WHO calls for 'intermittent' lockdowns in Pakistan as virus surges

News Network
June 10, 2020

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.

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Agencies
February 26,2020

Islamabad, Feb 26: Islamabad on Tuesday declared former Prime Minister Nawaz Sharif an absconder while simultaneously denying extending bail to him.

The federal cabinet presided over by Prime Minister Imran Khan, cited that Sharif failed to provide required medical reports and has violated the bail terms.

The government has also decided to freeze gas and electricity tariffs for the next four months, The Dawn reported.

"After Nawaz Sharif failed to submit his medical report of any hospital in London, the medical board rejected a medical certificate sent by him and [the government] declared him an absconder. From today, Nawaz Sharif is an absconder according to the law of land and if he does not return to the country he will be declared a proclaimed offender," said Dr Firdous Ashiq Awan, Special Assistant to the Prime Minister on Information, in a press conference.

She further asserted that the Punjab government, which was authorized by the Islamabad High Court (IHC) to decide Sharif's case on medical grounds, had written several letters asking him to submit his medical report from any hospital in London. However, he failed to do so and only sent a certificate that was not accepted by the medical board.

"If he (Nawaz Sharif) is seriously ill then why a comprehensive medical report is not being submitted to the medical board," Firdous added.

Further, she said that the office of the opposition leader was also waiting for his younger brother and Leader of the Opposition in the National Assembly Shahbaz Sharif, who was also staying in London for 'no reason'.

"He is getting a monthly salary and enjoying luxurious offices and other perks and privileges but not performing his duties required by his office and the people. Shahbaz Sahib, return to the country and justify your salary and other benefits being given from taxpayers' money," Firdous added.

On October 29 last year, the IHC granted bail for eight weeks to Sharif, who was convicted and disqualified in corruption cases, on medical grounds.

Sharif left Pakistan for London along with Shahbaz on November 19, 2019, for his medical treatments there.

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News Network
June 4,2020

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.

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Agencies
June 24,2020

Seoul, Jun 24: North Korea on Wednesday said leader Kim Jong Un suspended a planned military retaliation against South Korea, possibly slowing the pressure campaign it has waged against its rival amid stalled nuclear negotiations with the Trump administration.

Last week, the North had declared relations with the South as fully ruptured, destroyed an inter-Korean liaison office in its territory and threatened unspecified military action to censure Seoul for a lack of progress in bilateral cooperation and for activists floating anti-Pyongyang leaflets across the border.

Analysts say North Korea, after weeks deliberately raising tensions, may be pulling away just enough to make room for South Korean concessions.

Pyongyang's official Korean Central News Agency said Kim presided by video conference over a meeting Tuesday of the ruling Workers' Party's Central Military Commission, which decided to postpone plans for military action against the South brought up by the North's military leaders.

KCNA didn't specify why the decision was made. It said other discussions included bolstering the country's "war deterrent".

Yoh Sang-key, spokesman of South Korea's Unification Ministry, said Seoul was "closely reviewing" the North's report but didn't further elaborate.

Yoh also said it was the first report in state media of Kim holding a video conferencing meeting, but he didn't provide a specific answer when asked whether that would have something to do with the coronavirus.

The North says there hasn't been a single COVID-19 case on its territory, but the claim is questioned by outside experts.

Kim Dong-yub, an analyst from Seoul's Institute for Far Eastern Studies, said it's likely that the North is waiting for further action from the South to salvage ties from what it sees as a position of strength, rather than softening its stance on its rival.

"What's clear is that the North said (the military action) was postponed, not cancelled," said Kim, a former South Korean military official who participated in inter-Korean military negotiations.

Other experts say the North would be seeking something major from the South, possibly a commitment to resume operations at a shuttered joint factory park in Kaesong, which was where the liaison office was located, or restart South Korean tours to the North's Diamond Mountain resort.

Those steps are prohibited by the international sanctions against the North over its nuclear weapons programme.

The public face of the North's recent bashing of the South has been Kim Yo Jong, the powerful sister of leader Kim Jong Un, who has been confirmed as his top official on inter-Korean affairs.

Issuing harsh statements through state media, she had said the North's demolishing of the liaison office would be just the first in a series of retaliatory action against the enemy South and that she would leave it to the North's military to come up with the next steps.

The General Staff of the North's military has said it would send troops to the mothballed inter-Korean cooperation sites in Kaesong and Diamond Mountain and restart military drills in frontline areas.

Such steps would nullify a set of deals the Koreas reached during a flurry of diplomacy in 2018 that prohibited them from taking hostile action against each other.

Also condemning the South over North Korean refugees floating anti-Pyongyang leaflets across the border, the North said Monday it printed 12 million of its own propaganda leaflets to be dropped over the South in what would be its largest ever anti-Seoul leafleting campaign.

It wasn't immediately clear whether Kim's decision to hold back military action would affect the country's plans for leafleting. The North's military had said it would open border areas on land and sea and provide protection for civilians involved in the leafleting campaigns.

The North has a history of dialling up pressure against the South when it fails to get what it wants from the United States. The North's recent steps came after months of frustration over Seoul's unwillingness to defy US-led sanctions and restart the inter-Korean economic projects that would breathe life into its broken economy.

Nuclear negotiations between Pyongyang and Washington largely stalled after Kim's second summit with President Donald Trump last year in Vietnam, where the Americans rejected North Korea's demands for major sanctions relief in exchange for a partial surrender of its nuclear capabilities.

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