We could have more coronavirus outbreaks in tower blocks. Here’s how lockdown should work


Thea van de Mortel, Griffith University

The recent lockdown of nine social housing towers in Melbourne’s north to contain the spread of COVID-19 led to widespread concerns for residents’ welfare.

Among the concerns was that implementation of these lockdowns was less than perfect in terms of infection control.

In housing commission towers, many people live in close quarters and share facilities, making them a high-risk setting for outbreaks of infectious disease.

So it’s likely we’ll see more outbreaks in tower blocks, or even similar settings like hotels and apartment buildings, during the pandemic.




Read more:
Nine Melbourne tower blocks put into ‘hard lockdown’ – what does it mean, and will it work?


As of Sunday, there had reportedly been 237 COVID-19 cases across the affected towers. One tower remains in lockdown.

We don’t know whether any of these were sustained as a result of poor infection control practices during the lockdown period. But there are things we can do to keep residents as safe as possible in the event of further outbreaks in commission towers or similar settings.

The chain of infection

In the science of disease prevention and control, we often talk about something called the “chain of infection”. Stopping outbreaks taking hold is about disrupting this chain.

Understanding the chain of infection helps us design strategies to break the links.
Wikimedia Commons, CC BY

For COVID-19, the known reservoirs (sources) are infected people and contaminated objects.

The main modes of transmission are droplets spread by coughing, sneezing, and even talking. These droplets travel around 1 metre and might be inhaled by a person in close proximity, or settle rapidly to the ground.

Infection may occur via the transfer of the virus from contaminated objects or surfaces to your food or face.

Another potential route of transmission which continues to generate debate is the airborne route. This is where smaller droplets, called aerosols, travel further and stay in the air longer.

In the case of SARS-CoV-1 (SARS), airborne transmission was considered the most likely explanation for viral spread through the Amoy Gardens towers, an apartment complex in Hong Kong.

Contributing factors were poorly maintained plumbing — allowing airflow between floors — and bathroom fans that spread the virus through ventilation shafts.

Emerging evidence suggests airborne transmission may also be possible in the case of SARS-CoV-2 (the coronavirus that causes COVID-19).




Read more:
Is the airborne route a major source of coronavirus transmission?


Using this knowledge to break the chain

Because COVID-19 is relatively new, there’s no research specifically on prevention of transmission of this virus in residential towers. But we can base recommendations on what we know about similar previous outbreaks such as SARS, and by following general infection control principles.

To prevent droplet spread in a locked down residential building:

  • keep at least 1.5 metres away from others

  • allow only essential personnel in the building

  • residents should keep to their own apartment

  • people servicing the building can wear gloves and masks, but it’s important they be trained in their proper use

  • infected/symptomatic residents should wear a mask (and be aware of how to handle these correctly so as not to increase the risk of infection)

  • avoid shared spaces, for example shared laundries; limit numbers in lifts/stairwells at any given time

  • if movement is required, adopt staggered, rostered times to move through the building

  • if the structure allows it, utilise separate entry and exit points and one-way pathways through the building

  • practise good respiratory etiquette (such as coughing into your elbow). This can reduce the number of people each infected person passes the virus to.




Read more:
Which face mask should I wear?


To reduce spread via contaminated objects:

  • everyone who lives in or is visiting the building should frequently wash or sanitise their hands. Sanitiser should be available at entry and exit points and shared areas

  • avoid touching your face and your food unless your hands have been freshly cleaned

  • regular cleaning of shared spaces is important, including lift buttons, handrails, and door handles

  • rubbish bins should be kept in separate areas to other supplies to avoid cross-contamination.

Additional measures to reduce airborne spread include:

  • plumbing and ventilation systems should be maintained to ensure they’re operating effectively, particularly as buildings age

  • HEPA filters in air conditioners may help to filter out the virus.

Other outbreaks highlight the importance of effective infection control

In the Amoy Gardens outbreak, a visit by one infected person to the apartment complex led to more than 300 cases in the block, and subsequent cases outside the block.

Similarly, Ruby Princess passengers were responsible for about 10% of COVID-19 cases in Australia at the time the ship left Australian waters in April. Cruise ships have a comparatively high density of people in confined and shared spaces as do residential tower blocks.

