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Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

Beijing, Jul 6: A city in northern China on Sunday sounded an alert after a suspected case of bubonic plague was reported, according to official media here.

Bayannur, Inner Mongolia Autonomous Region, announced a level III warning of plague prevention and control, state-run People’s Daily Online reported.

The suspected bubonic plague case was reported on Saturday by a hospital in Bayannur. The local health authority announced that the warning period will continue until the end of 2020.

"At present, there is a risk of a human plague epidemic spreading in this city. The public should improve its self-protection awareness and ability, and report abnormal health conditions promptly,” the local health authority said.

On July 1, state-run Xinhua news agency said that two suspected cases of bubonic plague reported in Khovd province in western Mongolia have been confirmed by lab test results.

The confirmed cases are a 27-year-old resident and his 17-year-old brother, who are being treated at two separate hospitals in their province, it quoted a health official as saying.

The brothers ate marmot meat, the health official said, warning people not to eat marmot meat.

A total of 146 people who had contact with them have been isolated and treated at local hospitals, according to Narangerel.

Bubonic plague is a bacterial disease that is spread by fleas living on wild rodents such as marmots. It can kill an adult in less than 24 hours if not treated in time, according to the World Health Organization (WHO).

A couple died of bubonic plague in the western Mongolian province of Bayan-Ulgii last year after eating raw marmot meat.

The news of bubonic plague came after Chinese researchers issued an early warning over another potential pandemic caused by an influenza virus in pigs.

Scientists from China Agricultural University, the Chinese Centre for Disease Control and Prevention and other institutes detected a pig influenza virus bearing genotype 4 (G4), which is contagious among pigs and has the possibility of jumping to humans, as the G4 virus is able to bind with human cells, state-run Global Times reported last week.

The researchers are concerned that it could mutate further so that it can spread easily from person to person, and trigger a global outbreak, BBC reported.

"Controlling the prevailing G4 EA H1N1 viruses in pigs and close monitoring in human populations, especially workers in the swine industry, should be urgently implemented," Chinese researchers warned in the paper.

The new diseases were reported even as China grappled with the second attack of Covid-19 in Beijing after controlling it in Wuhan where it was first reported in December last year.

On Saturday, Beijing reported a single-digit Covid-19, local authorities said Sunday.

The number of newly confirmed Covid-19 cases reached a peak in Beijing on June 13 and 14 and then started declining in general, Xinhua quoted local officials as saying.

From June 11 to July 4, the city reported 334 confirmed locally transmitted cases, 47 per cent of whom are workers of the Xinfadi wholesale food market, the official said.