Tag Archives: covid19

Boom of E-commerce in India is a Postnatal Stage of American Booming

There are multiple reasons for the apparent e-commerce boom occurring worldwide. The rise in the use of mobile devices is effectively the biggest enabler. Buying and selling online is more flexible and passive, while secure payments add to the protection consumers expect. 

Since e-commerce became an indispensable part of the global retail structure, digitization has only helped in a substantial increase in its functioning. In 2019, an estimated 1.92 billion people used online portals for a combined e-retail sale of over $3.5 trillion worldwide. This number is steadily rising each year as more and more consumers embrace the digital movement. 

Speaking as an entrepreneur, there are multiple problems circulating the ecosystem which has significantly reduced the effectiveness and adoption of e-commerce in India. However, this poses the question of how, instead of when. 

As flexible businesses can readily adapt to technological changes, the same flexibility might not be easily seen in the consumers. A mutual transformation is necessary for e-commerce to be truly beneficial for all parties involved. For example, effectively adopting digitization for both parties is a must. For businesses, switching to more potent trends that boost customer satisfaction and allows greater reach and flexibility is the way forward. 

Unfortunately, the Indian consumer has been relatively slow in adapting to fundamental technological changes. This has a direct effect on businesses that find it difficult to engage and reach the otherwise huge consumer population in the country. 

Steadily, changing trends and mindsets have given rise to an industry that could reach its true potential in a short amount of time. However, as an essential segment of the global e-commerce ecosystem, India needs to step up and play the part it should in global business and become a beacon for other advancing countries to follow suit. 

The E-Commerce Boom in India

E-commerce in India has seen a massive rise in the past decade. This can be attributed majorly to the explosion in internet usage and in smartphone availability. Driven by the “Digital India” program, enhanced connectivity has allowed the Indian consumer to reach online retailers with ease. 

The COVID-19 pandemic brought heightened levels of uncertainty which served in the accelerated adoption of digital and its practices. India is set to become a promising digital economy with its rapidly increasing consumer count and subsequent consumption, data affordability, newer products, and better financial prospects. 

According to Statista, the $84 billion industry is set to grow further and reach $200 billion by 2027. However, even as the fourth largest retail market in the world, Indian e-commerce is still largely unorganized. Comparing it to the US market, e-commerce there makes a total of $407 billion currently, which is expected to rise to $476 billion by 2027.

There are multiple reasons why India might seem to lag behind bigger economies, especially when it comes to the e-commerce sector. Absence, and downright neglect to use advanced technologies, and a reluctant consumer mindset offers obstructions when it comes to creating an accessible digital landscape. 

One of the major issues with adapting digital trends is the hesitation consumers feel while shopping online. Traditional shopping might seem more “secure”, while online shopping is still considered high-risk. 

However, increasing internet access and the ease of digital payments have brought the country to the cusp of transformation, while the widespread acceptance of digital has added to the overall growth of the e-commerce sector. With changing demographics and alterations in policies, India has presented a unique potential in growing within the landscape. Gathering significant momentum, the Indian e-commerce boom is leaving its cocoon phase.

E-commerce Challenges in India when compared to the United States.

The e-commerce market in the United States consists of established firms like Amazon and Walmart. Whereas Indian sites are still in competition for a good-enough chunk of the market. Since diversity amongst customers leads to diversity in demand, the emergence of a single company that caters to everyone might be a difficult proposition.

As more and more consumers join the changing trends, the need for e-commerce platforms that can potentially uphold their side of the bargain and allow customers to easily make the switch from physical to digital could help the Indian e-commerce industry see a huge rise. Sales during festive seasons have already displayed the potency of the Indian consumer market. However, this temporary boom during certain times of the year needs to be made permanent to allow the Indian e-commerce businesses to foster and grow out globally. 

Comparing e-commerce in the United States and the state of digitization in India, we can deduce that customer mindset plays an important role in the trends that play out. Since digitization is relatively new to the Indian consumer, finding the right technologies and businesses to rely on is not an easy task. The huge discrepancy in online sales in the US market as compared to India is noticeable and does not effectively make sense as a bigger population should result in a bigger consumer market. 

This can be attributed to the tendencies of customers to readily embrace digital. Whereas in India, the average consumer is still trapped by a lack of resources and the correct mindset to adopt digital. This, however, is changing rapidly and tier 2 and tier 3 cities in India have already started showing their potential as prospective customers of the digital age. 

When we talk about consumers, the role of tier 2 and tier 3 cities have become apparent. In the Indian e-commerce ecosystem, tier 2 and tier 3 cities have shown the maximum growth potential, even outpacing tier 1 cities. This could be attributed to multiple factors. The adoption of social e-commerce, better delivery times, availability of local products, and the rising digitization of the population have allowed businesses to gain a competitive edge in tier 2 and tier 3 cities. The Direct-to-Consumer or D2C approach has also provided an effective backdrop in allowing customers to develop a stronger connection to the brands as well. 

Talking about the growth of the e-commerce sector in India, there are still various challenges being faced on either end. Customer mindset, reachability, poor logistics, and supply chain practices are causing the wagon wheel to slow down. High cash on delivery orders also increases fraudulent transactions and leaves the sellers vulnerable to losses. 

While bigger, more advanced economies are stepping in to solve these issues, Indian businesses continue degrading practices to get those conversions. A nationwide reform is incredibly necessary to allow businesses to stay afloat while allowing customers to change with the tide. 

There are plenty of changes that are coming to the industry. However, trailing behind developed nations in terms of policies and operations might not prove to be the best for either businesses or consumers. 

The United States ranks as the second largest e-commerce market in the world. Despite appearing highly established, online shopping in the US only accounts for 8.9% of overall retail sales. While the Indian online market only accounts for 4% of total retail sales. Compare this to China’s economy, and it is valued at $1.15 trillion and accounts for 23.1% of all retail sales. 

While the total population of the United States is far less than India’s, internet penetration is far greater. Internet penetration in the US is at a strong 89%, around 290 million people, which allows consumers to actively surf the web for their shopping requirements. Meanwhile in India, only 34.4% of the population, around 450 million people, have access to high-speed internet, one of the primary reasons why the Indian consumer has not been familiarized with online shopping. 

How E-Commerce in India is Developing

The Indian online sector fails to match the growth of e-commerce in larger markets like China and the United States. Despite that, development has been rampant and as businesses and customers rebound from the effects of COVID-19, a rise in customers making use of online services has been acknowledged.

The growth of e-commerce in India will be inclusive – one that empowers both sellers as well as buyers. For the consumers, e-commerce will provide convenient access to a wide variety of products at transparent prices, and for sellers, it will provide easy access to a large customer base.

Indian e-commerce businesses have started venturing into multiple avenues to provide a more unique customer experience. Social commerce is on the rise with easy product discovery options and more customers relying on information from peers and communities. Video content has also provided businesses with a strategy to help allow customers to make a favorable buying decision.

Influencer marketing has seen a significant rise and has allowed new businesses to reach a huge population without getting tangled in traditional marketing trends. Engagement sees a high rise when it comes to influencer marketing while costing only a fraction of the actual cost of reaching such a big portion of consumers. 

Technology-enabled innovations like hyper-local logistics, digital payments, analytics-driven customer engagement, virtually assisted shopping, warehouse robotics, etc. will also propel the growth of the sector and take its Gross Merchandise Value (GMV) to $100-120 billion by 2025.

