Category Archives: Corona Virus

She was just 12 when she dropped out of school and began clocking in for endless shifts at one of the garment factories springing up in Bangladesh, hoping to pull her family out of poverty.

Her fingers ached from stitching pants and shirts destined for sale in the United States and Europe, but the $30 the young woman made each month meant that for the first time, her family had regular meals, even luxuries like chicken and milk.

A decade later, she was providing a better life for her own child than she had ever imagined.

Then the world locked down, and Shahida Khatun, like millions of low-wage workers around the world, found herself back in the poverty she thought she had left behind.

In a matter of mere months, the coronavirus has wiped out global gains that took two decades to achieve, leaving an estimated two billion people at risk of abject poverty. However indiscriminate the virus may be in its spread, it has repeatedly proven itself anything but that when it comes to its effect on the world's most vulnerable communities.

The garment factory helped me and my family to get out of poverty, said Ms. Khatun, 22, who was laid off in March. But the coronavirus has pushed me back in.

For the first time since 1998, the World Bank says, global poverty rates are forecast to rise. By the end of the year, half a billion people may be pushed into destitution, largely because of the pandemic, the United Nations estimates.

Ms. Khatun was among thousands of women across South Asia who took factory jobs and, as they entered the work force, helped the world made inroads against poverty.

Now those gains are at grave risk.

These stories, of women entering the workplace and bringing their families out of poverty, of programs lifting the trajectories of families, those stories will be easy to destroy, said Abhijit Banerjee, a professor at the Massachusetts Institute of Technology and a winner of the 2019 Nobel Prize for economics.

While everyone will suffer, the developing world will be hardest hit. The World Bank estimates that sub-Saharan Africa will see its first recession in 25 years, with nearly half of all jobs lost across the continent. South Asia will most likely experience its worst economic performance in 40 years.

Most at risk are people working in the informal sector, which employs two billion people who have no access to benefits like unemployment assistance or health care. In Bangladesh, one million garment workers like Ms. Khatun 7 percent of the countrys work force, and many of them informally employed lost their jobs because of the global lockdowns.

For Ms. Khatun, whose husband was also laid off, that means that the familiar pangs of hunger are once again filling her days, and she runs into debt with a local grocer to manage even one scant meal of roti and mashed potato a day.

The financial shock waves could linger even after the virus is gone, experts warn. Countries like Bangladesh, which spent heavily on programs to improve education and provide health care, may no longer be able to fund them.

There will be groups of people who climbed up the ladder and will now fall back, Mr. Banerjee, the M.I.T. professor, said. There were so many fragile existences, families barely stitching together an existence. They will fall into poverty, and they may not come out of it.

The gains now at risk are a stark reminder of global inequality and how much more there is to be done. In 1990, 36 percent of the worlds population, or 1.9 billion people, lived on less than $1.90 a day. By 2016, that number had dropped to 734 million people, or 10 percent of the worlds population, largely because of progress in South Asia and China.

Since 2000, Bangladesh brought 33 million people 20 percent of its population out of poverty while funding programs that provided education to girls, increased life expectancy and improved literacy.

Famines that once plagued South Asia are now vanishingly rare, and the population less susceptible to disease and starvation.

But that progress may be reversed, experts worry, and funding for anti-poverty programs may be cut as governments struggle with stagnant growth rates or economic contractions as the world heads for a recession.

The tragedy is, its cyclical, said Natalia Linos, executive director of Harvard Universitys Franois-Xavier Bagnoud Center for Health and Human Rights. Poverty is a huge driver of disease, and illness is one of the big shocks that drive families into poverty and keep them there.

When it comes to a pandemic like the coronavirus outbreak, Ms. Linos said, the poor are even more outmatched than people with means. They cannot afford to stock up on food, which means they must go more frequently to stores, increasing their exposure. And even if they have jobs, they are unlikely to able to work from home.

A resolution that committed the United Nations to eliminating poverty and hunger and providing access to education for all by 2030 may now be a pipe dream.

