Australian director Roderick MacKay braved COVID-19 restrictions to make a “daunting” trip to the Venice film festival, where his debut feature The Furnace premieres on Friday (Sep 4).

MacKay had to get permission from Australian authorities to leave his own country, quarantine in Rome for two weeks before travelling to Venice, and will have to quarantine again when he goes back to Australia.

“Travelling during this time in history is sort of just a little bit daunting for any purpose,” 33-year old MacKay, who filmed a video of his journey and self-isolation on his mobile for Reuters, said in an interview.

“But to be doing so, to come to a top tier festival like Venice, to have your debut film premiere on the world stage, it’s certainly a whole other layer of dauntingness,” he said, adding he was happy and honoured to be at the world’s oldest film festival.

The Furnace, which is in the Horizon section outside the main competition, tells the little known story of cameleers brought to Australia by the British empire from India, Afghanistan and Persia in the second half of the 19th century and the local Aboriginal people they befriended.

The Venice film festival is the first such international event to go ahead in front of live audiences since the coronavirus pandemic shut much of the movie world down. It runs until Sep 12.

(Reporting by Hanna Rantala, Writing by Silvia Aloisi; Editing by Raissa Kasolowsky)

BARCELONA: Captain Lionel Messi has told Barcelona he wishes to leave the club immediately, a source confirmed on Tuesday (Aug 25), deepening the turmoil within the Catalan side less than two weeks after their humiliating 8-2 defeat by Bayern Munich.

The source said the club received a burofax from Messi’s lawyers declaring that the player, who has spent his entire career at Barca, wished to leave. A burofax is a service used in Spain to urgently dispatch a document through a certified email, which issues a digital certificate with legal validity.

The club subsequently sent Messi a burofax, stating they wanted him to stay and finish his career at Barca, added the source.

A second source added that the burofax Messi’s lawyers sent referred to a clause in the last contract the 33-year-old Argentine signed with the club in 2017 which allowed him to leave for free, a clause that expired on Jun 10 this year.

Under the terms of the contract which expires in 2021, the only way Messi can leave without the club’s consent is if a rival side pays his release clause of €700 million (US$828 million).

“The club considers that the contract is fully binding until 30 June 2021,” added the second source.

The Argentine’s request to leave Barca comes a day after Spanish media reported that new coach Ronald Koeman told Messi’s close friend and strike partner, Luis Suarez, that he does not wish the Uruguayan to stay at the club.

Other reports said that Chilean midfielder Arturo Vidal, Croatian midfielder Ivan Rakitic and French defender Samuel Umtiti have also been told they are no longer wanted.

Barca are in the midst of overhauling their squad following the 8-2 defeat by Bayern in the Champions League quarter-finals earlier this month, which condemned the club to a trophyless season for the first time in 12 years.

Messi, who has been named world player of the year a record six times, has grown increasingly unhappy in the last 12 months with how the club is being run under president Josep Maria Bartomeu.

In February, he lashed out at then sporting director Eric Abidal on social media and a couple of months later turned his anger on the club hierarchy for the way in which players were forced to take a pay cut to cope with the financial hit of the coronanvirus pandemic.

After Barca surrendered the La Liga title to Real Madrid in July, Messi slammed the team as being “weak” and “vulnerable” during an uncharacteristically fiery post-match interview.

BACKED BY PUYOL, SUAREZ

Former Barca captain Carles Puyol backed Messi’s wish to leave the club by writing on Twitter: “Respect and admiration, Leo. You have all my support, friend.”

Suarez then replied to Carlos’ tweet with two clapping emojis.

Ex-Barca president Joan Laporta blamed Bartomeu for the stance taken by Messi.

“Bartomeu and his board should quit immediately. They have undermined Messi to save them from the sporting and financial mess they have created. If they quit there might be some hope that Messi stays at Barca,” he tweeted.

Catalonia’s regional leader Quim Torra appeared to accept that Barca’s best ever player, who in 2019 was given the Creu de Sant Jordi award for services to the region, was about to leave.

He tweeted: “Catalonia will always be your home. Many thanks for all the happy moments and for your extraordinary football. We have been so lucky to share so many years of our lives with the best player in the world and a noble sportsman.”

SINGAPORE: The team from Tan Tock Seng Hospital (TTSH) and the National Centre for Infectious Diseases (NCID) has been here before.

For the first time since February, there are only around 20 COVID-19 patients warded in the NCID. At its peak, it had around 500 patients.

The NCID screening centre, led by TTSH’s emergency department, is scaling down. And it feels almost like it was when CNA Insider first met the team.

During the lull of late February to early March, Singapore’s recovery rates outpaced infections. And going back to business as usual was an option for the hospital.

But it soon proved to be the last thing possible when travellers and returning Singaporeans brought a wave of cases to the screening centre. For close to seven months, our cameras kept rolling.

In our final interview with Charmaine Manauis, who is part of the team leading efforts at the screening centre, the doctor finally does not look like she is rushing somewhere.

