G20 likely to boost IMF resources by $400bn-$500bn

May 15: Global tensions simmered over the race for a coronavirus vaccine Thursday, as the United States and China traded jabs, and France slammed pharmaceuticals giant Sanofi for suggesting the US would get any eventual vaccine first.

Scientists are working at breakneck speed to develop a vaccine for COVID-19, the disease caused by the virus, which has killed more than 300,000 people worldwide and pummelled economies.

From the US to Europe to Asia, national and local governments are easing lockdown orders to get people back to work -- while fretting over a possible second wave of infections.

Increased freedom of movement means an increased risk of contracting the virus, and so national labs and private firms are labouring to find the right formula for a vaccine.

The European Union's medicines agency offered some hope when it said one could be ready in a year, based on data from clinical trials already underway.

But Marco Cavaleri, the EMA's head of vaccines strategy, acknowledged that timeline was a "best-case scenario," and cautioned that "there may be delays."

The race for a vaccine has exposed a raw nerve in relations between the United States and China, where the virus was first detected late last year in the central city of Wuhan.

Two US agencies warned Wednesday that Chinese hackers were trying to steal COVID-19 vaccine research -- a claim Beijing rejected as "smearing" its reputation.

US President Donald Trump, who has ratcheted up the rhetoric against China, said he doesn't even want to engage with Chinese leader Xi Jinping -- potentially imperilling a trade deal between the world's top two economies.

"I'm very disappointed in China. I will tell you that right now," he said in an interview with Fox Business.

"There are many things we could do. We could do things. We could cut off the whole relationship."

On Capitol Hill, an ousted US health official told Congress that the Trump government had no strategy in place to find and distribute a vaccine to millions of Americans, warning of the "darkest winter" ahead.

"We don't have a single point of leadership right now for this response, and we don't have a master plan," said Rick Bright, who was removed last month as head of the US agency charged with developing a coronavirus vaccine.

The United States has registered nearly 86,000 deaths linked to COVID-19 -- the highest toll of any nation.

World leaders were among 140 signatories to a letter published Thursday saying any vaccine should not be patented and that the science should be shared among nations.

"Governments and international partners must unite around a global guarantee which ensures that, when a safe and effective vaccine is developed, it is produced rapidly at scale and made available for all people, in all countries, free of charge," it said.

But a row erupted in France after drugmaker Sanofi said it would reserve first shipments of any vaccine it discovered to the United States.

The comments prompted a swift rebuke from the French government -- President Emmanuel Macron's office said any vaccine should be treated as "a global public good, which is not submitted to market forces."

Sanofi chief executive Paul Hudson said the US had a risk-sharing model that allowed for manufacturing to start before a vaccine had been finally approved -- while Europe did not.

"The US government has the right to the largest pre-order because it's invested in taking the risk," Hudson told Bloomberg News.

Macron's top officials are scheduled to meet with Sanofi executives about the issue next week.

The search for a vaccine became even more urgent after the World Health Organization said the disease may never go away and the world would have to learn to live with it for good.

"This virus may become just another endemic virus in our communities and this virus may never go away," said Michael Ryan, the UN body's emergencies director.

The prospect of the disease lingering leaves governments facing a delicate balancing act between suppressing the pathogen and getting their economies up and running.

In the US, more grim economic data emerged Thursday, with nearly three million more Americans applying for unemployment benefits.

That takes the overall total to 36.5 million -- more than 10 percent of the US population.

Further signs of the damage to businesses emerged when Lloyd's of London forecast the pandemic will cost the global insurance industry about $203 billion.

European markets closed down, but Wall Street rallied despite the new jobless claims. In a sign of progress, the New York Stock Exchange trading floor was due to reopen on May 26.

The reopening of economies continued in earnest across Europe, where the EU has set out proposals for a phased restart of travel and the eventual lifting of border controls.

"Maybe it's a mistake, but we have no choice. Without tourists, we won't get by!" Enrico Facchetti, a 61-year-old former goldsmith, said of Venice's reopening.

Japan -- the world's third largest economy -- lifted a state of emergency across most of the country except for Tokyo and Osaka.

And Canadian Prime Minister Justin Trudeau said national parks would partially reopen on June 1.

But in Latin America, the virus continued to surge, with a 60 percent leap in cases in the Chilean capital of Santiago.

Authorities said 2,000 new graves were being dug at the main cemetery.

South Sudan reported its first COVID-19 death on Thursday.

And in Bangladesh, the first case was confirmed in the teeming Rohingya refugee camps in Bangladesh, which are home to nearly one million people.

The head of the World Health Organisation on Tuesday warned the novel coronavirus was a "very grave threat" for the world as he opened a conference to combat the epidemic.

"With 99% of cases in China, this remains very much an emergency for that country, but one that holds a very grave threat for the rest of the world," Tedros Adhanom Ghebreyesus said in Geneva.

Some 400 scientists will review how the virus is transmitted and possible vaccines at the two-day forum.

"What matters most is stopping the outbreak and saving lives. With your support, that's what we can do together," Tedros said.

The virus, first identified in China on December 31, has killed more than 1,000 people, infected over 42,000 and reached some 25 countries.

Participants will also discuss the source of the virus, which is thought to have originated in bats and reached humans via another animal such as snakes or pangolins.

There is no specific treatment or vaccine against the virus, which can cause respiratory failure.

Tedros, who has repeatedly urged countries affected to share their data, called for global "solidarity".

"That is especially true in relation to the sharing of samples and sequences. To defeat this outbreak, we need open and equitable sharing, according to the principles of fairness and equity," he said.

"We hope that one of the outcomes of this meeting will be an agreed roadmap for research around which researchers and donors will align," Tedros said.

Several companies and institutes in Australia, China, France, Germany and the United States are racing to develop a vaccine -- a process that normally takes years.

Asked whether scientists from Taiwan would be allowed to take part in this week's Geneva conference, WHO officials said that they would do so but only online -- along with colleagues from other parts of China.

While the WHO does not deal with Taiwan directly and only recognises Beijing, Taiwan was often allowed to attend annual assemblies and sideline meetings as an observer.

But in recent years it has been frozen out as Beijing takes an increasingly combative stance towards democratic Taiwan, which it considers its own territory.

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.