India is doing great, says Donald Trump

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.

London: Italy on Friday recorded the most daily deaths of any country since the start of the coronavirus pandemic and Spain had its deadliest day, as British Prime Minister Boris Johnson became the first major world leader to test positive.

Italy reported 969 new deaths, Spain 769 and France 299 as Europe reeled from a crisis that has put millions at risk around the world and threatened a global economic meltdown.

In other grim milestones, AFP tallies showed a total of 300,000 cases now recorded in Europe with more than 26,000 deaths worldwide, and the United States overtook China as the country with the most infections.

Italy showed infection rates continuing a downward trend and Spain said its rate of new infections appeared to be slowing, but other countries were bracing to feel the full impact of the virus's spread.

The World Health Organization's regional director for Africa warned the continent faced a "dramatic evolution" of the pandemic, as South Africa became the latest nation to start life under lockdown and reported its first COVID-19 deaths.

Johnson, whose country has seen more than 14,000 declared coronavirus cases and 759 deaths, said he had developed mild symptoms over the previous 24 hours and was self-isolating after testing positive.

Britain's Health Secretary Matt Hancock also tested positive with mild symptoms.

Europe has suffered the brunt of the coronavirus crisis in recent weeks, with millions across the continent on lockdown and the streets of Paris, Rome and Madrid eerily empty.

In France — where nearly 2,000 people have died -- the government announced it was extending its stay-at-home order until at least April 15. While severe, the 299 new deaths it recorded on Friday was lower than the 365 reported the previous day.

The death of a 16-year-old girl from the virus has particularly shaken France, and shattered the belief of many young people that they are immune.

The girl's mother Sabine told AFP that Julie "just had a cough" at first but deteriorated quickly. She died on Wednesday, less than a week after showing her first symptoms.

"It's unbearable," Sabine said. "We were supposed to have a normal life."

Focus was also turning to the United States, where the number of known infections jumped by 18,000 on Friday, reaching more than 97,000 -- higher than both China and Italy. The US also recorded 345 deaths over the past 24 hours, with a total toll of 1,478.

In New York City, health workers are battling a surging toll of dead and infected at the US epicentre of the crisis, including an increasing number of younger patients.

"Now it's 50-year-olds, 40-year-olds, 30-year-olds," said one respiratory therapist at the Jewish Medical Center in Queens.

They "didn't listen about not going out or protecting themselves and washing their hands", he said.

- 'Afraid and lost' -

The coronavirus first emerged in China late last year before spreading globally, with more than half a million declared cases in 183 countries and territories.

Over the last six days, as many new cases have been diagnosed around the world as in the previous 80 days.

Beijing managed to contain its spread with lockdowns and quarantines and its epicentre Wuhan is in the process of easing severe movement restrictions in place for two months.

Three billion people around the world have been told to stay indoors.

In a historic first, Pope Francis performed the rarely recited "Urbi et Orbi" blessing to an empty Saint Peter's Square.

"Thick darkness has gathered over our squares, our streets and our cities; it has taken over our lives, filling everything with a deafening silence and a distressing void, that stops everything as it passes by," he said.

"We find ourselves afraid and lost," he said, describing the coronavirus as a "tempest".

Health care systems even in the most developed nations are stretched to breaking point and medical workers have been having to make difficult choices.

"If I've got five patients and only one bed, I have to choose who gets it," Sara Chinchilla, a paediatrician at a hospital near Madrid, told AFP.

The WHO's chief Tedros Adhanom Ghebreyesus said the dire lack of protective gear for frontline health workers was one of the most pressing problems in the fight to prevent deaths.

"The chronic global shortage of personal protective equipment is now one of the most urgent threats to our collective ability to save lives," he told a virtual news conference in Geneva.

Lockdowns and other measures are wreaking havoc on the global economy, with fears of a downturn worse than the Great Depression of the 1930s.

"It is clear that we have entered a recession" that will be worse than in 2009 following the global financial crisis, International Monetary Fund chief Kristalina Georgieva said Friday.

Unprecedented stimulus measures have helped markets bounce back after a brutal month, but people around the world are bracing for economic hardship.

The United States reported that 3.3 million people applied for unemployment benefits last week -- by far the highest number ever recorded.

Retail workers in particular have suffered as many countries shutter non-essential business, while airlines and the global tourism industry have been dealt devastating blows.

The fashion industry was the latest hit on Friday, with Paris men's fashion week and haute couture shows cancelled along with Milan men's fashion week.

- Armies of volunteers -

The World Tourism Organization said Friday it expected tourist arrivals to fall by 20-30 percent this year, with losses of $300 billion-450 billion in international tourism receipts.

But there have been rays of hope in the midst of the crisis.

Armed groups in Cameroon, the Philippines and Yemen have moved in recent days to reduce violence after UN Secretary General Antonio Guterres issued an appeal for ceasefires.

And armies of volunteers have emerged in many countries to bring help to the needy, with food deliveries for the elderly, free taxi rides, accommodation for health workers, and even home-sewn face masks.

Beijing, Jun 17: China said Wednesday it wanted to avoid further clashes with India along their border after the first deadly confrontation between the two nuclear powers in decades.

The two countries have traded blame for Monday's high-altitude brawl that left at least 20 Indian soldiers dead, with China refusing to confirm so far whether there were any casualties on its side.

Chinese foreign ministry spokesman Zhao Lijian insisted again Wednesday that it was Indian troops who illegally crossed the border and attacked the Chinese side.

This led to "a serious physical confrontation between both sides that caused deaths and injuries", Zhao said at a regular briefing, without providing more details about the casualties.

He said China urges India to "strictly restrain frontline troops, do not illegally cross the border, do not make provocative gestures, do not take any unilateral actions that will complicate the border situation".

But he added that the two sides "will continue to resolve this issue through dialogue and negotiations".

"We of course don't wish to see more clashes," Zhao said.