More than 90 countries have asked the International Monetary Fund for assistance. But with all countries hurting, well-to-do nations may be too strapped to provide the aid the developing world needs or offer debt forgiveness, which some countries and aid organizations are calling for.

To avoid having large chunks of their population slipping into devastation, countries need to spend more, Mr. Banerjee said. In times of crises, like after World War II, economies rebounded because governments stepped in with big spending packages like the Marshall Plan.

But so far, economic stimulus packages and support for those newly out of work have been weak or nonexistent in much of the developing world.

While the United States has committed nearly $3 trillion in economic stimulus packages to help the poor and small businesses, India plans to spend just $22.5 billion on its population of 1.3 billion four times the size of Americas. Pakistan, the worlds fifth-largest country, has committed about $7.5 billion, far less than Japans $990 billion stimulus package.

In Bangladesh this week, several hundred garment factories decided to reopen a move almost certain to worsen the countrys coronavirus caseload.

Ms. Khatuns employer, however, remains shuttered.

The owner told employees that even after the pandemic, he may no longer have work for them. The demand for clothing in Western countries may drop if people have less to spend, he said.

Ms. Khatun worries she and her family will be evicted from the small room they rent, with a bathroom and kitchen they share with neighbors.

If they are thrown out, she said, they will return to the village she left a decade ago as a child determined to to improve her lot in life.

My only dream was to ensure a proper education for my son, she said. I wanted people to say, Look, although his mother worked for a garment factory, her son is well educated and has a good job.

That dream is now going to disappear.

Julfikar Ali Manik contributed reporting from Dhaka, Bangladesh.

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Millions Had Risen Out of Poverty. Coronavirus Is Pulling Them Back. - The New York Times

We log in every day at 7.45am. One by one, we join an array of faces on our screens. We doctors arent used to video-conferencing like this, and still greet each other with excited waving hands. Since the coronavirus crisis began, these daily virtual meetings have proved an invaluable way to keep up to speed on clinical guidelines, in-house protocols and staff wellbeing all of which are changing every day.

But these meetings also bring us news that we take more personally: how many of our patients have symptoms? How many have tested positive? How many have died? These are important questions, for sure, but my public health training reminds me to think globally. The coming year will see developments that will allow us to bring the virus under control in the west, but what about in other countries? I cannot help but think of my relatives in India, and what this pandemic will mean for them not just now, but in the future. The really important question is not who will die of coronavirus tomorrow, but in 200 years time.

For coronavirus is not the only pandemic the world faces. There is another one raging right now. Since cholera first spread across the globe, two centuries ago, it has killed about 50 million people. In the time it takes you to read this article, another five people will have died from it. It is now mostly ignored in the west, but in other parts of the world, it has never gone away.

While I will surely be able to offer my patients in England a coronavirus vaccine in a year or two, and while western health systems will be reinforced to be more ready for a potential future outbreak, I worry that we may repeat the mistakes of cholera: conquering coronavirus everywhere except for the poorest parts of the world.

To reach my grandparents house in Bihar, in north-east India, you have to take a car from Patna airport across one of the longest river bridges in the world, the Mahatma Gandhi Setu. This bridge takes you north over the river Ganges, past Hajipur, a city famous for its fragrant bananas, and up to Darbhanga, near the border with Nepal. When I was a child, the road was so damaged by the regions regular floods and monsoons that the journey, which would take just two hours in the UK, took seven hours, bumping over gut-lurching potholes. Today, the road is smooth and elevated, giving a spectacular view of the areas lush flood plains. They provide the perfect conditions for cultivating the fruits mangoes, lychees and guava that still flavour my memories of visits to my grandparents.

The wet, semi-tropical conditions in the Ganges delta also make it a hotspot for water-borne diseases. And it is in northern India that cholera is thought to have originated several millennia ago, owing to the abundance of still water pools and Hindu ceremonies involving worshippers washing themselves in rivers. A 2,000-year-old inscription at a temple in Gujarat vividly describes the clinical picture of patients afflicted by severe cholera: The lips blue, the face haggard, the eyes hollow, the stomach sunk in, the limbs contracted and crumpled as if by fire.