Finally, in Melbourne’s quarantine hotel bungle, we’ve seen what can happen when infection control measures are not implemented properly.




Read more:
Melbourne’s lockdown came too late. It’s time to consider moving infected people outside the home


Prior planning is vital

Until we have a vaccine, outbreaks in other tower blocks are likely.

While “hard lockdowns” come with problems and challenges, quarantine can prevent the further transmission of infection across the wider community and makes sense from a public health perspective.

The first thing to do is develop a clear plan with procedures for residents and support workers in advance so it can be implemented at short notice. Public health units can develop these plans but governments are ultimately responsible for directing this.

Residents must be clearly informed (in multiple languages) about the plan and what they need to do. Support workers must be trained on strategies to reduce infection transmission.The Conversation

Thea van de Mortel, Professor, Nursing and Deputy Head (Learn & Teaching), School of Nursing and Midwifery, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Despite Court Victories, Church Building in Indonesia Blocked


Islamists attack, issue threats to halt construction of worship center in West Java.

JAKARTA, Indonesia, September 22 (CDN) — A year after a church in West Java won a court battle over whether it could erect a worship building, Islamic extremists have blocked construction through attacks and intimidation tactics, church leaders said.

A mob of 50 Muslim extremists on Sept. 12 attacked construction workers at the Batak Christian Protestant Church (Huria Kristen Batak Protestan, or HKBP) site in Cinere village, near Depok City, in Limo district, eyewitnesses said; the 24 workers, who were on break, fled from the attackers, who chased them brandishing wooden boards studded with nails. Cinere village police arrived to restore order, but the mob left behind seven banners opposing the construction.

Three days later, Islamic groups demonstrated near the construction site on Puri Pesanggarahan IV St., demanding that all Christian activities in the area cease. About 70 Muslims participated in the demonstration, trying to approach the construction site until hundreds of police repelled them. Police have continued guarding the site.

The church won a case in West Java State Administrative Court on Sept. 17, 2009, rescinding a local order that had revoked the church’s building permit. The Supreme Court later upheld the Bandung court’s ruling, but threats have kept the church from proceeding.

Betty Sitompul, vice-chair of the church building committee, said she has received many intimidating text messages from a group opposed to the construction.

“They demanded that the church construction be halted,” she told Compass.

Sitompul added that some of the messages were intensely angry, and that all were aimed at stopping construction.

She said she an official of the Depok municipal government contacted her requesting that construction be delayed two months in order to discuss it with area residents. With a Supreme Court decision backing their case, church leaders declined and continued building.

Sitompul said she never yielded to threat or intimidation because the church construction project has a firm legal basis in the Supreme Court decision.

“There was no need to worry any longer,” she said. “I felt the problem was solved. It is normal for some to be dissatisfied.”

The Muslim Defenders’ Front (Front Pembela Islam, or FPI) reportedly participated in the Sept. 15 demonstration, but the FPI leader for Depok City, Habib Idrus Al Gadhri, denied opposing the area HKBP church.

“The rejection is from the Cinere Islam Solidarity Forum [FSUM] not from the FPI,” Al Gadhri told Compass.

He said that the HKBP church in Cinere is not facing opposition from the FPI but from the entire Muslim community.

“If FPI members are involved, I’m not responsible,” Al Gadhri said. “My advice is for the entire Muslim community in Cinere to sit down together and not demonstrate.”

The church had originally been granted a building permit in 1998. Applications for church permits are often fraught with difficulty in Indonesia, leaving many congregations no choice but to worship in private homes, hotels or rented conference facilities. Such gatherings leave churches open to threats and intimidation from activist groups such as the FPI, which in recent years has been responsible for the closure of many unregistered churches.

 

Congregational Concern

Despite having the law on their side, church leaders said many in the congregation are haunted with dread amid outbreaks of Islamic ire at the presence of churches in West Java, such as the Sept. 12 attack on the HKBP church in Ciketing, Bekasi, in which an elder was seriously wounded and a pastor injured.

Peter Tobing, head of the Cinere HKBP church building committee, said that some in the congregation and building committee feared that the outbreaks of Islamic opposition will lead to chaos.

The church is planning to sue the Depok municipality based on the allegation that its actions were illegal and caused deterioration at the site. When Depok Mayor Nur Mahmudi Ismail revoked the building permit for a multipurpose building and house of worship on March 27, 2009, it led to losses for the church as the congregation had to leave it unattended for a year, according to Tobing.

