Pakistan agencies foil IS plot to bomb ISI office in Multan

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.

Islamabad, Jun 10: The World Health Organization has told Pakistan it should implement "intermittent" lockdowns to counter a surge in coronavirus infections that has come as the country loosens restrictions, officials said.

Since the start of Pakistan's outbreak in March, Prime Minister Imran Khan opposed a nationwide lockdown of the sort seen elsewhere, arguing the impoverished country could not afford it.

Instead, Pakistan's four provinces ordered a patchwork of closures, but last week Khan said most of these restrictions would be lifted.

Health officials on Wednesday declared a record number of new cases in the past 24 hours. The country has now confirmed a total of more than 113,000 cases and 2,200 deaths -- though with testing still limited, real rates are thought to be much higher.

"As of today, Pakistan does not meet any of the pre-requisite conditions for opening the lockdown", the WHO said in a letter confirmed by Pakistan officials on Tuesday.

Many people have not adopted behavioural changes such as social distancing and frequent hand-washing, meaning "difficult" decisions will be required including "intermittent lockdowns" in targeted areas, the letter states.

Some 25 percent of tests in Pakistan come back positive for COVID-19, the WHO said, indicating high levels of infection in the general population.

The health body recommended an intermittent lockdown cycle of two weeks on, two weeks off.

Responding to the WHO's letter, Zafar Mirza, the prime minister's special advisor for health, said the country had "consciously but gradually" eased lockdowns while enforcing guidelines in shops, mosques and public transport.

"We have to make tough policy choices to strike a balance between lives and livelihoods," Mirza said Wednesday.

Punjab's provincial health minister Yasmin Rashid, who received the WHO's letter, said the provincial government had already given "orders to take strict action against those violating" virus guidelines.

Hospitals across Pakistan say they are at or near capacity, and some are turning COVID-19 patients away.

WHO Director-General Tedros Adhanom Ghebreyesus said Monday that 136,000 cases had been reported in the previous 24 hours, "the most in a single day so far", with the majority of them in South Asia and the Americas.

London, Apr 7: British Prime Minister Boris Johnson was moved to the intensive care unit of a London hospital after his coronavirus symptoms worsened Monday, just a day after he was admitted for what were said to be routine tests.

Johnson was admitted to St. Thomas’ Hospital late Sunday, 10 days after he was diagnosed with COVID-19, the first major world leader to be confirmed to have the virus.

Downing Street said Johnson was conscious and did not require ventilation, but he was moved into intensive care in case he needs it later, his office said in a statement.

Britain has no official post of deputy prime minister, but Foreign Secretary Dominic Raab has been designated to take over should Johnson become incapacitated.

Hours earlier, Johnson tweeted that he was in good spirits and thanked the National Health Service for taking care of him and others with the disease.

“On the advice of my doctor, I went into hospital for some routine tests as I’m still experiencing coronavirus symptoms,″ Johnson said in the tweet. “I’m in good spirits and keeping in touch with my team, as we work together to fight this virus and keep everyone safe.″

The prime minister's spokesman said earlier Monday that Johnson had spent a comfortable night and remained in charge of government after being admitted to the hospital because his cough and fever persisted.

Johnson's spokesman, James Slack, refused to say what kind of tests Johnson was undergoing. He insisted that "the PM remains in charge of the government."

“He is receiving updates in hospital and is continuing to receive a (ministerial red) box" of files and briefing papers, Slack said.

Prime Minister Narendra Modi on Monday hoped that his British counterpart Boris Johnson, admitted to a hospital for treatment of coronavirus, finds himself in perfect health soon.

"Hang in there, Prime Minister @BorisJohnson! Hope to see you out of hospital and in perfect health very soon," the prime minister wrote on Twitter.

The 55-year-old leader had been quarantined in his Downing Street residence since being diagnosed with COVID-19 on March 26. He continued to preside at daily meetings on the outbreak until Sunday. He released several video messages during his 10 days in isolation urging Britons to stay home and observe social distancing measures to help slow the spread of the virus.

Speaking earlier at the government's daily coronavirus press briefing, Raab said Johnson was being “regularly updated," but said he had not spoken to him since Saturday.

“He's in charge, but he’ll continue to take doctors’ advice on what to do next," Raab said.

Politicians from all parties wished Johnson a quick recovery. Opposition Labour Party leader Keir Starmer tweeted: “Terribly sad news. All the country’s thoughts are with the Prime Minister and his family during this incredibly difficult time."

Johnson's fiancee, Carrie Symonds, who is pregnant, is herself recovering from coronavirus symptoms.

Johnson was admitted to the hospital as a message to the nation from Queen Elizabeth II was being broadcast Sunday evening. The 93-year-old monarch urged the public to show resolve and follow advice to stay inside.

Concerns had been growing about Johnson’s welfare ever since he posted a message Friday saying that he was feeling better, though was still feverish.

The virus causes mild to moderate symptoms in most people, but for some, especially older adults and the infirm, it can cause pneumonia and lead to death.

The government said Monday that 51,608 people had been confirmed to have the coronavirus in Britain, 5,373 of whom have died.

Derek Hill, a professor of medical imaging science at University College London, said that since COVID-19 causes difficulty breathing, one test performed on people with the disease is lung imaging with ultrasound or CT scans to see how badly they might be affected.

Hill said there are various types of breathing help, depending on the person and the difficulties.

“The reasons some people get seriously ill with COVID-19 while others have minor symptoms is not yet fully understood,″ Hill said. “But doctors managing these patients report that more men than women have serious problems, and patients who are overweight or have previous health problems are at higher risk."