In the 19th century, the scientist Max von Pettenkofer believed, incorrectly, that cholera required certain soils and environmental factors unique to India, and so thought that it could not be contagious or endemic in Europe. But the persistence of cholera in this area has less to do with climate and more to do with political choices.

Cholera is an infectious disease that turns on all the taps in your gut, so that water and salts pour out of your system, giving you copious watery diarrhoea that looks starchy, like rice water. This diarrhoea helps the infection spread between people, leaving a trail of victims so severely dehydrated that, if they dont receive treatment, they shrivel up like prunes within hours.

For centuries, cholera only caused localised epidemics in north-east India. That was until 1817, when one of these outbreaks, originating in Bengal, spread across the world, starting the first of seven cholera pandemics. But just as Wuhan cannot be blamed for the current Covid-19 pandemic, we cannot hold this region responsible for choleras spread, any more than North America should be blamed for the 2009 H1N1 swine flu pandemic, which originated in industrially farmed pigs. What the spread of these diseases has in common is international trade, and the movement of animals and people that comes with it.

Empire shaped the history of cholera, and it was the economic concerns of imperial powers that brought cholera to heel in the west. But if imperialism was crucial to providing the impetus to end cholera, it also produced a logic that divided the world and only eliminated the disease from one half.

In his book Plagues and Peoples, the historian William Hardy McNeill describes how the British army carried cholera overland into Nepal and Afghanistan, while British navy and merchant ships carried it beyond the Indian Ocean. That is how the first pandemic spread from the Bay of Bengal to south-east Asia, the Middle East, east Africa, and then to Europe by the early 1820s.

In 1831, cholera reached the north-east of England, the region where I grew up. One of the first victims, in Sunderland, was a 12-year-old girl called Isabella Hazard. Her illness was characteristically swift: she was entirely well one evening and dead the next afternoon. She was an early victim of the first of a series of waves of the disease that caused pandemonium in 19th-century Europe. Port cities, crucial to trade, were affected particularly badly.

It is hard to imagine the panic created by the Blue Death, as cholera was nicknamed, because at the time its cause was a total mystery. The most common theory that the disease was associated with bad airs (or miasmas) inspired desperate experiments to control it. In Kingston, Jamaica, for instance, British colonial officers tried to banish the disease by firing cannons through the streets to destroy the morbific power that lurked in the dark alleys.

So cholera went on, unabated, in wave after wave of pandemics throughout the 19th century, causing millions of deaths, mainly in poor neighbourhoods. The working classes rioted across Europe, suspecting the disease was a conspiracy by the ruling elite, who they thought were poisoning them. In the 1830s, the revolutionary Mario Adorno accused the Bourbon royal family of concocting a devilish plot bent on poisoning the people of Sicily with cholera, as part of his attempt to topple them.

But disasters like pandemics are never just destructive they also induce change, and often spark scientific developments and social reforms. The European imperial powers eventually started pouring resources into discovering the true cause of the disease, primarily to prevent the catastrophic economic downturns that accompanied every fresh outbreak. This investment led to three major developments that helped end cholera in the western world: reforms that improved public health, to stop populations getting the disease in the first place; the discovery of new medicines, to prevent and treat the disease; and international cooperation, to unite against a common enemy.

In 1813, Frances Snow gave birth to her first child, John, in York. She and her husband, William, who worked at the local coal yard, raised John in one of the poorest parts of the city. Like Bihar in India, the area John grew up in was regularly affected by flooding, when the River Ouse broke its banks.

When John became a doctor, he grew sceptical of the idea that cholera was caused by miasmas. Instead, he suspected it had something to do with water. He famously proved his theory in 1854, during an outbreak in Soho which killed 616 people. He created a dot map of all the cholera cases in the area and spoke to the families to understand their daily habits, meticulously doing what we would today call contact tracing. He discovered that nearly everyone who had been afflicted used the same water pump on Broad Street. Snow had the handle of the pump removed, making it unusable, which led to a sharp decline in cholera cases in Soho. It was later found that this particular well was shallow and had been contaminated by a nearby cesspit. In one elegant experiment, Snow had unveiled the spectre of cholera, which had haunted him since his childhood: the cause was just plain old dirty water.