As Amazon launches its Amazon Smbhav program, its role in boosting the credibility of Atmanirbhar Bharat has allowed smaller businesses to unlock the potential in the e-commerce landscape. Amazon seeks to invest an incremental $1 Billion to digitize MSMEs to help them reach a significant part of the Indian consumer market. This initiative not only helps businesses but in turn increases Indian exports and brings additional jobs to the country. 

Jeff Bezos, the founder of Amazon, had this to say, “I predict the 21st century is going to be the Indian century” 

As India gets ready to leave an everlasting mark on the global business of e-commerce, a large ecosystem of startups and small businesses has already started innovating and accelerating India’s growth towards an Atmanirbhar Bharat. Amazon is looking to help these businesses reach their true potential by allowing them to scale their businesses by leveraging digitization and technology. 

Similarly, the initiative Spotlight North East is designed to boost the local economy, create new jobs, and help accelerate the growth and empowerment of women and the tribal communities across the North-East region of India. The program is set to benefit the artisans, weavers, and local businesses by helping them land the digital age and enabling them access to technology and consumers. 

Conclusion

We know that factors like higher income levels, better communication platforms, more smartphones, and intentional digitization has allowed e-commerce to prosper. However, the apparent e-commerce boom in India had been in the metamorphosis phase for the past decade. The fundamental issues which included low internet availability, disapproval of digitization, and neglect of services due to more trust in traditional marketplaces, have all been curbed with the right intent in place. 

Online platforms are easier, and much more stable than traditional marketplaces. Only now the general consumer is waking up to the fact which is going to allow the industry to witness explosive growth. The Indian e-commerce industry is moving on from its infancy and might be set to take on mega-markets like China and the US. This heightened increase will no doubt pose new threats and complications that would require start-ups and even older businesses to be more agile. If the upcoming venture is well-treated, Indian e-commerce might be set for an extraordinary upsurge. 

Vaibhav Lall is an engineer by education and an entrepreneur by choice. He is the founder of India’s largest online deal discovery platform – Khojdeal. Prior to jumping on the entrepreneurial bandwagon, Vaibhav has experience working with corporate giants like Mindtree and Cognizant as a Digital Marketing Consultant. From consulting Fortune 500 companies on digital transformation to launching a startup, he has deployed astute digital strategies that can impact an organization’s growth curve in various stages.

 

A Twitter plea from journalist, Vinay Srivastava.

COVID Overtakes India: Indian Americans Struggle With How to Support Their Loved Ones

This article is being revised and updated with information & resources. Originally published on April 30, 2021.

The second wave of COVID in India has caused over 18 million people to be affected by the virus, most of whom are currently struggling to get beds in hospitals, or oxygen supply, or sustainable food. 

People have lost lives before they were even given a chance. Thursday, April 29th, an India Currents’ writer’s cousin (a doctor) posted an urgent request for a ventilator with a bed in Jabalpur. A day later, the bed was not needed because the man passed away. He was only 52. 

Our writer’s communications with her cousin, a doctor, in India
Our writer’s communications with her cousin, a doctor, in India

Indian Americans are far from their families, unable to provide physical support or be with their loved ones at their deathbed.

“I wish I could be with my family and help. It’s horrible having to hear of young sons having to organize the funerals of their fathers,” a reader in the Bay Area reports.

Students in India feel frustrated and hurt with the current situation: “I can’t believe I’m doing assignments and working when people around me are struggling to just stay alive!?” While their siblings, or grandparents, or parents, or friends are hospitalized and struggling, students are preparing for exams or finishing assignments.

At an Ethnic Media Services briefing on the COVID crisis in India, the host of KALW Dispatches, Sandip Roy stated that the anxiety India is facing is quite new and never felt to this extent before: “A friend of mine sent a message saying my wife lost her uncle yesterday in Kanpur and he died at the back of a taxi looking for a bed”. 

He called out the actions (or lack thereof) taken to improve the public healthcare infrastructure, adding that the privileged tend to live in a bubble but COVID has broken that bubble between the privileged and the poor. 

“It is wonderful that the world has been stepping up to help India in need…I would like to think that it is not just for the geopolitical need but also because it is the right thing to do.” 

The global measures, however, do not “excuse” the government from not being more ready for the second wave. 

Studies done by multiple universities are projecting a surge in cases over the next two weeks (May 9-22). 

PRIME MINISTER’S ACTION

In the beginning phases, India was at the forefront of a promising vaccinated future. Prime Minister Modi had even generously donated doses to other countries that needed it. But, this act was met with backlash as Indians pointed out his inadequate response to the pandemic by holding rallies that usually involved large gatherings. People took to Twitter to address the poor governance. Hashtags such as ResignModi trended for hours. 

Tweets about Modi’s governance.
Tweets about Modi’s governance.

The government changed its policies, finally understanding the weight of the crisis and reducing the cost of the doses, and pushing to vaccinate those who are 18 and older beginning May 1st. However, the pandemic in India needs global aid and support. 

THE GLOBAL RESPONSE 

Multiple countries like the UK, the USA, Russia, Italy, and Germany have sent oxygen concentrators and various medical supplies to aid the raging pandemic in India. However, the primary requirement to save lives is the vaccine, of which India does not have enough doses. The U.S especially has been heavily criticized for stockpiling vaccines and not using them. Just recently, it was found that the United States is sitting on millions of vaccine doses that are not being pushed for us. Due to backlash, President Joe Biden confirmed that the US would be sending vaccines to India. 

California has also shipped out oxygen supplies to India in response. In a statement regarding the response to the crisis in India, Governor Gavin Newsom said, “Everyone deserves quality medical treatment against this terrible disease, and California will answer the call and provide aid to the people of India who so desperately need it.” 

Sunatya COVID Fundraiser (Image from @ucdsunatya)

College students have set up fundraisers for COVID relief in India through clubs and other organizations. The UC Davis Bharatanatyam dance club Sunatya for example posted an explanation of the crisis in India with links for donation.

WHAT WE CAN DO

Even though we see different media outlets update the number of cases every day, it is important to remember that each case is an individual human, not a statistic on a report. 

In the past week, there has been a flurry of messages on WhatsApp with different people that have been offering home-cooked meals for families. 

Activists in India have been constantly checking various websites and dashboards online that update oxygen, medicine, and bed availability; calling the numbers and verifying the reliability of the supplies. 

Due to the high need for these supplies, the suppliers often almost immediately are exhausted of their resources and end up having no more to offer. One Hyderabadi local, Meghana Kudligi has been continuously doing this for a couple of days and now has steady contacts that get in touch with her in case of an update. She is a student in college, and all her Instagram stories have offered donation links, food availability, medical supplies, oxygen, and beds. This can be done by any of us. Sharing a link, finding a verified donation page, donating money…we aren’t helpless! 

Resources from @meghanakudligi
Resources from @meghanakudligi
Resources from @meghanakudligi
Resources from @meghanakudligi

RESOURCES

 

Local Organizations

Multiple Organizations such as Anubhuti, TYCIA, Mazdoor Kitchen, and many many more have set up donation links for medicine, oxygen, and food supplies. 

