Vishwajeet Salunkhe and his brother Poorav wake up at 6 every morning. One sweeps the floor, the other mops, then one makes breakfast, while the other helps. Once breakfast is over, Poorav, who is 16 and studying in the tenth grade, uses his father’s old mobile phone to attend online classes. With his video off, he listens and makes notes – simultaneously, he also chops vegetables for their lunch.

By the time Poorav is finished, Vishwajeet, who is 19, is already by the stove in the adjoining kitchen, preparing their lunch. In the afternoon they eat together and get back to their studies. When there is free time, they watch something on television, but not for too long – the electricity bill is a perpetual concern. By late evening they are back in the kitchen to prepare dinner.

They seldom venture out to play with other boys in their neighbourhood, in the outskirts of the town of Osmanabad, Maharashtra. Between housework, studies and cooking, there is no time left. Their clothes are worn out, and there is scant furniture in their house. The ceiling and walls of their one-storey house are cracked and have started leaking during monsoons.

The two brothers live by themselves. This June, their father Prasad Salunkhe, who had been paralysed for nearly a decade after a stroke, succumbed to Covid-19. In 2012, when Vishwajeet was 11 years old, their mother died by suicide. He started cooking at an early age.

Back then, the boys could not understand grief; now, they have no time to grieve.

After their father’s death, local politicians and corporators turned up, offered condolences, clicked photographs and left. One MLA created a fixed deposit of Rs 1 lakh for Poorav, which he will be able to access after seven years.

Poorav is also eligible for other assistance intended for children orphaned by the pandemic. Under a central government scheme called PM Cares for Children, he is entitled to receive a sum of Rs 10 lakh as a fixed deposit. Similarly, the Maharashtra government will give him Rs 5 lakh, also as a fixed deposit.

But neither of these deposits have been created yet. Further, Poorav can withdraw the state government funds only after he turns 21. For the deposit made by the central government, he needs to wait till he is 23.

The only assistance Poorav will be able to access now is a monthly transfer of Rs 1,125 made by the Maharashtra government under a scheme called Bal Sangopan Yojana. Even this money hasn’t been dispensed yet.

The central government has also promised to provide orphans like Poorav with free health insurance and to pay their education fees, while the state government has promised to reserve jobs for them, and also to pay education fees. As an adult, Vishwajeet is not entitled to similar assistance.

Vishwajeet Salunkhe lost both his parents to Covid-19. Though he wants to pursue higher education, he is not eligible for any of the assistance intended for orphaned children, because he is not a minor.

For now, the boys have no money, apart from Rs 3,200 they get out of renting three rooms on the first floor and ground floor of their house. Their electricity bill is usually around Rs 300, their gas bill around Rs 800, and their grocery and phone bills total around Rs 5,000 a month. Vishwajeet helps neighbours by filling online forms or making online payments for them, earning few hundred rupees every month in the process.

“In the end, we request our father’s younger brother to help,” Vishwajeet said. “After multiple calls he lends some money. He is also very poor.”

Pradnya Bansode, a staffer of Maharashtra’s Women and Child Development department in Osmanabad, recounted the first time she visited the boys. “I was in a hurry, I kept calling them on the phone to reach home,” said Bansode, one of the district’s Child Protection Officers, who work with abandoned children and orphans, assist in adoption processes, and aid children in need of care. “I was waiting outside. After 20 minutes I saw them running and panting with grocery bags.” The brothers had run 3 km because they could not afford the Rs 20 they needed for an auto rickshaw ride. “Even I feel helpless,” Bansode said, choking up. “How do I help them?”

Bansode said the district’s Child Welfare Committee, which falls under the WCD department, had managed to get Poorav’s fee for the tenth grade waived off by speaking with school management. “But Vishwajeet is 19, not a minor anymore,” she said. “We can’t help him with education fees as per government norms.”

Vishwajeet wants to study computer technology. He scored 92% in a three-year diploma course in the subject after his tenth grade. Soon he will start applying to colleges, at which he expects the fee will be between Rs 50,000 and Rs 95,000 per year. With no legal guardian to support him, he cannot get an education loan.

“Itna tension hai, aage kaise padhu.” I am so worried, how will I study further, Vishwajeet said.

Across the world, the Covid-19 pandemic has killed a primary caregiver, parent or guardian, of more than 1.1 million children like Vishwajeet and Poorav, a Lancet study published this July estimated.