This was a problem for colonial powers, because their cities and colonies were unsanitary places. Rapid industrialisation had impoverished both English and Indian rural workers, triggering mass migrations to cities for work. Provided with no public amenities, these new migrants built makeshift homes in unhygienic and polluted slums. Snows revelations led to the creation of Improvement Trusts and a Commission for Public Health in major cities across India, and these did improve the sanitary conditions, but largely only for British expats and colonial officers. By the end of British rule, clean water was available to nearly all British citizens in India, but only 1% of Indians outside the colonial walls.

Today, more than half of Indian households have no access to any kind of formal sanitation, meaning that they must defecate in the open, and 70% of sewage is untreated when it re-enters rivers and streams. As a result, up to 30,000 people in India die from cholera every year. Those who can afford it resort to digging their own water wells, deep into the ground. Given the trouble and expense my grandparents went to do this, I know the fact that their well-water still gives me an upset stomach, forcing me to drink bottled water when I visit, brings them great shame. But it isnt their fault; there is only so much individuals can do when their government refuses to invest enough to ensure clean water for all its people.

John Snows discovery was the first step towards halting cholera. But as the pandemic continued to ravage Europe, effective medicines were needed to prevent and treat the disease. And those could only be developed once scientists understood how dirty water made us sick.

In Florence, a contemporary of Snows spent his days with his eye pressed up against the cold brass ring of a microscope that he himself had designed. Filippo Pacini was a professor of pathology and a pioneer in the kingdom of the tiny; he had a gift for the new art of microscopy and was naming previously undiscovered parts of the human body when he was only 19. He was convinced that the cause of many medical mysteries, like the ones that afflicted his sisters for most of their lives, could be found through careful observation with this powerful new tool.

Pacini studied the organs of four patients who had died of cholera. He pored over their intestines with his microscope, and noticed the same thing was wrong in each. The lining of their gut was highly abnormal: not pink and rubbery as it should be, but pale and coming off in floppy sheets, like soggy newspaper. When he teased apart this lining with a tiny probe, he noticed that multitudes of tadpole-like dots emerged from the tissue.

Pacini recognised that these dots which he called vibrios (commas), because of their shape must be the cause of cholera. He was the first person to observe for certain what had been speculated for centuries: that diseases could be caused by things too small to see by the naked eye. However, the scientific community failed to appreciate the value of his research, and his findings languished, largely ignored, for another three decades.

Pacini had discovered the germ, but it was not until the German physician Robert Koch himself discovered the comma bacillus in Egypt in 1883 that germ theory became popularised. During the following century, further research led to two crucial targeted therapies, based on breakthroughs by scientists from the Indian subcontinent shortly after it gained independence. In 1953, Hemanda Nath Chatterjee developed a simple mix of salt and sugar that could be added to water to safely replace the copious fluids lost as diarrhoea. The basic recipe is still used today.

Six years later, Sambhu Nath De discovered that cholera released a poisonous toxin, which deserved just as much attention as the bacterium itself. Using modest equipment in a laboratory in Kolkata, he showed that the bacteria were not needed to make people sick. If they were stewed in a soupy culture, then removed like whole spices even just the remaining broth was enough to cause life-threatening intestinal damage and give all the symptoms of the disease.

These discoveries transformed our understanding of cholera, and how it could be treated. They provided the basis of two new medicines: oral rehydration therapy, to replace lost salts; and a cholera vaccine, to induce an immune response against the bacteria and its toxin.

Today, its easy for westerners to get their hands on the most effective vaccine, Dukoral. Using it simply involves adding a vial of the liquid vaccine to water, together with a sachet of a granulated buffer that protects the vaccine from stomach acid. Its no harder than adding milk and sugar to tea. Two doses will induce an antibody response that will protect you for about five years. But Dukoral cannot be used in the areas where cholera is most prevalent, because they dont have access to clean water, so taking the medicine could actually put people at risk. Besides, it is unaffordable in those places; to earn enough to pay for two doses, the average Briton would have to work for less than an hour, while the average Indian farmer would have to work for three whole days.