“Because of this, construction began with the clearing of weeds and building materials [such as paint] that had degraded,” Tobing said.

Sitompul said the bases for the lawsuit are the court decisions declaring the Depok mayor’s revocation of the building permit to be illegal.

“The Depok municipal government must take responsibility for the losses incurred when the building permit was revoked,” she said.

The lawsuit will seek compensation for damages incurred over the last two years, she said.

“We are going to submit all the data to the Depok government,” Sitompul said. “Then we will file our suit in the Depok Municipal Court.”

The church plans to construct its multipurpose building on a 5,000-square meter lot. Construction was halted in the initial stages, with the bottom floor 30 percent completed. The church had spent some 600 million rupiahs (US$66,000), with total costs projected at 2 billion rupiahs (US$220,000).

Report from Compass Direct News

Christians in Jos, Nigeria Fear Further Attacks


Churches burned following assault on Catholic church in volatile Plateau state.

LAGOS, Nigeria, January 19 (CDN) — Gunshots and smoke continued to alarm residents of Jos in central Nigeria today, with the Christian community fearing further violence from Muslim youths who on Sunday (Jan. 17) attacked a Catholic church and burned down several other church buildings.

A 24-hour curfew imposed yesterday in Jos and the suburb of Bukuru by the Plateau state government was extended through Wednesday. Police said continuing violence was initially triggered by Sunday’s unprovoked attack by Muslim youths on worshippers at the St. Michael’s Catholic Church in Nasarawa Gwong, in the Jos North Local Government Area.

Also burned were buildings of the Christ Apostolic Church, Assemblies of God Church, three branches of the Church of Christ in Nigeria and two buildings of the Evangelical Church of West Africa, Christian leaders said.

The number of casualties continued to grow, reportedly reaching more than 100 as security forces tried to rein in rioters, with both Christian and Muslim groups still counting their losses. Hundreds have reportedly been wounded.

“We have been witnessing sporadic shootings in the last two days,” said the Rev. Chuwang Avou, secretary of the state chapter of the Christian Association of Nigeria. “We see some residents shooting sporadically into the air. We have also seen individuals with machine guns on parade in the state.”

Avou said many of those who are shooting are civilians, not policemen, and that they have been mounting road blocks and causing chaos in the area. At least 35 people have been arrested.

“What we have witnessed only goes to show that the problem in the state is far from over,” he said. “Many families have been displaced. There are a number who are receiving treatment in the hospital. The dusk-to-dawn curfew imposed in the state has not solved any problem, as there is still tension in the land.”

Avou said the crisis broke out when Muslim youths pursued a woman into a church during worship on Sunday, wreaking havoc on the service.

“Some Muslim youths invaded some churches and started burning and destroying properties,” he said. “We were told that the youths pursued a lady to the church. Nobody knew what the lady did. What we just discovered was that the entire atmosphere was ignited and houses were being burned.”

A Muslim group in the area, however, dismissed claims that Muslim youths ignited the tensions. They accused Christian youths of stopping a Muslim from rebuilding his house.

State Commissioner of Police Greg Anyating stated that Muslim youths were to blame for setting off the violence.

As violence continued today, there was a mass movement of Christians and Muslims from areas where rampaging youths were unleashing mayhem on the city despite heavy security. The Nigerian army was reportedly summoned to try to restore order.

The Rev. Ignatius Kaigama, co-chairman of the state Inter-Religious Council and Catholic Archbishop of Jos, condemned the recurring civil disturbances in the state and called on all to “sheath their swords and be their brothers’ keepers.”

The secretary of the Pentecostal Fellowship of Nigeria, Pastor Wale Adefarasin, said attacks on Christians are a manifestation of terrorism in the country.

“What we should realize is that the government is not helping situations,” he said. “It is an illusion that Nigeria is safe.”

He added that terrorism affects both Christians and Muslims negatively, and that it is the duty of elected officials to ensure that terrorists are detected early and deterred.

“The Muslim fundamentalists want to take over Jos by all means,” Pastor Adefarasin said. “They claim that Jos is a Muslim state, which is not true.”

