transmissible viruses in recent

history. Every day lost in effective response means the looming danger

of a surge in infections. India spends a paltry 1.28% of its GDP on

health care, and that may begin to bite if there's a full-blown outbreak.

Partial lockdowns in many cities - shutting schools, colleges, businesses

and suspending some rail transport - proves that the government fears

that community transmission of the virus might have begun.

Bracing for the inevitable, India is scaling up testing. Officials say existing

labs are able to provide results in six hours and each lab has the capacity to

test 90 samples a day which can be doubled. Fifty more state labs are

expected to begin testing samples by the end of the week, bringing the total

number of testing facilities to 122. Authorities claim that together, the labs

will be able to test 8,000 samples a day - a significant scaling up. In

addition, the government is planning to allow around 50 private labs to start

testing, but they will take up to 10 days to procure kits. (Testing at state-run

labs is free, and it is unclear whether the private labs will charge.)
Two rapid testing labs, capable of doing 1,400 tests a day, are expected

to be operational by the end of the week. India has also placed orders

for a million test kits, and will be possibly asking the WHO for a million

more.

"On testing, the government response has been proportionate, taking into

account scope, need and capacity," Henk Bekedam, WHO Representative to

India told me. "We recognise that laboratory networks are expanding the

scope and testing and they now include patients with severe acute respiratory

infection and influenza-like illness detected through the surveillance system.

It would also be important to look at 'atypical pneumonia' cases. If they are

without any distinctive cause, then they need to be considered for testing."l

beds

The weeks and months ahead will show whether these steps have been

enough. "We cannot say India has escaped community transmission,"

Mr Bhargava says candidly. And if and when there is an explosion of

infections and more sick people require hospitalisation, India will face

formidable challenges.

India has eight doctors per 10,000 people compared to 41 in Italy and 71

in Korea. It has one state-run hospital for more than 55,000 people.
(Private hospitals are out of reach for most people). The country has a

poor culture of testing, and most people with flu symptoms do not go to

doctors and instead try home remedies or go to pharmacies. There's a

scarcity of isolation beds, trained nursing staff and medics, and

ventilators and intensive care beds. India's influenza cases peak during

the monsoon season, and there is no reason why the coronavirus will not

make a second coming, virologists say. "Given the way it is progressing

in India, it seems it is about two weeks behind Spain and three weeks

behind Italy. But that's the number of known cases. And without

sufficient testing and shutting down large gatherings, the numbers could

be a lot worse," Shruti Rajagopalan, economist and a Senior Research

Fellow at the Mercatus Center at George Mason University, told me.

India's traditional neglect of public healthcare will begin to bite if the

disease spreads to its teeming small towns and villages. "This is a very

unique and real public health challenge," says Ms Rao. And it's early

days yet.

// TRUE TYPED COPY //

 INDIA TODAY

21st March 2020

111 labs for testing coronavirus will be functional across India from today: Health

Ministry

A total of 111 labs for testing coronavirus across the country will be

functional from today, said Lav Aggarwal, Joint Secretary, Health Ministry,

on Saturday.

"Dr Balram Bhargava, Director General of Indian Council of Medical

Research, has said that 111 labs for COVID19 diagnosis will be functional

by today evening," said Aggarwal at a press conference here.

On the private labs offering COVID19 testing, he said, "a detailed order will

be released on the matter by today evening."

He also said, "Today 262 people from Rome of which mostly are students

will come. They will be kept in quarantine centres as per the protocol."

1,600 Indians and people from other countries have till date been kept in

quarantine centres in India, he added.

"We should not just do testing for fashion or confidence-building measure,"

the Joint Secretary said while adding that "it is very important to understand

that testing should be done as per the protocol defined for testing."
Aggarwal also said that the states have been asked to use the National Health

Mission funds for their health sector preparedness.

"As of today, we are contact-tracing around 7,000 cases. Once we get factual

information on community transmission cases we will let people know," he

added.

The total number of positive cases of coronavirus has climbed to 271, said

the Union Ministry of Health and Family Welfare on Saturday.

A day after his address to the nation, Prime Minister Narendra Modi on

Friday said that the threat of the pandemic is common for all states and

underscored the need for Centre and all States to work together.

