Tag Archives: #COVID_19

Adopting Impermanence as a COVID Response

“All conditioned things are impermanent – when one sees this with wisdom, one turns away from suffering.”

-Gautama Buddha

In times of chaos and tribulation, it seems wise to refer to the teachings of those who sought to understand suffering. Impermanence is the word that comes to mind, yet humanity finds comfort in permanence. 

At the August 14th Ethnic Media Services briefing on the science behind COVID-19, doctors on the frontlines reaffirmed the motif I had been seeing – a contradictory society seeks change, yet is resistant to it.

This moment of truth in American history requires quick and consistent change. I wonder, can we rise up to the challenge?

Dr. Ashish Jha, Professor of Global Health at the Harvard T.H. Chan School of Public Health and the Director of the Harvard Global Health Institute remarked “America may have the worst response of any country in the world, to this pandemic” and added that we were in the same position, if not worse condition than Brazil, Russia, and Turkey. Further, he stresses that success with outbreak control has nothing to do with imposing government structures, the culture of the country, or the wealth of a nation. 

Government: Russia’s authoritarian government is struggling with containment.

Culture: East Asian and European countries are dissimilar in their cultural practices but both have managed to lower their COVID rates. 

Wealth: Vietnam, a developing nation, until recently, had avoided COVID-related deaths.

“It’s tempting to look for explanations for why other countries are doing better”, cautions Dr. Jha. He logically builds to the conclusion that where we have failed is in deploying ONE action effectively across all states. That is all that is required. With one-third of the U.S. population on the brink of succumbing to the pandemic, one third already fully at risk, and one-third managing to keep the pandemic at bay, mismatched messaging is wreaking havoc. Without a coordinated response from strong federal leadership, the COVID death numbers will not plateau. 

The onus of information dissemination and access to resources lies heavily on those in positions of power but behavioral change can come from the top-down and the bottom-up. 

Impermanence. The ability to adopt thought that lasts for an undetermined period of time. 

No one wants to be in lockdown. No one wants to wear a mask outside. No one wants to continuously get tested.

Just one of these, fully implemented and enforced, could be the key to end suffering. 

Dr. Nirav Shah, Senior Scholar at Stanford University’s Clinical Excellence Research Center and an elected member of the National Academy of Medicine, informs his research from the positive COVID control he has seen in Asian countries where schools remain open. He notes, “Right now there is a false choice between lives and livelihood.” That choice drives contention and spreads misinformation.

What is needed to re-open safely?

Early warning systems, broad & efficient testing, effective quarantine/isolation, adequate treatment capacity, actionable data collection, and vaccines. 

He brings forth antigen testing as the cheaper, faster method to detect COVID. Cost-effective and almost instantaneous results, I am feeling more optimistic as he continues to speak.

Source: U-T reporter Jonathan Wosen

Early warning systems and actionable data collection rely on the immediate transfer of information to an online database to make it accessible. Temperature monitoring using a thermometer linked to the internet would increase the efficiency of detecting COVID hotspots and roll out timely mandates required to limit spread. Dr. Shah’s blend of technology and the pandemic is the obvious way to move forward. Daily reporting is the necessary next step.

Source: Covid Act Now

So why haven’t we already been using this technology?

“We really need to start to think about a fundamentally different approach that protects privacy and lets public health [professionals] do their job”, Dr. Shah frustratedly shakes his head.

He is moving fast and hits a wall with effective quarantine/isolation and vaccines. The U.S. has expended no energy to strategize or provided resources for isolation and most vaccines are a year out still. 

“We are not anywhere close to doing well”, ends Dr. Shah. 

It seems Dr. Shah and Dr. Jha come to similar conclusions – the United States has the resources and the intelligence to rewrite the course we have taken with regards to the pandemic.

A grim message but I leave with positive outcomes. Testing is changing and so is data collection. Mitigation and prevention of COVID is plausible.

Can we adapt? Can we change? Can we make space for impermanence in our lives to end suffering?

Srishti Prabha is the Assistant 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.

Emerging From My Corona Cocoon

Just like everyone else, I remember where I was when the COVID-19  lockdown was announced. It struck as the school year was growing to a close in India. Thanks to it, the school where I worked closed down prematurely, and boy, was I happy about it. Fate laughed in my face just a few days later when just about everything locked down, and I understood a weird thing about myself.

I had been wanting some days to myself, where I could stay home, and forget about work. It happened. I wanted to stay in and not go out, vegetate at home completely. That happened. I wanted to concentrate on my home and my family. That happened too.

An ideal situation, yes, but just one caveat – it was not on my terms. Fate was forcing me to have a holiday. Every person I talked to said the same thing. Most of us being average salaried employees with a little money in the bank to fall back upon, we finally had some time to rest up and have family time. But to a man and woman, we resented it. To us, ‘it was the best of times, it was the worst of times’.

By the end of Lockdown 3, I’d truly had it. I got exactly what I asked for, but because it was imposed on me, I was PO-ed. As a family, we had maintained a kind of guarded peace at home, but we all knew that we were nearing the end of our tethers.