Violence hit the same area on Nov. 28-29, 2008, when murderous rioting sparked by Muslim attacks on Christians and their property left six pastors dead, at least 500 other people killed and 40 churches destroyed, according to church leaders. More than 25,000 persons were displaced in the two days of violence.

What began as outrage over suspected vote fraud in local elections quickly hit the religious fault line as angry Muslims took aim at Christian sites rather than at political targets. Police and troops reportedly killed about 400 rampaging Muslims in an effort to quell the unrest, and Islamists shot, slashed or stabbed to death more than 100 Christians.

The violence comes at a time of a leadership vacuum in Nigeria, with illness requiring Muslim President Umaru Yar’Adua to leave the country on Nov. 23 to seek treatment in Saudi Arabia.

Sectarian violence in Jos, a volatile mid-point where the predominantly Muslim north meets the mainly Christian south, left more than 1,000 people dead in 2001. Another 700 people were killed in sectarian outbreaks of violence in 2004. Located in Nigeria’s central region between the Muslim-majority north and the largely Christian south, Plateau state is home to various Christian ethnic groups co-existing uneasily with Muslim Hausa settlers. 

Report from Compass Direct News 

PAKISTAN: MUSLIMS ATTACK 110 HOMES OF CHRISTIANS


Beating of field worker leads to hatchet attack on his family, then on all village Christians.

LAHORE, Pakistan, July 3 (Compass Direct News) – After a Muslim beat a Christian field worker for asking him to let him pass on Tuesday (June 30), a cleric in a village near here used a mosque loudspeaker to announce a call to attack Christians that resulted in more than 500 Muslims ransacking and looting at least 110 houses.

With the mosque falsely broadcasting the accusation that the Christian had blasphemed Islam, the Muslim recruits rampaged through Kasur district’s Bahmaniwala village, breaking down gates, wrecking and plundering homes and in some cases beating Christian women. They set various items ablaze including vehicles, though Compass found fire damage to homes was minimal.

“We don’t even have potable water, as they have damaged the turbine,” villager Zareena Bibi told Compass. “We knew about the incident, but could never imagine that they would wreak such devastation. They have not spared a single house here.”

Outraged that the lower-class Christian field worker on his tractor had asked the Muslim to move out of his way, 15 to 20 Muslims had previously mounted a hatchet attack on the family of the field worker, 37-year-old Sardar Masih, wounding his brother’s head, family members told Compass.

Masih told Compass that after his family members had sought treatment at a local hospital – where medical staff members denied them local anesthesia for their stitches because they were Christians – they learned that a call to gather had been issued from a local mosque regarding the altercation.

“We were told that in that meeting they decided to blame Christians for blasphemy of their Islamic religion,” Masih told Compass. The Muslims in the meeting, he added, then schemed with Muslim cleric Muhammad Latif of Maanwala, who appealed from the mosque loudspeaker for villagers to gather to “teach Christians an exemplary lesson.”

Latif, who heads a vigilante group called Sunni Force, also managed to recruit Muslims from other hamlets, Masih said. Soon the number of Muslims swelled to 500 to 800, according to the eyewitnesses.

The ensuing attack began with the breaking of electricity meters at 110 homes, cutting their power, area Christians said.

Damages and Threats

Masih told Compass the triggering incident began when he and his 10-year-old son, Waqas Masih, were returning from the fields on a tractor at 7 p.m.

“When we entered the village, Muhammad Hussein and his nephew had parked their motorbike in the middle of the road,” Masih said. “I requested them to get it aside, and Hussein said that he did not know how a ‘sweeper’ [chuhra, a derogatory term designating lower-class Christians] could order him. I was with my son, and I only requested them to let us go as we are getting late.”

He said Hussein was drunk from a nearby wedding celebration.

“I only made the request, and then they got up on the tractor and dragged me down and began beating me,” Masih said. “Then my son ran home and told my family members.”

Masih’s brother, 32-year-old Ashraf Masih, told Compass that he was at home when Waqat arrived out of breath saying that two men were beating his father. Ashraf Masih and brothers Mushtaq Masih, 35, Tariq Masih, 25, and Shahbaz Masih, along with their cousins Shafiq and Vikram Masih and 65-year-old father Chanan Masih, rushed to the site. By the time they arrived, Ashraf Masih said, a large crowd had gathered, but they were only exchanging harsh words and the conflict was cooling down.

