Trump fires chief US lawyer who defied him on migrant ban

Geneva, Apr 23: The World Health Organisation (WHO) on Wednesday (local time) said that the COVID-19 crisis will not end any time soon, with several countries only in the initial stages of the fight against the virus.

"Make no mistake, we have a long way to go. Coronavirus will be with us for a long time. There is no question that stay at home orders and other physical distancing measures have successfully suppressed transmission in many countries," WHO chief Tedros Adhanom Ghebreyesus said in a press conference.

"Most countries are in the early stages of their epidemics. And some, which were affected early in the pandemic, are now starting to see a resurgence in the number of cases," he added.

COVID-19 has infected more than 2.6 million people around the world and a total of 1,83,027 people have died due to coronavirus, according to data from US-based Johns Hopkins University.

Beijing, Jan 23: China is putting on lockdown a city of 11 million people considered the epicenter of the new coronavirus outbreak that has killed 17 and infected nearly 600 people, as health authorities around the world work to prevent a global pandemic.

The previously unknown coronavirus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan. Cases have been detected as far away as the United States, stoking fears the virus is already spreading worldwide.

Wuhan's local government said it would shut down all urban transport networks and suspend outgoing flights from the city as of 10 a.m. (0200 GMT) Thursday, state media reported, adding that the government is urging citizens to not leave the city in the absence of special circumstances.

Contrasting with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people, China's communist government has this time given regular updates to try to avoid panic as millions of people travel for the Chinese Lunar New Year holiday.

Chinese authorities have confirmed 571 cases and 17 deaths as of end-Wednesday, state television reported on Thursday. There are eight other known cases around the world - Thailand has confirmed four cases, while the United States, Taiwan, South Korea and Japan have each reported one.

Vice Premier Sun Chunlan said during a visit to Wuhan that authorities needed to be open about the spread of the virus and their efforts to contain it, the official Xinhua news agency reported on Thursday, comments likely to reassure global health experts.

After a meeting at its Geneva headquarters on Wednesday, the World Health Organization (WHO) said it would decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters in Geneva that China's actions so far were "very strong" but called in Beijing to take "more and significant measures to limit or minimise the international spread".

"We stressed to them that by having a strong action not only they will control the outbreak in their country but they will also minimise the chances of this outbreak spreading internationally. So they recognise that," he said.

A senior U.S. State Department official also called on China to "play a bigger role in global health so they taking more and significant measures to limit or minimise the international spread".

"The lack of transparency in the past, especially with SARS ... gives us concern that that may be the case here," the official said, adding however that there were "positive signs that they have taken action in Wuhan".

Fears of a pandemic initially spooked markets but they regained their footing on Wednesday, with investors citing the robust response from authorities as reassuring.

VIRUS SPREADING

The outbreak began in Wuhan, a major transportation hub as well as central China's main industrial and commercial centre, and has now spread to other major population centers including Beijing, Shanghai and Hong Kong.

There is no known cure for the virus. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses, and can cause pneumonia.

Chinese authorities are still investigating the origins of the virus, though they confirmed the outbreak began at a market in Wuhan with illegal wildlife transactions and that it can spread from one person to another via respiratory transmission. Among confirmed patients are 15 medical workers, further adding to worries about a possible global pandemic.

Many Chinese were canceling trips, buying face masks, avoiding public places such as cinemas and shopping centers, and even turning to an online plague simulation game as a way to cope.

Airports globally stepped up screening passengers from China and the European Centre for Disease Control and Prevention (ECDC) said in a risk assessment that further global spread of the virus was likely.

Britain joined other countries including Australia in advising citizens against all but essential travel to Wuhan.

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.