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May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.

Beijing, Jan 23: China is putting on lockdown a city of 11 million people considered the epicenter of the new coronavirus outbreak that has killed 17 and infected nearly 600 people, as health authorities around the world work to prevent a global pandemic.

The previously unknown coronavirus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan. Cases have been detected as far away as the United States, stoking fears the virus is already spreading worldwide.

Wuhan's local government said it would shut down all urban transport networks and suspend outgoing flights from the city as of 10 a.m. (0200 GMT) Thursday, state media reported, adding that the government is urging citizens to not leave the city in the absence of special circumstances.

Contrasting with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people, China's communist government has this time given regular updates to try to avoid panic as millions of people travel for the Chinese Lunar New Year holiday.

Chinese authorities have confirmed 571 cases and 17 deaths as of end-Wednesday, state television reported on Thursday. There are eight other known cases around the world - Thailand has confirmed four cases, while the United States, Taiwan, South Korea and Japan have each reported one.

Vice Premier Sun Chunlan said during a visit to Wuhan that authorities needed to be open about the spread of the virus and their efforts to contain it, the official Xinhua news agency reported on Thursday, comments likely to reassure global health experts.

After a meeting at its Geneva headquarters on Wednesday, the World Health Organization (WHO) said it would decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters in Geneva that China's actions so far were "very strong" but called in Beijing to take "more and significant measures to limit or minimise the international spread".

"We stressed to them that by having a strong action not only they will control the outbreak in their country but they will also minimise the chances of this outbreak spreading internationally. So they recognise that," he said.

A senior U.S. State Department official also called on China to "play a bigger role in global health so they taking more and significant measures to limit or minimise the international spread".

"The lack of transparency in the past, especially with SARS ... gives us concern that that may be the case here," the official said, adding however that there were "positive signs that they have taken action in Wuhan".

Fears of a pandemic initially spooked markets but they regained their footing on Wednesday, with investors citing the robust response from authorities as reassuring.

VIRUS SPREADING

The outbreak began in Wuhan, a major transportation hub as well as central China's main industrial and commercial centre, and has now spread to other major population centers including Beijing, Shanghai and Hong Kong.

There is no known cure for the virus. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses, and can cause pneumonia.

Chinese authorities are still investigating the origins of the virus, though they confirmed the outbreak began at a market in Wuhan with illegal wildlife transactions and that it can spread from one person to another via respiratory transmission. Among confirmed patients are 15 medical workers, further adding to worries about a possible global pandemic.

Many Chinese were canceling trips, buying face masks, avoiding public places such as cinemas and shopping centers, and even turning to an online plague simulation game as a way to cope.

Airports globally stepped up screening passengers from China and the European Centre for Disease Control and Prevention (ECDC) said in a risk assessment that further global spread of the virus was likely.

Britain joined other countries including Australia in advising citizens against all but essential travel to Wuhan.

Jakarta, Mar 15: Indonesia's transport minister is in intensive care after testing positive for the novel coronavirus, an official has said, as schools and tourist attractions were ordered to close over the health threat.

Transportation Minister Budi Karya Sumadi was receiving treatment at an army hospital in Jakarta, State Secretary Pratikno said on Saturday.

A hospital spokesman said Sumadi was encountering difficulty breathing but that his condition was improving.

Pratikno said Sumadi was involved in virus mitigation efforts, particularly the evacuation of Indonesians from epicenters of the outbreak, and that President Joko Widodo had called for tests to be carried out on other ministers.

Cases of the virus in Indonesia, the world's fourth most populous country, have jumped from zero two weeks ago to 96, with five deaths, according to government spokesperson Achmad Yurianto.

He also said the virus has spread outside Greater Jakarta to Bandung in West Java, Solo in Central Java, Manado in North Sulawesi, Pontianak in West Kalimantan, as well as holiday havens Yogyakarta and Bali.

Following the increase, the government on Saturday established a task force on COVID-19 mitigation.

Jakarta's Governor Anies Baswedan announced that schools would close for two weeks starting Monday, and ordered the closure of city-owned tourist attractions, such as Ragunan Zoo and Ancol beach.

He emphasized that Jakarta would not be locked down but urged people "to be responsible" and called for social distancing when possible.

Similarly, the administration of Solo, Central Java, Friday announced that schools and tourist attractions would close after a coronavirus patient died in the region.

The World Health Organization has said it is particularly concerned about high-risk nations with weaker health systems, which who may lack the facilities to identify cases.

A day after declaring the coronavirus outbreak to be pandemic this week, WHO chief Tedros Adhanom Ghebreyesus called Indonesia's president Widodo and both agreed to "scale up cooperation."