Compiled resources: bit.ly/MutualAidIndia

More locally verified donation organizations by Meghana Kudligi: https://www.instagram.com/p/COQNpjDA9rI/?igshid=1f7x04yh8nioz

Yuva covid relief resources: https://www.instagram.com/weareyuvaa/guide/covid-relief-resources-pan-india/18074855854262944/?igshid=kjcjq6qi9okf

Indian American Projects Funding COVID Crisis in India

A group of photographers from the Indian Diaspora raising money for India’s Covid Crisis  – 100% of Profits Donated: https://shamiana.darkroom.tech/#

Indiaspora’s campaign for aid to India: https://www.chalogive.org/

Community Partners International (CPI) sending oxygen to India for ventilators:

Deshpande Foundation is collaborating with CPI to have a FedEx plane ready for delivery on May 8, 2021.  It will be loaded up with 3,400 oxygen concentrators and a few more million N-95 masks to balance the load and have it land in Mumbai by May 10th.  TATA Memorial Center will use these units in their own hospitals, as well as dispatch them to other hospitals.  The government of India will not be charging any customs duty.  It costs $1,500 to buy a unit.  Please donate funds to buy one or more units to save lives in India.  You can send the funds to

  • Bank Name: Wells Fargo Bank, NA
  • Bank Address: 2144 Shattuck Avenue Berkeley, CA 94704
  • Account Name: Community Partners International
  • Account Number: 6455450715
  • ABA / Routing Number: 121000248
  • Address: 580 California Street, 16th Floor, San Francisco, CA 94104
  • Tax ID 94-3375666

Rotary Club of Silicon Valley for Global Impact:

This campaign is a plea to raise funds to procure Oxygen Concentrators in larger quantities to meet the huge demand and help millions impacted. With the supply chain in place, the IAHV team can get these machines imported in 4 to 5 days. An Oxygen Concentrator cost is approximately $800 per unit. IAHV may also use these funds for other critical equipment such as Ventilators, Beds, etc., depending on how the situation evolves further.

***

In a time of anger and pain, the hope for better guides us. We can be the change we seek. It is important to remember that while pain and fear are spreading, there are also people on the ground working to deliver resources. Let’s take our emotional energy and invest it in the people doing the work.

Swati Ramaswamy is a recent graduate from UC Davis and is an aspiring creative writer who loathes speaking in the third person. 

Srishti Prabha is the Managing Editor at India Currents and has worked in low-income/affordable housing as an advocate for children, women, and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.

 

In Santa Clara County, Nearly 67% Of Residents 16 + Have Had A Vaccine Shot

The Number of Californians With at Least One Covid Vaccine Dose Continues to Rise.

More than 75% of California’s seniors have had at least one dose, which makes epidemiologists hopeful that other age groups will follow suit

Demand for covid vaccines is slowing across most of California, but as traffic at vaccination sites eases, the vaccination rates across the state are showing wide disparities.

In Santa Clara County, home to Silicon Valley, nearly 67% of residents 16 and older have had at least one dose as of Wednesday, compared with about 43% in San Bernardino County, east of Los Angeles. Statewide, about 58% of eligible residents have received at least one dose.

The differences reflect regional trends in vaccine hesitancy and resistance that researchers have been tracking for months, said Dean Bonner, associate survey director at the Public Policy Institute of California, a nonpartisan think tank.

In a PPIC survey released Wednesday, only 5% of respondents in the San Francisco Bay Area and 6% of those in Los Angeles said they wouldn’t be getting vaccinated. But that share is 19% in the Inland Empire and 20% in the Central Valley.

“More urban areas might be hitting a wall, but their number of shots given is higher,” said Bonner. “The rural areas might be hitting a wall maybe even before, but their shots given isn’t quite as high.”

Infectious disease experts estimate that anywhere from 50% to 85% of the populationwould need to get vaccinated to put a damper on the spread of the virus. But overall state numbers may mask pockets of unvaccinated Californians, concentrated inland, that will prevent these regions from achieving “herd immunity,” the point at which the unvaccinated are protected by the vaccinated. Epidemiologists worry that the virus may continue to circulate in these communities, threatening everyone.

The regional differences could be attributed, at least in part, to political opposition to the vaccine, said Bonner, as about 22% of Republicans and 17% of independents in the survey said they wouldn’t be getting the vaccine, compared with 3% of Democrats.

But officials and epidemiologists see some encouraging signs that the state has yet to hit a wall of vaccine refusal. “As a strongly blue state, one would expect that California is less likely than red states to hit a relatively low ceiling of vaccination, assuming that the access is good and the messaging is strong,” said Dr. Robert Wachter, chair of the department of medicine at the University of California-San Francisco School of Medicine.

As of Wednesday, 77% of seniors in California, and 68% of those ages 50 to 64, had received at least one dose of covid vaccine, according to a KHN analysis. These large percentages reflect the early vaccine eligibility of these age groups and are a hopeful sign considering how difficult it was to get a shot in the beginning of the year, said Rebecca Fielding-Miller, an assistant professor at the University of California-San Diego specializing in infectious diseases and public health.

“I’m very hopeful that addressing access would pick up at least another 10-15% before we need to really start addressing myths and hesitancy issues,” she said.

The state could see a new jump in vaccinations as workplaces, schools and event organizers begin to require the shots, Wachter said. For example, the University of California and California State University systems announced April 22 that their 1 million-plus students and staff members will be required to get vaccinated against covid once the shots are formally licensed by the Food and Drug Administration, likely to occur this summer.

Still, the red-blue political distinction on vaccination is meaningful within California as well as nationally. Despite depressed vaccine demand across the board, counties that lean conservative have lower rates of vaccinations.

In true-blue Los Angeles, 4.5 million first covid vaccine doses have been administered, meaning that about 55% of eligible Angelenos have gotten at least one shot.

But first-dose appointments at county-run sites were down at least 50% last week, said public health director Barbara Ferrer on Thursday. The county has opened several sites where people can walk in and get vaccinated without an appointment, but these walk-ins don’t make up for all of the unfilled spots.

Last week probably marked the first time the county did not administer 95% of the doses distributed to it, she said.

In San Diego and Orange counties, meanwhile, vaccination appointments are going unfilled or taking days to get booked up.

About 20% of appointments in Orange County started going unclaimed on April 25 and the slack has persisted, said Dr. Regina Chinsio-Kwong, deputy health officer.

However, based on survey data from last winter indicating that about 58% of Orange County residents plan to get vaccinated against the coronavirus, the county is still expecting more residents to seek out appointments. As of Sunday, about 49% of residents had received at least one dose.

In San Diego, officials expect all appointments to be filled despite the slowdown, said county spokesperson Michael Workman. About 54% of eligible residents had received at least one dose as of Wednesday.

In San Bernardino, the slowdown started in late March, said county spokesperson David Wert. Only 42% of county residents had gotten at least one dose as of Monday.

Across the state, officials are unclear on the extent to which hesitancy or lack of access to a vaccine are responsible for the slowdown.

Campaigns to educate, convince and reach out to people have started to pick up throughout the country, including targeted messaging for conservatives. Ten GOP doctors in Congress recently issued an ad urging their constituents to get vaccinated.

Santa Clara is shifting most county-run sites to enable walk-ins and expanding evening and weekend hours to make it easier for working people to get a shot. San Diego and San Bernardino are also allowing walk-ins.