According to data accessed by from National Commission for Protection of Child Rights through a Right to Information application, as of August 23, 2021, India had identified 101,032 such children. Of this number, 92,475 children lost a single parent and 8,161 children were orphaned – the total also includes 396 children who were abandoned during the pandemic.

“Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths,” the Lancet study noted.

Maharashtra is home to the highest number of children who lost one or both parents to Covid-19: a total of 15,395 children as of August 23, according to the RTI data. Gujarat has identified 9,033 such children, Odisha 8,498, and Andhra Pradesh 7,514. The most populous state in India, Uttar Pradesh, has identified 7,282 children.

Covid-19's toll on children

States Orphaned Lost one parent
Maharashtra 470 14925
Gujarat 1148 7885
Odisha 973 7522
Andhra Pradesh 322 7188
Uttar Pradesh 536 6743
Tamil Nadu 218 6601
West Bengal 308 6270
Rajasthan 796 5124
Delhi  275 5101
Madhya Pradesh 1165 2224
Government data till August 23, 2021, accessed from the National Commission for Protection of Child Rights through a Right to Information application.

Since the start of the pandemic, many states have announced varying forms of assistance to help children who lost parents to Covid-19. These measures include monthly aid, fixed deposits, assistance with educational fees and, in some states, counselling support. Apart from the Rs 10 lakh fixed deposit, the central government’s PM Cares for Children scheme also assures minors who lost both parents (or one surviving parent), or legal guardians during the pandemic a monthly stipend after turning 18, and free education and health insurance.

But the fine print of these measures means that large numbers of children who need assistance may not get it, or at least not when they need it.

In some states, children are only eligible if the deaths occurred within specific periods – for instance, March 2020 to June 2021 in Madhya Pradesh, and up to September 15, 2021, in Odisha. The measures also don’t cover those, like Vishwajeet, who are over 18 years of age and still studying.

Most of these states’ measures are focussed on orphans. This leaves out the more than 92,000 children who lost a single parent in India. Of the children in Maharashtra who lost a parent, 85.7% of children lost their father (2.9% lost both father and mother), typically indicating the loss of a major, or only, income source. But the assistance available to them is limited to the Bal Sangopan Yojana scheme.

In other, states, too, the assistance offered to these children is unlikely to suffice for their living and educational expenses. Gujarat has announced a sum of Rs 2,000 per month for children who lost a single parent and Rs 4,000 for orphans, while Odisha has committed to paying Rs 2,500 per month to children who lost one or both parents. Andhra Pradesh has announced a meagre aid of Rs 500 per month for children who lost a single parent.

Even where aid is available, children are frustrated by how long they will have to wait to access it.

As Vishwajeet put it when asked about the fixed deposit created by the MLA in his brother’s name: “What will I do with the money seven years later when I need it now?”

According to the Lancet study, “Psychosocial and economic support can help families to nurture children bereft of caregivers and help to ensure that institutionalisation is avoided.” But this advice is hard to implement in a country like India, where childcare facilities are skeletal and a short-staffed system is already overwhelmed with the rising number of children who have lost a caregiver. Although they are working hard, child protection officers are slowed down by a rule-bound administrative system. For now, numerous children remain unidentified, timely financial aid is yet to reach many families, and psychological support to the children has been delayed.

“Last year I had severe Covid infection and I was hospitalised,” said Vijay Doiphode, the chairperson of Mumbai’s Child Welfare Committee, or CWC. “I thought that was the worst phase. But it is now that I realise the disastrous impact of this pandemic.”

This story is part of Common Ground, our new in-depth and investigative reporting project. Sign up here to get a fresh story in your inbox every Wednesday.

Swati Kadam, who lost her husband Sunil in the first wave of Covid-19, in August 2020, is one of thousands who have to navigate the grindingly slow support system of the Maharashtra government. On the afternoon of June 23, as rain lashed the city, she visited the office of the Mumbai Child Welfare Committee in Dongri, in the premises of the Dongri Children’s Home. Every district in the country has such a committee, which falls under state Women and Child Development departments, and which takes up cases involving the care, protection and rehabilitation of children in need of help. With Kadam were her two children – a seven-year old daughter and a 12-year-old son.