I had wild dreams about what I’d do the instant lockdown lifted. Not exactly floating on pastel-colored clouds, laughing for no reason and blowing bubbles, but something of the kind that was more suited to an obese 50-year-old. Visiting the library, going out with like-minded friends to chat over coffee and pakodas, catching a movie with family, going clothes shopping, that kind of thing. You know, all the normal things people like to do that won’t break the bank.

Fate gave me the break I wanted. But the tab, when it came, was huge. Coming out of lockdown, nothing was normal, and I just didn’t know what to do. I wanted to go out, but go out where and do what? 

Meeting friends was out – nobody wanted to come to my house and nobody wanted me at theirs. I could shop for essentials, but where was the fun in buying atta and chili powder? Therapeutic shopping, where you buy what you don’t need with money you don’t have and suffer guilt pangs for days, was out because the malls weren’t open yet. Eating out was out … unless you wanted to picnic on the sidewalk – restaurants were only doing takeout. You couldn’t travel … heck, you couldn’t leave town because the city limits were closed.

I could go for a walk, but that would be just lame – like chewing on a carrot stick when you’ve got major cheesecake cravings. 

And then there was the psychological component. Fear was an overwhelming factor. I’d heard stories from my father about how, during the plague, they would vacate their house if they saw a dead rat. In the case of Corona, there wasn’t any overt sign at all. Any desire to meet anyone was overridden by the trepidation – were they symptomless carriers? Even if they were clean, who had they met?

Those were the insidious things about COVID – suspicion and misgiving. What if the person I’m talking to was carrying the virus? S/he just sniffed – was s/he sick? Was that a Corona sniff or generic? Why? You might give people heart attacks by just sneezing. 

 Ever since my childhood, I’ve always loved to ride in auto rickshaws. When we moved back to India, I had got back in my auto habit without missing a beat. Since I was too chicken to drive, I took autos everywhere to the extent that I became the patron saint of the ‘auto men’ at our street corner. But now with Corona dominating the landscape inside and out, it became an effort to commit to an auto ride. Yes, things that I’d taken for granted became painful decisions. 

When it came to food, it got weirder. The cooks, the deliverymen … and even the food – all were suspect. And, why was I paying the big bucks when I had all the ingredients at home and all the time in the world to cook it? It just felt wrong. Dang, I was becoming my mother!

So, where I had thought I couldn’t wait to get out, I was now afraid to leave the house. I wasn’t winning this game, I wasn’t even breaking even. Aargh, what was I to do?

That was when I got an invite … for a puja at a friend’s place! It was just perfect! I had a legitimate excuse to get out. I could actually meet people other than family. Also, though I’m not very religious, I believe in hedging my bets. It might not be a bad idea to work myself into His good books. Or Hers. And finally, I’d be eating someone else’s cooking – you just can’t refuse prasad, don’t you know?

Now came the preparations to step out. In India, by some association, silk and gold are related to prayer and religious observances in India and it is practically law that you must wear a silk sari to a religious ceremony. Who was I to question this hoary tradition … especially since I had a new silk sari with a newly stitched matching blouse that actually fit me? 

Dressing to go out took forever. I had always been quite at home in saris as I’d worn them since I was 18, but the two months of dressing down in pajama bottoms and tank tops had taken its toll. Draping the sari took 10 minutes longer than normal and it felt horribly uncomfortable. Wearing bangles or bracelets had been a pre-COVID habit too. I snapped on my watch and put on a bunch of gaily-colored bangles – and instantly felt like I was manacled. I put on a gold chain (remember the unwritten law?) and felt like a middle-aged street dog forced into a collar for the first time. As for when I put on some lipstick, I felt like a painted woman. It felt all wrong.

However, being made out of strong stuff, I sailed across the threshold all manacled and chained … only to have my husband call me back.

“Haven’t you forgotten something?” he asked. I had my purse, I had my handkerchief, I had some Tupperware in case of leftover prasad … what else did I need?

He held out a black cotton mask. I stared at it, full realization hitting me. Putting it on, I realized bitterly that I might as well have been wearing an old nightie. At least, I’d have been more comfortable.

A drive in an auto restored some of my mood. When I got there, however, I was greeted not by the usual tray with haldi, kumkum, and flowers, but by the lady of the house holding out hand sanitizer. The penetrating smell of the chemical didn’t vibe with the look and feel of puja. The place looked like a masquerade ball or a massive hold-up with everyone wearing masks. I couldn’t recognize most faces and blundered around until the puja began.

To me, pujas have always been a time for my mind to wander. After the first suklam baradaram vishnum, my mind took off as usual. It is hard to focus during a puja when there isn’t anything specific to focus on. Priests can say just about any shloka they want and get away with it as long as they are careful to insert some well-known ones in between. It may be pouring for hours, leaving everyone blaming global warming, while it is only the priest next door reciting the Varuna Japa shlokas for a Ganapathi puja. 

Then it was time for the unmasking … the eating, that is. The fare was simple, but delicious. As I tucked into the uppittu with coconut chutney and kesari baath, I finally felt at home. That was when I realized that it is the smallest things that make up normality – things like family and friends gathering for a meal, trading little jokes, laughing together. Meeting, catching up with each other. Taking selfies and pictures of unsuspecting people tucking into food. Laughing at silly things and sharing sad news. 

