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Telemedicine is becoming normal and  extremely useful during the time of the coronavirus epidemic. Hospital systems are increasing its use in the U.S. Europe, and Asia.

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The coronavirus health crisis with people staying at home in a lockdown has shown the tremendous potential for telemedicine. It has revolutionized the medical profession as more patients are treated over the phone or video app discussing symptoms in a virtual visit and treatment, when the situation is minor or not critical. A urology doctor discusses the potential for using telemedicine in his field and many other medical fields.

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The U.S. aid package to tackle the coronavirus includes $425 million for mental health and substance use disorders and $50 million for suicide prevention to ramp up mental health services. A telemedicine program for mental health providers is being expanded and a suicide prevention program at Veteran Affairs Department is being expanded to other Americans. Second lady Mrs Pence is supporting the suicide prevention program. 

Widespread anxiety and post traumatic stress disorder is expected by experts as a profound aftershock from the coronavirus.

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In launching the Ayushman Bharat Digital Mission prime minister Modi says it "has th potential of bringing a revolutionary change in India's health facilities."  Following the launch of Arogya Setu app and the 900 million vaccine doses given under Co-Win for the free vaccine campaign this is the next step.  To take healthcare facilities to a new level and integrate it with technology prime minister Modi noted the 1.25 billion remote consultations under telemedicine that have taken place since March 2021 under e-Sanjeevani. Using this people in all parts of India are able to connect with doctors of large hospitals in cities. Ayushman Digital will connect digital solutions of hospitals across India to each other. This would make process simplified and enhance ease of living. Under this plan every citizen would now get a digital health ID and health records digitally protected. The overall model is for preventive healthcare and in event of disease easy, affordable, accessible healthcare.  Part of the plan is to build the facilities and resources to be able to handle needs. For doctors and para medical manpower a comprehensive network of AIIMS and modern health institutions is being setup, and one medical college is being setup for every 3 Lok Sabha parliamentary constituencies. In villages and rural areas primary health care network is being strengthened. Over 80,000 centers of this type have been operationalized.    ...

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After the coronavirus pandemic the whole picture of life in retirement and aging is expected, says this report in WSJ.  Retirement homes are not viewed as a good place and about 30% of these homes in the U.S. are expected to close with financial difficulties. Most people will now work longer and continue to live at home. Telemedicine and other technology will help make this possible. Experts say most people will age and stay at home and financial incentives will be given for this to happen.  Aging will also be seen differently because of the resilience of older people during the coronavirus. People will be seen as productive and living a full life well into their seventies and eighties. Community services will expand. Government services including under Medicaid will consider that it is less costly to stay at home than in long term care facilities and provide financial coverage for caregiver or homecare aides help at home. Many new services and technology assisted services are being planned with a focus on older people and living productive lives, as America and Europe other countries shift their focus to this group. After coronavirus people are also looking to spend their years in a productive way, to do things that really matter and add meaning to their lives.. How to spend the next 10-20 years in the most meaningful way. ...

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This report in WSJ shows how people are adapting to coronavirus pandemic taking the long view and settling down with new arrangements that will continue into 2021. Some software engineers are shown redesigning their homes to setup offices for working dads and moms where they previously worked out of temporary arrangements in the home. Physicians used telemedicine in the early months of the pandemic. They still see patients only once or a couple of times a week in specially designed arrangements where patients stay in the parking lot till they their appointment and waiting rooms are largely empty. It is a season of deeper adaptation as people realize they are in this for the long run into 2021. Workers are setting up new routines and home offices, families are trying new rituals, and businesses are trying new ways to energize their employees, all with the objective of making it work in the long term. Though the economy has reopened office buildings are largely remaining empty, schools and colleges are remote teaching as cases are climbing with the daily average at 40,000 a week in the U.S. and over 70,000 in India each day. ...

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Since the last landing of a man on the moon in 1972, not much has happened. China recently made 3 lunar landings and Israel failed in its recent Beersheba module effort. India is trying a second time with Chandrayan 2 to make the soft landing in the last critical 15 minutes on the lunar surface without any problems.    The Indian space program has the potential to build up the global research and knowledge about our planet.  Factors unique to India's space program are its development of its own rockets, similar to China's. The multipurpose satellite system services a number of users- telecommunications, TV broadcasting, meteorology, disaster warning, land and water management, ocean studies, drought and flood forecasting. The fleet of satellites IRS (Indian Remote Sensing Satllite Systems) will be used for teleducation, telemedicine, and other new uses. The NAViC navigation Constellation System acts as India's own GPS reducing the need to rely on U.S. based GPS. Other aspects of India' space program are the effort to explore new planets with the Mars Orbiter Mission MARS , with a module reaching Martian orbit in 2014. ...