Inside, women and children lined up on a long, narrow wooden bench in a humid, dimly lit corridor, awaiting their turn to meet the members of the committee, whose office was a small room at the end of the corridor.

Mothers wait to meet officials of Mumbai’s Child Welfare Committee, in the premises of the Dongri Children’s Home. These committees take up cases involving the care, protection and rehabilitation of children.

Kadam, who is 33, sat in the corridor, clutching a plastic bag containing documents: her husband’s death certificate, his Covid-19 RT-PCR report, her children’s birth certificates. Her son and daughter sat quietly by her side. All the other children, too, were tucked by their mothers’ sides, none smiling or running around.

The children’s school fees, totalling Rs 58,000, were due. Kadam had come hoping the CWC would either provide her monetary aid, or direct school trustees to provide her with concessions.

Sunil, who worked as a computer technician, was admitted for an abdomen surgery in 2020 in KEM hospital, Parel, in central Mumbai. Days later he was detected with Covid-19. Kadam suspects he acquired the infection in the hospital. He died within a few days. He was just 37 years old, and had not had any other health problems.

“I thought of ending my life, but my relatives said I need to think about my children,” Kadam said.

Six months after Sunil’s death, his younger brother died by suicide, leaving behind a wife and young son. “He was attached to my husband and became depressed after his demise,” Kadam said.

Kadam, who has studied up to the twelfth, began a tiffin service to support her children, her sister-in-law and her son. But business has been difficult. “Customers are few. No one needs tiffin service with offices closed,” she said. With no income, Kadam used up her savings and even sold off her gold jewellery to support herself and her children. In May she wrote a letter to their school administration asking for an extension to deposit the children’s fees, explaining how difficult things were after her husband died. The school gave her time until this September to pay.

Within a few days, just when Kadam was thinking of withdrawing her children from the private school, an anganwadi worker called her to ask if there had been a Covid-19 death in their house. When Kadam replied that there had, the worker told her about Bal Sangopan Yojana. Kadam corralled medical documents as proof that Covid-19 killed her husband. She was finally hopeful of resolving her financial distress.

But the June 23 meeting left her flustered. After two hours of waiting, when Kadam’s turn arrived, the meeting lasted for barely eight minutes. Kadam realised that this was just the start of an arduous government procedure. If she followed through with it, her children, like other children who had lost one parent, would receive aid of Rs 1,125 per month each under Bal Sangopan Yojana. She also learnt that as a widow, she would qualify for a few different schemes, such as Indira Gandhi National Widow Pension scheme and Sanjay Gandhi Niradhar Anudan Yojana, which the government was encouraging women to avail of during the pandemic. But the financial aid in these schemes ranged only between Rs 200 and Rs 600 a month. In all, the money was simply not enough to cover the children’s school fees.

Kadam also had no idea when she would receive the money. “What do I do until the government deposits money in my account?” she asked after the meeting was over. She wondered if the money she had spent on the taxi ride to Dongri was wasted. Her two children, hungry, tugged at her to go home.

The process to find children whose parents succumbed to Covid-19 is tedious.

In Mumbai, for instance, the WCD took phone numbers and addresses of those who had died of Covid-19 from civic body Brihanmumbai Municipal Corporation and narrowed the list down to deaths in the 20-60 age group, the pool most likely to have left behind minor children. Between March 2020 and June 2021, there were 6,531 such fatalities. Officials began a painstaking exercise to first call the numbers in records, then, if numbers didn’t work, to visit homes and trace children and find out if they had moved from that address to another city or state.

Prajakta Desai, a staffer with WCD’s Mumbai Suburban office, said the office had printed 26,000 handbills and put them up in hospitals, railway stations and public spaces in Mumbai. “We have published ads in newspapers for people to report cases of orphaned children, or those who lost a single parent to Covid-19,” said Desai, one of the districts Child Probation Officers, who primarily oversees cases to do with the Juvenile Justice Act, but whose responsibilities often extend into other areas.

Prema Gadge, who was a district WCD officer of Mumbai until September, said that around half the phone numbers in the records were incorrect.

“For the rest, we started sending anganwadi workers to homes, but addresses were also incomplete or wrong,” she said.

In many cases, parents died after showing symptoms of Covid-19, but no RT-PCR tests were carried out to confirm the disease. “We are trying to figure out how to prove these were Covid deaths so that children can get aid,” said Shraddha Rane, a supervisor in Dadar.