I came away, reassured. No matter what, Corona can never take that away from us.

Lakshmi Palecanda moved from Montana, USA, to Mysore, India, and inhabits a strange land somewhere in between the two. Having discovered sixteen years ago that writing was a good excuse to get out of doing chores, she still uses it.

Game Theory Explains the Pandemic

The COVID-19 spell has left governments, markets, and civil society wobbling through disruptions and damage. The ambiguity that envelops not only the evolution of the disease but also its impact makes it a challenging and complex task for policymakers to devise a suitable policy response.

The pandemic has brought to the forefront some key ethical questions that we must explore. The ‘Human gene’ is thought of as the most skilled of making a choice based on ‘free will’, on ‘reason’ and ‘rationality’. From the study of human behavior, it is widely known that the current setting can be related to the behavior of people, the choices they make, and the human tendency for cognitive error, to be able to forecast patterns and design effective interventions.

Today, the whole world stands on the edge, geopolitics at a cusp, policymakers in a dilemma, to generate an appropriate policy response. This is the classic case for strategic thinking and can, therefore, draw on insights from behavioral economics and game theory. The former is a field of social sciences that is a blend of economics and psychology and looks into human decision-making behaviors, whereas the latter is the study of models based on strategic interactions between players, on rational choice and on maximizing behavior by the people.

In the context of the pandemic, the questions that come to one’s mind are:

  • How to encourage – and sustain – cooperation?
  • How to incentivize social distancing amongst people?
  • How to get various organizations and authorities to better coordinate?
  • How to get countries to cooperate and coordinate?

Game theory is the science of strategy that deals with outcomes that are produced by interactions, based on the behavior of the players. It is a tool to study interactions in the context of interdependencies.

A “game” is any situation involving two or more “players” in which the “fate” of each player depends not only on her “actions” but also on the actions of the other players. Some notable points are:

  1. A “situation” can be economic, social or political, etc. (e.g., social distancing). 
  2. A “player” can be a person or a group such as a firm, a political party, a country, etc. (e.g., a citizen). 
  3. The “fate” of a player is what she cares about such as profit, happiness, winning an election, growth, money, pay-offs, etc. (e.g., catch the virus or not, and keep one’s job or not). 
  4. An “action” is a choice or a strategy. (e.g., to social distance or not).

The main ingredients of a Game:

  1. Who are the players?
  2. What strategies does each player have
  3. What are the payoffs for each player?

The novel Covid-19 pandemic seems like a real-time situation that can be fitted well into the basic game theory model called the ‘Prisoner’s Dilemma’. The prisoner’s dilemma is basically a game in which there is an incentive to make a choice that may not produce the best possible or optimal outcome for the group as a whole.

Some aspects of this pandemic reflect the same premise, such as the decision to maintain social distancing during a pandemic looks a lot like a move in a multiplayer form of this game. One can either cooperate, and do something that costs a little while helping those around, or deviate, and bring one, a small benefit but at a greater cost to those around oneself. 

If one maintains social distancing, it is not necessary that he/she will not contract the virus as it also depends on what others are doing. Thus, it is a ‘game’-there are strategic interactions.

Let us say, we have a two-player Prisoner’s dilemma game. Both players ‘A’ and ‘B’ have two choices. Choice ‘C’, in which both choose to maintain social distancing and hence cooperate and, choice ‘D’, where they both deflect and do not social distance. The payoff matrix is given below:

Player B

Player A

 Strategies C D
C 5,5 (C, C) 0,8 (C, D)
D 8,0 (D, C) 1,1 (D, D)

 

The efficient outcome is (C, C) with respective payoffs (5,5). This occurs when they both agree to cooperate and maintain social distancing. This is the result of ‘Collective rationality’. The outcome “(5,5)” is preferred by both (everyone) but is unstable in that each person has an “incentive to cheat” – there is a temptation to go out when everyone is locked inside their respective homes. However, here both the players have a unilateral incentive to deflect and this outcome becomes unstable and fragile. Each player becomes vulnerable to the so-called ‘selfish gene’ inside of him and has an urge to cheat and deviate and thus get a higher payoff for oneself. If ‘A’ falls prey to this temptation, thinking that ‘B’ would have done the same and drops the precaution of social distancing, then he gets a small benefit (8,0) but at the cost to others in the society. If player ‘B’ is led off by the temptation to deviate assuming that ‘A’ would have reacted in the same way and decides not to distance himself, then likewise his payoff is (0,8). 

Thus, the Unique “dominant” (or “rational”) strategy for each person is ‘Not to Cooperate’. There arises a tension between “Individual Rationality” and “Collective Rationality”. Individual Rationality leads them to settle at the ‘optimal’ outcome, where both them end up in deviating with lower payoffs for themselves at (1,1) and a higher risk of getting the virus. This in fact is what is called the ‘Nash equilibrium’. Cooperation gets destroyed by the ‘Art of War’ and paradoxically non-cooperation becomes the dominant strategy.

Ironically, the biggest debate rattling the world is that which political power would emerge as the winner in this ‘COVID stirred race’ for dominance.

Questions that come to the ground are, whether a country should cooperate with others and share the results of its innovative practices or not? How to get from “(1,1)” to “(5,5)”? That is, how can one make a good outcome happen? This requires Cooperation and Trust. 

