Ebola death toll rises to 200 in Congo

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

Washington, Jul 15: The Trump administration has agreed to rescind its July 6 rule, which temporarily barred international students from staying in the United States unless they attend at least one in-person course, a federal district court judge said on Tuesday.

The U-turn by the Trump administration comes following a nationwide outrage against its July 6 order and a series of lawsuits filed by a large number of educational institutions, led by the prestigious Harvard University and Massachusetts Institute of Technology (MIT), seeking a permanent injunctive relief to bar the Department of Homeland Security (DHS) and the US Immigration and Customs Enforcement (ICE) from enforcing the federal guidelines barring international students attending colleges and universities offering only online courses from staying in the country.

As many as 17 US states and the District of Columbia, along with top American IT companies such as Google, Facebook and Microsoft, joined MIT and Harvard in the US District Court in Massachusetts against the DHS and the ICE in seeking an injunction to stop the entire rule from going into effect.

"I have been informed by the parties that they have come to a resolution. They will return to the status quo," Judge Allison Burroughs, the federal district judge in Boston, said in a surprise statement at the top of the hearing on the lawsuit.

The announcement comes as a big relief to international students, including those from India. In the 2018-2019 academic year, there were over 10 lakh international students in the US. According to a recent report of the Student and Exchange Visitor Program (SEVP), 1,94,556 Indian students were enrolled in various academic institutions in the US in January.

Judge Burroughs said the policy would apply nationwide.

"Both the policy directive and the frequently asked questions would not be enforced anyplace," she said, referring to the agreement between the US government and MIT and Harvard.

Congressman Brad Scneider said this is a great win for international students, colleges and common sense.

"The Administration needs to give us a plan to tackle our public health crisis - it can't be recklessly creating rules one day and rescinding them the next," he said in a tweet.

Last week, more than 136 Congressmen and 30 senators wrote to the Trump administration to rescind its order on international students.

"This is a major victory for the students, organisers and institutions of higher education in the #MA7 and all across the country that stood up and fought back against this racist and xenophobic rule," said Congresswoman Ayanna Pressley.

"Taking online classes shouldn't force international students out of our country," Congressman Mikie Sherrill said in a tweet.

In its July 6 notice, the ICE had said all student visa holders, whose university curricula were only offered online, "must depart the country or take other measures, such as transferring to a school with in-person instruction to remain in lawful status".

"If not, they may face immigration consequences, including but not limited to the initiation of removal proceedings," it had said.

In their lawsuit, the 17 states and the District of Columbia said for many international students, remote learning in the countries and communities they come from would impede their studies or be simply impossible.

The lawsuit alleged that the new rule imposes a significant economic harm by precluding thousands of international students from coming to and residing in the US and finding employment in fields such as science, technology, biotechnology, healthcare, business and finance, and education, and contributing to the overall economy.

In a separate filing, companies like Google, Facebook and Microsoft, along with the US Chamber of Commerce and other IT advocacy groups, asserted that the July 6 ICE directive will disrupt their recruiting plans, making it impossible to bring on board international students that businesses, including the amici, had planned to hire, and disturb the recruiting process on which the firms have relied on to identify and train their future employees.

The July 6 directive will make it impossible for a large number of international students to participate in the CPT and OPT programmes. The US will "nonsensically be sending...these graduates away to work for our global competitors and compete against us...instead of capitalising on the investment in their education here in the US", they said.

May 12: Gunmen stormed a hospital on Tuesday in an ongoing attack in the Afghan capital Kabul, as a suicide blast killed 15 people at a funeral in the country's restive east.

Special forces rescued 80 people including mothers and babies from the Kabul hospital after three gunmen launched a morning assault, killing at least four people, the interior ministry said in a statement.

Heavily armed forces were seen carrying babies wrapped in blankets away from the scene, as the clearance operation continued.

The facility, which has a large maternity ward, is located in the west of the city, home to the capital's minority Shiite Hazara community -- a frequent target of Sunni militants from the Islamic State group.

The flare-up in violence comes as Afghanistan grapples with myriad crises including a rise in militant operations across the country and a surge in coronavirus infections.

A paediatrician who fled the hospital told AFP he heard a loud explosion at the entrance of the building.

"The hospital was full of patients and doctors, there was total panic inside," he said, asking not to be named.

The maternity services at the hospital are supported by humanitarian organisation Doctors Without Borders (MSF).

"Hospitals and health workers must not be attacked. We call on all sides to stop attacking hospitals and health workers," said deputy health minister in the city, Waheed Majroh.

Around an hour later, a suicide bomber killed at least 15 people at the funeral of a local police commander in the country's eastern Nangarhar province, according to provincial spokesman Ataullah Khogyani.

The attacker detonated his explosives in the middle of the ceremony.

Zaher Adel, spokesman for the government hospital in Jalalabad, earlier said 12 bodies had arrived from the blast site and more than 50 people were being treated for injuries.

Amir Mohammad, who was wounded in the blast, said thousands of people had gathered for the funeral, an event which often draws huge crowds in Afghanistan.

The violence comes just a day after four roadside bombs exploded in a northern district of Kabul, wounding four civilians including a child.

The bombings were later claimed by the Islamic State group, according to the SITE intelligence group.

They were just the latest in a string of IS attacks on the capital.

In March, at least 25 people were killed by a gunman at a Sikh temple in Kabul, which was later claimed by the group.

IS is also responsible for an infamous attack in March 2017 on one of the country's largest hospitals, when gunmen disguised as doctors stormed the Kabul building and killed dozens.

In recent months, the jihadist group has suffered mounting setbacks after being hunted by US and Afghan forces as well as Taliban offensives targeting their fighters, but it still retains the ability to launch major assaults on urban centres.

The Taliban have largely refrained from launching large attacks on Afghan cities since February when they signed a landmark withdrawal deal with the US meant to pave the way for peace talks with the Kabul government.

Under the agreement, the Taliban promised not to target forces from the US-led coalition, but made no such pledge toward Afghan troops and have stepped up attacks in the provinces.

The Taliban have denied involvement in both of Tuesday's attacks.