We ask her how she feels looking back, now that things have quietened down. While she is usually composed, words fail her at this point.

She thinks of the manpower that came together to run the screening centre, and begins to tear up. “The screening centre is going to (be here for) a long time,” she says.

We remember, once again, the weight of a hospital’s work in this crisis and how drawer plans were put to the test, pivots were made and lessons learned.

This is an exclusive look behind the scenes at Singapore’s dedicated outbreak facility and how TTSH-NCID fought the COVID-19 battle to come out on top so far.

THE SCREENING CENTRE ENTERS THE STORM

On the afternoon of Mar 24, we receive a call from TTSH, which is shifting beds across the road to the NCID — so could we be there in an hour?

As it turns out, the day before was, in Manauis’ words, “the most terrible Monday”. There was an attendance of 523 at the screening centre, which until today is the most people the centre has seen.

WATCH: An exclusive look inside the NCID screening centre (Dur 5:20)

“The patients (had to) wait outside (for) two hours. Inside, we really needed to run,” says senior staff nurse Yu Yong, who volunteered to triage patients at the screening centre the first chance she got.

Singapore’s border restrictions for several European countries had kicked in, and many of the students and workers who flew home translated into more suspect cases.

READ: PM Lee urges returning travellers to stay home, isolate themselves

The proverbial storm had arrived, just weeks after the country saw a slowing rate of infection. It was time to make room for potential admissions at the NCID, which shared resources with TTSH.

We make it to TTSH’s geriatric ward 9D in time. It is eerily quiet, if not for the 20-odd nurses gathered around the 20 beds meant to “double stack” wards at the NCID.

Confirmed COVID-19 patients were going to be put in isolation rooms of two, rather than have a room to themselves, as there was “no theoretical transmission risk”, says NCID clinical director Shawn Vasoo.

The NCID wards were designed to scale up from 330 to 586 beds, he adds.

After the nurses set off with the requisite equipment — down lifts, around bends, through doors, across a linkway connecting the two buildings — less than an hour and multiple trips later, NCID Ward 5F is stocked.

Even with beds already on standby at the NCID, opening a ward is not as simple as it sounds, or looks.

TTSH chief nurse Hoi Shu Yin recalls that Feb 5, a day after Singapore’s first community transmission happened, was one of the most stressful times for her department.

The patients who contracted the coronavirus while working at the Yong Thai Hang health products shop triggered a change in the definition of a suspect case, to include those in close contact with Chinese travellers.

The attendance at the screening centre jumped from about 70 to more than 300 overnight. Back then, anyone being checked at the screening centre was admitted for isolation as a precaution, and only four wards were open at NCID.

It took 100 beds, in less than 24 hours, and a lot of manpower to outpace the surge.

WATCH: CNA Insider exclusive⁠: Inside TTSH’s fight against COVID-19 (Dur 32:33)

READ: Inside Singapore’s COVID-19 screening centre, on the front line against the disease

“There’s a lot of coordination to make sure the medication’s there, the linens are there, the kitchens catered the bento food for our staff … (since) they wouldn’t be able to leave the ward to purchase food,” Hoi says.

The materials management department supported them with supplies, the housekeeping team put up curtains and bedsheets in the wards, and engineers had to make sure the airflows were correct, says her counterpart, NCID nursing director Margaret Soon.

Since the day NCID opened in 2018, she adds, they have been drilled for this, but “it was a real test”.

On top of that, they have a military-inspired computer system to thank. Like the hospital’s nerve centre, the Command, Control and Communications (C3) system gathers data from all across TTSH-NCID, such as on supplies, patient flow and bed occupancy.

On the night the definition of a suspect case changed, C3 detected a surge of patients coming to the screening centre. The sustained high number “set off an alarm bell”, says TTSH chief operating officer Jamie Mervyn Lim.

“Very quickly, we activated the drawer plans,” he says. “We don’t want to be reactive, but (rather) to be ahead of the signs and signals that are presenting on the ground.”

By the time patients were admitted, there were enough beds for them.

THE PIVOT FROM FRONT LINE TO LAST LINE

On the same day the NCID’s capacity was expanded via the bed movement exercise, the Ministry of Health announced its first community isolation facility, D’Resort NTUC.

This was a “turning point” in Singapore’s isolation strategies, says Vasoo, whose job is to inform policymakers about clinical data from the ground.

With most of the cases sent to NCID before then, its clinicians learnt that age and medical history largely affected the severity of the virus infection.

“Most of the patients, thankfully, didn’t need ICU care. They didn’t need oxygen support. Their symptoms were mild, and generally they recovered uneventfully,” said Vasoo.

“We knew that such well patients probably shouldn’t be in an acute hospital bed … Those (beds) should be reserved for patients who are (sicker).”

His team then “came up with safe criteria to inform policymakers” about who were suitable for external care, the kind of monitoring the patients needed and the “criteria to re-refer these patients back to acute hospitals”.

