Will have to take military way if India doesn't listen, warns China

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.

Jun 23: US President Donald Trump has issued a proclamation to suspend issuing of H-1B visas, which is popular among Indian IT professionals, along with other foreign work visas for the rest of the year.

Trump said the step was essential to help millions of Americans who have lost their jobs due to the current economic crisis.

Issuing the proclamation ahead of the November presidential elections, Trump has ignored the mounting opposition to the order by various business organisations, lawmakers and human rights bodies.

The proclamation that comes into effect on June 24, is expected to impact a large number of Indian IT professionals and several American and Indian companies who were issued H-1B visas by the US government for the fiscal year 2021 beginning October 1.

They would now have to wait at least till the end of the current year before approaching the US diplomatic missions to get stamping. It would also impact a large number of Indian IT professionals who are seeking renewal of their H-1B visas.

“In the administration of our Nation's immigration system, we must remain mindful of the impact of foreign workers on the United States labour market, particularly in the current extraordinary environment of high domestic unemployment and depressed demand for labour,” said the proclamation issued by Trump.

In his proclamation, Trump said that the overall unemployment rate in the United States nearly quadrupled between February and May of 2020 -- producing some of the most extreme unemployment rates ever recorded by the Bureau of Labor Statistics.

While the May rate of 13.3 percent reflects a marked decline from April, millions of Americans remain out of work.

The proclamation also extends till the end of the year his previous executive order that had banned issuing of new green cards of lawful permanent residency.

Green card holders, once admitted pursuant to immigrant visas, are granted "open-market" employment authorisation documents, allowing them immediate eligibility to compete for almost any job, in any sector of the economy, he said.

“American workers compete against foreign nationals for jobs in every sector of our economy, including against millions of aliens who enter the United States to perform temporary work. Temporary workers are often accompanied by their spouses and children, many of whom also compete against American workers,” Trump said.

“Under ordinary circumstances, properly administered temporary worker programmes can provide benefits to the economy. But under the extraordinary circumstances of the economic contraction resulting from the COVID-19 outbreak, certain non-immigrant visa programmes authorising such employment pose an unusual threat to the employment of American workers,” he said.

For example, Trump said, between February and April of 2020, more than 17 million United States jobs were lost in industries in which employers are seeking to fill worker positions tied to H-2B nonimmigrant visas.

“During this same period, more than 20 million United States workers lost their jobs in key industries where employers are currently requesting H-1B and L workers to fill positions,” he said.

“Also, the May unemployment rate for young Americans, who compete with certain J non-immigrant visa applicants, has been particularly high -- 29.9 percent for 16-19-year-olds, and 23.2 percent for the 20-24-year-old group,” he said.

“The entry of additional workers through the H-1B, H-2B, J, and L non-immigrant visa programmes, therefore, presents a significant threat to employment opportunities for Americans affected by the extraordinary economic disruptions caused by the COVID-19 outbreak,” Trump said.

Trump observed that excess labour supply is particularly harmful to workers at the margin between employment and unemployment -- those who are typically "last in" during an economic expansion and "first out" during an economic contraction.

In recent years, these workers have been disproportionately represented by historically disadvantaged groups, including African Americans and other minorities, those without a college degree, and Americans with disabilities, he said.

The proclamation suspends and limits entry into the US of H-1B, H-2B and L visas and their dependents till December 31, 2020. It also includes certain categories of J visas like an intern, trainee, teacher, camp counselor, or summer work travel programme.

The new rule would apply only to those who are outside the US, do not have a valid non-immigrant visa and an official travel document other than a visa to enter the country.

According to the proclamation, it does not have an impact on lawful permanent residents of the United States and foreign nationals who are spouses or child of an American citizen.

Foreign nationals seeking to enter the US to provide temporary labour or services essential to the food supply chain are also exempted from the latest proclamation.

The new visa regulations requiring international students in the US with an F-1 visa to take at least one in-person course or face the prospect of deportation is likely to "cause uncertainties and difficulties" for some students, the Indian Embassy has said.

"These new modifications at a time when many of the US universities and colleges are yet to announce their plans for the new academic year are likely to cause uncertainties and difficulties for some Indian students wishing to pursue their studies in the US," said a spokesperson of the Indian Embassy.

Responding to media queries, the spokesperson said the Indian government has taken up the matter with concerned US officials.

At the India US Foreign Office Consultations held on July 7, Foreign Secretary Harsh Vardhan Shringla conveyed India's concerns on the matter to Under Secretary of State for Political Affairs David Hale.

According to a recent report of Student and Exchange Visitor Program (SEVP), there were 1,94,556 Indian students enrolled in various academic institutions of the US in January this year. Of these 1,26,132 were males and 68,405 were females.

Noting that partnership in higher education is a key component of the strong people-to-people ties between India and the US, the spokesperson said in the last two decades Indian students in American universities and colleges have been the harbingers of a strong partnership between technology and innovation sectors between the two countries.

The spokesperson hoped that the US authorities would provide adequate flexibility in their visa rule, keeping in mind the extraordinary circumstances created by the COVID-19 pandemic for the Indian students community.

We continue to engage all the stakeholders in the matters, including the US administration officials, Congressional leaders, universities and colleges as well as the Indian students community in the US as we move forward towards the 2020-21 academic year to further strengthen our bilateral partnership in higher education, the spokesperson said.

Announced by the SEVP on July 6, the new rules provide temporary exemptions for nonimmigrant students on F-1 and M-1 visas taking online classes due to the COVID-19 pandemic for the fall semester of the 2020 academic year.

While these modifications do provide some flexibility for US universities and colleges to adopt a hybrid model -- that is a mixture of online and in person classes -- they also restrict international students on F-1 and M-1 visas from taking courses entirely online, the spokesperson said.