Volcano on Indonesia's Bali erupts, flights cancelled

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.

Washington, May 27: Most viruses and other germs do not spread easily on flights, the US Center for Disease Control and Prevention has said in its COVID-19 guidelines which do not recommend following social distancing between two passengers inside a plane or keeping the middle seat unoccupied.

As a result of coronavirus pandemic, air traffic inside the US has come to a near halt. Air traffic is said to be down to about 90 per cent. For all travellers coming from overseas, the Center for Disease Control and Prevention (CDC) has recommended 14 days quarantine.

"Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on aeroplanes," the CDC has said in its set of COVID-19 guidelines for air travellers.

However, it noted that the air travellers were not risk-free especially in the time of the coronavirus pandemic and recommended Americans to avoid travel as far as possible.

"Air travel requires spending time in security lines and airport terminals, which can bring you in close contact with other people and frequently touched surfaces," it said.

"Social distancing is difficult on crowded flights, and you may have to sit near others (within six feet), sometimes for hours. This may increase your risk for exposure to the virus that causes COVID-19," the CDC said.

But instead of recommended social distancing inside commercial planes, the CDC has advised a series of preventive and hygienic measures to be taken by the airlines pilot and crew to prevent the spread of coronavirus.

The US Department of Transportation and Federal Aviation Administration in its latest safety alerts for operators on May 11 said that air carriers and crews conducting flight operations having a nexus to the US, including both domestic and foreign air carriers, should follow CDC's occupational health and safety guidance.

The CDC issued its guidelines in first guidelines for the airlines and airline crew on March and again in May.

The CDC, which has issued an exhaustive social guideline measures in various sections, is silent on keeping the middle seat of a plane unoccupied so as to maintain the six feet distance between two passengers.

It calls for the plane crew to report to the CDC a traveller with specific COVID-19 symptoms like fever, persistent cough, difficulty in breathing and appearing unwell.

Asking the airlines and cabin crew to review infection control guidelines for cabin crew, the CDC recommends several measures for cabin crew to protect themselves and others, manage a sick traveller, clean contaminated areas, and take actions after a flight.

Prominent among them include washing hands often with soap and water for at least 20 seconds, particularly after assisting sick travellers or touching potentially contaminated body fluids or surfaces and use of alcohol-based hand sanitizer (containing at least 60 per cent alcohol) if soap and water are not available.

Airlines should consider providing alcohol-based hand sanitizer to cabin and flight crews for their personal use, it said.

The CDC guidelines do not recommend following social distancing inside a plane between two passengers or keeping the middle seat unoccupied. But it asks to minimise contact between passengers and cabin crew and the sick person.

"If possible, separate the sick person from others (by a distance of 2 meters or 6 feet, ideally) and designate one crew member to serve the sick person. Offer a facemask, if available and if the sick person can tolerate it. If a facemask is not available or cannot be tolerated, ask the sick person to cover their mouth and nose with tissues when coughing or sneezing," said the CDC guidelines.

If no symptomatic passengers were identified during or immediately after the flight, the CDC recommends airlines to follow routine operating procedures for cleaning aircraft, managing solid waste, and wearing PPE.

"If symptomatic passengers are identified during or immediately after the flight, routine cleaning procedures should be followed, and enhanced cleaning procedures should also be used," it said.

Clean porous (soft) surfaces (e.g, cloth seats, cloth seat belts) at the seat of the symptomatic passengers and within 6 feet of the symptomatic passengers in all directions, it added.

United Nations, Jun 19: Half of the world's children -- one billion every year -- are affected by physical, sexual or psychological violence, suffering injuries and death because countries have failed to follow established strategies to protect them, the first report of its kind from the UN has said, with experts noting that the coronavirus-related lockdowns have left far too many youngsters stuck with their abusers.

While nearly all countries (88 per cent) have laws in place to protect minors, less than half (47 per cent) say they strongly enforce them, said the Global Status Report on Preventing Violence Against Children 2020 launched on Thursday.

Because countries have failed to follow established strategies to protect children, about one billion are affected each year by physical, sexual or psychological violence, it said.

"There is never any excuse for violence against children," WHO Director-General Tedros Adhanom Ghebreyesus said.

"We have evidence-based tools to prevent it, which we urge all countries to implement. Protecting the health and well-being of children is central to protecting our collective health and well-being, now and for the future," he said.

The report -- launched by the World Health Organisation, the UNICEF, the UNESCO, the Special Representative of the UN Secretary-General on Violence against Children and the End Violence Partnership -- charted progress in 155 countries against the "INSPIRE" framework, a set of seven strategies for preventing and responding to violence against children.

The report signaled a clear need in all countries to scale up efforts to implement them. It included the first ever global homicide estimates specifically for children under 18 years of age -- previous estimates were based on data that included 18 to 19-year olds.

According to the findings, in 2017, around 40,000 children were victims of homicide.

"Violence against children has always been pervasive, and now things could be getting much worse," UNICEF Executive Director Henrietta Fore said.

"Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer. It is urgent to scale up efforts to protect children during these times and beyond, including by designating social service workers as essential and strengthening child helplines," she said.

UNESCO Director-General Audrey Azoulay said during the COVID-19 pandemic, and the related school closures, "we have seen a rise in violence and hate online – and this includes bullying".

"Now, as schools begin to re-open, children are expressing their fears about going back to school. It is our collective responsibility to ensure that schools are safe environments for all children. We need to think and act collectively to stop violence at school and in our societies at large," Azoulay said.

Stay-at-home measures including school closures have limited the usual sources of support for families and individuals such as friends, extended family or professionals.

This further erodes victims’ ability to successfully cope with crises and the new routines of daily life. Spikes in calls to helplines for child abuse and intimate partner violence have been observed, the report said.

While online communities have become central to maintain many children's learning, support and play, an increase in harmful online behaviors including cyberbullying, risky online behavior and sexual exploitation have been identified.

“Whilst this report was being finalised, confinement measures and the disrupted provision of already limited child protection services exacerbated the vulnerability of children to various forms of violence," said Najat Maalla M’jid, Special Representative of the UN Secretary-General on Violence against Children.

Of the INSPIRE strategies, only access to schools through enrolment showed the most progress with 54 per cent of the countries reporting that a sufficient number of children in need were being reached in this way.

Between 32 per cent and 37 per cent of the countries considered that victims of violence could access support services, while 26 per cent of the countries provided programmes on parent and caregiver support; 21 per cent of the countries had programmes to change harmful norms; and 15 per cent of the countries had modifications to provide safe physical environments for children, the report said.

Although a majority of countries (83 per cent) have national data on violence against children, only 21 per cent used these to set baselines and national targets to prevent and respond to violence against children, it added.

The report said about 80 per cent of countries have national plans of action and policies but only one-fifth have plans that are fully funded or have measurable targets. A lack of funding combined with inadequate professional capacity are likely contributing factors and a reason why implementation has been slow.

"Ending violence against children is the right thing to do, a smart investment to make - and it's possible. We can and must create a world where every child can thrive," Howard Taylor of the End Violence Partnership said.