Then came the peak of the pandemic in Singapore, when positive cases went up anywhere from over 400 to 1,000-plus daily among foreign workers. The need to conserve healthcare capacity was no more apparent than then.

The NCID’s wards were filling up again, and the centre activated its expansion plans.

Six general wards in TTSH were converted into isolation wards to house migrant workers who tested positive and needed hospital care. Those who were recovering well were discharged to community isolation facilities , like the Singapore Expo and Changi Exhibition Centre.

But was this all part of TTSH-NCID’s drawer plans? Were they really, as touted, always one step ahead of the pandemic? They were “flexible”, NCID executive director Leo Yee Sin replies with a wry smile.

While the Severe Acute Respiratory Syndrome (Sars) outbreak in 2003 lay the base for most of TTSH-NCID’s outbreak response, she was careful to answer whether they were more prepared for COVID-19, given that “outbreaks come in different shapes and sizes”.

“I’d say, we thought we were prepared because we had the past experience,” said the professor, who was part of Singapore’s Sars fight as an infectious diseases doctor.

A lot of times I think we kind of underestimated the Sars-CoV-2, or COVID-19.

But chief of what they learnt from past experiences with infectious diseases, she stressed, was flexibility.

“It may not already be in your plan, but you must have a system where it’s flexible enough so that it becomes situation-based and we can still respond effectively.”

To this end, being able to preserve healthcare capacity for those who require it, by moving patients into community isolation facilities, “enabled (the hospital) to save as many lives as possible”, says TTSH chief executive Eugene Fidelis Soh.

This was especially important during the peak of the pandemic here, he adds. And as far as war metaphors go for COVID-19, no one puts it quite like him.

“We started as the front line of the outbreak response,” he says. “As local transmissions started to occur in the community, the front line of the outbreak response shifted into the community.

“That meant we became the last line of defence.”

WHEN THE FIRST DEATHS STRUCK

While most of Singapore’s COVID-19 cases came and went without serious complications, a fraction wound up in the intensive care unit. On Mar 21, Singapore saw its first two deaths.

For ICU nurse clinician Gu Chunguang, this year’s experience in a pandemic has been sorely different from her nearly 20 years seeing “life and death almost every day”.

This time, “even in (the patient’s) last moment”, family members were not allowed to hold the patient’s hand and say their goodbyes properly.

“They need to say their goodbye (on) the phone,” says Gu. “What you all see is outside the ICU ward. What we see is the reality and the sickest patients among all the COVID-19 (cases) we have.

Unfortunately, some patients, because of their age or their co-morbidity … despite our every effort, still pass on.

When the physicians think the patient might die soon, Gu helps to coordinate with medical social workers on a time for family members to call the ward’s dedicated mobile phone.

Then, in personal protective equipment (PPE) and the phone in a Ziploc bag, she takes them to their loved one.

Some family members “respond (in) anger”, and in one case, fainted during the video call, Gu recalls. “We feel sorry for the family … we just feel helpless.”

And among the patients, she can “see fear in their eyes”.

“Imagine when you try to snorkel, you breathe through a straw. And when this straw is almost closed, and you’re gasping for air, you try to hold on to something, but you can’t hold on,” she says.

In those quiet moments, she would hold the patient’s hand. “Mr So-and-so, we’re here with you,” she would say. “We’ll do our best to make sure your last moment is comfortable.”

The ICU team — comprising physicians, respiratory therapists, pharmacists, among almost 16 roles — started seeing patients in February and were busiest in March and April.

They tended to young and old, locals and migrant workers. Most of the time, the patients were intubated for life support.

“The trajectory for critically ill patients … can be very tumultuous,” said Vera Lim, a consultant doctor in the department of anaesthesiology, intensive care and pain medicine.

A patient can become “very, very ill, very, very suddenly”, multiple organs could be deteriorating at once and the patient would need a concoction of about 10 types of medication.

That is where ICU pharmacist Neo Rui Yi comes in. “ICU patients really change (condition) hour to hour. So we do quite a lot of frequent dose adjustments,” she says.

A patient, at any point, has at least 12 to 13 healthcare professionals to provide round-the-clock care, say Ng Ziqin, a senior resident doctor in respiratory and critical care medicine.

Some of the sickest patients were migrant workers who were young and fit. Tending to these patients “was an emotional period for (her) personally”.

One worker who “etched a deep memory” was so ill he needed to be laid prone on his belly, “to improve the oxygen delivery to the lungs,” she recounts.

This takes five to six healthcare workers to do and is especially difficult if the patient is unconscious and hooked up to many tubes.

One of the toughest parts of the job, however, comes a step before helping the patient, says senior respiratory therapist Emelin Tan.

It comes when rushing to wear, in sequence, an N95 mask, goggles, shower cap, yellow gown and gloves, going through one door to an “anti-room” and then waiting for that door to close before the door to the patient opens — while the patient is gasping for air.

