Syria-bound Russian military jet crashes with 92 onboard

Beijing/Zurich, Mar 4: China has approved the use of Swiss drugmaker Roche's anti-inflammation drug Actemra for patients who develop severe complications from the coronavirus as it urgently hunts for new ways to combat the deadly infection that is spreading worldwide.

China is hoping that some older drugs could stop severe cytokine release syndrome (CRS), or cytokine storms, an overreaction of the immune system which is considered a major factor behind catastrophic organ failure and death in some coronavirus patients.

Actemra, a biologic drug approved in 2010 in the United States for rheumatoid arthritis (RA), inhibits high Interleukin 6 (IL-6) protein levels that drive some inflammatory diseases.

China's National Health Commission said in treatment guidelines published online on Wednesday that Actemra can now be used to treat coronavirus patients with serious lung damage and high IL-6 levels.

Separately, researchers in the country are testing Actemra, known generically as tocilizumab, in a clinical trial expected to include 188 coronavirus patients and running until May 10.

Roche, which donated 14 million yuan ($2.02 million) worth of Actemra during February, said the trial was initiated independently by a third party with the aim of exploring the efficacy and safety of the drug in coronavirus patients with CRS.

It added that there was currently no published clinical trial data on the drug's safety or efficacy against the virus.

More than 3,000 people have died and 93,000 have been infected by the novel coronavirus thought to have originated in Wuhan, China, before spreading to around 90 countries including the United States, Italy, Switzerland, France and Germany.

The Swiss company, for which China is its No. 2 market behind the United States, also makes diagnostic gear to detect the coronavirus.

Since Actemra's approval a decade ago, it has become a go-to drug against other inflammatory conditions, including cytokine storms in cancer patients receiving cell therapies from Novartis and Gilead Sciences.

In 2012 it helped save the life of a young U.S. girl, the first child to be treated for leukaemia with Novatis' Kymriah, from a post-treatment rush of IL-6.

Priced at between $20-30,000 annually for RA according to SSR Health, Roche's medicine is also used for rare juvenile arthritis and giant cell arteritis, or inflammation of the blood vessels.

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

Apr 26: The remarkable story of an airman who overcame prejudice to become one of only a handful of Indian fighter pilots in the First World War has emerged in newly-released archive files by the UK's Commonwealth War Graves Commission (CWGC).

Lieutenant Shri Krishna Chanda Welinkar is one of the thousands of moving stories from the war preserved in family correspondence and being brought alive as part of a digitisation project.

The never-before-published files contain thousands of letters, pictures and other papers sent between the Commission and the next of the kin of First World War dead.

Among them is the story of Welinkar, who hailed from Bombay in colonial India. After much hardship and discrimination, he eventually became a pilot and went missing while on patrol over the skies above the Western Front in June 1918.

His family had to wait nearly three years before they finally knew for certain that he had died, and his grave was located.

“For everyone who died in the First World War, there was inevitably a partner, parent or child back home who had questions. The heartbreaking letters in CWGC's archive give us an insight into what it was like for those families trying to come to terms with their loss,” said Andrew Fetherston, chief archivist for CWGC.

“They are stories that show desperate searches for closure, former enemies uniting and, on many occasions, the sad realisation that a missing loved one would always remain so. We are pleased to be able to make this invaluable piece of World War history accessible to a new generation and help deepen our understanding of how the First World War impacted those who were left behind,” he said.

Welinkar was one of the 1.3 million Indians who answered the call to fight for the British Empire. Nearly 74,000 never saw their homeland again and are remembered today in cemeteries and memorials throughout the world, including France, Belgium, the Middle East and Africa.

Welinkar was a well-educated man studying at Cambridge University. He trained to become an aviator in Middlesex and wished to join the Royal Flying Corps, later known as the Royal Air Force.

Upon attempting to enlist, Welinkar encountered the same prejudices as his other fellow Indian airmen and was encouraged to become an air mechanic instead.

He was eventually given a commission in the Royal Flying Corps as an Officer. In 1918, he was posted to France and patrolled the skies above the Western Front.

In June 1918, Lieutenant Welinkar embarked on what would be his final patrol; he did not return and was reported missing. His fate remained unknown for many months afterwards.

The newly-released e-files chronicle the remarkable discovery of Welinkar and his final resting place long after the war had ended. Colonel Barton, who knew Welinkar, acted on behalf of his mother and helped find her missing son. They spoke to former enemies and honed their search to the grave of an unidentified man, buried by the Germans as “Oberleutnant S.C. Wumkar” in a grave in Rouvroy, Belgium.

The body was later moved and reinterred in Hangard Communal Cemetery Extension but it wasn't until the vital clue, found in the original German burial records in February 1921, that it was confirmed beyond doubt this grave was of Welinkar's.

In May 1921, Colonel Barton, on behalf of Welinkar's mother, requested that a Commission headstone be placed on the grave with the following personal inscription: “To the Honoured Memory of One of the Empire's Bravest Sons”.

This records – known as Enquiry Files – are part of a collection of nearly 3,000 files which have never been made available to the public before. Nearly half have been digitised so far, alongside a previously unreleased collection of more than 16,000 photographs held in negatives in the Commission's archive.

The files, internally referred to simply as E-Files, contain correspondence between the CWGC and the next of kin of the war dead. They often contain letters, typed memos between Commission staff and on occasion photos, maps and diagrams.

CWGC only holds an enquiry file for a small proportion of the 1.7 million people it commemorates from the Commonwealth. Today it is only possible to release those surviving records from the First World War because correspondence with families of Second World War casualties often involves people still alive today and cannot be made public for many years, due to the UK's data protection rules.

To date, more than 1,300 of the surviving 3,000 First World War enquiry files have been digitised.

The CWGC commemorates the 1.7 million Commonwealth servicemen and women who died during the two World Wars. It also holds and updates an extensive and accessible records archive, while operating over 23,000 locations in more than 150 countries and territories.