Other counties are returning unused doses to the state to be redistributed, a bounty from which Los Angeles County has benefited, according to Barbara Ferrer, director of the county public health department. Representatives from Blue Shield and the California Department of Public Health would not say which counties are sending doses back.

California’s good pandemic news, which has enabled counties to reopen many businesses, is one of the challenges to getting less-than-enthusiastic people in for their shots right now, said Wachter of UCSF.

As of Thursday, California has one of the lowest case rates in the U.S. at 31.3 cases per 100,000 and a covid-test positivity rate of 1.3%.

“My hope is that a strong communication campaign, perhaps coupled with some degree of vaccine requirements, will get some people to jump off the fence,” Wachter said.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Image: County of Santa Clara Public Health Department

To book your appointment go to https://covid19.sccgov.org/covid-19-vaccine-information

Oxygen Cylinders being sent to India (Image from the Office of Gavin Newsom)

California Governor Gavin Newsom Sends Aid to India

Governor Gavin Newsom announced yesterday that California will send lifesaving oxygen equipment to India as that country faces a devastating and fast-spreading surge of COVID-19 cases.

“When communities across the world need help, California steps up. As we surpass 28 million vaccinations and continue to see the lowest positivity rates in the country, we must meet this moment with compassion by aiding those that are hardest hit by this pandemic,” said Governor Newsom. “Everyone deserves quality medical treatment against this terrible disease, and California will answer the call and provide aid to the people of India who so desperately need it.”

Specifically, California will send the following supplies:

• 275 Oxygen Concentrators. Concentrates the oxygen from a gas supply by selectively removing nitrogen to supply an oxygen-enriched product gas stream. These units are capable of producing 10 liters per minute of oxygen supplied directly to patients via a mask.
• 440 Oxygen Cylinders. These are large metal cylinders designed to store oxygen that are used for both hospital and at-home use.
• 240 Oxygen Regulators. The high-flow oxygen regulators for H tanks are used to adjust and control the rate of oxygen flow. These devices provide for greater efficiency in the rate at which oxygen is delivered to patients.
• 210 Pulse Oximeters. Small sensors generally clipped to the finger, toe or ear lobe that measure the oxygen saturation within an individual’s blood to determine whether they are getting enough oxygen into their bloodstream.
• 1 Deployable Oxygen Concentrator Systems (DOCS). Capable of producing 120 liters per minute of oxygen and is generally used to fill large cylinders.

The distribution of these lifesaving supplies is being coordinated through the U.S. Agency for International Development and will be provided directly to health care providers and front-line workers. India reported nearly 350,000 new cases on Sunday, the largest single-day total of cases ever recorded by a single country. California’s contributions come as part of a wider effort by the United States to fight the spread of COVID-19 in India. On Sunday, the Biden Administration pledged to provide more medical aid to the country, including raw materials for vaccine production, test kits, ventilators, and PPE. The supplies being sent to India are now being tested, packed and prepared for shipment at state warehouse facilities and are expected to be flown out as soon as tomorrow.

California is in a position to distribute these lifesaving supplies because of the early, aggressive actions that Governor Newsom to combat COVID-19, which has resulted in the lowest positivity rates in the entire country and more than 28 million vaccines already having been administered in California. Even while providing these needed supplies to India, California still maintains a robust state stockpile to rapidly respond to any additional outbreaks that may occur within the state. Previously, Governor Newsom loaned ventilators to Michigan, New York, New Jersey, Illinois, Maryland, Nevada, and Delaware and also sent millions of items of PPE to neighboring states along the West Coast.

Gavin Newsom is the Governor of California, formerly Lieutenant Governor of California, and Mayor of San Francisco. Governor Newsom is married to Jennifer Siebel Newsom. They have four children: Montana, Hunter, Brooklynn, and Dutch. Newsom has been a pioneer on same-sex marriage, gun safety, marijuana, the death penalty, universal health care, access to preschool, technology, criminal justice reform, and the minimum wage, which has led to sweeping changes when his policies were ultimately accepted, embraced, and replicated across the state and nation.

 

A doctor holding a syringe.

An Indian-American Request to Biden: Sign this Petition!

We are requesting the US government to lift the embargo on exporting raw materials needed to make vaccines for India.

India is facing a severe crisis due to the resurgence of Covid infections in the country. Since March infections have ratcheted up, setting new case records on a near-daily basis, with more than 152,000 cases recorded on April 11, the largest single-day tally for the country. Some hospitals in cities such as Pune and Mumbai are running out of beds, and some vaccination centers said they’ve run out of vaccines. Meanwhile, migrant workers have started leaving their jobs in the cities to return to their villages, fearing a national lockdown like the one in 2020 that left hundreds of thousands of migrant workers jobless and without public transport to go back home.

The United States in February invoked the Defense Production Act, which gives the power to control the distribution of products, to curb the export of raw materials critical for vaccine production. Vaccine makers and experts in India have been concerned that the use of the Defense Production Act by the U.S. to boost its own vaccine production was resulting in exports of critical raw materials being stopped. Adar Poonawalla, CEO of Serum Institute of India, told The Associated Press that pivoting away from suppliers in the U.S. could result in a delay of up to six months for the production of the COVID-19 vaccine developed by Novavax. Serum Institute and Novavax have inked a deal to supply 1.1 billion doses of the vaccine to COVAX to equitably distribute it across the globe.

While prioritizing the needs of our own population is important, this consideration must be balanced with the need to tackle this pandemic on a global level and the current ferocious resurgence of Covid 19 in India will eventually put the US recovery as well as the global recovery at risk. We respectfully request the Biden administration to assist India, its friendly partner, and the world’s largest democracy, emerge from this unprecedented setback during this battle.

Please sign this petition I have put together:

https://www.change.org/p/joseph-r-biden-lift-us-embargo-on-exporting-vaccine-raw-materials-to-india

Prasenjit Sarkar has a Ph.D in Computer Science. His work experience includes working at IBM Research as well as founding and selling a startup in the big data space. He is passionate about education and giving back to society.

 

A Tale of Two Sumi(s) – When COVID19 Flatlined the Desi Beauty Business

Sumi Patel opened Sumi Beauty in 2007 and ran a thriving cosmetology business

Sumi Beauty Salon in Mountain View

on El Camino in Mountain View for more than 13 years. A single mom with two children, Sumi built a steady stream of customers seeking beauty treatments designed with desi clientele in mind. On offer were services like threading, waxing, skincare, and facials, as well as special heritage henna treatments and make-up for brides to be.  Her salon was popular.

“I’ve been going here for over a year and have always been so pleased with the results! The women who work here….both do great jobs at the Indian beauty salon,” says a testimonial on her website.

As Sumi’s clients became regulars, she hired an aesthetician to help with the increased workload.

And then the pandemic hit. On March 15, 2020, Sumi Beauty shut down as Governor Gavin Newsom’s pandemic regulations were enforced, flatlining Sumi Patel’s source of livelihood.

In Southern California, Sumita Batra, the CEO of a successful, family-run chain of beauty studios called Ziba Beauty, made a tough decision even before Newsom issued his statewide lockdown orders. She shuttered all 14 branches of her stores and laid off her entire team of 144 employees so they could file for unemployment benefits. Batra used her personal savings to fund their final paychecks and to keep her business afloat.

