Ankara, Baghdad and Riyadh ask: Are US air strikes working?

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.

The new visa regulations requiring international students in the US with an F-1 visa to take at least one in-person course or face the prospect of deportation is likely to "cause uncertainties and difficulties" for some students, the Indian Embassy has said.

"These new modifications at a time when many of the US universities and colleges are yet to announce their plans for the new academic year are likely to cause uncertainties and difficulties for some Indian students wishing to pursue their studies in the US," said a spokesperson of the Indian Embassy.

Responding to media queries, the spokesperson said the Indian government has taken up the matter with concerned US officials.

At the India US Foreign Office Consultations held on July 7, Foreign Secretary Harsh Vardhan Shringla conveyed India's concerns on the matter to Under Secretary of State for Political Affairs David Hale.

According to a recent report of Student and Exchange Visitor Program (SEVP), there were 1,94,556 Indian students enrolled in various academic institutions of the US in January this year. Of these 1,26,132 were males and 68,405 were females.

Noting that partnership in higher education is a key component of the strong people-to-people ties between India and the US, the spokesperson said in the last two decades Indian students in American universities and colleges have been the harbingers of a strong partnership between technology and innovation sectors between the two countries.

The spokesperson hoped that the US authorities would provide adequate flexibility in their visa rule, keeping in mind the extraordinary circumstances created by the COVID-19 pandemic for the Indian students community.

We continue to engage all the stakeholders in the matters, including the US administration officials, Congressional leaders, universities and colleges as well as the Indian students community in the US as we move forward towards the 2020-21 academic year to further strengthen our bilateral partnership in higher education, the spokesperson said.

Announced by the SEVP on July 6, the new rules provide temporary exemptions for nonimmigrant students on F-1 and M-1 visas taking online classes due to the COVID-19 pandemic for the fall semester of the 2020 academic year.

While these modifications do provide some flexibility for US universities and colleges to adopt a hybrid model -- that is a mixture of online and in person classes -- they also restrict international students on F-1 and M-1 visas from taking courses entirely online, the spokesperson said.

Moscow, Jul 2: Russian voters approved changes to the constitution that will allow President Vladimir Putin to hold power until 2036, but the weeklong plebiscite that concluded Wednesday was tarnished by widespread reports of pressure on voters and other irregularities.

With most of the nation's polls closed and 20% of precincts counted, 72% voted for the constitutional amendments, according to election officials.

For the first time in Russia, polls were kept open for a week to bolster turnout without increasing crowds casting ballots amid the coronavirus pandemic a provision that Kremlin critics denounced as an extra tool to manipulate the outcome.

A massive propaganda campaign and the opposition's failure to mount a coordinated challenge helped Putin get the result he wanted, but the plebiscite could end up eroding his position because of the unconventional methods used to boost participation and the dubious legal basis for the balloting.

By the time polls closed in Moscow and most other parts of Western Russia, the overall turnout was at 65%, according to election officials. In some regions, almost 90% of eligible voters cast ballots.

On Russia's easternmost Chukchi Peninsula, nine hours ahead of Moscow, officials quickly announced full preliminary results showing 80% of voters supported the amendments, and in other parts of the Far East, they said over 70% of voters backed the changes.

Kremlin critics and independent election observers questioned the turnout figures.

We look at neighboring regions, and anomalies are obvious there are regions where the turnout is artificially (boosted), there are regions where it is more or less real, Grigory Melkonyants, co-chair of the independent election monitoring group Golos, told The Associated Press.

Putin voted at a Moscow polling station, dutifully showing his passport to the election worker. His face was uncovered, unlike most of the other voters who were offered free masks at the entrance.

The vote completes a convoluted saga that began in January, when Putin first proposed the constitutional changes.

He offered to broaden the powers of parliament and redistribute authority among the branches of government, stoking speculation he might seek to become parliamentary speaker or chairman of the State Council when his presidential term ends in 2024.

His intentions became clear only hours before a vote in parliament, when legislator Valentina Tereshkova, a Soviet-era cosmonaut who was the first woman in space in 1963, proposed letting him run two more times.

The amendments, which also emphasize the primacy of Russian law over international norms, outlaw same-sex marriages and mention a belief in God as a core value, were quickly passed by the Kremlin-controlled legislature.

Putin, who has been in power for more than two decades longer than any other Kremlin leader since Soviet dictator Josef Stalin said he would decide later whether to run again in 2024.

He argued that resetting the term count was necessary to keep his lieutenants focused on their work instead of darting their eyes in search for possible successors.

Analyst Gleb Pavlovsky, a former Kremlin political consultant, said Putin's push to hold the vote despite the fact that Russia has thousands of new coronavirus infections each day reflected his potential vulnerabilities.

Putin lacks confidence in his inner circle and he's worried about the future, Pavlovsky said.

He wants an irrefutable proof of public support.

Even though the parliament's approval was enough to make it law, the 67-year-old Russian president put his constitutional plan to voters to showcase his broad support and add a democratic veneer to the changes.

But then the coronavirus pandemic engulfed Russia, forcing him to postpone the April 22 plebiscite.

The delay made Putin's campaign blitz lose momentum and left his constitutional reform plan hanging as the damage from the virus mounted and public discontent grew.

Plummeting incomes and rising unemployment during the outbreak have dented his approval ratings, which sank to 59%, the lowest level since he came to power, according to the Levada Center, Russia's top independent pollster.

Moscow-based political analyst Ekaterina Schulmann said the Kremlin had faced a difficult dilemma: Holding the vote sooner would have brought accusations of jeopardizing public health for political ends, while delaying it raised the risks of defeat.

Holding it in the autumn would have been too risky, she said.

In Moscow, several activists briefly lay on Red Square, forming the number 2036 with their bodies in protest before police stopped them.

Some others in Moscow and St. Petersburg staged one-person pickets and police didn't intervene.

Several hundred opposition supporters rallied in central Moscow to protest the changes, defying a ban on public gatherings imposed for the coronavirus outbreak. Police didn't intervene and even handed masks to the participants.

Authorities mounted a sweeping effort to persuade teachers, doctors, workers at public sector enterprises and others who are paid by the state to cast ballots. Reports surfaced from across the vast country of managers coercing people to vote.

The Kremlin has used other tactics to boost turnout and support for the amendments.