India’s spiraling Covid-19 crisis could lead to outbreaks and lockdowns in Australia because the hotel quarantine system is ‘not fit for purpose’ and flights from the high-risk nation should be immediately banned, doctors and politicians have warned.
In the last 24 hours alone, India recorded 332,730 new coronavirus cases and one in three people are testing positive in the capital, New Delhi, many suffering from highly infectious and more deadly mutant strains of the virus.
The disastrous outbreak, which has pushed hospitals to breaking point and required the mass burning of bodies in the streets, is already affecting Australia with a huge spike in cases among travellers from India in quarantine.
India’s Covid death toll could be ten times higher than is being officially reported, according to analysis of the numbers being burned in crematoriums. Pictured: A man walks past a burning funeral pyres of people who died from Covid-19 at a crematorium ground in New Delhi
Relatives and family members carry the dead body of a Covid-19 victim for a cremation at Nigambodh Ghat Crematorium, on the banks of the Yamuna river in New Delhi in the early hours of Thursday
Sydney recorded 18 new cases in quarantine on Friday and the Northern Territory recorded 12, of which 11 were from India.
The alarming rise has prompted Scott Morrison to cut flights from India by 30 per cent and require anyone travelling to get a negative test in any transit country before flying on to Australia.
However, medical experts are warning these moves are not enough – and that major quarantine changes need to be made to prevent outbreaks.
Australia has suffered 14 outbreaks caused by leaks from hotel quarantine since November, including six in Sydney and three in Brisbane. Sydney’s Northern Beaches Christmas lockdown is believed to be caused by infected travellers but no direct link was ever found.
Dr David Berger, an emergency flying doctor who practices in Lightning Ridge, NSW, published a paper in the Medical Journal of Australia on Wednesday which called for regional worker camps to be used instead of high-rise hotels and called for flights from India to be banned.
He has written an open letter to the government, signed by 350 colleagues, which calls for experts to recognise that Covid transmits in the air, not through contact or droplets as currently believed.
His paper says that between November and mid January ‘approximately 1 in 200 hotel quarantine cases led to infections outside the system’ causing outbreaks in Sydney, Melbourne Adelaide, Brisbane, and Perth.
Another 314,835 infections were reported on Thursday, the world record for a daily cases figure. Pictured: A graph showing India’s 7-day-average daily new coronavirus infections
Funeral pyres at a makeshift crematorium in the capital Delhi on Wednesday, the city of 29 millions is rapidly running out of hospital beds for patients, oxygen supplies and even basic medication
Discussing his paper on 2GB radio, Dr Berger said: ‘Almost all of those are variants. This virus is airborne. There is no documented case of transmission from contact such as lift buttons or surfaces. It can be transmitted over significant distances and ventilation is critical to this.
‘Unfortunately these hotels that we’re using were never designed for people to be cooped up in them for two weeks with no opening windows.
‘They have gaps under the doors, the ventilation is not designed to be infectious disease proof. They’re just not suitable. These facilities are just not designed for it.’
He said the quarantine system needs a total overhaul, adding: ‘We need to move to a situation where we have air-gapped quarantine like they do in the Northern Territory. Australia is full of mining camps and such like.
‘It is not beyond the wit of Australia to establish mini caravan parks or mining camps close to major cities, where they can have access to fresh air and there is zero risk of cross contamination.
‘Until we do that we are not going to be safe. We are going to have to pause travel and get better facilities.’
What measures has Australia taken to stop Covid-19 spreading from India?
National Cabinet agreed to place additional restrictions on Australian citizens and permanent residents seeking to enter Australia from high risk countries which are experiencing rapidly increasing COVID-19 outbreaks. The Commonwealth will work to establish a list of high risk countries. Going forward:
· Anyone entering Australia who has been in a high risk country in the last 14 days before entering Australia and is transiting through a third country will need to return a negative PCR test 72 hours prior to entering Australia from the final point of embarkation.
· The Commonwealth will further restrict outbound travel exemptions to high risk countries to strictly essential travel only.
Prime Minister Scott Morrison (pictured) has put in place a series of measures to stop Covid entering Australia from India and other high-risk countries
To address the significant increase in COVID-19 positive case numbers in returned travellers from India, National Cabinet agreed to:
· Reducing the number of passengers on Government facilitated flights into the Centre of National Resilience at Howard Springs for all flights departing India, until the rate of positive cases has decreased to acceptable levels.
· An approximate 30 per cent reduction in passenger numbers for Australians returning from India on Government-facilitated flights during May 2021. In addition, four of the scheduled facilitated flights will be rescheduled from May to June 2021.
· A 30 per cent reduction on commercial flights direct from India to Australia, as soon as it is practical.