Threading service at Ziba Beauty

As the pandemic placed communities of color under siege, minority-owned small businesses like the ones run by Sumi Patel and Sumita Batra were among the hardest hit.

While workers of color were impacted by job losses, women’s job losses were significantly higher than men’s, reported Chad Stone, Chief Economist at The Center on Budget and Policy Priorities (CBPP), at an ethnic media press briefing on March 12. Stone co-authored a study which found that “Workers born abroad, especially women, were more likely to work in the industries hit hardest by the pandemic and have suffered disproportionate job losses.”

For both Sumi(s), the impact of losing a lifetime of work was devastating.

Ziba Beauty had been in business for 33 years since it first opened shop in Artesia, CA.  It had served more than forty-five thousand customers out of its 14 studios. Batra describes the experience of closing her stores as going “into a complete meltdown.” Losing her business felt “like losing a family member.”

Sumita Batra, CEO, Ziba Beauty

Batra applied for PPP funds “using every contact in her book and everything in her power,” but it still took several weeks to arrive.

In Mountain View, Patel negotiated a deal with her landlord to pay a lower rental rate to tide her over the pandemic and applied for a loan from the Paycheck Protection program for Small Businesses.

“But my business is very small, so I did not get that much,” said Patel, who had to let her aesthetician go.

One year after the pandemic hit, the business has dwindled at Sumi Beauty. Before the pandemic, Patel would see at up to 20 to 25 customers a day. “Today, I saw one person,” she notes, after which she waited for 3 hours for a walk-in customer. Customers aren’t calling to make appointments Patel added. She does not understand why.  On weekends, business picks up a little. “Maybe I’ll have 4 or 5 customers.”

Her salon can only accommodate one person at a time, as pandemic restrictions are still in place.

She briefly reopened last year when restrictions were lifted before shutting down again as infections rose. “My business is reduced to only 10% of what it was before the pandemic. We’re not back to 100 %. This whole year has been very hard.”

Ziba Beauty remained closed, announcing that its priority was the safety of customers and employees.

In March 2021 Biden signed off on the ‘American Rescue Plan Act’ -a  $1.9 Trillion COVID Relief Bill which the CBPP predicts will help millions and bolster the economy.

Chad Stone reports that the coronavirus relief package and its new round of stimulus payments are aimed at “getting the virus under control,” so that life can get back to normal, reducing the levels of hardship many Americans have endured over the past year, and which has been particularly acute among people of color and immigrants.” It will provide a stimulus for an economic recovery that had stalled “only halfway back to full employment,” he added.

But the Congressional Budget Office projects that the economy won’t return to its full potential until 2025. Today’s labor market, says the CBPP analysis, is much weaker than the headline numbers suggest.

According to the CBPP, Federal Reserve Chair Jerome Powell recently testified that “The economic recovery remains uneven and far from complete, and the path ahead is highly uncertain. . . . There is a long way to go.”

Sumi Batra agrees.

“Touch services coming back too soon will be one of the things that end up spreading COVID.”

At the risk of losing her 33-year-old brand after shutting down last year, Batra was adamant that she would not reopen until it was safe to do so. “I’m not going to feel comfortable opening up my stores and risking my team as well as my customers.”

Touch services like threading operate in ‘intimate spaces’ says Batra, where aesthetician and client sit in close contact. So a ‘phased opening is the right approach’ because a threading artist works differently from a hairdresser.

Unlike e-commerce companies, touch service industries need a phased reopening to facilitate a safe recovery post pandemic. Batra is calling for a separate stimulus for the beauty and nail industries, and suggests they need to come together to create a recovery plan that will ensure the safety of practitioners and clients.

Sumi Patel says though her salon now is fully open her customers are ‘scared to come back,’ even though she has implemented health and safety changes. When threading eyebrows on a customer, for example, she wears a mask and anchors the thread around her neck instead of holding it in her mouth, which is the traditional technique. She attributes the drop in clients to the fact that many of her customers from the IT industry, may not need beauty services now that many work from home, do not socialize, or travel.

At Ziba Beauty which has gradually reopened about 6 stores, Batra is using  PPE and stringent safety measures. At the start of each day, each studio is thoroughly sterilized by a UVC robot, and bookings, payments, check-in and check out are contactless.

For Sumi Patel who has two kids to support, the loss of income has been a challenge

“Right now it’s a tough time. My only hope is that my business will come back – I hope.”

Meera Kymal is the Contributing Editor at India Currents.

Anjana Nagarajan Butaney contributed to this report.

 

I Decided to Paint and Give 100 Ganeshas After COVID Hit the Bay Area

2020 has been a challenge for all of us and will be etched in our memory for our lifetime.

Painting was always on my bucket list and in February  2020 I decided to enroll in art class. But as luck would have it, just after 3 classes, COVID happened. My art teacher asked me to continue practicing painting with the advice “Just believe in yourself and you will do it”   

March 2020 arrived and gave the whole world the gift of time with nowhere to go. After much soul searching, I decided to devote an hour or so every day to pursue my passion for painting. I realized there is nothing to lose and I would improve by learning from my mistakes. I decided to paint for an audience of one – myself. 

My first painting was in March 2020 when ‘Stay at home’ was first announced around the globe.  I decided to paint to bring calmness and peace to my anxious mind about the uncertainty looming around the global pandemic.  I decided to paint Ganesha, the remover of obstacles, as I always visualized that Ganesha up there was guiding me and watching out for me. Painting was like meditation and was truly therapeutic, engaging the brain cells in a very unique way.  

The best part was that I was very inspired by my first effort and decided to continue painting. I am truly grateful for the encouragement from my hubby, daughter-in-law, daughter,  and son. Their honest feedback and the perfect gift of an artist table on Mother’s Day helped me to better focus on creating artwork. 

I shared pictures of my artwork with friends and family via social media. My next-door neighbor was very impressed and asked if I could paint Ganesha for her. Suddenly my passion and free time had a purpose. One thing led to another and in the span of 365 days,  I have created over 100 paintings and shared or gifted over 85 paintings with neighbors, coworkers, family, and friends around the globe. 

Beside Ganesha, I challenged myself to line art with topics that evoke serenity – like ‘Newborn bond,’  ‘Meditation,’ and ‘Gratitude.’ 

My newfound passion was a perfect win-win situation. I had an outlet for my creativity and found purpose while hunkered down at home, while my family and friends enjoyed my artwork in their home.  

I was touched by their comments; ‘Your aura comes through in the paintings of love and laughter,” “The meditation painting reminds me that no matter what is going on in my life, I can find peace,” “You inspired me to start painting again,” and, “I will keep your Ganesha painting next to my Allah to bring peace in this world.” 

It was humbling that my artwork could bring joy and happiness to brighten the life of my near and dear ones. The icing on the cake was when my Mom asked me to paint a Ganesha for her 80th birthday celebration.  

While we cannot control what life throws at us, we can control how we react to it. Life is all about finding joy and happiness in those situations.  

I have transformed my very lonely dining room into a lively art studio. This corner of my house energizes and brings serenity at the same time. The vivid colors remind me of the blessings of beauty from Mother Nature, and serenity comes from the knowledge  that a superior power  is always giving me the strength to face any obstacles in life or removing them for me 

Twenty years from now, I hope to look back to my COVID phase as the time I discovered a new passion in my life and proudly say that I am a COVID-born artist!