While necessary, it is the sense of helplessness that upsets Tan. “I have to get through all these physical barriers first, just to go in and offer reassurance,” she says.

Ultimately, she and the team try to remember that they are doing their best. “If a patient passes on … it’s more (about) how they passed on. That’s important to me,” she adds.

FAIL-SAFE, NOT FOOLPROOF: STAFF INFECTIONS

When it is all hands on deck to manage a pandemic, the last thing a hospital needs is an in-house cluster.

On Mar 30, in the thick of the imported cases, an NCID porter tested positive for COVID-19, the first of 10 staff infections (as of Aug 28).

In 2003, there were 97 probable Sars cases among healthcare workers, when TTSH was the main hospital dealing with the outbreak.

READ: 66 COVID-19 cases among healthcare workers and support staff

The porter was a 20-year-old Malaysian, who was in Malaysia from Mar 16 to 17 just before the country’s movement control order set in. He reported onset of symptoms on Mar 28 and was confirmed positive the next day.

The department of clinical epidemiology got down to work immediately.

It took one click on the staff surveillance system to identify his “first generation” contacts in the hospital, specifying those who had interacted with him for more than 30 minutes — thanks to a tracking device for everyone in the NCID.

“That helps us determine who’s a close contact versus someone who just walked past,” says Angela Chow, the doctor who leads the department.

If a contact was “unfortunately” not in PPE, “then we can quickly identify who had been exposed before the person becomes symptomatic”.

On top of the tracking system, all staff must input their temperature twice a day. A dedicated team watches this data closely, especially from those working at the screening centre and outbreak wards.

When staff fall sick with respiratory symptoms, TTSH-NCID “insists” that they visit the screening centre rather than a family doctor, to “close the gap as to where they’d go”, says Brenda Ang, the clinical director of TTSH’s infection prevention and control department.

“You could say this is Big Brother watching you, but just say this is a friendly father, a hospital observing people for staff safety.”

Underlying the surveillance system are the hospital’s infection control measures, which hinge on basic things, like posters and instructional videos to remind staff how to don and doff their PPE safely. Every staff member, even contractors, is also “mask-fitted” for the most suitable N95 mask.

It was found that none of the 10 infected staff members contracted COVID-19 in the course of their work, notes Chow.

THAT MISLABELLING INCIDENT

More than half a year after work for COVID-19 began, with the microbiology laboratory’s testing capacity ramped up from 500 to 2,000 tests a day, Adjunct Assistant Professor Partha Pratim De’s nightmare comes true.

A mislabelling incident leads a student to be incorrectly diagnosed with COVID-19.

The TTSH head of laboratory medicine pushes back our interview, scheduled the next day, by a week. When we meet again, he tells us it was just not a good time.

“The honest answer is that it was a very simple, basic error. But around that, there were a whole lot of other contributory factors. A lot,” he says.

READ: Jurong West Secondary student incorrectly diagnosed with COVID-19, TTSH apologises for ‘human error’

The Jurong West Secondary student had her specimen “cross-labelled” with a migrant worker’s owing to a “human error in the laboratory”, according to a TTSH media release on July 14.

With the case reclassified, the Education Ministry said there was no student-to-student transmission.

The polymerase chain reaction (PCR) test, as CNA Insider witnessed in our very first shoot inside the testing lab, is a very manual task.

WATCH: How COVID-19 testing is done in Singapore (7:10)

Lab technicians must be precise in handling, measuring and transferring the specimens, even in the wee hours, since COVID-19 testing was taking place 24/7.

“In the past, we were having to manually enter the patients’ details. And for a thousand of those, in the middle of the night, that’s quite a lot, when the PCR team is trying to do the more complicated, actual PCR work,” says Partha De.

“This was … distracting them, and they were more likely to make errors.”

READ: ‘We can’t afford to make any mistake’: Inside a COVID-19 testing lab in Singapore

The patient registration and results entry processes are now automatic, “which helped to reduce the fatigue”. What machines cannot do, however, is relieve the “psychological demands” of the job.

“Even when we tell them to take their time … (the staff) have a very service-oriented mentality. They know there are patients waiting at the end of this, and they want to do their best,” says Partha De. “So we’ve had to try and manage all of that.

“I have to support them. I have to keep them going.”

READY FOR A SECOND WAVE

Asked how the past six months have been for him, he says one word “sums it up”. “Very tiring,” he replies with emphasis. “But it’s been necessary.”

While other hospital departments are gradually returning to pre-COVID-19, the lab’s workload has doubled as Singapore’s testing strategy expands. The lab almost hit its maximum capacity of 2,000 tests in 24 hours in July, and is averaging 1,000 a day.

“Previously we were doing diagnostic testing, which is of people who have symptoms,” says Partha De. “That’s now moved on to screening, which is testing of people who are well, who have no symptoms.”

They include construction workers, schoolteachers and delivery riders, to name a few.