“Government figures may have missed several Covid-19 deaths that went unreported, especially in hotspots,” admitted Maharashtra WCD minister Yashomati Thakur. She added that even in the case of deaths where there were no test reports, families would be eligible for aid.

It took 15 days for 60-year-old Jayshree Kadam, an anganwadi worker, to trace two siblings, aged four and ten, from Dharavi slums to Dombivli, 43 km away. When she first heard about the two children, who had lost their father in April, she visited their tiny slum room and found that it was occupied by new tenants. Neighbours told her the family had moved elsewhere.

For a fortnight, Jayshree randomly visited households to inquire about the children. One day someone pointed at a passer-by, and said he was the deceased father’s friend. The friend gave Kadam a phone number. It was of the widow, Kavita Kadam. Kavita told Jayshree that Covid-19 had killed her husband, Atish, and her father-in-law within a week. With the death of the two breadwinners, the family’s income fell to zero. Kavita, her mother-in-law and two children moved to Dombivli, a satellite town north of Mumbai, where rent was cheaper.

Kavita, who had studied up to the tenth grade, had exhausted her savings, and was looking for jobs as a domestic worker. “I told her to come to Dharavi for free ration, but she has no money to make the trip,” Jayshree said. “So I took all her details over the phone and submitted the form in the office.”

Between 600 and 700 anganwadi workers have been put on the job in Mumbai, in addition to their existing work of distributing rations for children, and monitoring pregnant and lactating mothers. Each anganwadi worker visits a home with a list of questions. Did someone die due to Covid-19? Is there a child, and if so, how old? How many members does the family have? What is the monthly income? Who is the guardian?

The work is made particularly difficult because of people’s fear of Covid-19.

“People turn us away, they refuse to talk about Covid. There is still so much stigma attached,” said Sujata Patil, a supervisor who works in Kurla’s slums.

The names of children are given to the district WCD office. There, data under 29 heads is entered into a spreadsheet, including details of the children’s education, family, financial condition and health, said Sneha Joshi, a child probation officer in Mumbai.

As the files of these children piled up in their office, Shobha Shelar, a Mumbai Suburban district WCD officer, sighed. “Tracing them is just the beginning,” she said. “ There is a whole procedure left before government aid can finally reach them.”

Once a child, who lost a parent to Covid-19, is found by an anganwadi worker, he or she is presented to the district Child Welfare Committee. The CWC then directs a Women and Child Development department official to prepare a 14-page long special investigation report. The report is a deep-dive into the child’s life, their guardians, the amenities they have at home, their need for education and financial support, as well as for psychological support.

“Not just education, family and finances, we fill even small details like whether the home has a TV or fridge,” said Prajakta Desai. The child is again presented to the CWC, which may issue a final directive to the WCD to dispense the necessary aid or seek more information before taking a decision. If there is no guardian, the CWC may order that the child be transferred to a shelter home.

After paperwork is done, bank details are fed into the system to initiate monthly aid. In mid-October, four months after announcing the measure, the Maharashtra government began transferring funds for the Rs 5 lakh fixed deposits it had assured children who had lost both their parents. Yashomati Thakur said that the state finance department was yet to allocate funds for Bal Sangopan Yojana, and added that she had proposed an increase of the aid from Rs 1,125 to Rs 2,500 per month. “Our proposal was rejected once by the state government, we have submitted it again,” she said. “We are pushing the government to increase the aid.”

While the state has announced free education for orphans, if a child who lost a single parent, needs support for their education, the CWC calls school trustees to request a fee concession, or brings in an NGO that can offer financial support.

If fast-tracked, the process takes three days, but on the ground the procedure for each case has been taking months because of a serious shortage of staff. As a result, WCD is focussing on orphans first, before they move to children who lost a single parent.

According to data from the WCD, as of July, the department had 3,921 sanctioned posts for class I to class IV officers, of which 1,551 posts, or 39.5%, were vacant. There were 262 Child Probation Officers, and just 50 counsellors. With 15,395 children who had lost one or both parents to Covid-19 in the state, that means each CPO had to handle nearly 60 cases. The ratio was even more steep in Mumbai, which had 15 CPOs for 1,376 children, meaning each officer had to handle more than 90 cases.

