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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.

Kuala Lumpur, Feb 25: The government party led by Interim Malaysian Prime Minister Mahathir Mohamad has rejected his resignation, urging him to continue leading it and the country, now shrouded in political uncertainty.

During an extraordinary meeting held on Monday night, the Malaysian United Indigenous Party (Bersatu) unanimously rejected the 94-year-old Prime Minister's decision, reports Efe news.

Mahathir, the world's oldest head of government, presented his resignation on Monday, later accepted by King Abdullah Pahang, on condition that he continue as Interim Prime Minister until a new government is formed.

That decision caused a domino effect that broke the Patakan Harapan (Alliance of Hope) alliance, formed in 2018 by four political parties that prevailed in that year's general elections.

Bersatu and 11 Popular Justice Party deputies announced their departure from the coalition, although they reaffirmed their confidence in Mahathir as Malaysia's political leader.

"We remain intact and prepared to build a party to face the difficulties," Marzuki Yahya, Bersatu Secretary-General, said after the meeting.

Confusion reigns in the country, with some local media claiming Bersatu and the 11 deputies Justice Party deputies intended to form a new government with opposition parties, including the historic Barisan Nasional coalition, under Mahathir's leadership.

Lim Guan Eng, Finance Minister and coalition member, said in a statement that the chief executive himself had informed him he had no intention of forming a coalition with Barisan, which suffered a historic defeat in the last elections.

A future government will need at least 112 of 222 parliament votes.

Mahathir returned to politics in 2018 heading the Patakan Harapan coalition to defeat his predecessor Najib Razak, marred by the corruption suspicions offenses.

To that end, Mahathir joined Anwar Ibrahim, a former political ally who fell out of favour in 1999 and was imprisoned five years on charges of corruption and sodomy, whom he promised to be his successor in power.

Beijing, Jun 16: The coronavirus situation in China's capital is "extremely severe", a city official warned Tuesday, as 27 new infections were reported from Beijing where a new cluster has sparked a huge trace-and-test programme.

The COVID-19 resurgence -- believed to have started at the sprawling Xinfadi wholesale food market in the capital -- has sparked alarm as China had largely brought its outbreak under control through mass testing and lockdowns imposed earlier in the year.

The new cases took the number of confirmed infections in Beijing over the past five days to 106, as authorities locked down almost 30 communities in the city and tested tens of thousands of people.

"The epidemic situation in the capital is extremely severe," Beijing city spokesman Xu Hejian warned at a press conference.

The World Health Organization had already expressed concern about the cluster, pointing to Beijing's size and connectivity.

Officials in the capital have said they will test stall owners and managers at all of the city's food markets, restaurants and government canteens.

Beijing's coronavirus testing capacity has been expanded to 90,000 a day, according to China's official news agency Xinhua.

On Tuesday, the capital's transport commission banned taxi- and ride-hailing services from driving out of the city, Xinhua reported, in another move to try and contain the new outbreak.

All indoor sports and entertainment venues in Beijing were ordered to shut on Monday, and some other cities across China warned they would quarantine those arriving from the capital.

The National Health Commission also reported four new domestic infections in Hebei province, which surrounds Beijing, and a case reported in southwestern Sichuan province was linked to the Beijing cluster.

Authorities were also racing to track people from Beijing who had travelled to other parts of China, and those who visited the capital have been encouraged to get tested.

Beijing spokesman Xu said: "High-risk people who have left Beijing must inform local authorities immediately."

Market inspections

Authorities shut down another market on Tuesday -- Tiantaohonglian in the central Xicheng district -- after one employee there was diagnosed with COVID-19, state broadcaster CCTV reported.

Seven residential estates surrounding that market were also locked down.

In total, Beijing officials said Tuesday they have disinfected 276 agricultural markets, closed 11 markets, and disinfected more than 33,000 food and beverage businesses in a bid to stamp out the new cluster.

Officials had warned Sunday that since May 30, 200,000 people had visited the Xinfadi market -- the original site of the new outbreak.

More than 8,000 workers from Xinfadi have been tested and sent to centralised quarantine facilities.

Until this recent outbreak, most of China's cases in recent months were nationals returning home as the pandemic spread to other countries.

China's Center for Disease Control and Prevention said Monday that the virus strain found in the Beijing outbreak was a "major epidemic strain in the European countries".

While the virus was detected on chopping boards used to handle imported salmon at Xinfadi, "it does not clearly or definitely indicate it's from imported seafood", Wu Zunyou, the body's chief epidemiologist, said in an interview with state broadcaster CCTV.

"Ever since new cases suddenly emerged in Beijing, we have tried to figure out the reasons for the outbreak since there were no COVID-19 cases found over the past two months," Wu Zunyou said.

"We came up with several possibilities, and the most likely one is that the carrier of the novel coronavirus comes from outside China or other parts of China and brought it here."

On Tuesday, another eight imported cases were reported.