While addressing the nation on Thursday, Prime Minister Narendra Modi

urged citizens to follow 'Janata Curfew' from 7 am to 9 pm on Sunday to

contain the spread of coronavirus.

// TRUE TYPED COPY //

FORBES

17th March 2020

 Norway Hands Out $2,000 Fines Or Jail For Ignoring Coronavirus

Quarantine

BY- David Nikel

Norwegian authorities have confirmed that a fine of 20,000 Norwegian

kroner ($2,000) or a 15-day jail sentence will be handed out to anyone

caught breaking home quarantine or home isolation rules. Anyone caught

staying in a country cabin outside of their home municipality risks a fine of

15,000 Norwegian kroner ($1,500) or 10 days in prison, while anyone

organising a cultural or sports event will also face a hefty fine.

Criminal justice measures are “required”

It appears the home quarantine and home isolation regulations implemented

to try and curb the spread of the coronavirus that causes the COVID-19

disease have been seen by some as advisory. They are in fact law, having

been brought in as part of emergency measures under the Control of

Infectious Diseases Act.

Other emergency measures include the banning of all foreign citizens who

are not residents of Norway from entering the country. The Norwegian

Prime Minister Erna Solberg has also banned Norwegians from staying in a

cabin located outside their home municipality, in a bid to ensure rural health

services are not overwhelmed.

The announcement of the fines came as part of guidance issued by Norway’s

Director of Public Prosecutions to the Police and prosecuting authorities.

They said the serious situation “requires that criminal justice measures be

used to help reduce the spread of the virus.”

The punishments were confirmed in an online-only press conference held by

Norway’s Minister of Justice, Monica Mæland. Rather than focus on the

fines, she instead praised the Norwegian community spirit: “Keep going, be

a good caregiver, friend, partner and available neighbor.”

TV2 reported that Oslo’s Police District is investigating “several criminal

cases” related to the spread of the coronavirus and the COVID-19 outbreak.

Mæland asked the Police to hire 300 to 400 more officers to maintain

staffing levels due to high levels of quarantine within the force.

Home quarantine and home isolation in Norway

Under the most recent guidance from the Norwegian Institute of Public

Health (FHI), anyone who has returned from travel outside of Norway since

February 27 must be home quarantined for 14 days after returning home.

Previously excluded, those returning from Finland and Sweden must also

home quarantine if they returned to Norway since March 17. This applies to

everyone, regardless of symptoms. Anyone who has been in close contact

with a confirmed COVID-19 case is also subject to home quarantine.

Those subject to home quarantine must limit contact with other people.

Leaving the house for a walk is permitted, but going to work, using public

transport and visiting places where it is difficult to maintain a 1-2 meter

distance from others is not permitted.

Those confirmed or suspected of infection are subject to the more

restrictive home isolation regulations. This means staying inside and

remaining isolated as much as possible from other people within the

household

// TRUE TYPED COPY //

NYDAILY NEWS

21st March 2020

 Hefty fines, jail time, expulsion: how governments around the world are

dealing with people who ignore quarantine orders

Countries around the world are enacting tough measures in the hopes to

flatten the curve of coronavirus infection by slowing the spread of COVID-

19.

However, as many governments are quickly discovering, a mere suggestion

of maintaining proper social distancing might not be the most effective way

to persuade citizens to comply with unprecedented personal freedom

restrictions.

In the United Arab Emirates, people who fail to follow a mandatory 14-day

quarantine can face imprisonment of up to five years. Perpetrators can also

be fined between 50,000 to 100,000 Emirati dirham ($13,600 to $27,200),

according to Gulf News.

On Wednesday, the Indian Ministry of Health and Family Welfare

also warned that penal action will be taken against those who violated its

quarantine directives, but didn’t specify what those penalties would look

like.

On Friday, CNN reported that a Chinese-Australian living in Beijing went

out for a jog — and broke her quarantine in the process. Her workout came

at a price: she lost her job and was ordered to leave China.
According to the Australian Broadcast Corporation, the maximum penalty

for “breaching a public health order” in South Australia is 25,000 Australian

dollars ($14,480); in Queensland is 13,345 Australian dollars ($7,730) and

in Victoria, 20,000 Australian dollars ($11,580).

