Dawn journalist Cyril Almeida barred from leaving Pakistan

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.

Washington, May 1:The novel coronavirus, that has killed over 230,000 people globally so far and has shattered economies, emerged from a virology lab in the Wuhan city of China, US President Donald Trump claimed Thursday with a high degree of confidence.

"Yes, I have. Yes, I have," Trump told reporters at the East Room of the White House when asked if he has seen anything at this point that gives him a high degree of confidence that the Wuhan Institute of Virology is where the virus originated.

The president, however, refuse to provide any details, except for saying that investigations are on and it would be out soon.

Asked what gave him a high degree of confidence that the virus originated from the Wuhan Institute of Virology, he said, "I can't tell you that. I'm not allowed to tell you that."

The president, however, did not hold his Chinese counterpart Xi Jinping responsible for this. "I don't want to say that, I don't want to say that, but certainly it could have been stopped. It came out of China and it could have been stopped and I wish they had stopped it and so does the whole world wish they had stopped it."

Reiterating that this is something that could have been contained at Wuhan ground zero, he said that China could have contained it. "They were either unable to, or they chose not to. And the world has suffered greatly."

One of two things happened, he reasoned. "They either didn't do it and you know they couldn't do it from a competent standpoint or they let it spread and I would say probably it got out of control."

"But there's another case that how come they stopped all of the planes and all of the traffic from going into China, but they didn't stop the planes and the traffic from coming into the United States and from coming into all over Europe," he said, citing the example of Italy, the hardest-hit European country.

"This country (the US) is very lucky and I'm very lucky that I put the ban on China, as you know, very early on. In January, we put the ban on China and that was a very early day. That wasn't a late day, that was an early day. Then, we later put the ban on in Europe," he said.

Before holding them accountable, Trump said he wants to find out what happened. "I think we'll be able to get a very good -- a very powerful definition of exactly what happened. We're working on it strongly now and I think it's going to be very powerful," he said.

"But they could have stopped it. They are a very brilliant nation, scientifically and otherwise. It got loose, let's say, and they could have capped it. They could have stopped it, but they didn't. And they stopped the planes from going to China, but they didn't stop them from going to the rest of the world. What was that all about?” he asked.

"We should have the answer to that in the not-too-distant future and that will determine a lot how I feel about China," Trump said.

When asked if President Xi misled him, Trump said, "Something happened. I don't say misleading or not. I'll let you know that. I mean, I'll be able to give you that answer at some point in the hopefully not-too-distant future."

The entire world has suffered as a result of this, he said.

"We have had tremendous death and tremendous sorrow, sadness, and nobody's ever seen anything like it. So, have most of the countries of the world. They've suffered tremendously. It's something that is going to have to be dealt with. We'll have to see," said the president.

Washington, May 1: The United States on Thursday recorded 29,625 new coronavirus cases, and 2,035 deaths in the last 24 hours, according to Johns Hopkins University.

The total number of coronavirus cases has reached 1,069,534 and the death toll stands at 63,001, CNN reported.

The novel coronavirus has infected more than 3.2 million people and killed at least 233,000 globally, according to Johns Hopkins University.