Hema Alur-Kundargi is a registered dietitian, culinary artist, and is determined to be a lifelong learner. Find her at @theculinarydietitian

Stanford’s Dr. Nirav Shah on Vaccines VS. Variants

Breaking news that virulent variants from Brazil, South Africa, and the UK are multiplying across borders even as homegrown strains are mutating on US soil, has raised a number of questions.

Are variants more contagious?
Will they cause worse infections?
Are current vaccines effective against mutating variants?
And should we take different precautions to keep safe?

Dr. Nirav Shah, MD, MPH, of Stanford University’s Clinical Excellence Research Center, fielded questions and concerns from ethnic media reporters at a press briefing on March 19. Along with other COVID 19 experts from the Bay Area, Dr. Shah shared information about new strains of the virus and safety net information for communities of color who want to sign up to get their vaccine shot.

“We cannot start to celebrate just yet,” said Shah, even though America reached an important milestone when the 100 millionth vaccine was administered on March 19.

The Story of Virus Variants

The emergence of variants has raised the specter that the current generation of vaccines might be rendered obsolete before they have even been fully rolled out. Are variants gaining ground and will they be immune to distinct vaccines before we reach herd immunity?

“It’s a race between how fast we get people fully vaccinated versus the level of disease in a community and how much transmission is going on,” explained Shah, about how a variant becomes dominant.

In heavily infected communities, the more virus particles there are, the greater the chance of one being different. All you need is a spike protein change, said Shah, which will give the variant a better chance of attaching to cells, so it spreads better and faster, becoming the dominant strain.

Simultaneously, as more people get vaccinated to combat COVID19, “the selective advantage of some particles relative to other particles, allow them to spread much faster.”

Now the race is on to get everyone vaccinated before the B.1.1.7. variant – the most dominant variant takes over.

“The story of virus variants is the story of evolution and natural selection,” added Shah.

Investigations of Variants

Currently, the CDC and WHO are studying the spread of three designated variants. Variants of interest -like the P2 which have ‘caused a cluster of infections’  in some countries, seem to be driving a surge in cases, though less is known about their transmissibility and lethality, or even if vaccine recipients are ‘fully neutralized against them or not’.

Their genetic sequence has some changes which suggest they may be more contagious, said Shah, and likely to be resistant to immunity bestowed by vaccines, treatments, or tests.

People are at greater risk from variants of concern that could reinfect survivors of certain Covid19 strains. Therapies and vaccines may be less effective against these strains which have “proven to be more contagious and cause more severe disease,” explained Shah.

Recent studies report that COVID-19 survivors and fully vaccinated people seem able to fight off infection from the virulent B.1.1.7 variant but may have less protection against the B.1.3.5.1 variant. Shah referred to research that shows the B.1.1.7 variant spreads about 50% faster and is more lethal, relative to prior strains of the virus.

The good news is that the existing range of vaccines (Pfizer, Moderna, Oxford/Astra Zeneca, and Novavax) have proven effective against this variant.  But less is known about the transmissibility and lethality of the P1, B.1.4.2.7, and  B.1.4.2.9 strains.

So far, however, assured Shah, no variants have met the definition for variants of high consequence which refer to strains that cause “more severe disease, more hospitalizations, and have been shown to defeat medical countermeasures” – like vaccines, anti-viral drugs, or monoclonal antibodies.

In the contest between vaccines and variants, “We will win the race by …vaccinating people as quickly…and broadly as possible” noted Shah.

An Annual Shot

Infectious disease experts liken variants to flu viruses which require new flu vaccines every year; scientists are even considering the possibility of multivalent vaccines designed to immunize against two or more strains of the virus.

“It’s a race of the mutant viruses against the vaccines…and to date, none of the mutants have escaped fully the major vaccines. The hope is that with minor modifications, we can get the continued evolution of the vaccines to match the evolution of the viruses.” It wouldn’t be surprising if the COVID vaccine was administered like a flu shot every year, added Shah.

Getting to Herd Immunity

The likelihood of reaching herd immunity will be a reality if at least  70% or more of the population are resistant to existing strains of the virus. However, as states relax public health restrictions as well as mask and social distancing mandates, herd immunity may be challenging to achieve.  “More people getting infected simply means more chance of variants,” cautioned Shah.

I asked Dr. Shah if we would need a new generation of vaccines before the current vaccine roll is complete and if boosters would be introduced. “I am an optimist”, said Shah. “I imagine we would have booster shots by the fall but what’s important is that we all get that first shot, and make sure the vulnerable and elderly get theirs. That will make us collectively win”.

Dr. Shah reiterated that the Moderna, Pfizer, and Johnson & Johnson vaccines authorized by the Food and Drug Administration (FDA) for emergency use, are still the most powerful tools to fight all the strains of COVID-19.

“This is a race for the world,” said Dr. Nirav Shah. “We know the virus doesn’t respect any borders, and so we should be as broad as possible in our thinking about getting the vaccine to everyone across the world.”

Helpful links:

Meera Kymal is the Contributing Editor at India Currents

COVID Creates Hunger Crisis in India

As the COVD-19 tsunami began its global spread, it exacerbated crises that were already taking a toll of vulnerable populations across the world.

In India the pandemic triggered a domestic migrant worker disaster. In Yemen it threatened a death toll far worse than the one inflicted by civil war.  And in Central America, where farming was destroyed by years of extreme climate events, the pandemic wrecked food security for 1.7 million people, according to the United Nations World Food Programme (WFP)

“COVID is making the poorest of the world poorer and the hungriest hungrier,” said Steve Taravella, a senior spokesperson for the WFP, at an ethnic media press briefing on February 26 to discuss the fallout from the pandemic. Advocates warned that a coronavirus-induced global famine loomed for millions.

“270 million people marching towards the brink of starvation need our help today more than ever,”  WFP’s Executive Director, David Beasley, told the UN Security Council last year. “Famine is literally on the horizon.”

The pandemic has inflicted its heaviest toll on poorer communities in the developing world, exposing the inequities driven by poverty and economic inequality that plague marginalized populations.

In India nearly 1 in 3 people face moderate or severe food insecurity, said Parul Sachdeva, India Country Representative for Give2Asia, a non-profit that supports charities in the Asia Pacific. India has the distinction of being the country with the largest number of food insecure people, and accounts for 22% of the global burden of food insecurity. When the pandemic hit, people were already struggling with poverty and socio-economic crises that gave them less food to eat. The lockdown that followed disrupted both the harvest and the food supply chain. More than a hundred million people and their incomes were affected by the inability to harvest crops in time.

When India enforced a shutdown to stop the coronavirus spread, it forced tens of thousands of migrant workers to make the long trek back to their villages after they lost jobs and wages. Without ration cards or money to buy food, the disruption to food chains put thousands at risk of hunger, leaving them to rely on NGOs and charitable civic organizations like Akshaya Patra, rather than the government, to provide food aid.

In a double whammy, the pandemic lockdown that increased food insecurity also fueled gender-based violence (GBV).

During lockdown, reported cases of gender-based violence more than doubled during the pandemic, said Aradhana Srivastava, of WFP’s India office. “The extent of suffering is actually much larger than what is being seen.” Research shows that domestic violence closely correlates with income levels, said Srivastava, and GBV is higher among lower-income households and food-insecure families. Increased food insecurity causes mental stress in households and triggers domestic violence towards women. “The increased incidence of domestic violence is linked to loss of livelihoods, loss of access to food — so there is a direct bearing.”