There are other, cheaper cholera vaccines, such as Shanchol, which is manufactured by Shantha Biotechnics in India. This has the advantage of not needing any extra water, as it is poured directly into the mouth. But it is not as effective as Dukoral, as it does not protect you against the toxin, just the bacteria. Plus, it still requires two doses given two weeks apart. Thats hardly feasible for healthcare workers trying to cover vast areas of rural India.

There are many other obstacles to cholera vaccination programmes. To be effective, they must reach enough of the population to achieve herd immunity. This requires accurate surveillance, which is impossible without a strong and centralised public health system. Like the other countries where cholera is still endemic, India lacks this infrastructure, largely owing to the long shadow of colonial extraction, post-colonial debt, and loans granted by the IMF and the World Bank in the 1990s on the condition that the government reduce its spending, which led to cuts to public health and education programmes the very things that a society needs to haul itself out of the conditions that stoke cholera.

So although the World Health Organization (WHO) recommends the use of the cholera vaccine in areas where cholera is endemic, and despite the existence of an easy-to-use vaccine which is manufactured in their own country, my relatives in their remote village in Bihar have not had it. But if I, as a westerner, want to visit them for a week, I can easily get it in the UK.

Oral rehydration therapy and the cholera vaccine have greatly reduced choleras reach in subsequent decades, but it has not gone away completely. Two years after Sambu Nath Des seminal research, a new pandemic the seventh sprung up in Indonesia and took hold in Asia and north Africa. This pandemic is still ongoing. More than a billion people live in countries at risk of the disease which, by no coincidence, are some of the poorest countries on earth.

In the two decades after cholera first reached Europe, individual European nations, acting in isolation, tried in vain to prevent and contain it. But there was no point cleaning up port cities at great expense when you could not vouch for the sailors and cargo flowing through it. They eventually realised that a problem caused by globalisation required an international solution.

This led to the first example of global cooperation in order to combat a disease. In 1851, the first International Sanitary Conference, convening the major European imperial powers, was held in Paris. Still, it took time for all those gathered to reach a consensus, and the first International Sanitary Conventions were not adopted until 1892.

According to Anne-Emanuelle Birn, a professor at the University of Toronto School of Public Health, trade was the driving motive of these meetings, and public health just a necessary means. They proved successful: transnational interventions, such as quarantine and disease surveillance by international health bureaux, did bring down cholera deaths. These International Sanitary Conferences proved the power of international cooperation to improve health and boost the economy, and provided the blueprint for the Health Organization of the League of Nations, and later the WHO.

Perhaps the greatest achievement of this cooperation came in 1979, when smallpox was eradicated globally. But unlike smallpox, cholera has not been eradicated not because of some insurmountable biological hurdle, but because we have thrown our weight behind schemes that focus solely on cholera, rather than trying to end the poverty that makes such diseases likely. There are still about 3 million cases and 100,000 deaths from cholera every year, all entirely preventable. Based on recent estimates, from 1 January to 25 March of this year, cholera claimed more lives than the coronavirus. But we are saying so much about coronavirus and so little about cholera because coronavirus has broken the unwritten rule that dangerous infections should not befall those in the west.

A map of the places still struggling with cholera shows 47 countries in Central America, sub-Saharan Africa and southern Asia. This might seem to confirm that tropical countries are bound to nurture this bacteria, because of their warm climates and high population density. But the experience of the Marshall Islands, a remote Pacific archipelago that suffered a cholera outbreak at the end of 2000 and start of 2001, shows that there is nothing inevitable about where the disease takes its toll. As the University of Hawaii researchers Seiji Yamada and Wesley Palmer have shown, two neighbouring islands there experienced very different fates despite having similar climates and being just four miles apart.

