COVID-19 and supply chain risk mitigation: a case study from India

PurposeThis study prioritizes the supply chain risks (SCRs) and determines risk mitigation strategies (RMSs) for the Indian apparel industry to mitigate the shock of the COVID-19 pandemic disruption.Design/methodology/approachInitially, 23 SCRs within the apparel industry are identified through an extant literature review. Further, a fuzzy analytical hierarchy process (FAHP) is utilized to prioritize the SCRs considering the epidemic situations to understand the criticality of SCRs and determine appropriate RMSs to mitigate the shock of SCRs during COVID-19.FindingsThis study prioritized and ranked the SCRs within the Indian apparel industry based on their severity during the COVID-19 disruption. Results indicate that the demand uncertainty and pandemic disruption risks are the most critical. Based on the SCRs, the present work evaluated and suggested the flexibility and postponement mitigation strategies for the case under study.Research limitations/implicationsThis study has novel implications to the existing literature on supply chain risk management in the form of the FAHP framework. Supply chain practitioners from the other industrial sectors can extend the proposed FAHP framework to assess the SCRs and identify suitable mitigation strategies. The results aid the practitioners working in an apparel industry to benchmark and deploy the proposed RMSs in their firm.Originality/valueThe present study is a unique and earlier attempt to develop a quantitative framework using FAHP to evaluate and determine the risk mitigation strategy for managing the SCRs during the coronavirus epidemic.

Mucormycosis—The Rising Epidemic in a Pandemic: An Observational Case Study in a Tertiary Care Hospital

Mucormycosis is a rare and ominous fungal disease caused by the order Mucorales fungi. As per Indian data, uncontrolled diabetes is the main risk factor associated with mucormycosis. But during this SARS COV-2 pandemic, a huge rise in the number of mucormycosis cases has been observed in different states in India in last 10-12 months in the second wave. The immune dysfunction caused by this virus and the use of high doses of steroids appears to be a double-edged sword and causes immunosuppression with hyperglycemia, increasing the risk of secondary bacterial and invasive fungal infections (IFIs). Objective We conducted a prospective observational study involving individuals with proven mucormycosis in ABVIMS & Dr RML Hospital, New Delhi. The demographic profile with various clinical presentations, histopathological findings, predisposing factors, management, and final outcomes were recorded. Results We included 53 patients in our study. Rhino-orbital-cerebral mucormycosis was the most common (21/53, 39.6%) presentation followed by rhino-orbital (17/53, 32.0%), rhino-cerebral (10/53, 18.8% ) rhinosinusitis (4/53, 7.5%) and pulmonary involvement in 1/53, (1.8%). The cutaneous involvement was seen in 8 patients (15.0%), disseminated mucormycosis as meningitis in 2 patients (3.7%), and dual fungal infection with aspergillosis was seen in 2 patients (3.7%). The predisposing factors being diabetes mellitus (40/53, 75.4%), with newly diagnosed diabetes in previously undiagnosed (10/ 53, 18.8%), SARS-COV-2 (33/53, 62.2%), steroid intake (30/53, 56.6% ), prolonged hospital stay (29/53, 54.7%), use of oxygen therapy (19/53, 35.8%), and diabetic ketoacidosis in 2 patients (3.7%) Amphotericin B (liposomal form) was the primary therapy in all 53 patients. Hypokalemia (8/53, 15.0%) was seen as side effect of amphotericin-B although renal functions were normal in all patients. Surgical debridement was performed in 43(77.3%) patients and transcutaneous retrobulbar amphotericin-B (TRAMB) was given in 16 patients (30.1%). Total mortality in our study is of 9 patients (16.9%). Conclusions Diabetes mellitus was the dominant predisposing factor in all forms of mucormycosis which also includes newly diagnosed diabetes. Hyperglycemia and immune dysregulation by SARS-CoV-2 and high dose corticosteroid use on large scale served a favorable environment for this invasive fungus.

Experiences of Urban Slum-Dwelling Women With Maternal and Child Health Services During COVID-19 Pandemic: A Multi-City Qualitative Study From India.

Objectives: The COVID-19 pandemic containment necessitated the diversion of substantial health care resources thus affecting the routine essential care, and posing barriers to achieving the Sustainable Development Goals (SDGs). We explored the experiences of vulnerable communities-urban-slum-dwelling women regarding maternal and child health services during COVID-19. Methods: We conducted 48 in-depth interviews in four Indian states-12 in each state among urban-slum antenatal, intra-natal, and postnatal women. We used framework analysis. Results: Amidst the implementation of the mandatory stay-at-home, many women acknowledged that routine immunization services and antenatal check-ups remained uninterrupted, and were mostly provided at the community level. To prevent transmission, the family members and relatives had restricted visits to the health facility during labor or post-delivery. Women preferred to have a shorter hospital stay post-delivery and reduced routine postnatal check-ups for fear of infection. Conclusion: India has a variety of national and state-level programs focused on improving MCH indicators to achieve the SDGs. COVID-19 inadvertently interrupted some components of health services, insinuating the need for a disaster or pandemic-resilient MCH services delivery system.