Is there a need for a “third” party to enforce the peace, to enforce cooperation, to enforce a lockdown? Yes, perhaps and the “third” party can be the Sovereign (i.e., the State)?

What are the payoffs and the costs?

What should be the geo-political policy response?

Here lies the ‘tight-spot’ faced by policymakers today…

In the current times, the main players are the citizens and the governments whose choices make a difference and to a large extent play a vital role in checking the pandemic, which had constructed the game theory model in question, in the first place. COVID-19 will reshape our world. We don’t yet know when the crisis will end. But we can be sure that by the time it does, our world will look very different. How different will depend on the choices we make today. Every stakeholder’s choice is an externality for others. 

Global pandemics need global solutions. ‘Radical scaling up of international cooperation among scientists, economists and policy-makers is the need of the hour’. A cooperative strategy by all the players in the ‘Covid-Game’ is the optimum one. It is the Nash equilibrium, in the ‘Covid-induced policy-cogmaire’!  

Malini Sharma is the Senior Assistant Professor and Head of the Department of Economics at the Daulat Ram College, University of Delhi in India.

A Tale of Two Valleys

Whew.

For the next year, my ability to Google will be ensured by the fact that roughly 200,000 people across 50 countries are working from home.

And, I can like your Facebook posts for, well, forever, because Mark Zuckerberg “guesses as much as 50 percent of the company’s 45,000-person workforce could be working entirely remotely in the next five to 10 years.”

These may be private sector decisions. But they impact the public’s understanding of immigrants and immigration. And that leads policymakers to value the Googler much more than the farmworker.

Look, as COVID-19 cases keep growing across California, the state’s tech industry and its nearly 1.8 million workers in 2018 — with over 805,000 of those jobs in San Francisco and San Jose — is doing fine. Their companies are growing, their bottom lines look great.

And, with the exception of those on the sector’s retail or gig front line, most are working from home.

The breathless media coverage leads us to think that this is the new reality for most workers. It is not.

Among U.S. workers, 11 percent are employed in the agricultural and food sectors — almost twice as many as those who work in tech. Of the approximately 22 million full- and part-time jobs in the ag and food sector, about 2.6 million are direct on-farm jobs, and nearly 13 million are jobs in food service, eating and drinking places.

These workers are not earning six-figure salaries. And they definitely are not working from home. (If they are working at all.)

In fact, go about two hours east of the work-from-home Silicon Valley and you find yourself in the hot fields of the Central Valley where more than 250 different crops, with an estimated value of $17 billion per year, are grown. In total, the Valley supplies 8% of U.S. agricultural output (by value) and produces a quarter of the nation’s food, including 40% of our fruits, nuts, and other table foods.

Over 675,000 people work in the agricultural industry up and down the Central Valley.

In California, like across the country, these are the jobs that require workers to go to the “office.” But, for these workers, the office is a field, a farm, or a ranch where something needs to be planted or picked, cared for, or caught.

Everything surrounding these jobs puts people at risk. Sharing a ride to work, close quarters at the workplace, homes that do not afford any modicum of social distancing. As a result, the rate of positive coronavirus tests in the Central Valley could be as high as 17.7% — more than double the 7.8% statewide average over the last seven days.

While California works to get financial and medical resources directly to these agricultural communities, the federal government turns a blind eye. Under the CARES Act, both parents must have Social Security numbers for the family to receive relief. This makes entire families, including U.S. citizen children and spouses, ineligible for much-needed COVID-19 economic assistance.

This is a dynamic playing out in communities across the country. Immigrant families, even those with U.S. citizens among them, are going without any sort of relief.

These are trying times that require all of us to sacrifice. For some, the sacrifice is social distancing and working from home, while raising a family. For others, it is losing your job altogether.

And, for others, it is doing a job that is essential to the health of the country — but detrimental to your own health.

As we approach six months of this national crisis, it is easy to lose perspective and think that our own reality is the reality of others, to believe that our protection from COVID-19 is the same protection others have.

We begin to think COVID-19 is a disease “they” get. “They” did something to put themselves at risk. “They” were not healthy enough to fight off the disease. “They” live somewhere else, do something else.

Well, more than we probably realize, “they” are putting food on our table. And, “they” are most likely to be people of color and/or immigrants.

This lack of perspective leads the nation down a slippery path where economic and social divisions widen, where moral leadership is replaced by transactional leadership, where the bottom line is more important than people.

It’s a dangerous path that leaves the least among us without support — left to fend for themselves without health care or financial relief.

There is still time for the country to get off this path, and for Congress to ensure that all of us can access the relief and support we need.

The fact is that the skilled farmworker, documented or not, putting food on our table is just as, if not more, important to our lives and livelihood as the skilled engineer putting Google on our screens.

Ali Noorani is President and CEO of National Immigration Forum, author of There Goes the Neighborhood, host of Only in America. And, terrible golfer.

Featured Image by Coolcaesar and licence here.

Original article can be found here.

Ethnicity Matters to Stem Cell Recipients

Indians are dying unnecessarily from blood cancers. There is a shortage of Indians available on the national registry to assist fellow Indians who have been diagnosed with leukemia, lymphoma, and other blood cancers. What’s the solution? To encourage more Indians/South Asians to register as potential stem cell donors.

