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Elderly people amid reports that some Nursing Homes have been practically abandoned by workers relatives are turning to Digital Technology to help keep in contact and smokers light out for one last time in restaurants in tokyo a ban on indoor smoking goes into effect in one of the last major cities where its still allowed its hoped a band will also help fight the coronavirus. Im sorry kelly walk into the program italy has held a minutes silence to remember be 11 and a half 1000 fellow citizens who have died in the corona virus pandemic. Flag the nation wide were lowered to half mast as here in rome as overburdened hospitals and Health Workers struggled to cope it till the remains the epicenter of the pen demick in europe with almost 102000 people infected a nation wide lockdown has been in place for weeks and the government has warned that it could know could go on for much longer and joining me now from rome is correspondent seem a good does so you know its striking really to see this shift in italy since the outbreak began i mean we had videos a few weeks ago of residents on a balcony singing and now silence and youre absolutely right sara i mean its from singing to silence singing for solidarity and sign and sooty to remember all the victims the more than 11500 victims people who have died with tobit 19 as well as to all of the Health Care Workers that are fighting this infection this pictures disease and its important to remember all of that more than 11500 victims you did you do have at least 61 doctors that have lost their lives to cope 19 of the flags were flying at half mast all throughout the as well as at the vatican and a real a somber reality of that stan greenfield for many people to remember that said that the authorities are trying to stress the fact that the number of new infections does appear to be stabilizing and some have pro projected that perhaps the peak of infection could arrived within the next 7 to 10 days and in the meantime we know that residents have been under Strict Lockdown for weeks now it was supposed to end on friday but now its been extended until at least april 12th thats Easter Sunday how are people coping with such a long lockdown like this. You know youre right its day 22 now of this lockdown in a lot of families of course theres a massive psychological stress just being cooped up at home and having to juggle work life as well as family life and school life for their children thats for those who are lucky enough to have jobs unfortunately there are those that are really struggling literally do make ends meet because youre either unemployed or for instance particularly in the south of the country which is poorer and has a high Unemployment Rate you have people who often do clandestine work or work in the black as they say even that work has run out and so they are struggling just to buy food to feed their families and thats why the government has set aside 400000000 euros to be distributed among all the Town Councils that they would use to set up through douchy so that people can feed themselves and their families and that will be an additional 4300000000 euros of help on its way that said though there is concern about the Economic Impact all of this is happening here in italy and theres some concern that the European Countries north should be doing more to help in italy and perhaps create a more. Solidarity in terms of helping you to deal with its debt crisis as well and so a lot of medias as well as regional officials have written a letter to germany for a greater coordination is as one has done after will war to all kinds of measures on the Table Including a socalled corona bond sima group to joining us with the view from rome today thank you. Well spain has europes 2nd highest death toll behind italy with nearly 8200 deaths but with elderly people at high risk Nursing Homes in spain have been overwhelmed by the number of infections there are reports of poor conditions and relatives fear for their loved ones because they are banned from visiting them our correspondent john Philip Schultz has this report from seville. What is happening behind these windows concerns many spaniards almost 2000 nursing home residents have died after contracting the coronavirus every day more homes are affected rafael morenos uncle has parkinsons and lives in a nursing home in Southern Spain a while ago he learned that the 1st cases of coronavirus had been diagnosed there too since then he tells me the residents of the nursing home and their relatives have become increasingly worried. So what are they doing to do with it just because at least. I cant work has complained about terrible conditions in many homes they say theres not enough protective clothing and that hundreds of their colleagues are infected authorities are investigating reports that some workers went home after the 1st cases were identified leaving residents forgotten their bets the dramatic situation in many Nursing Homes has shocked people here in spain the spender society takes pride in its Strong Family ties and in taking well care of people possible criminal neglect and the feeling of helplessness among family members has started to affect the south. And a lot of spaniards fear that the situation in Nursing Homes might get worse in the coming days. In the nursing home where. Lives the management of whats approved now but are frail and the other relatives feel a little bit closer to their loved ones. Or brazil has latin americas highest number of reported coronavirus cases more than 4500 but that has not stopped the countrys populous president boasts an audio of downplaying