The lab is “expecting that COVID-19 will become a new normal respiratory virus that we’ll test for every year”, as with swine flu, H1N1 and the seasonal flu. “Hopefully with a vaccine against it as well,” Partha De adds.

Places like Australia, Hong Kong, Japan and South Korea have seen a resurgence of COVID-19 cases. Despite the slowdown in Singapore, TTSH’s emergency department — while it has released its augmented manpower to their conventional roles — is not letting up.

“Every day, I’d look at the newspaper, and I’d see a little bit of an increase … in the community cases, and then we’d get worried,” said Manauis. The department is, however, prepared.

“In case of surges, we already have workflows in place … We have standby manpower that can be activated within eight hours,” she cites. “Our infrastructure’s already in place, so we’re ready.”

To ensure that doctors are not “de-skilled” regarding screening centre protocols, she continues to lead monthly trainings for doctors from the surgery, radiology, psychiatry and neurosurgery divisions, she says.

She is also training new staff continuously “so that existing medical staff don’t get burnt out”.

In a Talking Point episode, Lim the COO outlined some of the “contingency plans in place” for a second wave, such as standby beds and facilities, fully equipped.

“In 24 to 48 hours, we’re able to ramp up,” he told the programme.

As for other patient services, chairman of TTSH’s medical board, Associate Professor Chin Jing Jih, said a “hospital services prioritisation committee” has been formed.

“We get the doctors to prioritise many of the needs of these patients … That helps us to not overwhelm ourselves, and reserve some of this capacity in case a second wave arrives,” he said.

“The principle is to ensure that patients are triaged according to their needs and those who require timely treatment aren’t deprived.”

TTSH-NCID have also collaborated with other hospitals to take on urgent cases “in the event (the hospital) is overwhelmed by demands”.

WATCH: COVID-19 second wave: Is Singapore ready? (21:08)

A SENSE OF DUTY

For all their plans, to Soh the CEO, the most important factor in the hospital’s state of readiness is its people.

“Our people choose to join TTSH, knowing that one day they may be called upon to serve in the front lines of an outbreak response here in Singapore,” he says.

“To them, this is a sense of duty.”

Dietetic technicians have rolled up their sleeves to help the security department marshal vehicles. Corporate communications specialists have taken on visitor registrations. And of course, doctors, nurses, allied health workers and ancillary staff have stepped up at the screening centre and outbreak wards.

It has been a united front against the pandemic. As of Sep 7, the NCID has admitted more than 4,000 patients with COVID-19 infection.

“I’m tremendously proud of my colleagues. They’re marvellous. They’re kind hearted, and they give the best in their care,” says Soh.

As for planning ahead, it is post-Sars 2003 all over again. “We learn with every outbreak. So for me, NCID will always be a work in progress.”

MAHANOY CITY, Pennsylvania: Mike Gaval looks out from the Gilberton coal-fired power plant down the valley to Mahanoy City, the town he grew up in, and up the hill to the wind turbines spinning on the horizon.

Gaval would be the last person to call himself a coal critic. For 30 years, he’s worked at the plant, which supplies power to the local prison and the grid; before that, his grandfather was a miner who blasted massive seams of anthracite and brought it to the surface.

His hometown is a place made, and unmade, by anthracite, the coal that fuelled the Industrial Revolution, provided heat for millions in sprawling cities, spawned rail networks and still heats homes in Mahanoy City. Trucks carrying anthracite and its byproducts constantly run back and forth through town, coating the old row houses that line the main street with a layer of gray dust.

But the glory days of coal are long gone, and Gaval wrestles with its legacy in heating not just homes and boilers, but the planet.

“With climate change and how the industry I work in is contributing to that, it could be somewhat of a struggle, especially if you have kids. It makes you wonder: Are you doing the right thing?” said Gaval, 56, a husband and father of two sons. “But on the other hand, people have got to work. And for people in this area, this has been their whole life.”

The two generations of the Gaval family, Mike and Cindy and their sons, Justin and Michael, are woven into the fabric of Mahanoy City. Both Mike and Michael played on the high school football team, the Golden Bears. Today Michael volunteers as a coach, but he dreams of leaving, if he can whittle down a mountain of student debt.

Cindy is from Shenandoah, 10 minutes away, and has recently returned to work sorting goods at an Amazon warehouse near here after taking months off to protect the family during the coronavirus pandemic. Justin took a job at a plastics plant after driving gun trucks down ancient alleys in Afghanistan while serving in the Army Reserve.

But even though they’re deeply rooted in Mahanoy City, they’re also a minority in this region: voters who didn’t support Donald Trump in 2016 and who won’t vote for the Republican president in November, in a town where Trump signs sprout everywhere and no Joe Biden signs are to be seen, even though the Democratic nominee for president grew up in another blue-collar town, Scranton, an hour away.

This year, the country almost seems at war with itself, over politics and the coronavirus pandemic, race and the economy, climate change and energy. Far from the streets of protest and the halls of power, the Gavals nonetheless find their lives intersecting with this moment of American crisis from Mahanoy City, a small town that gets smaller every year.

