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Islamabad, Jun 10: The World Health Organization has told Pakistan it should implement "intermittent" lockdowns to counter a surge in coronavirus infections that has come as the country loosens restrictions, officials said.

Since the start of Pakistan's outbreak in March, Prime Minister Imran Khan opposed a nationwide lockdown of the sort seen elsewhere, arguing the impoverished country could not afford it.

Instead, Pakistan's four provinces ordered a patchwork of closures, but last week Khan said most of these restrictions would be lifted.

Health officials on Wednesday declared a record number of new cases in the past 24 hours. The country has now confirmed a total of more than 113,000 cases and 2,200 deaths -- though with testing still limited, real rates are thought to be much higher.

"As of today, Pakistan does not meet any of the pre-requisite conditions for opening the lockdown", the WHO said in a letter confirmed by Pakistan officials on Tuesday.

Many people have not adopted behavioural changes such as social distancing and frequent hand-washing, meaning "difficult" decisions will be required including "intermittent lockdowns" in targeted areas, the letter states.

Some 25 percent of tests in Pakistan come back positive for COVID-19, the WHO said, indicating high levels of infection in the general population.

The health body recommended an intermittent lockdown cycle of two weeks on, two weeks off.

Responding to the WHO's letter, Zafar Mirza, the prime minister's special advisor for health, said the country had "consciously but gradually" eased lockdowns while enforcing guidelines in shops, mosques and public transport.

"We have to make tough policy choices to strike a balance between lives and livelihoods," Mirza said Wednesday.

Punjab's provincial health minister Yasmin Rashid, who received the WHO's letter, said the provincial government had already given "orders to take strict action against those violating" virus guidelines.

Hospitals across Pakistan say they are at or near capacity, and some are turning COVID-19 patients away.

WHO Director-General Tedros Adhanom Ghebreyesus said Monday that 136,000 cases had been reported in the previous 24 hours, "the most in a single day so far", with the majority of them in South Asia and the Americas.

Istanbul, Jul 11: Turkish President Recep Tayyip Erdogan announced Friday that the Hagia Sophia, one of the architectural wonders of the world, would be reopened for Muslim worship, sparking fury in the Christian community and neighbouring Greece.

His declaration came after a top Turkish court revoked the sixth-century Byzantine monument's status as a museum, clearing the way for it to be turned back into a mosque.

The UNESCO World Heritage site in historic Istanbul, a magnet for tourists worldwide, was first constructed as a cathedral in the Christian Byzantine Empire but was converted into a mosque after the Ottoman conquest of Constantinople in 1453.

The Council of State, Turkey's highest administrative court, unanimously cancelled a 1934 cabinet decision to turn it into a museum and said Hagia Sophia was registered as a mosque in its property deeds.

The landmark ruling could inflame tensions not just with the West and Turkey's historic foe Greece but also Russia, with which Erdogan has forged an increasingly close partnership in recent years.

'Millions of Christians not heard'

Greece swiftly branded the move by Muslim-majority Turkey an "open provocation to the civilised world".

"The nationalism displayed by Erdogan... takes his country back six centuries," Culture Minister Lina Mendoni said in a statement.

The Russian Orthodox Church was equally scathing.

"The concern of millions of Christians were not heard," Church spokesman Vladimir Legoida told Interfax news agency.

The decision "shows that all pleas regarding the need to handle the situation extremely delicately were ignored," he said.

UNESCO chief Audrey Azoulay said she "deeply regrets" the decision made without prior dialogue with the UN's cultural agency.

The move was also condemned by the US Commission on International Religious Freedom, which said it was an "unequivocal politicisation" of the monument.

Hagia Sophia, which stands opposite the impressive Sultanahmet Mosque -- often called the Blue Mosque, has been a museum since 1935 and open to believers of all faiths.

Transforming it from a mosque was a key reform under the new republic born out of the ashes of the Ottoman Empire.

Sharing a presidential decree which named Hagia Sophia as a "mosque", Erdogan announced its administration would be handed over to Turkey's religious affairs directorate known as Diyanet.

"May we be blessed," he commented. The decree was published on the official gazette.

Erdogan has in recent years placed great emphasis on the battles which resulted in the defeat of Byzantium by the Ottomans, with lavish celebrations held every year to mark the conquest.

Muslim clerics have occasionally recited prayers in the museum on key anniversaries or religious holidays.

"The decision is intended to score points with Erdogan's pious and nationalist constituents," said Anthony Skinner of the risk assessment firm Verisk Maplecroft.

"Hagia Sophia is arguably the most conspicuous symbol of Turkey's Ottoman past -- one which Erdogan is leveraging to strengthen his base while snubbing domestic and foreign rivals," he told AFP.

'Chains broken'

A few hundred Turks carrying Turkish flags gathered outside Hagia Sophia shouting "Chains broken, Hagia Sophia reopened".

Police heightened security measures around the building, according to AFP journalists.

"It's been a dream since we were kids," said Erdal Gencler, an Istanbul resident.

"(Hagia Sophia) finds its true purpose again. We are very excited, proud, and hopeful that there will be beautiful services here," he added.

Fatma, a woman with tearful eyes, said: "Of course I am crying. (Hagia Sophia) belongs to us."

Ahead of the court decision, Justice Minister Abdulhamit Gul shared a picture of Hagia Sophia on his official Twitter account, with a message: "Have a good Friday."

Finance Minister Berat Albayrak, Erdogan's son-in-law, tweeted that Hagia Sophia would be reopened to Muslim worship "sooner or later", referring to a quote from Turkish poet Necip Fazil Kisakurek.

The Council of State had on July 2 debated the case brought by a Turkish group -- the Association for the Protection of Historic Monuments and the Environment, which demanded Hagia Sophia be reopened for Muslim prayers.

Since 2005, there have been several attempts to change the building's status. In 2018, the Constitutional Court rejected one application.

Despite occasional protests outside the site by Islamic groups, Turkish authorities had until now kept the building as a museum.

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.