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Just about half of Africa's population is within 25 kilometres of a fiber network for mobile telephone connections. In Nigeria this is much lower at 14%. Instead of having to lay costly fiber optic networks for high speed broadband connections Africa can benefit from new 5G network technologies that enable Africa to leapfrog to better high speed internet connections. The telecom company MTN has started testing 5G mobile internet in Nigeria with live demonstrations in Abuja and Calabar, and in other Nigerian cities during a 3 month trial period. Nigeria is one of the few African countries that is pushing 5G with rollout in 2020. 5G uses radio waves to transmit and receive data between an antenna and one's mobile phone. It operates at high radio wave frequencies which cannot travel as far as other frequencies, so a denser network of base stations or masts is needed. This makes it highly suitable for large urban areas. A report by GMSA shows that South Africa, Nigeria and Kenya and four other African countries will have 5G by 2025 and this will be about 3% of mobile data compared to 16% worldwide. Problems with use of 4G in Nigeria show the issues facing Africa. Cost of using 4G is high for the average user, so that only 4% of users of mobile internet in Nigeria are 4G even though Nigeria has an extensive 4G network. Instead 40% of Nigerian users use 3G networks. 5G faster internet could help Africa in areas such as health with telemedicine, and in remote education, say experts. They also say 5G rollout in Africa will benefit from drop in costs as the technology becomes widely used in Europe, China and America. ...

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Every day lost in the struggle with coronavirus is a big thing, which is why Itay's most affluent northern region has gone from being well equipped with resources of healthcare to seeing the health system overburdened to the point of disaster. This WSJ report shows why this has a lesson and an early warning for how the U.S. and other countries should design their response. It is also why the White House team that includes President Trump in the U.S. emphasized the plan for just the first 15 Days in the news conference at the Brady Room in the White House on March 16. It is saying the first 15 days are critical, not a day to lose.  It does not matter if you are an advanced economy with state of the art hospitals. Social behaviours must change, old rules rewritten and implemented throughout nations, quickly in days. Here WSJ shows lessons learned by Dr. Cereda at the Hospital of the University of Pennsylvania who trained in Milan and was in constant contact with colleagues in Milan and elsewhere. Many of the lessons relate to not overburdening hospitals and health systems and protecting health systems. This means mild to moderate cases are managed from home and not in the hospital, through massive deployment of outreach services and telemedicine. It means therapies can be delivered at home or through mobile clinics. The second major lesson from Italy is to protect healthcare workers and doctors. The entire White House team with Dr Faucci of CDC and Dr Brx, head of Infectious Diseases in the U.S. news conference of president Trump March 16, focused on the goal of protecting healthcare workers, doctors and hospitals, so they remained strong to take on the crisis. The second goal of the White House team is to protect the elderly with medical conditions. To do this only the most serious patients are treated in hospitals the rest for mild to moderate at home.  Studying the conditions in Bergamo and other parts of Lombardy and northern Italy, is helping U.S. medical leaders to prepare for the current nationwide effort, the 15 days plan announced by the White House. The lessons from the Papa Giovanni Hospital in Bergamo are important say U.S. medical leaders, including Dr. Brendan Carr, head of emergency medicine at Mount Sinai Health System in New York.  He says build capacity in hospital beds before we need it. Clear out hospital space and add new hospital beds.  ...

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Some of the concern about the economy comes from the economic damage done by the coronavirus. The longer the shutdowns continue the more the damage. About 17 million have filed claims for unemployment benefits. The WSJ consensus of 57 economists is that 14.4 million jobs will be lost in coming months, and the unemployment rate will rise to a record 13% in June, from a 50 year low of 3.5% in February. The earliest the economy could go back to the level in February 2020 is 27 months says the WSJ economist survey. The brighter side of this comes in two aspects of this pandemic recovery curve. By flattening the curve and strict testing, contact tracing and isolation till the vaccine is developed about half the jobs lost can be recovered by the end of summer, says Moody's Analytics. The vaccine a year from now or in 9 months by November 2020 would allow the economy to recover faster. A more optimistic view comes from Daiwa Capital Markets which predicts many of people laid off will be recalled quickly allowing the labor market to recover in 6 months by September or October 2020. Only finance and real estate might take longer but most of the industries where the vast majority of jobs are could be back on their feet. The credible evidence supporting this perspective of a rebound comes from Colorado and Washington which require large employers to specify whether layoffs are temporary or permanent, 70% this year are temporary. Compare this to the prior 2009 recession where this figure was less than 1%- as reported by WSJ. The big push in this direction will be the $2 trillion that the Trump administration and U.S. Congress have committed to this task. Even more so is the determination of president Trump to protect American workers at all costs, that every job counts, and that businesses without exception to get the money have to show that workers are retained. The very success of the aid is being judged by how quickly people are back to work. Now for a look at where the situation is today- Oxford Economics, a UK based forecasting and consulting firm, projects 27.9 million jobs lost with industries other than those ordered to close making up 8 to 10 million of that number. It projects April's report will will capture late March layoffs. It will show cuts to 3.4 million business services workers, including lawyers, software groups, architects and consultants, advertising professionals, in addition to 1.5 million non-essential healthcare workers, 100,000 information workers. One conclusion of this report is that the virus does not discriminate across business groups and business service workers are also affected. Many companies that were hiring will cancel that move and many will cut hours worked. Many of these business services are not a priority. Hospitals are affected too, as they cut elective surgical procedures and routine care that are major revenue sources. Some are now charging for telemedicine visits to maintain some revenue stream. State and local governments employ 20 million workers. As tax receipts decline these local governments will face choices of cutting payrolls and services without enough federal government relief. In a way laying off workers and having them take unemployment benefits shifts that burden to the federal government so that services for overtime to police and paramedics, retention and deployment of nurses in schools.    ...

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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...