· National Cabinet will seek advice from the Australian Technical Advisory Group on Immunisation (ATAGI) regarding the benefits of having aircrew vaccinated as a priority cohort.
· The Commonwealth will seek Rapid Antigen Testing (RAT) for Australians returning on direct flights from high risk countries.
Dr Berger said flights from India, which is being ravaged by wildly infectious mutant strains of Covid should be stopped.
‘Given the risk that India currently presents with its highly transmissible, highly infectious variant, which is absolutely out-of-control, I think there is an argument for a very temporary cessation of travel from India,’ he said.
‘We need to revamp hotel quarantine so it is safe. Our line of defence is very thin.’
State leaders have also expressed concerns about the increasing number of cases coming from India into Australia.
Western Australia premier Mark McGowan said on Thursday: ‘India’s is obviously full of Covid. We are very concerned about India and that’s why we have suggested a suspension, a reduction, in the number of people returning from India.’
He said he feared the quarantine system would not be able to cope after the virus was transmitted between guests in closed opposite rooms at the Mercure Hotel Perth, including to a man who tested positive after leaving the hotel and returning to Melbourne on Friday.
The man, who is asymptomatic, arrived in Melbourne on Wednesday after completing 14 days of quarantine at the hotel.
Genomic testing has confirmed the virus spread in the corridors of the hotel from a couple who had returned from India.
A pregnant mother and her four-year-old daughter who were staying across the corridor have also tested positive and remain in quarantine at the hotel.
The premier said: ‘Obviously [the situation in India] is a big risk to the broader community and the integrity of our hotel quarantine system. It’s not zero-risk environment. It’s not perfect. As we have seen, somehow between two rooms that had closed doors, there has been transmission.’
Mr Morrison said on Friday it was not necessary to overhaul the quarantine system but explained why he cut flight capacity from India.
‘The total number of cases that are occurring in quarantine are about the same they have been all year.
‘So, we haven’t seen a spike in the number of total cases over that period of time. There’s been a slight increase in the last week or so – the quarantine system is not failing because of that at this point.
‘So, we need to put if place the risk management that protects it going over the next few weeks.’
Use worker camps NOT hotels and wear N95 masks: Dr Berger’s plan to shore up the quarantine system
• Reinforce the border through improved ventilation in quarantine facilities, vaccination of workers and the use of airborne PPE
• Replace high-rise quarantine facilities with accommodation modelled on the Howard Springs facility, in which residents are separated by open air
• Update all COVID-19 guidance to emphasise the risk of aerosol transmission of SARSCoV-2
• Mandate and fund ventilation assessments and upgrades of essential public institutions, such as hospitals, schools, aged care facilities and prisons
• Promote strategies to reduce transmission risk through clear public health messaging and education
• Ensure the availability of fit-tested P2/FFP2/N95 respirators for anyone in contact with a potential COVID-19 patient
• Replace the harmful concept of ‘aerosol generating procedures’ as the sole risk for airborne spread with the knowledge that airborne spread is likely the norm in all situations, given SARS-CoV-2 containing aerosols are readily produced by breathing
• Fast track research into indoor air quality, including the study of carbon dioxide (CO2) monitoring as a surrogate measure of indoor air quality and airborne pathogen risk
• Include recommendations on the usage of indoor air cleaners such as appropriately sized portable air filtration (HEPA) units or simple, practical and low-cost homemade devices using MERV-11/13 filters and box fans
• Develop clear national ventilation standards for indoor environments
• Broaden the diversity of people advising on infection control, by including experts from aerosol science, engineering, HVAC, occupational hygiene, occupational health and safety, and organisational psychology
India’s Covid tsunami: AMRIT DHILLON’s harrowing dispatch reveals a nation living in terror as it’s hit by ‘double and even TRIPLE mutation’ Covid variants that don’t show up in tests – so should Australia let in ANYONE from the subcontinent?
The terror that blighted the final hours of Swapnil Rastogi’s father Raj is something his son will never forget.
That, and his own desperation as he drove around Lucknow, the capital of India’s populous Uttar Pradesh state, searching for a hospital bed.
Earlier, he had managed to source precious oxygen from a friend as his father’s coronavirus symptoms worsened. But it was not enough to save him: Raj, just 59, died in the back seat of Swapnil’s car, leaving his grief-stricken son bewildered and angry in equal measure.
Pictured: A view of a crematorium ground where mass cremation of victims who died due to the coronavirus disease (COVID-19), is seen at a crematorium in New Delhi on April 22, 2021
A mass cremation of victims who died of Covid-19 is seen at a crematorium ground in Delhi on Thursday, April 22, 2021
Relatives of a Covid-19 victim mourn during a cremation at Nigambodh Ghat Crematorium, on the banks of the Yamuna river in New Delhi in the early hour of April 22, 2021
‘It wasn’t the virus that killed my father, it was the lack of treatment,’ he says. ‘I ran around to a dozen hospitals but couldn’t find a bed for him. The system has collapsed.’