This is the story of an American family and an American town, both struggling with what they once were – and what they will be.

A TOWN IN DECLINE

Mahanoy City, a grid of row houses, many crumbling, used to bustle. It took off during the Civil War when demand for anthracite soared. Soon after, the abundant work the mines offered, no education necessary, brought waves of Irish, Welsh and Lithuanian immigrants. Eventually the town boasted an Opera House, a brewery and more than 120 bars.

A century ago, the population tipped 16,600. Now, it’s less than 4,000 – and falling. The thriving shops and saloons have been replaced by Dollar Generals and Family Dollars and a smattering of bars that take turns being open on different nights because of the low demand. Until it was demolished a few years back, the abandoned Kaier brewery loomed over the edge of downtown, its broken windows and mouldering interior a haunting symbol of the town’s decline.

Several row houses surrounding the Gavals’ home are collapsing. The sons and Mike keep teasing Cindy that they should buy them up. But Cindy figures that all they have to do is wait for them to fall down or get to the point where they will have to be demolished, then get them for next to nothing.

Cindy, 54, said she doesn’t talk politics in this town in Schuylkill County where 70 per cent of voters went for Trump in 2016, even though Trump won Pennsylvania by only a little over 1 percentage point four years ago and now faces a tough challenge from Biden. Polls of Pennsylvania voters show the former vice president leading Trump by about five percentage points.

“There’s a lot of Trump lovers,” she said about the people she works with, most of whom she counts as pals. “And we don’t agree on it, so I don’t say nothing, or we’d get at it. I’ll throw a little dig here and there about Trump because I don’t like him. But it is what it is. There’s nothing I’m going to do to change it. So you just got to kind of go with the flow.”

Michael, 26, was an all-state quarterback, rushing for 30 touchdowns and passing for 12 in his final high school year. But that wasn’t enough to get a free ride through college; after graduation he had US$115,000 in loans, more than four times what his parents’ home is worth.

He lives with Mike and Cindy, working for the Pennsylvania Department of Aging, helping to oversee probes into abuse and neglect of seniors – work that got a lot tougher when the coronavirus pandemic brought face-to-face inspections to a halt. He hopes to cut enough debt to move to Florida or North Carolina one day with his fiancé, Kattya Palacios, who is also loaded down with student loans.

Justin, 33, lives 10 minutes away in neighbouring Frackville and works 12-hour shifts at a factory that makes fibers from superheated plastic. The fibres are used in things like disinfectant wipes and face masks; business has been good during the pandemic. But it’s also a job without much room for advancement.

When he got out of the service, he worked for six months at a state-run juvenile detention centre, but after the mental and physical stress of serving in Afghanistan, he had a hard time dealing with arguments with the kids there. He also worked at a steel plant, where he admitted to voting for former President Barack Obama, and “I was called the N-word lover. So, I mean, that’s like openly out on the shop floor at work.”

Justin thought about working for a superstore, but the job didn’t offer health insurance right away. Then he found the plastics plant, which offered insurance from day one. Although many workers in the United States earning higher pay take health insurance for granted, getting a job with insurance can be difficult; only 49 per cent of Americans receive employee-sponsored health insurance, according to the Kaiser Family Foundation.

On climate change, he’s like his dad. “We both think that taking care of the environment is an important part of what our society should be doing today,” he said. “We know that it’s doing bad things to our environment.”

Justin, who says he thinks “humanity’s facing a crisis,” worries about giant plastic graveyards in the oceans and his role contributing to it, but he also realises the demand for the factory’s products is unlikely to drop anytime soon.

“I understand that on a personal level I can’t do anything to change that; this has to be a huge governmental policy,” he said. “It has to be tackled on that level, or else nothing’s going to matter, in my view.”

DOWNWARD SPIRAL FOR COAL

One day Mike walked around town with Michael and Kattya, talking about growing up in a town that was falling down around them.

They stopped at some wooden steps that led up a hillside to an old brick building, its windows and doors boarded up, “Mahanoy Area” in big black letters above the entrance. Mike said it was the middle school he went to, but it had long been abandoned.

On the main street, a poster advertised the annual meat raffle fundraiser poster in the window of the Mahanoy City Elks Lodge, an elegant building that used to be a theatre.

When he was young, Mike tried college but never settled on a major and dropped out. Afterward, he was working at a grocery in town when Cindy got pregnant. He needed better pay, so he sought work at a breaker, which smashes coal into chunks to heat homes and businesses, and then heard about work at the coal power station. Since Mike has been at the plant, coal has gone from powering half of US electricity to less than a quarter.

Despite Trump declaring that the regulatory “war” on coal is over, coal plants keep shutting and US coal output last year fell to its lowest level since 1978.

Mike, a longtime fan of US space missions, first heard of global warming from James Hansen, the NASA scientist who testified before Congress about the threat of climate change back in 1988. “When I saw his name with NASA, that sort of gave it a little air of credibility, I would argue.”