The US maintains a military base on Kwajalein Island, where the menial labour is carried out by low-paid workers who live on another nearby island, Ebeye. Many of them are descended from refugees from other islands in the archipelago who were displaced by US weapons testing in the 40s and 50s. The housing and infrastructure provided to them on Ebeye by the military is not much better than a slum. The average household is home to nine people, so infections spread rapidly. The sewers pour their contents into lagoons where people swim and fish, and when it rains they overflow into the streets.

At the time of the outbreak, there was no running water on Ebeye. Furthermore, since the land there was not fit for agriculture, traditional Marshallese ingredients were unavailable, and nearly all food was imported, unhealthy and expensive, leaving many malnourished. It was a ship bringing food to the island that is thought to have started the outbreak of 2000-2001.

On Kwajalein Island, meanwhile, the residents are almost exclusively American expats who work for private military contractors. They live in detached villas with amenities like those of a beach resort, and the population density is 20 times less than that on Ebeye. Once the outbreak had begun, workers were only allowed to commute from Ebeye to Kwajalein if they could prove that they had received vaccination or prophylactic antibiotics. During the cholera outbreak, there were 400 cases and six deaths on Ebeye. However, on Kwajalein there was not a single case.

What made contracting cholera so likely on Ebeye and so unlikely on Kwajalein has nothing to do with climate or geography. There is no biological or environmental reason why cholera cannot be eradicated for good in Ebeye, and Bihar, and right across the world. It is not the knowhow that is lacking, but rather the political will to extend these benefits to all people.

It is now 200 years since the cholera pandemics began, more than 150 years since the bacteria was identified, and 60 years since an inexpensive treatment and vaccination regime was developed. And yet still this contagion is plaguing some countries as if none of that progress had ever happened. That is the real lesson of cholera.

There are fears that coronavirus is now distributed so widely that, like cholera, it may be here for the long haul. It is not yet known whether this current coronavirus, Sars-CoV-2, will eventually mutate to cause milder, cold-like symptoms, like the four endemic coronaviruses; or instead go the way of the first Sars coronavirus and remain as a deadly, but contained, infection. In either scenario, Sars-CoV-2 or a similar future virus could, like cholera, be eliminated only from the richer parts of the world, and left to circulate, with deadly consequences, in the worlds poorest regions.

The world will eventually recover a semblance of normality by adopting the same three techniques we used against cholera: prevention of transmission, targeted treatments and global cooperation between nations. But as we saw with cholera, all three strategies can exacerbate global divides, if they are applied selectively to protect only the richer half of the world.

There are signs that this is happening already: from richer countries buying up so much extra personal protective equipment that poor countries will be unable to obtain or afford enough to protect their health workers; to the outsourcing of coronavirus clinical trials to poor countries, like India, that will be less able to afford the vaccine once it is developed; to poor countries becoming blind spots in the worlds gaze on coronavirus, because they lack the digital infrastructure necessary to collect comprehensive data about their outbreaks.

It is hardly news that we live in an unequal world. In the 90s, global health experts began to refer to the so-called 10/90 gap, based on the fact that only 10% of health research funding was addressing the health problems that affected 90% of the worlds population. At the time, diarrhoeal diseases accounted for 7.2% of global disease burden, but attracted only 0.06% of health research investment. The 10/90 gap has remained largely unchanged. But with this new pandemic, we have an opportunity to put that right.

Just as cholera gave birth to global health, coronavirus should trigger its latest reboot. Richard Smith, the former editor of the BMJ, has compared the stages of global health since the first cholera pandemics to the updates of an operating system. I welcome what he calls Global Health 4.0: namely, research and policy led by researchers and activists from poor countries. And while the WHO has not always lived up to its lofty goals, nor managed to achieve eradication of cholera as it did for smallpox, the solution is not to weaken it, as per Donald Trumps removal of funding, but the opposite: it needs much more funding, and more independence from corporate donors, if it is to help tackle the socio-economic conditions that make us sick.

Besides the basic moral argument for a system of public health and international cooperation that benefits all people, it is also in everyones interests, because as long as infections blight poor countries, they will continue to pose a threat to the west, too. The Nigerian global health scholar Obijiofor Aginam has written that enormous sacrifices must then be made by the developed world to confront mutual vulnerability. Coronavirus has reminded us, once again, of this mutual vulnerability.