“Registering is easy,” says Dinesh Chandrasekhar, who along with his wife, registered at the Hindu temple in Livermore, CA. “It only takes about 5 minutes. You can complete the online registration and a swab kit will be mailed to you. When you receive the kit, swab the inside of your cheek and pop the kit in the mail. Postage is pre-paid and you don’t have to leave your home. And, the testing is free.”

Dinesh serves as an ambassador for the Asian American Donor Program (AADP), a 30-year-old nonprofit organization in Alameda, CA that works to educate Indians and other ethnically diverse people about the importance of registering as potential stem cell donors. In the past year, AADP has worked with 10 Indian patients in need.

Joining the Be The Match® registry means volunteering to be listed as a potential blood stem cell donor, ready to save the life of any patient anywhere in the world who is in need of a transplant.

“With the coronavirus pandemic and the need for six-foot distancing, we have canceled our in-person community registration events,” says Carol Gillespie, AADP’s executive director. “So, our community education and awareness efforts, which generate new donors, are suffering and blood cancer patients are worried.”

The coronavirus has had a dismal impact on patients diagnosed with blood cancers like leukemia and lymphoma, and other illnesses treatable by a stem cell transplant. Blood cancer patients are afraid that a life-saving donor will not be found in time. They are scared that if a matching donor is found, that person, because of COVID-19, will not want to go to a clinic to have their stem cells collected.

Locating a stem cell donor and having a stem cell transplant is an example of a health care disparity. For people of color, there is a shortage of donors on the Be The Match® national registry. Patients of South Asian/Indian heritage face challenges, as the population is severely under-represented as donors.

At any given time, there are 12,000 people looking for a matching stem cell donor to help save their life. Patients are from all walks of life and are from numerous racial and ethnic groups.

Dinesh Chandrasekhar’s Story

Dinesh and his wife registered with the AADP as potential stem cell donors. Then, in the fall of 2014, Dinesh was notified that he was a match for a patient. 

“I got very excited about the opportunity of being able to help someone in need, but at the same time, I suddenly got apprehensive about the process,” Dinesh says. “But, after talking with an amazing person at Be The Match®, I was completely clear about what I was expected to do. After that, I had no fear.”

Dinesh liked that the stem cell donation process was simple and convenient for him, the donor. And, there were no expenses for him.

When lab work found that Dinesh had high blood pressure, the transplant procedure was called off.“I was never more disappointed in my life,” he says. “It was a huge shock that I could not donate.

In January 2015, Dinesh was notified again that he was a match for a patient in need. He was asked how his blood pressure was and he said he and his doctor worked on it and it was now normal. In April of 2015, Dinesh donated his peripheral blood stem cells.

Dinesh donating stem cells.

“It ended up that I donated for the same patient. And, interestingly, we are both the same age. It was like destiny,” Dinesh says.

The process at Stanford Hospital took a little more than four hours. Dinesh’s blood was taken out of Dinesh’s arm and then cycled through a machine that separates the stem cells from the other blood cells. The stem cells are kept in a separate bag, while the rest of the blood is returned to the donor. During this time, Dinesh watched TV shows.

“I was mind blown about the science behind this and that this (his stem cells) would produce immunity in another person who was compatible with my stem cells,” Dinesh says.

“Giving your stem cells is not like you are donating a part of your body (kidney, liver, etc.),” Dinesh says. 

Before going to a clinic or hospital, donors are given shots that stimulate white blood cell production. “This production moves blood stem cells from the marrow into the bloodstream so that the stem cells can be collected from the donor,” says Gillespie.  “So you are missing nothing.”

Upon returning home, Dinesh ate lunch and slept for about three hours. “The next morning I felt normal and went back to work,” he says. “I would do it again.”

After six months, Dinesh was told that his recipient was doing well and back to their normal life.

“Registering and, then, donating my stem cells was fulfilling,” Dinesh says. “As human beings, we are here to help each other.”

Join the registry by texting AADP to 61474 or visit AADP. Visit AADP’s Instagram page for upcoming Live Interviews. AADP also hosts special events.

IP Law and Trade Policies Compete With Medical Needs

The role of Intellectual Property Law and Trade Policies in Innovation and the access to medicines and medical technologies compete against each other in the Corona impacted world.

COVID-19 has shaken the world and medical technological breakthroughs with new vaccines or drugs would be the only way to save mankind. A global health crisis always triggers concerns over patented medicines and treatments that may impede access to affordable healthcare. A global pandemic or a health crisis stimulates the need for better access to medicines, creating a gray area between the protection of ideas, investments, and access to medicines for the larger good of public health. 

The Emerging Issue     

Intellectual Property Rights awards exclusivity to the inventor or the owner to manufacture and sell their invention.  

Almost a decade ago when HIV/AIDS had become a global crisis, concerns of better access to medicines were raised. Developing nations had concerns with regard to the implementation of strong Intellectual Property regimes as it would have a negative effect on the efforts to improve public health, thereby making it difficult for governments to have policies for affordable healthcare.