On Thursday, a 26-year-old man who arrived in the Isle of Man by boat

failed to self-isolate. He now faces a fine of up to 10,000 pounds ($11,650)

and jail time, according to The Guardian.

The small island, a self-governing British Crown dependency in the Irish

Sea between England and Ireland, recorded its first two cases Friday.

Police in Austria are “really ramping up their patrols,” Charlotte King, a

local student told BBC News radio. “They are making sure everybody stick

to the regulations. There’s loads of signs everywhere, and we can get

penalties of up to 3,600 ($4,000) euros if we break any of the regulations.”

In the U.S., the situation still reflects its uncharted territory status.

On Friday, Gov. Cuomo announced that all nonessential workers in New

York State should stay inside their homes at all times, except for critical

travel, such as going out to get food, supplies or medication.

The unprecedented action, which will go into effect Sunday, means that, one

in five Americans will soon be under a “stay at home” order according to

the BBC.
Other densely populated states, such as California, Illinois and New Jersey,

have all issued orders for its residents to stay at home.

While the never-before-imagined situation becomes the new normal for

freedom-loving U.S. residents, local law enforcement officials have started

to deal with rule-breakers across the land.

Earlier this month, the family of Missouri’s first confirmed coronavirus

case ignored quarantine orders and went to a father-daughter school dance.

St. Louis County Executive Sam Page said in a press conference that if the

father breaks isolation orders again, officials will “issue a formal quarantine

that will require him and the rest of his family to stay in their home by the

force of law.”

// TRUE TYPED COPY //

 INDIA TODAY

22nd March 2020

Coronavirus: Govt allows private labs to conduct tests for Covid-19, caps cost at Rs

4,500

The central government on Saturday recommended that the maximum

charge for each Covid-19 test by private laboratories should not exceed Rs

4,500.

All private laboratories which have NABL accreditation for real-time PCR

SA for RNA virus will be allowed to conduct COVID-19 tests, according to

the guidelines issued by the Indian Council of Medical Research (ICMR) for

COVID-19 testing in private laboratories, which were notified by the Union

Health Ministry on Saturday night.

The National Task Force recommends that the maximum cost for testing

should not exceed Rs 4,500. This may include Rs 1,500 as a screening test

for suspect cases and an additional Rs 3,000 for confirmation test, the

guidelines said.

"However, the ICMR encourages free or subsidised testing in this hour of

national public health emergency," the guidelines stated.

An order issued by the Union Health ministry said the failure to comply with

the guidelines will result in legal action.

According to the guidelines on sample collection and testing, the ICMR has

called for ensuring appropriate biosafety and biosecurity precautions while

collecting respiratory samples (oropharnygeal and nasal swab) from a

patient.

Alternatively, a COVID-19 specific separate sample collection site may be

created, it said.

"Preferable home collection of samples may be done by all the private

laboratories which will help avoid the contact of people with the suspect

cases during local travel to reach the laboratory," the notification stated.

Commercial kits for real-time PCR-based diagnosis of COVID-19 should be

US FDA approved or European CE certified or both for in vitro diagnosis of

COVID-19 under emergency use, under intimation to the Drug Controller

General of India, the guidelines added.

All the laboratory staff involved in COVID-19 testing should be

appropriately trained in good laboratory practices and performing real-time

PCR. All the biomedicial waste should be disposed off in accordance with

national guidelines.
Laboratory test should only be offered when prescribed by a qualified

physician as per the ICMR guidelines for COVID-19, the notification stated.

As far as the reporting protocols are concerned, the guidelines said that any

laboratory before starting its activities must ensure immediate/real-time

reporting of the test results along with the contact details to the ICMR

headquarters data base.

Each laboratory will be given a registration number by the ICMR which

should be prominently exhibited in case any advertisement is made and also

in the report, the notification stated.

The guidelines may be amended from time to time, the notification stated.

// TRUE TYPED COPY //

 TRUE COPY

https://www.mohfw.gov.in/pdf/AdvisoryforHospitalsandMedicalInstitutions.

pdf