A senior WCD official admitted they were “terribly understaffed”. WCD minister Thakur said the government was aware of the problem and was trying to fill vacant posts.

The dearth of officers means sometimes officials perform duties outside their formal roles.

Rahul Kantikhar, the superintendent of the Dongri Children Home, is among those who have taken on the additional responsibility of counselling orphans who lost their parents to Covid-19, after undergoing an online training course set up by the Maharashtra government, of 40 sessions with the National Institute of Mental Health and Neuro-Sciences Bangalore. He has been assigned cases of eight orphans in Mumbai.

“Everyone is working hard in this pandemic, the doctors, nurses, police,” Kantikhar said. “I thought even I should help in whatever way possible. So I agreed to take over the counselling part along with my routine work.” He has visited each of the eight children once, spoken to them for an hour at length, and often follows up with them over the phone.

Santosh Khopade, a WCD counsellor in Ulhasnagar, a satellite town 50 km north of Mumbai, has taken on the additional responsibility of probation officer since July. Apart from the counselling that he already does, he now also visits children’s homes to prepare special investigation reports.

When met Khopade it was a Sunday in rainy August. In his arms was his own daughter, aged two. “My wife is working, it is my turn to look after her,” he explained as he walks towards a slum dwelling in Kalyan, where two sisters, aged seven and five, lived with their grandparents, Suman and Laxman Malusare. Their mother succumbed to Covid-19 in April and their father died in a road accident in 2018.

Santosh Khopade, a counsellor, is also working as a probation officer to help expedite the process of filing special investigation reports. On weekends, his daughter tags along as he visits homes of orphans.

He is particularly worried about the girls. This is his fourth visit in a month to them in Anandnagar slum. They had watched in April as their breathless mother was lifted from a bed and heaved onto an auto-rickshaw, never to return.

Now the seven-year-old questions her faith in god. “She keeps asking why god took her mother away,” their grandmother said.

Since her mother’s death she had turned to watching mobile videos for hours at a stretch. She wears thick spectacles, and the doctor has warned the family about allowing her excessive screen time. “She is stubborn now, she gets angry if we take away the phone,” Malusare said. The younger sister, meanwhile, has become “clingy”.

The elderly grandparents do not understand that the kids needs counselling for trauma. For them there are more pressing issues – they have to struggle to feed the children and themselves, and run the house with a fixed limited pension. They have created bank accounts for both the children but the government is yet to deposit the money under Bal Sangopan Yojana or the fixed deposits to which they are entitled.

“We want them to receive financial aid while we are alive,” Malusare, aged 73, said. “What will happen once we are gone? Who will ensure they get their aid of Rs 5 lakh or Rs 10 lakh as the government has promised?”

Laxman Malusare takes his granddaughters for tuition class in Anandnagar slum. After their mother’s death, the two children have been diagnosed with anxiety and other mental health problems.

Khopade took both the girls to a psychiatrist. For the elder sister, the doctor, Vikas Deshmukh made the following notes: “angry, irritable, need to limit mobile use to one hour a day, try to look for a hobby”. He diagnosed the younger one with childhood depression. “They are both in trauma of losing their mother,” he said. “If not treated now, this can develop into adulthood issues.”

Khopade has resolved to keep following up until he sees improvement in the girls. They are one of the few fortunate enough to reach a point where there is access to free government counselling. “There must be so many like her out there,” he said. “And we can’t be everywhere.”

There are similar stories of psychological trauma and economic distress from all over the state, just like the rest of the country. Fiveyear-old Ruhi, in Mumbai’s Naigaon, last saw her father over a video call last June 2020. He died of Covid on June 2. Since then her mother Jahnvi has been working longer hours at a courier company, where she earns Rs 2,500 a month. Ruhi has grown stubborn and irritable, but is yet to be counselled.

Sixteen-year-old Neha’s father ran a vadapav stall in Wadala, and died last July. Her mother has now taken up domestic work at a high-rise near their slum, even as Neha wonders if she will even be able to finish her education.

Sugra Siddiqui, was seven months pregnant when her husband Rafiquddin died in June 2020. She now has two children, a son aged 11 and a daughter, ten months old. She has no means to earn a living and relies on her brother-in-law’s son for shelter and food in South Mumbai’s Nagpada area. With no money to pay her son’s annual private school fee of Rs 12,600, she is considering shifting him to a government school.