“I told Muhammad Hussein that whoever he is, he has no right to lord it over them,” Ashraf Masih told Compass, adding that as they were leaving Hussein asked how could chuhras talk to them that way.

After the brief encounter, Ashraf Masih said, they went home back, not knowing that Hussein and his cohorts were planning to attack them. After half an hour, he said, Hussein and 15 to 20 other men armed with sticks and hatchets launched their assault on their house.

“They broke the door and smaller walls, and they beat my father, my mother and paternal uncle,” he said.

An assailant delivered a blow with hatchet to the head of his brother Mushtaq Masih, Ashraf Masih said, and blood gushed out. Other brothers also received hatchet wounds.

“When we realized that our life was in danger, we recklessly fought and made them flee,” he said. “Three of their men were also injured, but I don’t know their names.”

Afterward village official Muhammad Shafiq went to the family and warned them not to go to police, he said.

“We followed his advice, but he cheated on us,” Ashraf Masih said. “He took the Muslim party to the police station, where they got an FIR [First Information Report] registered, and then Shafiq and Manawala Deputy Mayor [Zulfiqar Ali] Bhutto took them to a hospital to get a medico-legal report.”

The family learned 90 minutes after the altercation that the Muslim assailants had gone to the police station, he said.

“Then we also rushed to the Sadar police station, but the police told us that an FIR had already been registered of the incident so they could not write another report,” Ashraf Masih said. “Then we went to Kasur Civil Hospital to obtain medical treatment, but when we entered the hospital they were already sitting there, and with them were Muhammad Shafiq and Dr. Bhutto.”

The injured Masih family members were shocked, he said, to learn that Shafiq had brought the assailants to the hospital but had told them not to go to the police station or the hospital for treatment.

After waiting for hours for medical treatment with no one paying them any attention, he said, at 5 a.m. their wounds were stitched without local anesthesia.

“The medical staff treated us like animals, and even made us sit outside all night,” Ashraf Masih said.

After the received basic first-aid treatment, Ashraf Masih said, his brother Sardar Masih suggested that they not go home for a few days, as the police had filed the Muslim assailants’ FIR. “Only our women were at home when our house was attacked the next day,” he said.

In spite of the assault on the family the day of the triggering incident, local Christians said no one foresaw the attack on the community on Wednesday (July 1).

“We thought that it was just an ordinary clash and would settle down with the passage of time, but they not only came back and attacked us, they then did havoc to all Christian families,” said Chanan Masih, the brothers’ father, adding that there was no justification for the attack on all the Christian villagers. “We used to visit their houses and even respected their Muslim call to prayer.”

On that day most of the men were away harvesting crops and others had gone to the Lahore Vegetable Market to sell them, while still others were busy getting Christians bailed out in the case filed against them. Area Christians said that most of their homes were therefore defenseless.

The Muslim mobs entered homes where mostly women and children were present and in some instances beat the women, local Christians said. In other instances, they said, women ran up to their roofs or to nearby fields and hid themselves to save their honor and lives.

“In one sad instance, a young girl who was taking bath got so nervous that she ran to the fields stark naked,” said one local Christian. “Such was the perilous state after 15 to 20 men entered each Christian house after breaking down gates.”

Throughout the violence that began about 7:30 p.m. and lasted two hours, area Christians said, the assailants threatened to throw all Christians out of the village.

Local resident Zareena Bibi told Compass that the looters stole from her son, Vikram Bashir, money from recent crop sales – 200,000 rupees (US$2,470) – along with 70,000 rupees (US$865) in cash gathered at his marriage the previous week. The attackers also stole a gold ornament from his bride worth 30,000 rupees (US$370).

Naseem Masih told Compass that her family had gold and more than 200,000 rupees looted. Amid broken glass, she pointed toward damages to two doors, a window grill, a fan, crockery and kitchen utensils that could no longer be used. Her mother-in-law said that they made her remove her gold earrings.

“My son got married only three months ago,” said one area Christian. “They took out new clothes from trunks and threw them on the floor so that they may not remain useful. They also gathered such articles and put them on fire. They were shouting that they would throw out these ‘sweepers’ from here.”

