US Coronavirus Cases Surge Past 1,15,000; Donald Trump Mulls New York Quarantine

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.

Beijing, Feb 18: Police in China have arrested a prominent activist who had been a fugitive for weeks and criticised President Xi Jinping's handling of the coronavirus epidemic while in hiding, a rights group said Tuesday.

Anti-corruption activist Xu Zhiyong was arrested on Saturday after being on the run since December, according to Amnesty International.

China's ruling Communist Party has severely curtailed civil liberties since Xi took power in 2012, rounding up rights lawyers, labour activists and even Marxist students.

The death this month of a whistleblowing doctor who was reprimanded by police for raising the alarm about the deadly new virus before dying of it himself triggered rare calls for political reform and freedom of speech.

The "Chinese government's battle against the coronavirus has in no way diverted it from its ongoing general campaign to crush all dissenting voices," said Patrick Poon, China researcher at Amnesty International, in an emailed statement.

Another source, who spoke to news agency on the condition of anonymity, said Xu had been arrested in the southern city of Guangzhou.

Guangzhou police did not respond to requests for comment.

Xu went into hiding after authorities broke up a December gathering of intellectuals discussing political reform in the eastern coastal city of Xiamen in Fujian province, prior to the coronavirus crisis.

Over a dozen lawyers and activists were detained or disappeared after the Xiamen gathering, according to rights groups -- and Xu's detention appears linked to his presence at the meeting, explained Poon.

But while on the run, Xu continued to post information on Twitter about rights issues.

On February 4 Xu released an article calling on Xi to step down and criticised his leadership across a range of issues including the US-China trade war, Hong Kong's pro-democracy protests and the coronavirus epidemic, which has now killed nearly 1,900 people.

"Medical supplies are tight, hospitals are filled with patients, and a large number of infected people have no way to be diagnosed," he wrote. "It's a mess."

"The coronavirus outbreak shows just how important values like freedom of expression and transparency are -- the exact values that Xu has long advocated," Yaqiu Wang, China researcher at Human Rights Watch, told news agency.

But the disappearance of Xu illustrates how the Chinese state "persists in its old ways" by "silencing its critics", she said.

Xu -- who founded a movement calling for greater transparency among high-ranking officials -- previously served a four-year prison sentence from 2013 to 2017 for organising an "illegal gathering".

"That he was a fugitive for so many days while continuing to speak out, that in itself was... a kind of challenge to (Chinese authorities)," said Hua Ze, a long-time friend of Xu who told AFP she lost contact with the Chinese activist on Saturday morning.

Kathmandu, June 18: Nepal's National Assembly on Thursday unanimously passed the Constitution Amendment Bill to update the country's political and administrative map incorporating three Indian territories. 

The new map also includes land controlled by India. It requires President Bidhya Devi Bhandari's approval.

India, which controls the region - a slice of land including Limpiyadhura, Lipulekh and Kalapani areas in the northwest - has rejected the map, saying it is not based on historical facts or evidence.

India has termed as untenable the "artificial enlargement" of territorial claims by Nepal after its lower house of parliament on Saturday unanimously approved the new political map of the country featuring areas which India maintains belong to it.

The National Assembly, or the upper house of the Nepalese parliament, unanimously passed the constitution amendment bill providing for inclusion of the country's new political map in its national emblem.

The bill was passed with all the 57 members present voting in its favour.

The dispute

The latest border dispute between the countries began last month after India inaugurated Himalayan link road built in a disputed region that lies at a strategic three-way junction with Tibet and China.

The 80km (50-mile) road, inaugurated by Indian Defence Minister Rajnath Singh, cuts through the Lipulekh Himalayan pass, considered one of the shortest and most feasible trade routes between India and China.

The road cuts the travel time and distance from India to Tibet's Mansarovar lake, considered holy by the Hindus.

But Nepal says about 19km of the road passes through its area and fiercely contested the inauguration of the road, viewing the alleged incursion as a stark example of bullying by its much larger neighbour.

Nepal, which was never under colonial rule, has long claimed the areas of Limpiyadhura, Kalapani and Lipulekh under the 1816 Sugauli treaty with the British East India Company, although these areas have remained under the control of Indian troops since India fought a war with China in 1962.