The major problem in developing nations is that the prime population pays for their own drugs and state provisions are selective and constrained. Though the concept of state health insurance schemes is blooming, its effectiveness, to date, is questionable. 

A similar situation exists in the current scenario for COVID-19 where not only are the beds in each hospital limited, but extravagant costs have to be borne by patients.

In Tamil Nadu, India, private hospitals are charging a whopping amount of Rs 30,000 per day, even though government orders state otherwise, capping the charges at Rs 7500 for mildly asymptomatic patients and in case they have been admitted to Intensive Care Unit then the charges are capped at maximum Rs. 15,000 per day. Claims of unfair charges are popping up every day where hospitals are being accused of merely robbing patients.

Not only that, exploitative pricing has become a common predicament in most Asian Countries where hospitals are overcharging in COVID-19 rapid tests. The rapid test packages offered by hospitals have been differing from 500,000 rupiah to 5.7 million rupiah ($32 to $365). Exorbitant pricing remains an issue in the United States as well, where an individual faced a $1.1 million hospital bill.

Access to proper healthcare has already started becoming a concern with hospitals turning the major crisis into a money minting machine, even when there is no absolute drug or vaccine for the disease. The concern is, if every entity starts to look at this crisis as an opportunity, sustaining public policy will be a distant task for the government.

The Exclusivity of a Patent 

The key objective of the patent system is to reward exclusively to the innovator for an invention that is novel and has some industrially enhanced efficacy to it. The patented innovation could be a product or a process, as engraved in the TRIPs (Trade-Related Aspects of Intellectual Property Right) Agreement, 1995. The patentee creates a solution to a problem and as an incentive, an exclusive right is given to the owner, to produce and sell it, for 20 long years. The pharmaceutical industry is majorly dependent on the patent system to recover its research and development cost and to generate profits for future innovation.

The Competing Interest: Public Health

Compulsory licensing is an act where the government authorizes a third-party to use, make and sell a patent without the permission of the patentee or the owner, when the medicine is not available at a reasonable and affordable price or when it is not obtainable in a justified quantity. Compulsory Licensing and competition from generic or biosimilar products are general issues that threaten many patent holders. A competing interest is involved here, where on one side, there is a greater good of public interest where the ownership of technological innovation should be with the public, and on the other side, there is private ownership of patents fuelling further innovations. 

Biosimilar and generic drugs are sold at a cheaper price and are said to have a trade-distorting effect. However, the provision of consensual licensing instead of any legal compulsion might be a silver lining to this whole circumstance. The possibility stems from the current world scenario where corporate social responsibilities on Multinational Corporations (MNC’s) are an obligation and a single-minded pursuit of business is no more encouraged. This can definitely balance the competing interests of the right holders and the public interest at large. 

With the current COVID-19 scenario, the World Health Organization has accepted a proposal for patent pooling in order to collectively share the patent right, test data, and information required to create drugs and vaccines. It showcases an attempt towards navigating patent rights for all countries thereby making new innovations available to everyone.

Patent Pooling is a framework where one or two patent holders enter into an agreement to share their innovation by means of licensing with each other or with a third party in order to provide fruitful technological solutions. Patent pooling can even help in the scenario where technology is not entirely developed and thereby lead to new innovations without any hindrance to access.

However, with the United States trying to quit the World Health Organization, a question emerges – ‘in case they do terminate their relationship, how is the patent pool going to function?’ We all know what happened to the International Trade Organization when the United States chose not to be a part of it and now with the changes in the current arrangement, the question emerges again. The world is approaching multilateralism and is finally able to compromise with nationalism in order to work in solidarity. 

Lahama Mazumdar is currently working as a Teaching Assistant in National University of Study and Research in Law, Ranchi and is a doctoral student at National Law University Odisha. 

Windows to the Soul

Windows to the Soul

As hugs turn into virtual high-fives

And pajamas become our cocoons,

As sanitizer turns into a balm for our weary nerves

And TP becomes our most prized possession,

 

We lumber out of hibernation every morning

With nowhere to go but the couch.

The only thing we’re creating these days

Is a six feet force field around us.

 

As we fight to flatten the curve,

This insidious little bug flattened our lives.

Zoom-ing through our days is ok, 

But i-contact is not eye contact.

 

As I walk around I see a sea of masks

Like extras in a dystopian movie,

Their eyes constantly scanning for threats, avoiding mine

I can’t read them, can’t tell what they’re thinking.

 

“Windows to the soul,” they said.

Not anymore.

I’m not afraid but sad,

As our humanity falls victim to social distancing.

******

Riya Arora is currently a sophomore at The Harker School. She finds her passion in social advocacy and giving a voice to those without one. Already involved in several non-profit organizations, she is also the founder of her own called Touched By MS. Outside of school, she is a 2x national medalist in figure skating and is on the San Jose Sharks synchronized team.

Fear and Hope

 Fear and Hope

Life without living, a burden to bear!

In the midst of thorns, hope like roses

flourishes and releases sweet fragrance.

“Sweet are the uses of adversity.”

It too will wither away, slowly though.

“Suffering makes a man wise.”

Where there is suffering, there is hope

waiting patiently in the wings for the cue.

 

Haltingly though, let’s bear the burden

and march along toward our homes,

though they may now seem far away.