Sardar Masih said that his family’s house was especially hard-hit during the violence and looting. The attackers not only damaged his tractor, he said, but they put sandy soil in its engine that rendered it nonfunctional. The tractor was the main source of income for the family, he added, and without it they were left virtually unemployed.

“They have tried to make us completely poor and without any home,” he said.

Expel and Ostracize

Similarly, Naseem Masih told Compass that the assailants had burned their 10 donkey carts. And a few area Christians also reported that some families had been deprived of the dowries they had accumulated over the years for their daughters yet to be given in marriage.

Local resident Allah Ditta told Compass that he had gone to Lahore Market to sell crops.

“We were informed over the phone that Muslims had attacked us,” he said, adding that the assailants beat his wife and children and also looted 100,000 rupees (US$1,235) from his home.

Local Christians said that on Wednesday (July 1), at about 2 p.m. several young Muslims gathered and began chanting slogans calling for the expulsion of Christians, saying, “We will not let them live here.” By 2:30 p.m., the area mosque was announcing that no shop should provide anything to Christians and that they should totally ostracize them.

“This announcement was made by Maulvi Latif,” one Christian said. Maulvi is an honorific referring to an expert in Islamic law.

Another Christian said that Latif had twice before created problems for Christians, though on a smaller scale. Area Christians and Muslims have lived next to each other peaceably for more than a century and had good relations, village Christians said.

“There has never been any such incident before,” said one Christian.

When Compass entered the village and asked about the conflicts this week, Muslims claimed complete ignorance of them.

Talks and Restoration

The Community Development Initiative (CDI) advocacy group is facilitating talks between the two sides, though mistrust still runs high in the area, said CDI Research Officer Napoleon Qayyum. He said the CDI requested that Water and Power and Power Development Authority (WAPDA) Managing Director Tahir Basharat Cheema ensure that electricity be restored to the houses of Christians.

After the request, electricity was provisionally restored to several Christian families until new electricity meters are installed, he said, adding that WAPDA has begun installing new electricity meters at no cost as well. Qayyum said that Mushtaq Masih had requested that the CDI take up the case of the brothers, and that the organization would provide legal assistance to others who were injured with the help of the American Center of Law and Justice (ACLJ).

CDI is also providing meals to all 110 families, he said.

“Our partner, ACLJ, is constantly monitoring the situation and is providing its full support in this difficult time,” Qayyum said. Several Christian organizations were visiting the area and providing help to the injured, he said, adding that the only area church building was unaffected by the assault.

Muslim Leaders Appalled

Among Muslim leaders, Pakistan Peoples Party Member of Provincial Assembly (MPA) Chaudhry Ahmed Ali Tohlu told Compass that the culprits must be brought to justice. Tohlu asserted that Muslims would be able to repeat such violence only over his dead body and those of other like-minded Muslim leaders.

“I am born in a Muslim family, but today I am feeling bad because of what my fellow Muslims have done,” he said.

Member of National Assembly Sheikh Wasim of the Pakistan Muslim League-Nawaz said, “Christians are our brothers and sisters, and what has been done to them is very unjust, and being a Muslim I apologize to the Christian community in my capacity.”

Divisional Police Officer Kasur Sultan said the violence “is a shameful incident,” and Union Council Nazim Sardar Fakhir said, “We all are ashamed, and those who instigated the matter should be brought to book.”

Human Rights and Minority Affairs Provincial Minister Kamran Michael said that Chief Minister Shahbaz Sharif had told him over the phone to go to the village and express solidarity with the Christian community. He pledged that all damages would be covered by the government.

“Our religion teaches peace, so we should forgive the culprits, but the government will take action against the culprits,” Michael said.

MPA Joel Amir Sahotra condemned the looting that characterized the attack.

In the aftermath of the violence, police, civil administration, politicians and Christians of the area met, CDI’s Qayyum said, and established a 12-member committee to keep watch and inform authorities of any wrongdoing.

“Till the time things are normalized, anyone found fueling the matter would be punished, and the committee is responsible for informing the police,” he said. “After the meeting, Deputy Mayor Zulfiqar Ali Bhutto and I went together in the mosque and Bhutto made a public announcement on the loudspeaker.”

The deputy mayor announced from the mosque that what took place was shameful and that all the shops must resume selling everything to the Christian community, he said.

Area Christians, however, said they remained fearful of new outbreaks of violence.

Report from Compass Direct News