Obama refuses to meet Zardari in Chicago

Feb 2: The Philippines on Sunday reported the first death from a new virus outside of China, where authorities delayed the opening of schools in the worst-hit province and tightened quarantine measures in a city that allow only one family member to venture out to buy supplies.

The Philippine Department of Health said a 44-year-old Chinese man from Wuhan was admitted on Jan. 25 after experiencing a fever, cough, and sore throat. He developed severe pneumonia, and in his last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise.”

The man’s 38-year-old female companion, also from Wuhan, also tested positive for the virus and remains in hospital isolation in Manila.

President Rodrigo Duterte approved a temporary ban on all travelers, except Filipinos, from China and its autonomous regions. The U.S., Japan, Singapore and Australia have imposed similar restrictions despite criticism from China and an assessment from the World Health Organization that they were unnecessarily hurting trade and travel.

The death toll in China climbed by 45 to 304 and the number of cases by 2,590 to 14,380, according to the National Health Commission, well above the number of those infected in in the 2002-03 outbreak of SARS, or severe acute respiratory syndrome, which broke out in southern China and spread worldwide.

Meanwhile, six officials in the city of Huanggang, neighboring the epicenter of Wuhan in Hubei province, have been fired over “poor performance” in handling the outbreak, the official Xinhua News Agency reported.

It cited the mayor as saying the city’s “capabilities to treat the patients remained inadequate and there is a severe shortage in medical supplies such as protective suits and medical masks.”

After Huanggang, the trading center of Wenzhou in coastal Zhejiang province also confined people to homes, allowing only one family member to venture out every other day to buy necessary supplies.

With the outbreak showing little sign of abating, authorities in Hubei and elsewhere have extended the Lunar New Year holiday, due to end this week, well into February. The annual travel crunch of millions of people returning from their hometowns to the cities is thought to pose a major threat of secondary infection at a time when authorities are encouraging people to avoid public gatherings.

All Hubei schools will postpone the opening of the new semester until further notice and students from elsewhere who visited over the holiday will also be excused from classes.

Far away on China’s southeast coast, the manufacturing hub of Wenzhou put off the opening of government offices until Feb. 9, private businesses until Feb. 17 and schools until March 1.

With nearly 10 million people, Wenzhou has reported 241 confirmed cases of the virus, one of the highest levels outside Hubei. Similar measures have been announced in the provinces and cities of Heilongjiang, Shandong, Guizhou, Hebei and Hunan, while the major cities of Shanghai and Beijing were on indefinite leave pending developments.

Despite imposing drastic travel restrictions at home, China has chafed at those imposed by foreign governments, criticizing Washington’s order barring entry to most non-citizens who visited China in the past two weeks. Apart from dinging China’s international reputation, such steps could worsen a domestic economy already growing at its lowest rate in decades.

The crisis is the latest to confront Chinese leader Xi Jinping, who has been beset by months of anti-government protests in the semi-autonomous Chinese city of Hong Kong, the reelection of Taiwan’s pro-independence president and criticism over human rights violations in the traditionally Muslim northwestern territory of Xinjiang. Economically, Xi faces lagging demand and dramatically slower growth at home while the tariff war with the U.S. remains largely unresolved.

Among a growing number of airlines suspending flights to mainland China was Qatar Airways. The Doha-based carrier said on its website that its flights would stop Monday. It blamed “significant operational challenges caused by entry restrictions imposed by a number of countries” for the suspension of flights.

Oman also halted flights to China, as did Saudi Arabia’s flagship national carrier, Saudia.

Saudi Arabia’s state-run TV reported that 10 Saudi students were evacuated from Wuhan on a special flight. It said the students would be screened upon arrival, but did not say whether they would be quarantined for 14 days.

This weekend, South Korea and India flew hundreds of their citizens out of Wuhan. They went into a two-week quarantine.

On Sunday, South Korea reported three more cases for a total of 15. They include an evacuee, a Chinese relative of a man who tested positive and a man who returned from Wuhan. India reported a second case, also in southern Kerala state.

South Korea also barred foreigners who have stayed or traveled to Hubei province within the last 14 days from entering the country.

Indonesia flew back 241 nationals from Wuhan on Sunday and quarantined them on the remote Natuna Islands for two weeks. Several hundred residents protested the move, with one saying, “This is not because we do not have a sense of solidarity with fellow nationals. But because we fear they could infect us with the deadly virus from China.”

A Turkish military transport plane carrying 42 people arrived in Ankara from Wutan Saturday night. The 32 Turkish, six Azerbaijani, three Georgian nationals and an Albanian will remain under observation for 14 days, together with 20 personnel who participated in the evacuation, Health Minister Fahrettin Koca said.

Vietnam counted its seventh case, a Vietnamese-American man who had a two-hour layover in Wuhan on his way from the U.S. to Ho Chi Minh City.

The virus’ rapid spread in two months prompted the WHO on Thursday to declare it a global emergency.

That declaration “flipped the switch” from a cautious attitude to recommending governments prepare for the possibility the virus might spread, said the WHO representative in Beijing, Gauden Galea. Most cases reported so far have been people who visited China or their family members.

WHO said it was especially concerned that some cases abroad involved human-to-human transmission.

“Countries need to get ready for possible importation in order to identify cases as early as possible and in order to be ready for a domestic outbreak control, if that happens,” Galea told The Associated Press.

Both the new virus and SARS are from the coronavirus family, which also includes those that cause the common cold.

The death rate in China is falling, but the number of confirmed cases will keep growing because thousands of specimens from suspected cases have yet to be tested, Galea said.

“The case fatality ratio is settling out at a much lower level than we were reporting three, now four, weeks ago,” he said.

Although scientists expect to see limited transmission of the virus between people with family or other close contact, they are concerned about cases of infection spreading to people who might have less exposure.

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.

President Donald Trump gave a new justification for killing Qassim Suleimani, telling a gathering of Republican donors that the top Iranian general was "saying bad things about our country" before the strike, which led to his decision to authorise his killing. "How much are we going to listen to?" Trump said on Friday, according to remarks from a fundraiser obtained by CNN.

With his typical dramatic flourish, Trump recounted the scene as he monitored the strikes from the White House Situation Room when Suleimani was killed. The president spoke in a ballroom at his Mar-a-Lago club in Palm Beach, Florida, at a Republican event that raised $10 million for Trump's 2020 campaign.

The January 3 killing of Suleimani prompted Iran to retaliate with missile strikes against US forces in Iraq days later and almost triggered a broad war between the two countries. "They're together sir," Trump said military officials told him. "Sir, they have two minutes and 11 seconds. No emotion. Two minutes and 11 seconds to live, sir. They're in the car, they're in an armoured vehicle. Sir, they have approximately one minute to live, sir. Thirty seconds. Ten, 9, 8 ...'"

"Then all of a sudden, boom," he said. "They're gone, sir. Cutting off, I said, where is this guy?" Trump continued. "That was the last I heard from him". It was the most detailed account that Trump has given of the drone strike, which has drawn criticism from some US lawmakers because neither the president nor his advisers have provided public information to back up their statements that Suleimani presented an "imminent" threat to US.

Trump's comments came a day after he warned Iran's supreme leader Ayatollah Ali Khamenei to be "very careful with his words". According to Trump, Khamenei's speech on Friday, in which he attacked the "vicious" US and described UK, France and Germany as "America's lackeys", was a mistake.