the danger posed by the pandemic Brazils Health minister has openly contradicted the president saying that people need to protect themselves through social distancing now social media giants are stepping into the fray they are moving posts showing the president disregarding Public Health advice. Brazils far right president jebel sonora likes to portray himself as a man of the people. But his closeness to the people in these images has proved too much for social media platforms Facebook Instagram and twitter. Theyve now removed this video accusing both sonora of putting lives at risk by ignoring official guidelines on social distancing but also narrow is unrepentant. This total isolation if it goes on like this in the future we will have a serious problem with the brutal amount of unemployment it will take years to resolve. The president alleges his aim is to protect the poor who are suffering the most those jobs are destroyed because of quarantine measures he says people need to get back to work but this stance has put him at all its not just with official advice from Health Professionals imploring people to stay at home but also with the majority of brazil state governors a many local politicians they have busy repurchasing venues such as the samba drive in. Turning it into a shelter for the homeless and vulnerable for the duration of the pandemic bracing for the onslaught. I think everyones appeal is stay at home the home is this one it will be the spaces that are being offered so the ideal is that they stay here and do not walk around the streets and be exposed to such a lethal virus these for our views if you dont want as a number of infections and deaths increases another big concern is how to stop the virus spreading among the citys favelas here theres often no Running Water or electricity and people are increasingly dependent on food handouts lets take a look now at some other ways corona virus is impacting people around the world russia has reported its biggest one day rise in new cases some 500. 00 bringing that countrys total to more than 2300. 00 authorities in belgium have confirmed the death of a 12 Year Old Girl infected with covert 19 although serious infections among the young remain rare several countries have reported exceptions and the World Health Organization is warning that even though the focus is now on europe and the United States the coronavirus pandemic is still quote far from over and asia and the pacific region. And the German Football League has confirmed that the restart date for the bundestag the will be april 30th at the earliest germanys Top Tier League has been suspended since march 13th the clubs agreed on tuesday that the suspension should be extended because of the coronavirus however games may still be played behind closed doors when the season resumes there are 9 rounds of matches left in the current one to sleep. Small Business Owners on the selfemployed in germany have been among the hardest hit by the coronavirus shutdown if help doesnt come quickly many will go under so the federal government and the german states have launched a variety of rescue packages but will they be enough to save everyone. Owns a small fashion shop like many other small Business Owners hes facing a host of problems meeting payroll and paying rent and other expenses like this spring collection which cost 20000. 00 euros in this area here spring jacket from flax have a kind of Expiration Date that depending on the weather probably may if we dont reopen before then well have a real problem if this problem. Hes receiving 9000 euros in Emergency Support from the state that will help at least for the moment thats good advice that its not enough if we dont make Additional Support available in 6 or 8 weeks will see the 1st bankruptcy 6 years off to a one year stint blitheness leave the clock is ticking up assure the hair salon in berlin the city unveiled a loan program for small Business Owners but soon after the program had gone on line the funds were tapped out. I was in minutes late the website shut down at 11 pm and reopened at 6 the next morning and this is what i saw i almost made it i almost got Financial Support my now its too late. To spend. Berlin has said it will replenish the pilot but its already becoming clear that rescuing all the countrys small Business Owners and the selfemployed would cost far more than initially expected and the tokyo summer olympics may have been postponed for a year but not a new law banning smoking the japanese capitol is one of the worlds major cities where people can still Smoke Cigarettes at restaurant tables the new ban was originally meant to make a leg dining smokefree but officials now hope that it will have the added benefit of slowing the spread of coronavirus though tokyo streets are more quiet these days its restaurants and bars still beckon after hours most welcome smokers but thats about to change a bad schedule to make the city tobacco free in time for the now postponed olympics comes into effect on wednesday Health Experts warn that smokers are likely to be more vulnerable to the coronavirus but that hasnt persuaded these patrons to quit. Of course they know that smoking increases my chances of getting the virus but i cant just stop its an indulgence. If i get the virus i get the virus theres nothing i can do about it then sorry. The impact on customers i guess fewer people will come initially theyll come as usual but if they cant smoke will gradually stop coming thats exactly what city authorities are hoping for with the number of corona virus infections on the rise they say people have to stop going out and socializing at bars and nightclubs. Constant