IMF calls for 'urgent' action by India amid slowdown

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.

Microsoft's Indian-origin CEO Satya Nadella on Monday voiced concern over the contentious Citizenship Amendment Act (CAA), saying what is happening is "sad" and he would love to see a Bangladeshi immigrant create the next unicorn in India.

His comments came while speaking to editors at a Microsoft event in Manhattan where he was asked about the contentious issue of CAA which grants citizenship to persecuted non-Muslim minorities from Pakistan, Bangladesh and Afghanistan.

"I think what is happening is sad... It's just bad.... I would love to see a Bangladeshi immigrant who comes to India and creates the next unicorn in India or becomes the next CEO of Infosys," Nadella was quoted as saying by Ben Smith, the Editor-in-Chief of New York-based BuzzFeed News.

In a statement issued by Microsoft India, Nadella said: "Every country will and should define its borders, protect national security and set immigration policy accordingly. And in democracies, that is something that the people and their governments will debate and define within those bounds.

"I’m shaped by my Indian heritage, growing up in a multicultural India and my immigrant experience in the United States. My hope is for an India where an immigrant can aspire to found a prosperous start-up or lead a multinational corporation benefitting Indian society and the economy at large".

The Centre last week issued a gazette notification announcing that the CAA has come into effect from January 10, 2020.

The CAA was passed by Parliament on December 11.

According to the legislation, members of Hindu, Sikh, Buddhist, Jain, Parsi and Christian communities who have come from Pakistan, Bangladesh and Afghanistan till December 31, 2014, due to religious persecution will not be treated as illegal immigrants but given Indian citizenship.

There have been widespread protests against the Act in different parts of the country.

In Uttar Pradesh, at least 19 persons were killed in anti-CAA protests.

Karachi, May 25: The pilot of the Pakistan International Airlines (PIA)'s crashed plane ignored three warnings from the air traffic controllers about the aircraft's altitude and speed before the landing, saying he was satisfied and would handle the situation, according to a report on Monday.

The national flag carrier's PK-8303 tragedy on Friday, in which 97 people were killed and two miraculously survived, is one of the most catastrophic aviation disasters in the country's history.

The Airbus A-320 from Lahore to Karachi was 15 nautical miles from the Jinnah International Airport, flying at an altitude of 10,000 feet above the ground instead of 7,000 when the Air Traffic Control (ATC) issued its first warning to lower the plane's altitude, Geo News quoted an ATC report as saying.

Instead of lowering the altitude, the pilot responded by saying that he was satisfied. When only 10 nautical miles were left till the airport, the plane was at an altitude of 7,000 feet instead of 3,000 feet, it said.

The ATC issued a second warning to the pilot to lower the plane's altitude. However, the pilot responded again by stating that he was satisfied and would handle the situation, saying he was ready for landing, the report said.

The report said that the plane had enough fuel to fly for two hours and 34 minutes, while its total flying time was recorded at one hour and 33 minutes.

Pakistani investigators are trying to find out if the crash is attributable to a pilot error or a technical glitch.

According to a report prepared by the country's Civil Aviation Authority (CAA), the plane's engines had scraped the runway thrice on the pilot's first attempt to land, causing friction and sparks recorded by the experts.

When the aircraft scraped the ground on the first failed attempt at landing, the engine's oil tank and fuel pump may have been damaged and started to leak, preventing the pilot from achieving the required thrust and speed to raise the aircraft to safety, the report said.

The pilot made a decision "on his own" to undertake a "go-around" after he failed to land the first time. It was only during the go-around that the ATC was informed that landing gear was not deploying, it said.

"The pilot was directed by the air traffic controller to take the aircraft to 3,000 feet, but he managed only 1,800. When the cockpit was reminded to go for the 3,000 feet level, the first officer said 'we are trying'," the report said.

Experts said that the failure to achieve the directed height indicates that the engines were not responding. The aircraft, thereafter, tilted and crashed suddenly.

The flight crashed at the Jinnah Garden area near Model Colony in Malir on Friday afternoon, minutes before its landing in Karachi's Jinnah International Airport. Eleven people on the ground were injured.

The probe team, headed by Air Commodore Muhammad Usman Ghani, President of the Aircraft Accident and Investigation Board, is expected to submit a full report in about three months.

According to the PIA's engineering and maintenance department, the last check of the plane was done on March 21 this year and it had flown from Muscat to Lahore a day before the crash.

In the wake of the COVID-19 pandemic, the Pakistan government had allowed the limited domestic flight operations from five major airports - Islamabad, Karachi, Lahore, Peshawar and Quetta - from May 16.

After the plane tragedy, the PIA has called off its domestic operation.