Examination of Hotel Management Aspirants' Perspectives Towards A Career in the Technologically Inclined Hospitality Sector-Special Reference to the Housekeeping Industry

The Indian travel & hospitality industry has exponentially developed and has the substantial potential of the amazing social and chronicled legacy, landscapes, and places of natural characteristic excellence spread over the nation. The Indian hospitality and travel industry helps the nation in generating revenue and plays a highly significant role in creating sources of foreign exchange. 39 million opportunities for new jobs were created in 2020. Moreover, the no. of jobs will be increased to 52.3 million in the travel industry of India by 2028. Covid19 has a severely deleterious influence on the educational system of the entire world. Thus, the entire educational platforms i.e. from kindergarten to the universities have been shut down due to the high density of population to avoid the spread of the deadly coronavirus. Propitiously, having gained the experience from the epidemic 2003 SARS, educationalists of the hospitality world are ceaselessly changing reaction activities to the obscure pandemic situation and applying their best to keep up the activity of the training framework. The study investigates 443 students of hospitality management which are in the final year of their graduation. Thus, this paper is an attempt to understand the perception of hotel management aspirants', with special focus given to the housekeeping department.

COVID-19 Lesion Segmentation and Classification of Lung CTs Using GMM-Based Hidden Markov Random Field and ResNet 18

COVID-19 has been circulating around the world for over a year, causing a severe pandemic in every country, affecting billions of people. One of the most extensively utilized diagnostic methodologies for diagnosing and detecting the presence of the COVID-19 virus is reverse transcription-polymerase chain reaction (RT-PCR). Various ideas have been proposed for the detection of COVID-19 using medical imaging. CT or computed tomography is one of the beneficial technologies for diagnosing COVID-19 patients, the need for screening of positive patients is an essential task to prevent the spread of the disease. Segmentation of Lung CT is the initial step to segment the infection caused by the virus in the lungs and to analyze the lungs CT. This article introduces a novel Hidden Markov Random Field based on Gaussian Mix Model (GMM-HMRF) method ensembled with the modified ResNet18 deep architecture for binary classification. The proposed architecture performed well in terms of accuracy, sensitivity, and specificity and achieved 86.1%, 86.77%, and 85.45%, respectively.

Pulmonary Embolism as Post-COVID-19 Sequelae: Role of Lung Perfusion Scintigraphy.

We present the case of a 41-year-old male, suspected to have pulmonary thromboembolism with a history of coronavirus disease 2019 (COVID-19) infection 1 month ago. He presented with dyspnea and dry cough for 2 weeks. D-dimer was >776.70 mcg/L. Lung perfusion scan with Tc-99m macroaggregated albumin revealed multiple bilateral segmental perfusion defects with no mass lesion/consolidation on high-resolution computed tomography (CT) of lungs suggestive of pulmonary embolism (PE) present according to perfusion only modified PIOPED II criteria. CT pulmonary angiogram showed a large filling defect in the right pulmonary artery. The case emphasizes the prolonged sequelae following COVID-19 after recovery from the acute phase of the illness. Lung perfusion scintigraphy can play an important role in the screening of such patients who may be at risk for developing PE as post-COVID-19 sequelae.

SARS-CoV-2 in wastewater: Challenges for developing countries.

The COVID-19 pandemic that has engulfed the world, has affected the human lives in several aspects. The detection of SARS-CoV-2 in faeces and urine of the infected person, even after viral clearance in the respiratory tract, and its presence in untreated wastewater raises the possibility of fecal-oral transmission in future. The situation is likely to be more aggravated in developing and least developed countries struggling with the problem of ineffective waste disposal system, open defecation, poor sanitation, and limited access to clean drinking water. In this review, the available data on wastewater treatment, sanitation status and healthcare infrastructure from middle- and low-income countries is collected and correlated with the risk associated with the fecal-oral transmission of SARS-CoV-2. The review also highlights the limitation of COVID-19 surveillance through sewage monitoring in these countries owing to the absence of proper sewerage system. An inclusive approach of awareness, prevention, and mitigation from global to the local levels is required to overcome this challenging situation in developing countries.