Nepal earthquake: At least 66 killed, including 17 in India; over 1100 injured

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, May 12: British Prime Minister Boris Johnson has warned that a mass vaccine for the novel coronavirus may be over a year away and, in the worst-case scenario, may in fact never be found.

In his foreword to the government’s new 50-page guidance on a step by step easing of the lockdown measures in place to control the spread of the deadly virus, the UK prime minister lays out plans for businesses to gradually start reopening with “COVID-19 Secure” measures of social distancing and for the public to use “good solid British common sense” as the economy is unlocked.

“A mass vaccine or treatment may be more than a year away,” said Johnson, highlighting the work being done in the UK by scientists at Oxford University and Imperial College London towards this mission.

“Indeed, in a worst-case scenario, we may never find a vaccine. So our plan must countenance a situation where we are in this, together, for the long haul, even while doing all we can to avoid that outcome,” he said.

Admitting that a vaccine or drug-based treatment is the only “feasible long-term solution”, he said the UK has accelerated this with “promising” vaccine development programmes and a collaboration between Oxford University and pharma major AstraZeneca was a vital step that could help rapidly advance the manufacture of a Covid-19 vaccine when it is ready.

As part of global efforts, he flagged the GBP 388 million in aid funding for research into vaccines, tests and treatment, including GBP 250m to the Coalition for Epidemic Preparedness Innovations.

“But while we hope for a breakthrough, hope is not a plan,” he said, as he unveiled his plan for starting to lift lockdown restrictions from this week in phases.

Following a televised address to the nation on Sunday night and a statement in Parliament on Monday, the guidance comes into effect in public life across England from Wednesday when people will be allowed one-to-one contact with people other than those they live with, as long as they remain outside and two metres apart.

They are allowed to play sport with a friend or family member from outside their household or socialise with them in the open air for the first time in more than six weeks since the lockdown was imposed.

People are still advised to work from home where possible but start heading into work where necessary, in sectors such as construction and manufacturing, keeping the social distancing norms in place.

Under the step by step plan, by the start of next month non-essential shops will also reopen, with some hairdressers, pubs and cinemas to follow from July. However, as part of a Covid-19 Alert System, if infection rates are seen to be rising again, restrictions would be tightened “possibly at short notice”.

Fines for breaching the new rules will also be increased to GBP 100 and will double for each repeat offence, up to a maximum of GBP 3,200.

Johnson said: "I must ask the country to be patient with a continued disruption to our normal way of life, but to be relentless in pursuing our mission to build the systems we need. The worst possible outcome would be a return to the virus being out of control – with the cost to human life, and – through the inevitable re-imposition of severe restrictions – the cost to the economy. We must stay alert, control the virus, and in doing so, save lives.

“Then, as vaccines and treatment become available, we will move to another new phase, where we will learn to live with Covid-19 for the longer term without it dominating our lives.”

The devolved administrations of Scotland and Wales are putting their own measures in place and keeping the “stay at home” message in place, rather than switch to the new “stay alert” message.

The UK government’s latest messaging has come under attack from the Opposition and other sections of society over a feared lack of clarity for the general public.

Washington D.C., April 21: North Korea's leader, Kim Jong Un, is in grave danger following a surgery this month, according to a US intelligence official with direct knowledge.

Kim recently missed the celebration of his grandfather's birthday on April 15, which raised speculation about his well-being. He had been seen four days before that at a government meeting, according to intelligence reports cited by CNN.

The National Security Council and Office of the Director of National Intelligence have however declined to comment on the matter.

CNN has also reached out to the CIA and the State Department for comment and sought comment from the South Koreans.

Kim's absences from official state media often spark speculation and rumors about his health. North Korea has no free press and is often a black hole when it comes to the country's leadership. Analysts are heavily reliant on scanning state media dispatches and watching propaganda videos for any semblance of a clue.

Kim last appeared in North Korean state media on April 11. April 15 -- North Korea's most important holiday, the anniversary of the birth of the country's founding father, Kim Il Sung -- came and went without any official mention of Kim Jong Un's movements.

Experts are unsure of what to make of Kim's absence from any festivities celebrating his grandfather. When North Korean leaders have not shown up to these important celebrations in the past, it has portended major developments. But it has also turned out to be nothing.

"There have been a number of recent rumours about Kim's health (smoking, heart, and brain). If Kim is hospitalized, it would explain why he wasn't present on the important April 15th celebrations," said Bruce Klingner, a senior research fellow at the Heritage Foundation and former CIA deputy division chief for North Korea. "But, over the years, there have been a number of false health rumors about Kim Jong-un or his father. We'll have to wait and see."

Kim Jong Il's absence from a parade celebrating North Korea's 60th anniversary in 2008 was followed by rumblings that he was in poor health. It was later revealed he had a stroke, after which his health continued to decline until his death in 2011.

Kim Jong Un disappeared from the public eye for more than a month in 2014, which also prompted speculation about his health. He returned sporting a cane, and days later South Korean intelligence said that he had a cyst removed from his ankle.