Since 2014, prolonged drought and excessive hurricanes in Central America have destroyed staple crops. But severe climate events and poverty – the key causes of food insecurity – have worsened with the pandemic. “The face of hunger In Central America has changed,” stated Elio Rujano, a Communications Officer for the World Food program. In Nicaragua, El Salvador, Honduras and Guatemala, food insecurity has now spread from rural communities into urban areas. COVID lockdowns have taken away income from daily wage earners – 50% of the economy depends on informal labor – which has made it harder for people to meet basic needs like food.

Six years of conflict inYemen has ripped apart the country’s infrastructure and fragile heath system, displacing almost 4 million of its 30 million inhabitants. Conflict has become the main driver of hunger, as food prices skyrocket, and frontlines move. With COVID and the ensuing lockdown, the hunger situation hit new peak in Yemen. WFP forecasts a severe risk of famine and acute malnutrition in 2021 for 2 million children aged 1 to 5, which will have severe long term impact felt by “generations to come.” But famine has not been declared in Yemen even though “people are dying of hunger,” said Annabel Symington – Head of Communications for the WFP in Yemen, calling for funds to mount programs and interventions. “The time to act is now.”

The WFP feeds 100 million in 88 countries every year divided between 3 initiatives:1.Natural disasters, typhoon, cyclones, 2. Conflicts, and 3. Ongoing non-emergency aid such as school meals, pregnant women new mother nutrition, community help, and small farmers. In 2020, WFP was awarded the Nobel Peace Prize for its efforts to combat hunger.

“We provide basics for sustainability till long term solutions can be developed,” said Taravella.  For years the WFP “chipped away” effectively at hunger rates. But conflict, climate and COVID-19 are causing  humanitarian crises of catastrophic proportions, making it impossible for people to access food. Before COVID-19 there were about 135 million hungry people in the world. Today nearly 690 million people don’t know where their next meal is coming from. WFP projects they need $13.5 billion to bridge the gaps in their budget.

According to Taravella, a small group of 2200 billionaires hold about $8 trillion in global wealth. They could help to overturn the tidal wave of food insecurity washing over the world’s poor.

“We are making an appeal to the world’s exceptionally wealthy people to help us close that gap,” he added.

To donate

https://secure.wfpusa.org/donate/save-lives-giving-food-today-donate-now-7?ms=2000_UNR_wfp_redirect_EX&redirected=UShttps://secure.wfpusa.org/donate/save-lives-giving-food-today-donate-now-7?ms=2000_UNR_wfp_redirect_EX&redirected=US

https://sharethemeal.org/en/index.html

Meera Kymal is the Contributing Editor at India Currents.
Image by billy cedeno from Pixabay

Kusum Lata Sawhney’s Poems Ponder Chaos in COVID Times

What might we have done differently when the coronavirus invaded our lives? Kusum Lata Sawhney explores the possibilities through poetry.

Sawhney’s book of poems ’We Might Have …’ chronicles the unprecedented times we are facing with the COVID crisis. The poems look at events as they unfold, and the many stages the world faces as it confronts the unknown.

Her vivid accounts of the first appearance of the virus, the lockdowns and the fear, the isolation, the anger, the kindness, the chaos, the suffering, the economy in chaos, and subsequently, the global response inextricably linked to humanity’s inherent quest for survival, remind us of the completely unexpected and abnormal year that 2020 was.

Sawhney lucidly explores the themes of mass consumption and greed, which she terms ‘the deceit of excess’, going on to describe humanity’s shortsightedness in exploiting nature and the lack of respect for the natural world – a few of the many factors that have contributed to nature’s retribution, in the form of the pandemic.

In a poem, she explains,

“We might have spawned wildlife transmissions,

Encouraged callous breeding, hosts and mutations,

We might have ruthlessly plundered and aided to our plight.”

The poems are a mirror to the destructive nature of man and the viral darkness. In addition, they are also an attempt to capture the period that was, what is and what might be. She stresses on the need to reflect and bring about a radical change in the way we live and work, to move away from being divisive and selfish. A transformation is in order to usher in a kinder, more thoughtful, and harmonious world.

Describing change and an altered way of living, she writes,

“Where tech online at home is safe

We might reduce mass gatherings too

Learn to eat and pray in solitude

We might have to educate, adapt and change

Plenty will be lost but there will be gains.”

Learning to change, adapt and look within, in a deeply fractured world requires magnanimity and empathy. Where do we go from here and which path do we take? A time of reckoning, learning new skills and perhaps a gentler way of life are the lessons of the pandemic. In her words,

“We might have been ruthless, selfish and short

Strength and alternatives to whimsy
an agile plot

We might have to relearn, retool and rethink

And in this darkest of times truly learn a new link”.

The message ultimately is one of hope. Perhaps the transformative power of poetry will help us recognize and achieve that.

Shonali Madapa is a brand designer and photographer who runs a design studio Lumos Design. She follows patterns of culture, nature, society, and behavior through travel photography and writing.

Edited by Meera Kymal, the Contributing Editor at India Currents.

College Tuition Sparked a Mental Health Crisis

Then the Hefty Hospital Bill Arrived!

Despite a lifelong struggle with panic attacks, Divya Singh made a brave move across the world last fall from her home in Mumbai, India. She enrolled at Hofstra University in Hempstead, New York, to study physics and explore an interest in standup comedy in Manhattan.

Arriving in the midst of the CIVID-19 pandemic and isolated in her dorm room, Singh’s anxiety ballooned when her family had trouble coming up with the money for a $16,000 tuition installment. Hofstra warned her she would have to vacate the dorm after the term ended if she was not paid up. At one point, she ran into obstacles transferring money onto her campus meal card.

“I’m a literally broke college student that didn’t have money for food,” she recalled. “At that moment of panic, I didn’t want to do anything or leave my bed.”

In late October, she called the campus counseling center hotline and met with a psychologist. “All I wanted was someone to listen to me and validate the fact that I wasn’t going crazy,” she said.

Instead, when she mentioned suicidal thoughts, the psychologist insisted on a psychiatric evaluation. Singh was taken by ambulance to Long Island Jewish Medical Center in New Hyde Park, New York, and kept for a week on a psychiatric ward at nearby Zucker Hillside Hospital. Both are part of the Northwell Health system.

The experience — lots of time alone and a few therapy sessions — was of minimal benefit psychologically, she said. Singh emerged facing the same tuition debt as before.

And then another bill came.

The Patient: Divya Singh, a 20-year-old student at Hofstra University.

Medical Service: Seven-day inpatient psychiatric stay at Zucker Hillside Hospital in Glen Oaks, New York.

Service Provider: Northwell Health, a large nonprofit hospital system in New York City and Long Island.

Total Bill: Northwell charged $50,282, which Singh’s insurer, Aetna, reduced to $17,066 under its contract with Northwell. The plan required Singh to pay $3,413.20 of that.

What Gives: Singh had purchased her Aetna insurance plan through Hofstra, paying $1,107 for the fall term. Aetna markets the plan specifically for students. Under its terms, students can be on the hook for up to $7,350 of the costs of medical care during a year, according to plan documents. Singh’s Northwell bill of around $3,413 is the plan’s requirement that she pay for 20% of the costs of her hospital stay.

