Thai king Adulyadej dies after 7-decade long reign

Beijing/Zurich, Mar 4: China has approved the use of Swiss drugmaker Roche's anti-inflammation drug Actemra for patients who develop severe complications from the coronavirus as it urgently hunts for new ways to combat the deadly infection that is spreading worldwide.

China is hoping that some older drugs could stop severe cytokine release syndrome (CRS), or cytokine storms, an overreaction of the immune system which is considered a major factor behind catastrophic organ failure and death in some coronavirus patients.

Actemra, a biologic drug approved in 2010 in the United States for rheumatoid arthritis (RA), inhibits high Interleukin 6 (IL-6) protein levels that drive some inflammatory diseases.

China's National Health Commission said in treatment guidelines published online on Wednesday that Actemra can now be used to treat coronavirus patients with serious lung damage and high IL-6 levels.

Separately, researchers in the country are testing Actemra, known generically as tocilizumab, in a clinical trial expected to include 188 coronavirus patients and running until May 10.

Roche, which donated 14 million yuan ($2.02 million) worth of Actemra during February, said the trial was initiated independently by a third party with the aim of exploring the efficacy and safety of the drug in coronavirus patients with CRS.

It added that there was currently no published clinical trial data on the drug's safety or efficacy against the virus.

More than 3,000 people have died and 93,000 have been infected by the novel coronavirus thought to have originated in Wuhan, China, before spreading to around 90 countries including the United States, Italy, Switzerland, France and Germany.

The Swiss company, for which China is its No. 2 market behind the United States, also makes diagnostic gear to detect the coronavirus.

Since Actemra's approval a decade ago, it has become a go-to drug against other inflammatory conditions, including cytokine storms in cancer patients receiving cell therapies from Novartis and Gilead Sciences.

In 2012 it helped save the life of a young U.S. girl, the first child to be treated for leukaemia with Novatis' Kymriah, from a post-treatment rush of IL-6.

Priced at between $20-30,000 annually for RA according to SSR Health, Roche's medicine is also used for rare juvenile arthritis and giant cell arteritis, or inflammation of the blood vessels.

London, May 3: The British government had a contingency plan for prime minister Boris Johnson’s death as his condition deteriorated while he battled COVID-19 last month in intensive care, Johnson said in an interview with The Sun newspaper.

Johnson returned to work on Monday, a month after testing positive for COVID-19. Johnson, 55, spent 10 days in isolation in Downing Street from late March, but was then was taken to London’s St Thomas’ Hospital where he received oxygen treatment and spent three nights in intensive care.

“They had a strategy to deal with a ‘death of Stalin’-type scenario,” Johnson, 55, was quoted as saying by The Sun. “It was a tough old moment, I won’t deny it.”

After Johnson was discharged, St Thomas’ said it was glad to have cared for the prime minister, but the hospital has given no details about the gravity of his illness beyond stating that he was treated in intensive care.

Johnson and his fiancée, Carrie Symonds, on Saturday announced the name of their newly born son as Wilfred Lawrie Nicholas, partly as a tribute to two of the intensive care doctors who they said had saved Johnson’s life.

“The doctors had all sorts of arrangements for what to do if things went badly wrong,” Johnson said of his COVID-19 battle. “The bloody indicators kept going in the wrong direction.”

He said doctors discussed invasive ventilation.

“The bad moment came when it was 50-50 whether they were going to have to put a tube down my windpipe,” he said. “That was when it got a bit . . . they were starting to think about how to handle it presentationally.”

New York, Apr 5: New York State, the epicentre of the coronavirus pandemic in the US, continued to record the highest count of daily deaths from COVID-19 as a staggering number of 630 people died in a 24-hour period and Governor Andrew Cuomo said the outbreak in the state could peak in about seven days.

The state had recorded the highest single increase in the number of deaths from novel coronavirus in a single day between April 2 and 3 when 562 people had died, one person dying from the viral infection almost every two-and-a-half minutes.

In the 24 hours since April 4, the death toll grew to 630, "all-time increase" up to a total of 3,565, up from 2,935 on Friday morning, Cuomo said.

The daily death toll in New York continues to grow at record numbers as the state remains the most impacted in the US from coronavirus.

Coronavirus cases in New York State now stand at 113,704, out of the country's total number of 312,146. New Jersey, the second most impacted state in the US, has about 30,000 COVID-19 cases.

New York City alone has 63,306 coronavirus patients, up from 57,169 the previous 24 hours, and 2,624 deaths.

Cuomo said the apex in the state, the point where the number of infections on a daily basis hits the high point, is still about 4-8 days away.

"We have been talking about hitting that apex, the high point of the curve. I call it the battle of the mountaintop. That's going to be the number one point of engagement of the enemy," he said.

"But our reading of the projections is we're somewhere in the seven-day range, four, five, six seven, eight day range. Nobody can give you a specific number, which makes it very frustrating to plan when they can't give you a specific number or a specific date, but we're in that range," Cuomo said.

"We are not yet at the apex. Part of me would like to be at the apex and just let's do it. But there's part of me that says it's good that we're not at the apex because we're not yet ready for the apex either, still working on the capacity of the (healthcare) system," the governor said.

Cuomo has expressed anger over the short supply of essential medical equipment for healthcare professionals to help them deal with the surge in coronavirus cases across the state and the country.

He said personal protective equipment (PPE) such as masks, gowns and face shields are in short supply in New York as they are across the country and there is need for companies to make these materials.

"It is unbelievable to me that in the New York State, in the United States of America, we can't make these materials and that we are all shopping China to try to get these materials and we're all competing against each other," he had said earlier.

Cuomo said on Saturday that the state has 85,000 volunteers, including 22,000 from outside the state, and he will also be signing an executive order to allow medical students who were slated to graduate to begin practising, supplementing the state's healthcare professional capacity.

On ventilators, he said the state had ordered 17,000 but there was not enough supply in the federal stockpile to meet this growing demand across the state.    

"China is remarkably the repository for all of these orders - ventilators, PPE, it all goes back to China, which long term we have to figure out why we wound up in this situation where we don't have the manufacturing capacity in this country," he said, adding, "New York has been shopping in China."

The Chinese government helped facilitate a donation of 1,000 ventilators that will arrive at the JFK Airport in the city, he said, as he thanked the Chinese government, Alibaba head Jack Ma, the Jack Ma Foundation, Alibaba co-founder co-founder Joe Tsai and China's Consul General Huang Ping.
In addition, the state of Oregon would deliver 140 ventilators to New York.    

Cuomo has signed an executive order allowing the state to redistribute ventilators and personal protective equipment from hospitals, private sector companies and institutions that don't currently need them and redeploy the equipment to other hospitals with the highest need.
Those institutions will either get their ventilator back or they will be reimbursed and paid for their ventilator so they can buy a new ventilator.
The 2,500-bed facility at the Javits Convention Centre, which was supposed to be used for non-COVID patients, will now be used as COVID-positive facility.

"The federal government will staff that and the federal government with equip that. That is a big deal because that 2,500-bed facility will relieve a lot of pressure on the downstate system as a significant number of beds and that facility has to make that transition quickly and that's what we're focused on," Cuomo said.

Cuomo emphasised that he wants the pandemic to end as soon as possible as it is taking an unprecedented strain on life.

"I want this to be all over. It's only gone on for 30 days since our first case. It feels like an entire lifetime. I think we all feel the same. This stresses this country, this state, in a way that nothing else has frankly, in my lifetime. It stresses us on every level.

The economy is stressed, the social fabric is stressed, the social systems are stressed, transportation is stressed," he said.