Sugra Siddiqui was seven months pregnant when her husband Rafiquddin died, in June 2020. She has two children and no source of income, and relies on her brother-in-law’s son to feed and shelter her family.

Many of these families cannot access the psychological care they need. “There is class divide even in the way grief is handled,” said Dr Samir Dalwai, member of the Maharashtra Paediatric Task Force.

He pointed out that awareness about psychological issues “is limited to affluent sections, but in slums no one has time to manage mental wellbeing when there is a financial crisis.”

“Timely counselling is important,” Deshmukh said. “These children can develop low confidence, social anxiety, lack of trust as they grow. Such trauma can change their personality. In most cases, they recover, but a handful can slip into depression.”

Yashomati Thakur, Maharashtra WCD minister, said that the state had signed a memorandum of understanding with the Indian Psychiatric Society to provide pro-bono counselling services to children. But these private psychiatrists are largely located in cities like Mumbai, Thane and Pune. “Our aim is to provide counseling to all children,” Thakur said. “And we are implementing whatever is doable. There is a coordination that needs to happen between us and health department, and us and education department. Mental health, in fact, is the most important subject that everybody has to look into.”

In Osmanabad, where 231 children are recorded to have lost one or both parents to Covid-19, there is just one government counselor, who has to cover two districts: Osmanabad and Latur. Child protection officer Yogesh Shegar said he does whatever counselling he can when he meets children. But that counselling is limited to minors, not their adult siblings.

Government school teachers 48-year-old Nitin and 40-year-old Asmita Chandanshive died 15 days apart in Osmanabad, between April and May, leaving behind two sons, Aman, aged 13, and Prajot, aged 19. The couple had been on Covid-19 duty to look for high risk contacts in the village of Warvanti. Their children should have been eligible for a central government insurance payout of Rs 50 lakh, assured to “Covid-19 warriors” under the Pradhan Mantri Garib Kalyan Yojana.

But the Osmanabad administration has not cleared the money, citing a technicality.

“There were no written orders,” said Vijayadevi Pawar, a member of the Warvanti gram panchayat. “We do not know if they contracted the infection during Covid-19 duty.”

Their sons claim that the gram panchayat office had issued oral orders, and since Maharashtra was battling a Covid wave, their parents did not refuse. Osmanabad collector Kaustubh Diwegaonkar said he would resolve the matter. “If they were asked by the administration to report for Covid-19 duty, the paperwork for insurance will be processed,” he said. “I will personally look into it.”

School teachers Nitin and Asmita Chandanshive died 15 days apart, leaving behind two sons. Their family says they had been assigned Covid duty, but authorities claim there were no written orders.

At the time of publication, other assistance, such as the Rs 10 lakh and Rs 5 lakh fixed deposits and the Bal Sangopan Yojana payments, had not been dispensed either. District officials explained that before making the transfer, they were waiting for a special event to be organised, which would be attended by the district’s guardian minister, Shankarrao Gadakh.

The boys, meanwhile, are consumed by the thought of the sudden ruthlessness with which the virus killed their parents. Aman has been counselled to some extent, but Prajot hasn’t, since he is an adult, and out of WCD’s ambit, local officials said.

The brothers have been separated. Aman lives with their maternal uncle at his parents’ home and Prajot has shifted 50 km away to live with a maternal grandaunt and an uncle in Murud, Latur district. Aman will soon be sent to Chandrapur, 500 km away, in to join a Sainik School, where he will stay in a hostel.

Thirteen-year-old Aman has been separated from his 19-year-old brother Prajot after the deaths of their parents. Next year, he will be sent to an army school, where he will stay in a hostel.

Prajot is preparing for the National Eligibility cum Entrance Test for admission to an undergraduate programme in medicine. “He remains quiet,” observed his uncle Swapnil. “He could not study at home. So I brought him here to live with me. There were too many people and politicians visiting them there. They would cry and he would be drawn back into a sad atmosphere.”

Prajot spends hours in his room alone, pouring over his books. He makes no demands, never complains, and eats whatever is cooked. But his uncle worries he is withdrawing into a shell. “We hope in a few months the situation will be better,” he said.

*First names of all minors have been changed.

This reporting was supported by a grant from the Thakur Family Foundation. Thakur Family Foundation has not exercised any editorial control over the contents of this article.

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