these locations fall under all 3 locations for close contact that can result in a high risk of infection. Closed spaces with bad ventilation densely packed crowds of people and close distance between people. The governor has already asked tokyos residents to stay indoors but her requests arent binding and as much of life continues as usual medical experts in japan are calling on the government to declare a state of emergency before its too late. Youre watching dont forget our web site where there is all the latest news and information around the fact that theres that is that dot com you can also follow us on social media im sorry kelly n. P. R. Left you so much for joining us. Combating the corona pandemic. Where does research stand. What are scientists learning. Background information and news. Hour carona update. The covert 19 special and next on d w. The global corona crisis you can find more Information Online at e. W. Dot com and on t. W. Social Media Channels. This pandemic is overwhelming its just so many people that need the breathing machines that just simply havent been manufactured yet. Imagine youre a doctor and have a 30 year old patient and an 80 year old both infected with the coronavirus both strong severe symptoms and both need an oxygen mask but you only have one who should use this kind of decision is called tria which is french and the means deciding who has a higher chance of survival and is given a higher priority in medical treatment and who might be left to the. Doctors. Around the globe are taking these decisions right now what does that mean for those doctors and what are the ethics behind triology thats what were looking at today in all special coverage of the covert 19 crisis here on the w m god all things welcome it all comes down to how well the Health System is prepared for a pandemic in the end is the number of intensive care beds and ventilators that counts currently most Health System outside italy and france are holding the line but around the world hospitals are filling up trio might become a reality for doctors sooner or later. This is the worst Case Scenario when treating patients in front stopped as a force to make life or death decisions patients save the age of 81 not be put on mechanical ventilators this process is called tria. The time comes from the french 28 it means the sourcing of an allocation of treatment to patients modern medical triano was invented during the napoleonic wars france spain and italy of the worst affected countries in europe more than 100000 people have been infected with the virus in italy and i nearly 12000 have died and the longer the crisis continues the more often doctors are faced with making some very tough decisions and stalk about those decisions are now joined by dr to be escort is a physician and the epidemiologist the director also the director of the institute for Public Health of berlin start a hospital professor. Physician teaching medical ethics at Heidelberg University lets start with you dr corder were not yet doing in germany are doctors well prepared for taking these decisions. Well world orders are well prepared against other doctors in the world after training and the hospitals and physicians already stationed. Theoretical as in when whats reaction is necessary in germany it will be very challenging for a doctors and medical students here as well. To put how does trash work in a hospital is it just one doctor who ends up being the only one responsible and carries this burden well or certainly operating procedures in place so its going to imagine eventually you have a very short time to decide in which case it louis left by its leading position d in a medical teams on the side will get a better legs or not so its going to be a very challenging situation so therefore the support of the local law structures the hospital as well as the legal system is very important to support these medical teams to make these decisions but talking about these procedures the professor how can doctors and hospitals actually prepare for tria. Then i think. From an ethical point of humor and prepayment for these decisions is crucial for 2 reasons the question of uniform rules in order to ensure a fair education of resources. Across teams across units and hospitals and because doctors in their everyday clinical dont and im not familiar not at ease this as such decisions because the traditional clinical ethics is patient centered and not at for allocating patients at Different Levels of contingency care so from an ethical shift here we need to actually are 2 areas things 1st victory at forecourts that provides for a step by step evaluation and criteria for testing patients and in germany several medical association pettish recommendations but we are protocol last week with their ketamine for ethics in medicine in that heat and 2nd each hospital and test if and test out these fillers should be implemented and therefore actually asked teams that include expertise of intensive care physicians. Maybe even clinical ethics committees can support in setting up this process its think the most important think its s. And thing as doctors that there are only if they give it up is not to charge for the responsibility taken in these decisions thats one key issue of course but what about normal doctors say in the Community Village doctors who have common patients do they also or might they also face these ethical dilemmas. I think not those that this end is and the decision on. Who gets under ventilator is obviously not the primary care physician that they have at their tree as decisions if there are many patients who are going to transfer to the hospital. If