Although such coinsurance requirements are common in American health plans, they can be financially overwhelming for students with no income and families whose finances are already under the extreme stress of high tuition. Singh’s Hofstra bill for the academic year, including room and board and ancillary fees, totaled $68,275.

As a result, Singh found herself beset by a double whammy of bills from two of the costliest kinds of institutions in America — colleges and hospitals — both with prices that inexorably rise faster than inflation.

Divya Singh, a student at Hofstra University in Hempstead, New York, sought counseling help after feeling panicked when she had trouble paying a big tuition bill. A weeklong stay in a psychiatric hospital followedalong with a $3,413 bill. (Jackie Molloy for KHN)

For hospitals, there is supposed to be a relief valve. The Internal Revenue Service requires all nonprofit hospitals to have a financial assistance policy that lowers or eliminates bills for people without the financial resources to pay them. Such financial assistance — commonly known as charity care — is a condition for hospitals to maintain their tax-exempt status, shielding them from having to pay property taxes on often expansive campuses.

Northwell’s financial assistance policy limits the hospital from charging more than $150 for individuals who earn $12,880 a year or less. It offers discounts on a sliding scale for individuals earning up to $64,400 a year, although people with savings or other “available assets” above $10,000 might get less or not qualify.

The IRS requires hospitals to “widely publicize” the availability of financial assistance, inform all patients about how they can obtain it and include “a conspicuous written notice” on billing statements.

While the bill Northwell sent Singh includes a reference to “financial difficulties” and a phone number to call, it did not explicitly state that the hospital might reduce or waive the bill. Instead, the letter obliquely said “we can assist you in making budget payment arrangements” — a phrase that conjures installment payments rather than debt relief.

Resolution: In a written statement, Northwell said that although “all eligible patients are offered generous financial payment options … it is not required that providers list the options on the bill.” Northwell stated: “If a patient calls the number provided and expresses financial hardship, the patient is assisted with a financial need application.” However, Northwell lamented, “unfortunately, many patients do not call.”

Indeed, a KHN investigation in 2019 found that, nationwide, 45% of nonprofit hospital organizations were routinely sending medical bills to patients whose incomes were low enough to qualify for charity care. Those bills, which totaled $2.7 billion, were most likely an undercount since they included only the debt hospitals had given up trying to collect.

Singh said the worker who took down her insurance information during her hospital stay never explained that Northwell might reduce her portion of the charge. She said she didn’t realize that was a possibility from the language in the bill they sent.

Northwell said in a statement that after KHN contacted it about Singh’s case, Northwell dispatched a caseworker to contact her. Singh said the caseworker helped Singh enroll in Medicaid, the state-federal health insurance program for low-income people. Foreign students are not generally eligible for Medicaid, but in New York they can get coverage for emergency services. With the addition of Medicaid’s coverage, Singh should end up paying nothing if the stay is retroactively approved, Northwell said.

At the same time the caseworker was helping Singh, Singh received a “final reminder” letter from Northwell about her bill. That letter also mentioned Northwell’s financial assistance, but only within the context of people who completely lack health insurance.

“Send payment or contact us within 21 days to avoid further collection activity,” the letter said.

The Takeaway: Despite stricter requirements from the Affordable Care Act and the IRS to make nonprofit hospitals proactively educate patients about the various forms of financial relief they offer, the onus still remains on patients. If you have trouble paying a bill, call the hospital and ask for a copy of its financial assistance policy and the application to request your bill be discounted or excused.

Be aware that hospitals generally require proof of your financial circumstances such as pay stubs or unemployment checks. Even if you have health insurance that covers much of your medical bill, you may still be eligible to have your bill lowered or get on a government insurance program like Medicaid.

You can also find documentation online: All nonprofit hospitals are required to post financial assistance policies on their websites. They must provide summaries written in plain language and versions translated into foreign languages spoken by significant portions of their communities. Be aware that financial assistance is distinct from paying your full debt off in installments, which is what hospitals sometimes first propose.

Although the IRS rules don’t govern for-profit hospitals, many of those also offer concessions for people with proven financial hardship. The criteria and generosity of charity care vary among hospitals, but many give breaks to families with middle-class incomes: Northwell’s policy, for instance, extends to families of four earning $132,500 a year.

Singh’s family has paid off her fall tuition and half of her spring tuition so far. She still owes $16,565.

Singh said the back and forth over her hospital bill continues to cause anxiety. “The treatment I got in the hospital, after I’ve gotten out, it hasn’t helped,” she said. “I have nightmares about that place.” The biggest benefit of her week there, she said, was bonding with the other patients “because they were also miserable with the way they were being treated.”

Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills.
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Can Schools Reopen Safely?

The Centers for Disease Control and Prevention (CDC) on Friday, February 13th, 2021, issued new guidelines for the reopening of K-12 schools. Many teachers and parents have raised concerns about the early reopening of schools.

Returning to schools before teachers can be fully vaccinated has raised fears in the community.  The guidelines state that although teachers should be vaccinated as quickly as possible, (preferably after health care workers and long-term-care facility residents ) they do not need to be vaccinated before schools can reopen. 

In order to make it easier on the schools to open, the CDC has also given a pass to the schools on physical distancing. Schools are encouraged to put in effect physical distancing to the greatest extent possible requiring it only when community transmission of the virus is high.

The expense and logistics of widespread screening, which would be a heavy burden for school districts, has also been lightened to the extent possible.

Central to the debate over school reopening is whether children are efficient COVID-19 transmitters and likely to increase community spread when programs reopen.

Though evidence suggests that children under 10 are less likely to get the virus, students can carry infection back home to the community,” says Christina Martini, a kindergarten teacher who has a Masters in Education from Purdue University.  

“There is concern if they live with their grandparents who are seventy or eighty years old”, said Akil Vohra, Asian American Lead (AALead) at an Ethnic Media Services‘s briefing titled “When Can We Reopen Schools?  Search For Common Ground on Divisive Issue”.

In addition to Vohra, the panel included experts Louis Freedberg, Executive Director of EdSource, Tyrone Howard, Professor of Education, UCLA, and Director of Black Male Institute, and Bernita Bradley from the National Parents Union. They offered a range of perspectives on the struggle to get children back to the classroom.  

Karla Franco, a Los Angeles parent, talked about how the stakes are highest for students of color in major urban districts, whose studies show they are losing ground the longer they are out of the classroom and who have the least confidence in the safety of their schools and the responsiveness of their school officials. 

Education experts are concerned about the consequences of students being out of school for such a prolonged period. There is growing evidence that some students who are learning remotely are falling significantly behind academically.

Freedberg highlighted the unusually high numbers of children and adolescents who are depressed, anxious or experiencing other mental health issues. “When you look at the research it looks like kids need to be back in school”, he said. “On the social emotional level reports show higher rates of depression, PTSD due to social isolation and not being in contact with other kids, but also kids are in a home where the parents are struggling with new economic stresses due to job losses and there is the uncertainty around school.” 

“The schools are under pressure to reopen and they do have to at some point. The new CDC guidelines guide schools on how to openly safely with effective mitigation measures,” said Martini.

Ritu Marwah is a 2020 California reporting and engagement fellow at USC Annenberg’s Center for Health Journalism.

Photo by Kelly Sikkema on Unsplash