India, Pak ink visa pact; but concern on terror remains

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.

China is aggressively pursuing a diverse range of tactics -- from cyber-attacks to recruiting insiders for economic espionage, Indian security agencies have warned. The specific alert circulated among key stakeholders suggests that Chinese operatives are not only planning to steal classified cutting-edge defense technology but also eyeing to recruit best academicians and researchers around the globe, especially from the US.

Sources said they have noticed that China has authorized an "aggressive program of stealing US science and technology information by recruiting Americans in the technology sector with access to trade secrets".

In the technology sector of the US, many Indians scientists are working at the forefront. "This is a serious matter for Indian government and security establishments," said a top source further adding that Chinese always pursue economic espionage because it suits their low cost manufacturing sector on the basis of stolen research and costly design developed by top companies across the globe.

"An alert was also issued in early January about Chinese cyber intrusion attempts at several companies where Indian researchers are working. The espionage attempt was to target UAV technology and certain top-end military equipment designs. After stealing the techniques and design, China starts producing these equipment domestically and sells at a cheaper rate, inflicting irreparable damage to the original equipment manufacturers," the sources in the security establishment observed.

Recently, the US accused China for targeting academia by sending researchers to American labs and using talent recruitment programme to steal scientific analysis. The US has also found that young recruits of the People's Liberation Army posing as students are entering into various universities across the globe to get research papers and recruit academia.

Earlier this year, the US charged a former Boston University student of visa fraud for failing to disclose the status as a lieutenant in the China's People's Liberation Army.

The US intelligence agencies have found that their "universities have become a soft target in the global espionage war with China".

In January this year, the US Department of Justice charged a leading academician at the Harvard University for hiding his alleged role in a Chinese government programme.

In July last year, the Federal Bureau of Investigation (FBI) Director Christopher Wray had revealed that the FBI is probing nearly 1,000 cases of economic espionage and attempted intellectual property theft, nearly all of them leading back to China.

Accordingly, Indian Missions have been informed about the threats being posed by Chinese spies and attempts to recruit Indian scientists and technologists working in the US and other parts of the world.

Sources further stated that security establishments in India have informed the scientist fraternity to be on alert amid threat posed by Chinese spies.

The Chinese had earlier recruited a personnel, Dongfan Chung, working at Boeing for economic espionage. Chung had stolen secret technology to benefit Chinese government and during the raid at his house more than 2.5 lakh classified pages related to Boeing were recovered.

"There has been intense debate on the international platforms regarding Chinese-sponsored theft of intellectual property. American agencies have gone on record to say that China was targeting trade secrets. In the backdrop of pandemic and global health crisis, Indian establishments in defence and technology sectors have been told to be extra cautious as China is planning to become the most advanced economy while the other countries are crippled by the highly contagious virus," the sources further added.

Jan 23: Pakistan's Prime Minister Imran Khan called on Wednesday for the United Nations to help mediate between nuclear armed India and Pakistan over the disputed territory of Kashmir.

"This is a potential flashpoint," Khan said during a media briefing at the annual meeting of the World Economic Forum in Davos, Switzerland, adding that it was time for the "international institutions ... specifically set up to stop this" to "come into action".

The Indian government in August revoked the constitutional autonomy of Indian-administered Kashmir, splitting the Muslim-majority region into two federal territories in a bid to integrate it fully with the rest of the country.

Kashmir is claimed in full by both India and Pakistan. The two countries have gone to war twice over it, and both rule parts of it. India's portion has been plagued by separatist violence since the late 1980s.

Khan said his biggest fear was how New Delhi would respond to ongoing protests in India over a citizenship law that many feel targets Muslims.

"We're not close to a conflict right now ... What if the protests get worse in India, and to distract attention from that, what if ..."

The prime minister said he had discussed the prospect of war between his country and India in a Tuesday meeting with US President Donald Trump. Trump later said he had offered to help mediate between the two countries.

Khan said Pakistan and the United States were closer in their approach to the Taliban armed rebellion in Afghanistan than they had been for many years. He said he had never seen a military solution to that conflict.

"Finally the position of the US is there should be negotiations and a peace plan."

In a separate on-stage conversation later on Wednesday, Khan said he had told Trump in their meeting that a war with Iran would be "a disaster for the world". Trump had not responded, Khan said.

Khan made some of his most straightforward comments when asked why Pakistan has been muted in defence of Uighurs in China.

China has been widely condemned for setting up complexes in remote Xinjiang province that Beijing describes as "vocational training centres" to stamp out ""extremism and give people new skills.

The United Nations says at least one million ethnic Uighurs and other Muslims have been detained.

When pressed on China's policies, Khan said Pakistan's relations with Beijing were too important for him to speak out publicly.

"China has helped us when we were at rock bottom. We are really grateful to the Chinese government, so we have decided that any issues we have had with China we will handle privately."