Don’t let negativity deflect our hope.

 

Difficult it may be to bear suffering

that is within us; let’s face it with positive energy.

******

Satyam Sikha Moorty is a Ph.D. in American Literature from the University of Utah, Salt Lake City, and taught for 31 years at Southern Utah University. He has two chapbooks ready: “Who Am I? and other poems”  and “Poems of Fear and Songs of Hope.”  His book “Passage from India: Poems, Short Stories, and Essays” has recently been published by Austin Macauley, London, England

Notes: “Sweet are the uses of adversity”—Shakespeare, “As You Like It,” Act II. Scene i.

“Suffering Makes a man wise”—Aeschylus, from his “Fragments”

Let Us Talk About Our Periods

In light of the World Menstrual Health and Hygiene Day observed recently (28th May), I won’t pad how I feel about the stigma and taboo around periods.

We all came into this world from the same place – the uterus. A concept that apparently requires reminding. The same process that is essential for bringing life on earth is associated with shame, humiliation, and even disgust in many parts of the world. 

My father is a doctor, so menstrual health was treated as just another health issue in my household. Despite growing up in a small non-city (district) in the state of Bihar in India, I was fortunate enough that my home was a safe space where there was no disgust associated with this topic. I was allowed to sit in all poojas and welcome to whine about my horrible cramps. But, outside the house, things were different. Friends and even aunties had strange names for the monthly cycle – from “Aunty flow” to “being down”. 

Fifteen years later, telling the same people that I am writing an article on menstrual health and hygiene was in itself a great litmus test for the taboo and stigma around this topic even now. No one said that they were disgusted by the notion to my face but I got a lot of uncomfortable nods and grunts.

This is a matter of health

People need to understand that menstrual pain is a medical condition (and unbearable one at that) and we need to talk about it – create awareness and bust myths.

According to a study, at least one in four women experiences distressing menstrual pain characterized by a need for medication and absenteeism from study or social activities. Period cramps (also known as dysmenorrhea), are mostly caused by a hormonal imbalance, which can start before the period commences and last for several days.

And right now, amidst lockdowns and increased isolation due to COVID-19 all over the world, there have been reports of increasing “period stress” that is affecting women’s cycles and overall menstrual health. According to a study by Mayo Clinic, stress can not only cause increased menstrual pain but it can also delay the periods or cause Amenorrhea or the absence of menstruation. 

So, instead of disguising this very natural and normal occurrence as a matter of shame, disgust, and humiliation, we need to de-stigmatize it and create conversations around this topic.

Some natural remedies that have worked wonders for me

Period cramps can be horrible and many women go through this pain every month. To mitigate it, here are a few easy, reliable, tested, and tried natural remedies for better menstrual health.

When it comes to cramps, I try not to pop painkillers (anymore). Full disclosure: I used to pop 3-4 Ibuprofen tablets during one cycle when I was younger but now that I am 30 and probably a bit wiser, I find myself more inclined towards natural remedies. 

Herbs like chasteberry and wild yam have been used for thousands of years for treating menstrual pain and boosting women’s health.

I recently discovered and subscribed to The Scarlet Company’s Scarlet – a natural tonic that contains both these super herbs and more, and it has helped me a lot with my cramps and flow.

Another thing that never fails to work, is a hot water bag. I swear by hot water bags and cannot go without them during my periods. They not only help with cramps but also ease the flow.

Yoga also helps a lot. Just 20 minutes of sun salutation every day can make those horrible back pains go away.

This is 2020

The world is getting crazier, stranger, and scarier every day. When one girl comes out of the “period-shaming” closet, she voices the pain and struggles of many others who might be still stuck inside. As a society, we need to do better. And, creating unnecessary sensationalism, stigma or taboo around serious health concerns and issues is not doing anyone any good. Can I get an Amen?

Surabhi Pandey, a former Delhi Doordarshan presenter, is a journalist based in Singapore. She is the author of ‘Nascent Wings’ and ‘Saturated Agitation’ and has contributed to more than 15 anthologies in English and Hindi in India and Singapore. 

Nexts Steps to Reduce Anxiety

Are you feeling anxious during these troubled and difficult COVID times? Anxiety starts to affect our mental and physical status. We worry about our families, friends, and ourselves. What if something happens, what next? Fear, and anxiety, come from thinking of the future.

Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs. In the traditional Maslow pyramid, we see that the basic physiological ( food, water, warmth, rest) and safety needs ( security, safety) are not met for many of us. Many have lost their jobs, do not have a roof over their heads, or even food to eat. This causes immense anxiety, frustration, anger, and fear. However, even for those whose primary needs are met, there is still a tremendous amount of anxiety. To help understand and cope with this feeling in these unusual times I have redefined the upper part of the pyramid.

In these uneasy COVID times, it is necessary to ease our minds. What are our emotional needs during a difficult time like this? Here is a simple diagram that helps explain it. During this time it is good to go within us.

Let’s look at this diagram. We need to accept this situation as it is. It may not be what we anticipated or wanted, but with Acceptance, it will be easier to deal with the situation, rather than fight against it. 

