Modi arrives in Myanmar, to step up engagement with ASEAN

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.

London, Mar 4: The UK government has reiterated its concern over the potential impact of the Citizenship Amendment Act (CAA) and said it is continuing to follow the events in India closely.

In response to an urgent question on “Recent Violence in India” tabled by Pakistani-origin Opposition Labour Party MP Khalid Mahmood in the House of Commons on Tuesday, UK’s Minister of State in the Foreign and Commonwealth Office (FCO) Nigel Adams said the UK engages with India at all levels, including on human rights, and also referred to the country's "proud history" of inclusive government and religious tolerance.

"The UK government also have concerns about the potential impact of the legislation (CAA),” said Adams, the Minister for Asia who was standing in for UK Foreign Secretary Dominic Raab, who is on a visit to Turkey.

"It is because of our close relationship with the government of India that we are able to discuss difficult issues with them and make clear our concerns where we have them, including on the rights of minorities. We will continue to follow events closely and to raise our concerns when we have with them,” said the minister.

While Mahmood, who had tabled the urgent question for an FCO statement, described the government response as “facile”, another Pakistani-origin MP Nusrat Ghani called on the government to relay the UK Parliament's concerns to the Indian authorities.

British Sikh Labour MP Tanmanjeet Singh Dhesi said the violence had brought back “painful personal memories” from the 1984 Sikh riots while he was studying in India and fellow Sikh MP Preet Kaur Gill also referenced 1984 in her intervention.

Other MPs sought to highlight the steps taken by the Indian authorities to restore “peace and tranquillity” in Delhi.

“He will be aware that it is not just Muslims who have been killed; Hindus have also been killed as part of the riots,” said Conservative Party MP Bob Blackman.

Scottish National Party (SNP) MP Alyn Smith sought the UK government’s intervention to share best practice around countering the online disinformation campaign being used in India to “inflame tensions”.

“We are in constant contact on these issues, and we know how important this is to Members of Parliament and their constituents, who may have family in the area,” said Adams, in his response.

For the first time in the 15 years of the Global Risks Report, the climate change and environment risk has occupied all the top five slots.

According to the 15th edition of the World Economic Forum's (WEF) Global Risks Report, the top five risks in terms of likelihood are extreme weather, climate action failure, natural disasters, biodiversity loss and human-made environmental disasters. They all fall in the one category of climate change and related environmental disasters.

WEF President Borge Brende said the world was feeling long-mounting and interconnected risks.

The report also points to how citizens are protesting across the world as discontent rises with failed systems that are creating inequality. The citizens' discontent had hardened with systems that had failed to promote advancement, it said.

"Disapproval of how governments are addressing profound economic and social issues has sparked protests throughout the world, potentially weakening the ability of governments to take decisive action should a downturn occur. Without economic and social stability, countries could lack the financial resources, fiscal margin, political capital or social support needed to confront key global risks," it said.

Listing the grim scenario, Borge said the global economy was faced with "synchronised slowdown", the past five years had been the warmest on record and cyber attacks were expected to increase this year.

The report warns that while the myriad risks were rising, time was running out on how to prevent them.

Borge said the growing palpability of shared economic, environmental and societal risks indicated that the horizon had shortened for preventing "or even mitigating" some of the direst consequences of global risks.

"It's sobering that in the face of this development, when the challenges before us demand immediate collective action, fractures within the global community appear to only be widening," he said.

The report points to grave concern about the consequences of continued environmental degradation, including the record pace of species decline.

Pointing to an unsettled geopolitical environment, the report said today's risk landscape was one in which new centres of power and influence were forming and old alliance structures and global institutions were being tested.

"While these changes can create openings for new partnership structures in the immediate term, they are putting stress on systems of coordination and challenging norms around shared responsibility. Unless stakeholders adapt multilateral mechanisms for this turbulent period, the risks that were once on the horizon will continue to arrive," it said.

Calling it a "an unsettled world", the WEF report notes that powerful economic, demographic and technological forces were shaping a new balance of power. "The result is an unsettled geopolitical landscape in which states are increasingly viewing opportunities and challenges through unilateral lenses," it said.

"What were once givens regarding alliance structures and multilateral systems no longer hold as states question the value of long-standing frameworks, adopt more nationalist postures in pursuit of individual agendas and weigh the potential geopolitical consequences of economic decoupling. Beyond the risk of conflict, if stakeholders concentrate on immediate geo-strategic advantage and fail to re-imagine or adapt mechanisms for coordination during this unsettled period, opportunities for action on key priorities may slip away," the WEF said.

In a chapter on risks to economic stability and social cohesion, it said a challenging economic climate might persist this year and members of the multi-stakeholder community saw "economic confrontations" and "domestic political polarisation" as the top risks in 2020.

The report also warned of downward pressure on the global economy from macroeconomic fragilities and financial inequality. These pressures continued to intensify in 2019, increasing the risk of economic stagnation.

Low trade barriers, fiscal prudence and strong global investment, once seen as fundamentals for economic growth, are fraying as leaders advance nationalist policies. The margins for monetary and fiscal stimuli are also narrower than before the 2008-2009 financial crisis, creating uncertainty about how well countercyclical policies will work.

The strategic partners for the WEF report included Marsh & McLennan and Zurich Insurance Group. The academic advisers were National University of Singapore, Oxford Martin School, University of Oxford and Wharton Risk Management and Decision Processes Center, University of Pennsylvania.