Epic nuclear case: Island nation takes on India, Pak, Britain

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, May 30: President Donald Trump said Friday he would strip several of Hong Kong's special privileges with the United States and bar some Chinese students from US universities in anger over Beijing's bid to exert control in the financial hub.

In a day of concerted action, the United States and Britain also raised alarm at the UN Security Council over a controversial new security law for Hong Kong, angering Beijing which said the issue had no place at the world body.

In a White House appearance that Trump had teased for a day, the US president attacked China over its treatment of the former British colony, saying it was "diminishing the city's longstanding and proud status."

"This is a tragedy for the people of Hong Kong, the people of China and indeed the people of the world," Trump said.

Trump also said he was terminating the US relationship with the World Health Organization, which he has accused of pro-China bias in its management of the coronavirus crisis.

But Trump was light on specifics and notably avoided personal criticism of President Xi Jinping, with whom he has boasted of having a friendship even as the two powers feud over a rising range of issues.

"I am directing my administration to begin the process of eliminating policy that gives Hong Kong different and special treatment," Trump said.

"This will affect the full range of agreements, from our extradition treaty to our export controls on dual-use technologies and more, with few exceptions," he said.

Secretary of State Mike Pompeo on Wednesday informed Congress that the Trump administration would no longer consider Hong Kong to be separate under US law, but it was up to Trump to spell out the consequences.

China this week pressed ahead on a law that would ban subversion and other perceived offenses against its rule in Hong Kong, which was rocked by months of massive pro-democracy protests last year.

US restricts students

In one move that could have long-reaching consequences, Trump issued an order to ban graduate students from US universities who are connected to China's military.

"For years, the government of China has conducted elicit espionage to steal our industrial secrets, of which there are many," Trump said.

Hawkish Republicans have been clamoring to kick out Chinese students enrolled in sensitive fields. The FBI in February said it was investigating 1,000 cases of Chinese economic espionage and technological theft.

But any move to deter students is unwelcome for US universities, which rely increasingly on tuition from foreigners and have already been hit hard by the COVID-19 shutdown.

China has been the top source of foreign students to the United States for the past decade with nearly 370,000 Chinese at US universities, although Trump's order will not directly affect undergraduates.

Critics say Trump has been eager to fan outrage about China to deflect attention from his own handling of the coronavirus pandemic that has killed more than 100,000 people in the United States, the highest number of deaths of any country.

Chuck Schumer, the top Democrat in the Senate, called Trump's announcement "just pathetic."

Eliot Engel, a Democrat who heads the House Foreign Affairs Committee, noted that Trump treaded lightly on Hong Kong during last year's protests as he sought a trade deal with Xi.

"Now, the president wants to shift the blame for his failures onto China, so he's doing the right thing for the wrong reason," Engel said.

Trump's order could also trigger retaliation. China in March expelled US journalists after the Trump administration tightened visa rules for staff at Chinese state media.

Clash at UN

The United States and Britain earlier in the day urged China to reconsider the Hong Kong law during talks at the UN Security Council, where China wields a veto -- making any formal session, let alone action against Beijing, impossible.

The Western allies raised Hong Kong in an informal, closed-door videoconference where China cannot block the agenda.

They said China was violating an international commitment as the 1984 handover agreement with Britain, in which Beijing promised to maintain the financial hub's separate system until at least 2047, was registered with the United Nations.

"The United States is resolute, and calls upon all UN members states to join us in demanding that the PRC immediately reverse course and honor its international legal commitments to this institution and to the Hong Kong people," said US Ambassador Kelly Craft, referring to the People's Republic of China.  

China demanded that the United States and Britain "immediately stop interfering in Hong Kong affairs," saying the law did not fall under the Security Council's mandate.

"Any attempt to use Hong Kong to interfere in China's internal matters is doomed to fail," warned a statement from China's UN mission.

"There was no consensus, no formal discussion in the Security Council, and the US and the UK's move came to nothing," it said.

Beijing/Wuhan, Apr 17: China's coronavirus death toll mounted to 4,632 on Friday as the country revised figures in its epicentre Wuhan with 1,290 additional fatalities amid international criticism of under-reporting of COVID-19 data.

The Wuhan municipal headquarters on Friday revised the number of confirmed COVID-19 cases and deaths due to the disease, state-run Xinhua news agency reported.

As of April 16, the total number of confirmed coronavirus cases in Wuhan was increased by 325 to 50,333 and the number of fatalities up by 1,290 to 3,869.

The revised figure raised China's overall COVID-19 death toll to 4,632. The total number of cases also increased to 82,692.

The Wuhan municipal headquarters in a notification said the revisions were made in accordance with related laws and regulations as well as the principle of being responsible for history, the people and the deceased.

The revision of figures came amid sharp criticism of China by the US and other nations for its alleged under-reporting of the coronavirus cases and cover-up of the origin of the viral strain, which emerged in Wuhan in December last, reportedly from the local Hunan sea food market.

Explaining the reason for the figure revision, the Wuhan municipality said it was done to ensure that the information on the city's COVID-19 epidemic is open and transparent, and that the data are accurate.

Listing the reasons for the data discrepancies, it said the surging number of patients at the early stage of the epidemic overwhelmed medical resources and the admission capacity of medical institutions. Some patients died at home without having been treated in hospitals.

Besides, during the height of their treating efforts, hospitals were operating beyond their capacities and medical staff were preoccupied with saving and treating patients, resulting in belated, missed and mistaken reporting.

Also, due to a rapid increase of designated hospitals for treating COVID-19 patients -- including those administered by ministries, Hubei Province, Wuhan city and its districts, those affiliated to companies, as well as private hospitals and makeshift hospitals -- a few medical institutions were not linked to the epidemic information network and failed to report their data in time.

The registered information of some of the deceased patients was incomplete, and there were repetitions and mistakes in the reporting, the Wuhan authorities noted.

Citing an official of the Wuhan municipal headquarters, Xinhua reported that a group for epidemic-related big data and epidemiological investigations was established in late March.

The group used information from online systems and collected full information from all epidemic-related locations to ensure that facts about every case are accurate and every figure is objective and correct.

"What lie behind the epidemic data are the lives and health of the general public, as well as the credibility of the government," the official was quoted by the report.

The timely revision of the figures, among other things, shows respect for every single life, the official said.

Meanwhile, the revised cases were not included in the overall national figures released by China's National Commission (NHC) in its daily report on Friday as it reports previous day's cases.

As per NHC data, as of Thursday the overall confirmed cases of coronavirus was 82,367, including 3,342 deaths.

As many as 1,081 patients are being treated and 77,944 people discharged after recovery, it said.

NHC said it received reports of 26 new confirmed COVID-19 cases from the mainland on Thursday, of which 15 were imported.

The other 11 new cases were domestically transmitted, it said, noting that five cases were reported in Guangdong Province, three in Heilongjiang Province, two in Shandong Province and one in Liaoning Province.

No death was reported on Thursday on the mainland.

As of Thursday, China has a total of 1,549 imported cases, NHC said, adding that 879 were undergoing treatment with 45 in severe condition. Besides, there were 66 new asymptomatic cases, taking the tally to 1,038.