He began to worry about how his work was contributing to the problem.

“I could always say I was just a small piece of the puzzle. But then if everyone says that, that’s the whole puzzle,” he said. “Hopefully I didn’t do too bad, screw it up too much.”

Meanwhile, market dynamics are getting worse for coal. Natural gas is plentiful, and Pennsylvania is a top producer of the fuel. Costs for solar and wind power are falling. Besides looming regulations on coal plant emissions after the Trump era, coal has other costs. Its plants need frequent maintenance, and the constant stream of ash they produce must be taken away and disposed of.

The region’s other coal plant shut recently, but Mike expects the Gilberton plant, where he does everything from working the control room to the ash unloader, to keep running for the foreseeable future. The plant runs on culm, basically the waste that’s left over from anthracite production. There are black mountains of culm all over the region, hundreds of thousands of tons left over from more than a century of mining.

Cindy has often thought they could move somewhere else and seek other opportunities. But Mike is content with Mahanoy City, his family and friends. He might not agree on politics with a lot of people in town, but he finds that eventually they help one another out, no matter their views.

“You just try and split the divide between what you feel is right and wrong and try and find common ground,” he said.

Instead of dwelling on today’s troubles, he prefers to have faith in the next generation to make progress.

“If you look at the history of almost any country, you are going to go through those types of times,” he said. “I think eventually they will move forward with it all, and come out, I think, in a better spot.”

SINGAPORE: Inevitable.

That was the word Health Minister Gan Kim Yong used on Jan 22 when describing the possibility of an imported case of the Wuhan coronavirus in Singapore.

Singapore is a global transport hub, he reasoned. And the situation in China is constantly evolving, with Thailand then Japan also announcing confirmed cases.

READ: Singapore confirms 3 new cases of Wuhan virus; total of 10 infected

It all started at the turn of the new year, when Wuhan in China’s central Hubei province announced the outbreak of a cluster of severe pneumonia. More than two weeks later, on the same day Mr Gan spoke to reporters, 17 people in China had died from the new virus, with more than 470 confirmed cases.

Mr Gan also announced that he would jointly lead a multi-ministry task force to tackle the spread of the virus in Singapore. After SARS infected 238 and killed 33 people here in 2003, this was serious business.

Just a day later, the inevitable happened.

Singapore had its first case of the Wuhan virus.

HOLIDAY TO HOSPITAL

On Jan 20, a 66-year-old Wuhan resident flew with his family to Singapore from Guangzhou on a China Southern flight. The next day, he developed a fever and began coughing.

READ: Wuhan virus in Singapore: What can you do?

When he visited Singapore General Hospital on Jan 22, he was immediately isolated, diagnosed with pneumonia and identified as a suspect case at 10pm. The next evening, he tested positive for the new coronavirus.

Singapore had been gearing up for this moment.

Initially, authorities implemented temperature screening at Changi Airport only for travellers from Wuhan. This was soon extended to all travellers from China , with those found to have pneumonia and recent travel history to China isolated.

In China, authorities locked down Wuhan in an attempt to contain the fast-spreading virus. Scoot, the budget arm of Singapore Airlines, cancelled flights to the city.

Before the first case was announced, Prime Minister Lee Hsien Loong took time out of the annual economic meeting in Davos to give his first public comments on the situation. After the SARS episode, Singapore was better prepared to deal with another outbreak, he reassured.

Additional measures came swiftly. Singapore expanded temperature screening to land and sea checkpoints, as authorities braced for a high volume of travel during the Chinese New Year holiday.

READ: Wuhan virus in Singapore: What we know about the confirmed cases

SECOND AND THIRD CASES

In the early hours of Jan 24, Mr Lee in his yearly Chinese New Year message said Singaporeans should be calm but watchful . The Government was implementing measures to keep everybody safe and healthy, he added.

Later that afternoon, the Ministry of Health (MOH) announced two more confirmed cases of the virus: The 37-year-old son of the first case and a 53-year-old woman from Wuhan who arrived in Singapore via a Scoot flight on Jan 21.

According to MOH, the woman had visited Orchard Road, Marina Bay Sands and Gardens by the Bay, and used public transport like taxis and the MRT. But officials stressed that the risk of transient contact was low.

This did not stop Singaporeans from snapping up masks, thermometers and hand sanitisers at pharmacies islandwide, with reports of long queues and empty shelves. MOH, however, said the supply of masks was more than sufficient .

Back in Wuhan, anxious foreigners awaited evacuation. People were told to stay at home as public transport had been halted and the healthcare system was overwhelmed. On Jan 25, Singapore’s Ministry of Foreign Affairs said it was in touch with 35 Singaporeans in Wuhan , stating that they were well.

Also that day, Malaysia announced its first three cases of the Wuhan virus, all linked to Singapore’s first case.