Routine is a sequence of actions regularly followed. In these times it would be beneficial to create a healthy routine. Pick things that you have control over and make them an integral part of your routine.  When new things show up that are not in your control, let them go, and don’t let it affect your routine. In this process of not being able to be always in control of happenings, anger, and frustration arise, which need to be slowly released. 

Would you like to connect with others? We have been asked to social distance. The effects of this have brought about sadness and a feeling of loneliness. Even though you are social distancing, you can nurture your relationships with emotional Connections. Go on, pick up the phone, and speak with a friend, text, or use social media. Share your feelings and know that you are still connected even though you are physically apart. This is not forever.

The world has slowed down so that you can discover yourself. Think about taking a pause and figuring out what is the new normal.  When you Reset, what you thought meant something important to you may have changed. What seemed normal no longer seems useful to you. 

For many of us, it is hard to concentrate on our emotional needs when we are filled with anxiety and fear.  Use these next steps to reduce your anxiety first so that you can take care of yourself and the needs within.

  1. Reduce watching and listening to negative news.
  2. Enjoy family time with a feeling of gratitude. I understand it is difficult at times being under the same roof. Cooking, cleaning, teaching kids (homeschooling), video conference meetings, loud music, dogs barking. Once this is over you will realize that this was an opportune time to bond with each other. So make it happen now.
  3. Be in the present. Anxiety, worries, and fear come from thinking of what will happen in the future. Just live for the moment as life is precious and should not be taken for granted. 
  4. I find yoga, meditation, and most of all a good night’s sleep valuable to calm my mind.  Many apps and sites offer meditation sequences. 
  5. Practice gratitude. Gratitude for being you, for having the smallest of things. Gratitude for the frontline workers, researchers and so much more. 
  6. Exercise helps release your feel-good chemicals. If you are allowed to and it is safe then, walk, run, cycle with 6-foot social distancing in a non-crowded area while wearing a mask. Come home and wash your hands. 
  7. It is time to take on a new hobby, or even learn a new language. All the things you always wanted to do but didn’t have time for. 
  8. Charity is giving. Giving makes you have a feeling of purpose and control. Donate to an organization, assist the elderly, support those who need your help. 

I keep asking myself what is troubling me. Is it the fear of my fragile life, that my loved ones or I am locked down at home? So many things keep flitting through my mind causing anxiety, but the best approach is to look at what I have and be thankful. Be in the moment. 

Geetanjali Arunkumar is a writer, artist, life coach. She is the author of ‘You Are the Cake’.

Veiled and Shut: A Response to Navigating Autism

This poem was written as a response to the piece Navigating Autism. I was moved by what Swathi Chettipally had written and I thought, “life goes on with all its ebbs and flows, perhaps accentuated at this challenging time, for children with disabilities/differently-abled and those with chronic illness.”
Veiled and Shut

 

The sing-song of your, ‘mama’ rings in my head

 

The blithe spirit numbed

Now so lonely in a crowd

 

No joy gladdens

No fears felt?

 

These distant eyes

That once spoke

Mystic, shut, veiled

In self-enchanted?

 

What thoughts repressed

And brilliance locked

What love burned

And pain muted

 

Oh, lament unsaid…

 

No tears shed,

No laughter spread…

 

The sing-song of your, ‘mama’ rings in my head

******

Madhu Raghavan is a pediatrician who enjoys writing, exploring our great outdoors, gardening, and art as a pastime. She is also the artist of the featured image.

The Bedner Family Presents: BYE CORONA!

On Friday, March 13, 2020, a crazy idea popped into my head, and I began writing down some lyrics to convey it. This was the day the news of SIP (Shelter In Place) became official, and I thought, “YES!  A silly family project and an outlet to be creative during this unknown time period.”  As I delved in, I had an aha moment. I wanted this project to be more. I wanted it to mean more.  

I took a deep breath because I knew my realization involved confronting the daunting Beast known as iMovie. I warily explained how I would need its cooperation to help my inspiration come to life. The Beast did not respond kindly.  In fact, I would say it was downright cruel: taunting me with overwhelming features, with no explanation on how to use them, and then throwing them repeatedly in my face as I gingerly attempted to learn. “DAMN YOU, BEAST!,” was a frequent wail, accompanied by embarrassing temper tantrums that would rival those of a two-year-old. And, as in dealing with a toddler, I did the dance of countless time-ins and time-outs. At one point the time out was so long that I thought this brainchild was a thing of the past. A fleeting flash of imagination.

Lucky for me and unluckily for the Beast, I have many flaws, but being a quitter isn’t one of them. With the support and permission of incredible friends and family, I carried on. And nine weeks later, here we are – metaphorically, if each week symbolizes a month – I am now giving birth to this project.

A time like this flushes all essential realizations (pun intended) to the surface. We are more alike than we are different, and we are more together than we are apart.  

I share this video/message with you and the world because I believe in for what it stands. I believe we will all be in this together, push through this together, and come out of this together, even stronger than ever before. From my heart to yours…..

Sangini Majmudar Bedner is a former Miss India USA, Stanford University graduate, teacher, writer, and professional actress, dancer and choreographer. Sangini thrives on connecting with her roots and incorporating them into her life adventures. Her greatest purpose is collaborating with her imagination; her greatest pride is being a passionate mom to her two boys.