there are many patients in need so i think the same criteria of seriousness and and comorbidities that go into the triac or the courts in the hospital can also be at night in the periphery for normal primary care physician or at least of importance for him. Coming back to you how well can you predict actually whether a person will probably die even if treated isnt that also a bit of a lottery but there are certain fuselage of parameters medical history medical experience of the trade in decisions that will help to support your decision but there is no certainty that to the minute decision is it is the right one and also theres only. So you can spend it it seems made a difference decisions the canoe up situation there will be a circle a learning curve. There and incident it seems a little early best to really use the arts or the rest of the arts professor winkler coming back to you as an ethicist what can you tell a frontline doctor who is facing a decision like that could you give us an example. Well i think 1st it would be employer groups or to acknowledge that these that have to sessions that kind of head out spend our common doctors ethics and summer test of fetch if you have such dilemma and then coming back to those rules and protocols that we have now is set up saying. There are different face this pandemic and if you have not enough mental it does for our patients who needs your have to pray or test though its. Certain that you will and that they will survive and then others and there we have clearly laid out criteria so that this was a good set Current Situation up the patient come up to tease frey if he isnt criteria but for example age just let it ride here that went into our recommendation and said cherry and if i think the 3rd thing that i would recommend is make. A way out of. A terrible suppliants in secular absolute terms because you know that this is a serious stress and more and otherwise stressing situation and this church as a bit up now or in the hospital as that slow relieve the stress that happens in trio situations professor having to and doctor to be a score thank you very much. And hours every day heres a science correspondent stare equal him for the couple of answers to questions that you have sent him keep them coming today its about how men and women can be differently affected by coping 19 its the covance gender gap. Study suggests men are more likely to catch covert 1000. 00 than women is that true it does indeed appear that men are more likely to test positive for the disease than women are in other words men make up more than the 50 percent of confirmed cases you would expect if the virus infected men and women with equal frequency. Are men more likely to die from cove in 1000 as well. Here the data is theres more conclusive and what its saying is that men are more likely to die after infection with covert 19 then women are the numbers are very striking for example in italy where over 70 percent of the confirmed patients who succumbed to the disease were men also the coronavirus really does appear to be more lethal for men than it is for women. So why are men more vulnerable than women. Like so much else about this virus we just dont know enough at this point to really pin down why its killing more men than it is women but researchers have hazarded some guesses on average worldwide more than women do men pursue behaviors that are considered to be health risks like smoking tobacco or were Drinking Alcohol and everyone should know those risks those unhealthy behaviors can also lead to what are called comorbidities those are conditions like like hypertension or a cardiovascular disease or chronic lung disease and many of the victims of covert 19 were elderly men with comorbidities yet other researchers are trying to cast some light on the issue by focusing on the biological and genetic differences between men and women could estrogen be playing a protective role for example maybe there are also some well documented immune system differences between men and women and whats most probable is that all of those factors social behavioral biological that theyre all going to play a role in why covert 19 is hitting men harder than its hitting women theres not going to be a simple straightforward explanation. On the Derrick Williams there keep the questions coming and that was our covered 900 special for more on the pandemic to check out our social Media Channels and our web site thats d w dot com of course which is dedicated covert 900 pages in 30 languages and now we want to leave you with a few images from that egypt the famous Great Pyramids unpleasant with messages of unity im solid out with those battling noble caracal and i was across the globe the 1st time last night stay safe. Thank you those keeping us safe flashed across the towering structure at the visa plaza. Even if the coronavirus is sending football into a forced rain. By doing we will still be bringing you that start. Small. And the stories eventually surrounding our favorite sport. Because we wont let the soccer fun stop just yet. Kickoff. Next on d w. On doing the crazy thing in full time. How to handle our new lives in times of the current of pandemic. D. W. Reporter this is just like everyone else is wrong and shes looking for answers and thankfully with the help of jamie expect to have a public policy. Issue is not life as we know it. All in this together our new web series. Closely. Listen carefully. Dont move to super. Nice to do good. Discover the world. Subscribe to the documentary on you tube. I dont want to look at the video was. Or i must be missing and

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