FOURTH AND FIFTH CASES

On the evening of Jan 26, Singapore confirmed its fourth case : A 36-year-old Chinese man from Wuhan who arrived in Singapore with his family on Jan 22.

The next day, the task force announced to a packed press conference that it was ramping up measures to combat the outbreak. This included increased border checks and compulsory leave of absence for students, teachers, healthcare and eldercare workers returning from China.

READ: Wuhan virus outbreak – At a glance

Furthermore, several university hostels , government-linked chalets and the Outward Bound camp on Pulau Ubin were being prepared as quarantine facilities, as authorities anticipated a potential spike in the number of people needing to be isolated.

Task force ministers took turns detailing the Government’s strategies, including how it plans to ease the potential impact on workers and the economy . They also revealed that officials were working with China to repatriate Singaporeans stuck in Wuhan.

National Development Minister Lawrence Wong, who co-leads the task force, said Singapore should be psychologically prepared that the Wuhan virus could be worse than SARS , although he said it was too early to tell how the two compared.

Meanwhile, the World Health Organization updated its Wuhan virus risk level to “very high in China, high at the regional level and high at the global level”. It admitted that it had incorrectly stated in previous reports that the global risk was “moderate”.

MOH officials highlighted that the ministry was working with healthcare stakeholders to improve its virus testing capabilities, even as scientists around the world scrambled to find a vaccine .

Later that evening, Singapore confirmed its fifth case : A 56-year-old Chinese woman from Wuhan who arrived in Singapore with her family on Jan 18. This comes as the WHO said it was still probing if the virus could spread before symptoms emerged.

SIXTH AND SEVENTH CASES

On Jan 28, Singapore announced its sixth and seventh cases , both Chinese nationals from Wuhan: A 56-year-old and another 35-year-old man who arrived in Singapore on Jan 19 and Jan 23, respectively.

The Government had indicated that it was prepared to do more if necessary , with such efforts soon becoming apparent.

At the same press briefing, authorities announced that Singapore would stop entry or transit for new visitors who have travelled to Hubei in the last 14 days, as well as holders of Chinese passports issued in Hubei.

The country would also suspend new visas being issued for holders of Chinese passports issued in Hubei, as well as previously issued short-term visas and multiple-visit visas. The measures follow similar restrictions in places like Malaysia , Mongolia, Hong Kong and Macau .

Social media had been buzzing with discussions, questions and speculation about the virus.

Later that evening, the Protection from Online Falsehoods and Manipulation Act (POFMA) Office issued a targeted correction direction to Facebook over two posts claiming that Woodlands MRT station was closed due to the virus.

It was the second correction notice issued in relation to the Wuhan virus, following a HardwareZone Forum post claiming that a person in Singapore had died from the virus. Earlier, the Government had stressed the need for swift action against such falsehoods.

NO END IN SIGHT, BUT SOME GOOD NEWS

This is especially as the virus is expected to stick around for some time.

Experts warned that the outbreak could last months, as research emerged that the virus could have been present in China since Dec 1 , a full month before Wuhan raised the alarm.

READ: PM Lee says Singapore ‘better prepared’ for another virus after SARS outbreak

Global efforts to combat the virus also started to pick up momentum. On Jan 29, the United States announced that it was developing a vaccine for the deadly virus, although the process could take six months before moving to the next phase.

Scientists in Australia also said they had successfully developed a lab-grown version of the Wuhan coronavirus, the first to be recreated outside of China, in a breakthrough that could help combat the global spread of the illness.

The virus sample would be used to generate an antibody test, allowing detection of the virus in patients who had not shown symptoms, and create a vaccine.

Russia also revealed that it was working with China to develop a vaccine, stating that Beijing has handed over the virus genome to rapidly develop express-tests that can identify the virus in the human body within two hours.

EIGHTH, NINTH AND 10TH CASES

In the evening of Jan 29, Singapore confirmed its three latest cases , again all Chinese nationals who travelled from Wuhan.

The eighth and ninth cases are a married couple – a 56-year-old woman and 56-year-old man. They arrived in Singapore on Jan 19 and are currently isolated at the National Centre for Infectious Diseases (NCID).

The 10th case is a 56-year-old man who arrived in Singapore on Jan 20. He developed symptoms on Jan 21 and was admitted to NCID a week later, after being identified as a suspect case at a health screening station at Marina South Pier.

“This is consistent with our assessment that more imported cases are expected from Hubei province,” MOH said, reiterating that there is currently no evidence of community spread in Singapore.

WHAT NEXT?

With China reporting more cases and deaths as the days go by, and the virus continuing to spread to more countries, the global challenge to contain the virus is self-evident.

In Singapore, efforts to deal with the challenge have intensified, with more in the pipeline if necessary. Still, as Mr Lee pointed out in a Facebook post on Jan 26, people have to go about their work and lives, to make sure the country’s systems continue to run smoothly and things get done.

He said: “We must remain vigilant and take precautions to protect ourselves, but as the saying goes, Keep Calm and Carry On.”

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