10,000 children killed, maimed in conflicts worldwide

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

Seoul, Jul 26: North Korean authorities have imposed a lockdown on the border city of Kaesong after discovering what they called the country's first suspected case of the novel coronavirus, state media reported Sunday.

Leader Kim Jong Un convened an emergency politburo meeting on Saturday to implement a "maximum emergency system and issue a top-class alert" to contain the virus, official news agency KCNA said.

If confirmed, it would be the first officially recognised COVID-19 case in the North where medical infrastructure is seen as woefully inadequate for dealing with any epidemic.

KCNA said a defector who had left for the South three years ago returned on July 19 after "illegally crossing" the heavily fortified border dividing the countries.

But there have been no reports in the South of anyone leaving through what is one of the world's most secure borders, replete with minefields and guard posts.

Pyongyang has previously insisted not a single case of the coronavirus had been seen in the North despite the illness having swept the globe, and the country's borders remain closed.

The patient was found in Kaesong City, which borders the South, and "was put under strict quarantine", as would anybody who had come in close contact, state media said.

It was a "dangerous situation... that may lead to a deadly and destructive disaster", the media outlet added.

Kim was quoted as saying "the vicious virus could be said to have entered the country", and officials on Friday took the "preemptive measure of totally blocking Kaesong City".

The nuclear-armed North closed its borders in late January as the virus spread in neighbouring China and imposed tough restrictions that put thousands of its people into isolation, but analysts say the North is unlikely to have avoided the contagion.

South Korea is currently recording around 40 to 60 cases a day.

Earlier this month Kim warned against any "hasty" relaxation of anti-coronavirus measures, indicating the country will keep its borders closed for the foreseeable future.

Manila, Apr 13: The Asian Development Bank (ADB) on Monday tripled the size of its response to novel coronavirus disease (COVID-19) pandemic to 20 billion dollars and approved measures to streamline its operations for quicker and more flexible delivery of assistance.

The package expands ADB's 6.5 billion dollars initial response announced on March 18, adding 13.5 billion dollars in resources to help ADB's developing member countries counter the severe macroeconomic and health impacts caused by COVID-19.

The 20 billion dollar package includes about 2.5 billion dollars in concessional and grant resources.

"This pandemic threatens to severely set back economic, social, and development gains in Asia and the Pacific, reverse progress on poverty reduction and throw economies into recession," said ADB President Masatsugu Asakawa.

"Our expanded and comprehensive package of assistance, made possible with the strong support of our board, will be delivered more quickly, flexibly and forcefully to the governments and the private sector in our developing member countries to help them address the urgent challenges in tackling the pandemic and economic downturn," he said in a statement.

ADB's most recent assessment released on April 3 estimates the global impact of the pandemic at between 2.3 and 4.8 per cent of gross domestic product. Regional growth is forecast to decline from 5.2 per cent last year to 2.2 per cent in 2020.

The new package includes the establishment of a COVID-19 pandemic response option under ADB's countercyclical support facility.

Up to 13 billion dollars will be provided through this new option to help governments of developing member countries implement effective countercyclical expenditure programs to mitigate impacts of the COVID-19 pandemic, with a particular focus on the poor and the vulnerable.

Grant resources will continue to be deployed quickly for providing medical and personal protective equipment and supplies from expanded procurement sources.

Some 2 billion dollars from the 20 billion dollar package will be made available for the private sector. Loans and guarantees will be provided to financial institutions to rejuvenate trade and supply chains.

Enhanced microfinance loan and guarantee support and a facility to help liquidity-starved small and medium-sized enterprises, including those run by female entrepreneurs, will be implemented alongside direct financing of companies responding to or impacted by COVID-19.

The response package includes a number of adjustments to policies and business processes that will allow ADB to respond more rapidly and flexibly to the crisis. These include measures to streamline internal business processes, widen the eligibility and scope of various support facilities and make the terms and conditions of lending more tailored.

All support under the expanded package will be provided in close collaboration with international organisations, including the International Monetary Fund, World Bank Group, World Health Organisation, UNICEF, other UN agencies and the broader global community.