To prevent further pandemics, Aginam calls for a communitarian globalism: a bottom-up approach, based on ideals of fairness, justice, and equitable distribution of scarce but moderate global resources. We have already seen glimpses of this kind of solidarity in the current crisis: from the communist government in Kerala giving food and shelter to migrant workers; to the Somalian doctors offering their help in crisis zones such as Italy; to Cuba allowing an infected British cruise ship to dock to receive timely medical care by its doctors.

There are, of course, important differences between coronavirus and cholera. The fact that coronavirus has a higher transmission rate than cholera, for instance, will make curbing its spread particularly challenging. But the lesson from cholera holds nonetheless. If we allow global health to be funded and governed by the old colonial logic that is embedded in its current structures, then the story will play out as it did for cholera.

For now, I will continue to worry about my patients and colleagues in England, and how many of them will succumb to this virus. But while there are certainly better and worse ways to respond to the crisis here in the short term, history will judge us not just on who dies from coronavirus today, but in the centuries to come.

For when my patients die during a pandemic in one of the richest countries in the world, it is of course a tragedy, but I can take comfort in the fact that it is an exceptional one, and that every effort is being made to prevent further such deaths. A much bigger moral failing would be if there are still people in the poorest parts of the earth dying of coronavirus in 2200. In 50 years time, when I take the road north through Bihar to my ancestral home, I hope I will be able to buy a bunch of bananas in Hajipur without wearing a mask, and fill my nostrils with their sweetness.

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Cholera and coronavirus: why we must not repeat the same mistakes - The Guardian

More than 70% of patients with coronavirus admitted to critical care are men, according to new data.

The figures come from the UKs Intensive Care National Audit and Research Centre (ICNARC) and were based on a sample of 7,542 critically-ill patients confirmed as having Covid-19. Researchers found that 5,389 of these patients were men and 2,149 were women.

The report, published on Friday, also found that men were more likely to die in intensive care, with 51% dying compared to about 43% of the women who were admitted.

The report analysed data on patients with confirmed Covid-19 from 286 NHS critical care units in England, Wales and Northern Ireland taking part in the ICNARC programme up to 4pm on Thursday.

The new data echoes comments of a leading expert who said that Covid-19 was just as deadly as Ebola for people admitted to hospital in the UK.

Prof Calum Semple from the University of Liverpool, a consultant respiratory paediatrician at Alder Hey childrens hospital and chief investigator on a study published on Wednesday, said the data highlighted the danger of coronavirus.

Research by Semple and his team found that of the total number of coronavirus patients admitted to hospital, 17% required admission to high dependency or intensive care units and of these, 31% were discharged alive, 45% died and 24% continued to be treated in hospital.

Semple explained: Some people persist in believing that Covid-19 is no worse than a bad dose of flu.

They are gravely mistaken. Despite the best supportive care that we can provide, the crude case fatality rate for people who are admitted to hospital that is, the proportion of people ill enough to need hospital treatment who then die with severe Covid-19 is 35 to 40%, which is similar to that for people admitted to hospital with Ebola. Its a really nasty disease.

The new ICNARC data also showed that around 56% of 60 to 69-year-olds, 67% of 70 to 79-year-olds, and 65% of people aged 80 and over admitted to critical care died there, compared to about 24% of people aged under 50.

It also found that about 26% of patients in critical care with Covid-19 were black or Asian, compared to 66% who were of white ethnicity.

A separate Institute for Fiscal Studies report found that per capita deaths among the black Caribbean population in English hospitals are three times those of white British people.

This follows a report from the Office for National Statistics which found people living in the most deprived areas of England have experienced coronavirus mortality rates more than double those living in the least deprived areas.

The ICNARC report also said that 25% of critical care coronavirus patients were from the most deprived quintile (fifth of the population), compared to 14.5% who were in the least deprived one.

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Coronavirus: over 70% of critical care patients in UK are men - The Guardian