Few would dispute his words. Today Mr Rastogi’s anger is matched only by the sense of fear stalking India’s population of almost 1.4billion as a second wave of the pandemic overwhelms the country’s hospitals, leaves citizens dying on the streets and sees not only desperate families but even hospital managers appealing for oxygen supplies on social media.
Epidemiologists here are reporting virulent new variants driving this surge, including a ‘double mutation’ variant B1617 that does not always show up in tests even in those patients with full-blown symptoms and whose CT scans show all the tell-tale signs of coronavirus damage.
There is even more frightening talk, too, of a ‘triple’ mutation variant. Will vaccines be effective against such variants?
That would be more of a worry here, perhaps, if more people had been vaccinated – it stands at less than 10 per cent of the population so far.
It is no exaggeration to say that it feels near calamitous at times. Government and hospital helplines ring out unanswered while the streets of cities and small towns are thronged with panic-stricken daughters, sons, husbands and wives doing what Mr Rastogi did – driving for hours to find oxygen or a hospital bed.
The health ministry said there were 2,074 fatalities on Thursday, a new record for the country, but believed to be vastly under-reported
A man pays his respects to his relative as he performs the last rights at a crematorium on the outskirts of New Delhi on Thursday
Multiple funeral pyres of those patients who died of COVID-19 disease are seen burning at a ground that has been converted into a crematorium for mass cremation of coronavirus victims, in New Delhi, India, Wednesday, April 21, 2021
Meanwhile, crematoria work through the night – contrary to Hindu custom which dictates that no bodies be burnt after sundown – to cope with the rising body count, the lines of funeral pyres sending black smoke into the horizon of every major city.
Even so, the backlog of bodies is such that families have to wait hours in the baking 35C heat before they can cremate their loved ones, huddled in groups alongside the makeshift platforms built to accommodate the shrouded corpses.
India’s horrifying state of affairs has led journalist Iram Hussein to label the situation nothing short of ‘a holocaust’.
She had to beg for her parents – both critically ill with Covid – to be given a hospital bed only to find there were no facilities to treat them. ‘They have got nothing to fight this. No medicines, no oxygen,’ Ms Hussein said. ‘I am seeing biblical scenes.’
They are scenes which are unfolding everywhere, from the most affluent corners of cities to the poorest rural communities, overwhelmed by both the savagery and speed of the virus.
And the fact that these tragedies are occurring in a country which, until as recently as a month ago, appeared to have weathered coronavirus better than many in the West, makes them all the more astonishing. Wind the clock back a year and epidemiologists were predicting that India, with its vast community of rural and urban poor, faced unprecedented challenges as the first wave of the pandemic rolled across the globe.
We were told people would die on the streets of our cities, while rural villages would have too many deaths to document. Yet none of this happened. While around 114,000 died up to September/October last year when the pandemic peaked, India’s vastly underfunded and fragile healthcare system coped.
Quite why India escaped relatively lightly remains the subject of mystery and conjecture among ordinary people and experts alike.
At its peak, the country was still reporting only 90,000 cases a day – a relative sliver of its vast population, and a number that had dropped to 20,000 by January.
Was it the relatively young demographic and low rate of obesity? Was it the BCG jab routinely given to Indian children to guard against deadly tuberculosis? Or perhaps the population had stronger immune systems developed to cope with the widespread lack of sanitation?
An aerial view of a crematorium ground in Delhi on Thursday shows the scale of the devastation caused by Covid-19 in India
Oxygen, hospital beds and vaccines are running low in India, where some patients have been turned away from hospital because of shortages. Pictured: A cemetery worker in PPE collects logs to be used in funeral pyres
Despite huge numbers of infections, Prime Minister Narendra Modi has said lockdowns are a last resort. Pictured: Funeral pyres blaze ar a crematorium ground in New Delhi
The reality is that, aside from a harsh but effective lockdown, nobody really knows. What is clear, however is that as January ticked into February and cases dipped for the thirtieth consecutive week, complacency set in among both the population and its leaders.
From January onwards, most restrictions were relaxed, and since then many Indians have been celebrating one Hindu festival after another, mingling in vast crowds with little in the way of social distancing.
In March, a crowd of 57,000 gathered at the Narendra Modi Stadium to watch India play England in Ahmedabad, Gujarat.
From April 1 onwards, millions gathered on certain days at the annual Kumbh Mela festival, despite calls by doctors alarmed by an uptick in figures from early February for it to be called off.
Among them was Dr A Fathahudeen, a highly respected medic who is part of Kerala state’s Covid taskforce. ‘I said in February that Covid had not gone anywhere and a tsunami would hit us if urgent actions were not taken,’ he said recently. ‘Sadly, a tsunami has indeed hit us now.’
It is a prediction that India’s prime minister, Narendra Modi, certainly chose to ignore. Lax, complacent, over-confident, and lulled into a false sense of security by India’s moderate first wave, he made few preparations for a second wave despite the overwhelming evidence from Europe and America that it would come.
Nor has he led by example: for the last two months he has been driving election campaigns for local state assemblies, which involve mass rallies attended by hundreds of thousands of people.
Funeral pyres of people who died from the coronavirus are seen at a crematorium ground in New Delhi on Thursday
India’s healthcare system is buckling under the strain of a vicious second wave. Pictured: A cemetery worker pulls a cart of wooden logs to be used in funeral pyres on Thursday
An Indian boy carries an empty oxygen cylinder for filling at oxygen filling centre in Bangalore on Wednesday. There is a shortage of oxygen cylinders in certain COVID-19 affected areas but the Karnataka state government has said that it will do its best to make sure the distribution of liquid medical oxygen is smooth and there will be no shortage
Even so, the speed with which the latest wave has spread through the population has surprised everyone.
Against a backdrop of pictures of near-empty Covid wards, and news that the temporary hospitals and isolation centres hastily erected during the first wave had been decommissioned, we started meeting outdoors in cafes and parks again.
Yet a month later here we are, thousands are dying daily, and not just because of the virus alone but because they cannot get life-saving treatment. India’s healthcare’s system is on its knees, and the consequences have been heart-rending. People are dying on park benches, in car parks, and in ambulances outside hospitals.
For once, the rich are as helpless as the poor. In a country where money and connections could always ensure access to some of the best healthcare in the world, the second wave has come as a rude shock. Money has no currency now.
On Tuesday and Wednesday, some of the top private hospitals in New Delhi said they had only a couple of hours of oxygen left, after which its patients would start dying – those on ventilators within minutes and other patients within hours.
When a truck with oxygen cylinders arrived at one New Delhi hospital at 1.30am – half an hour before it was due to run out – doctors and nurses there wept with relief.
It’s little wonder that people are palpably scared: if you call for an ambulance it will not come, and even if it does there is nowhere to take you.
It’s a visceral fear I have succumbed to myself this week, having woken up yesterday with Covid symptoms that have confined me to my bed. As I am in my late fifties, I’ve already had one Covid vaccination, and so far my symptoms are not severe, but I cannot shake off the lingering fear that should I deteriorate there is little that can be done. If I wake up at night struggling to breathe, I have no plan of action.
Nor are the young immune. While most serious cases and deaths have predominantly involved the elderly and those with pre-existing conditions, younger people are also suffering.
Just this week, the 34-year-old son of a prominent Indian politician died from Covid.
The backlog of tests in laboratories – four days worth – does not help. Without the Covid-positive test, you can’t be admitted to hospital even if you manage to find a bed, so people are dying while waiting for a test or the result.
Vaccination cannot be relied on either: while some 2.7million vaccine doses are given daily, less than 10 per cent of the population has been vaccinated so far – a number that must rise exponentially to make a difference.
A crematorium worker checks a burning pyre of a Covid-19 victim at Nigambodh Ghat Crematorium on the banks of the Yamuna river in New Delhi in the early hour of April 22, 2021
Multiple funeral pyres of those patients who died of COVID-19 disease are seen burning at a ground that has been converted into a crematorium
President Modi’s response has been startlingly ineffectual. This week, as evening bulletins broadcast images of grieving and desperate citizens, his only real intervention has been to declare that oxygen supplies can no longer be used for industrial purposes but must be given to hospitals instead.
How much difference that will make remains to be seen, and at the moment it is social media that people have turned to for answers, with citizens tweeting links to hospitals they have heard may have a bed, and WhatsApp groups trying to source oxygen supplies or construct makeshift isolation units in empty houses.
On Twitter, anti-Modi hashtags are trending, along with the phrase: ‘You are responsible Mr Modi’. And beside herself with grief, one young woman, who cremated her mother on Tuesday, asked a question many are pondering this week: ‘May I ask Modi and Amit Shah [the equivalent of the Home Affairs minister] why they are campaigning in West Bengal? Are they not seeing people dying here in the capital?’
Incredibly, Mr Modi was due to visit West Bengal today for another political rally, instead of staying in the capital to monitor the scourge that has engulfed the country.
Belatedly, he cancelled it last night – but not before an impression of heartless indifference had been created.
No wonder a customised image of Mr Modi’s party’s symbol, the orange lotus, is doing the rounds on Twitter. Instead of petals emerging from the leaves, it shows the blazing orange flames of a funeral pyre.