Indian students in Germany need not pay to study: Envoy

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.

Beijing, Jun 17: Beijing's airports cancelled more than 1,200 flights and schools in the Chinese capital were closed again on Wednesday as authorities rushed to contain a new coronavirus outbreak linked to a wholesale food market.

The city reported 31 new cases on Wednesday while officials urged residents not to leave Beijing, with fears growing about a second wave of infections in China, which had largely brought its outbreak under control.

Tens of thousands of people linked to the new Beijing virus cluster -- believed to have started in the sprawling Xinfadi wholesale food market -- are being tested, with almost 30 residential compounds in the city now under lockdown.

At least 1,255 scheduled flights were cancelled Wednesday morning, state-run People's Daily reported, nearly 70 percent of all trips to and from Beijing's main airports.

The outbreak had already forced authorities to announce a travel ban for residents of "medium- or high-risk" areas of the city, while requiring other residents to take nucleic acid tests in order to leave Beijing.

Meanwhile, several provinces were quarantining travellers from Beijing, where all schools -- which had mostly reopened -- have been ordered to close again and return to online classes.

"The epidemic situation in the capital is extremely severe," Beijing city spokesman Xu Hejian warned Tuesday.

Mass testing under way

Officials have closed 11 markets and disinfected thousands of food and beverage businesses in Beijing after the outbreak was detected.

The city has now reported 137 infections over the last six days, with six new asymptomatic cases and three suspected cases on Wednesday, according to the municipal health commission.

An additional two domestic cases, one in neighbouring Hebei province and another in Zhejiang, were reported by national authorities on Wednesday, while there were 11 imported cases.

Authorities have so far banned group sports, ordered people to wear masks in crowded enclosed spaces, and suspended inter-provincial group tours in response to the outbreak.

Officials said that since May 30, more than 200,000 people had visited Xinfadi market, which supplies more than 70 percent of Beijing's fruit and vegetables.

More than 8,000 workers there were tested and quarantined.

Until the new outbreak, most of China's recent cases were nationals returning from abroad as COVID-19 spread globally, and the government had all but declared victory against the disease.

China's Center for Disease Control and Prevention said Monday that the virus type found in the Beijing outbreak was a "major epidemic strain" in Europe.

May 14: The UN’s children agency has warned that an additional 6,000 children could die daily from preventable causes over the next six months as the COVID-19 pandemic weakens the health systems and disrupts routine services, the first time that the number of children dying before their fifth birthday could increase worldwide in decades.

As the coronavirus outbreak enters its fifth month, the UN Children’s Fund (UNICEF) requested USD 1.6 billion to support its humanitarian response for children impacted by the pandemic.

The health crisis is “quickly becoming a child rights crisis. And without urgent action, a further 6,000 under-fives could die each day,” it said.

With a dramatic increase in the costs of supplies, shipment and care, the agency appeal is up from a USD 651.6 million request made in late March – reflecting the devastating socioeconomic consequences of the disease and families’ rising needs.

"Schools are closed, parents are out of work and families are under strain," UNICEF Executive Director Henrietta Fore said on Tuesday.

 “As we reimagine what a post-COVID world would look like, these funds will help us respond to the crisis, recover from its aftermath, and protect children from its knock-on effects.”

The estimate of the 6,000 additional deaths from preventable causes over the next six months is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health, published on Wednesday in the Lancet Global Health Journal.

UNICEF said it was based on the worst of three scenarios analysing 118 low and middle-income countries, estimating that an additional 1.2 million deaths could occur in just the next six months, due to reductions in routine health coverage, and an increase in so-called child wasting.

Around 56,700 more maternal deaths could also occur in just six months, in addition to the 144,000 likely deaths across the same group of countries. The worst case scenario, of children dying before their fifth birthdays, would represent an increase "for the first time in decades,” Fore said.

"We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths, be lost,” she said.

Access to essential services, like routine immunisation, has already been compromised for hundreds of millions of children and threatens a significant increase in child mortality.

According to a UNICEF analysis, some 77 per cent of children under the age of 18 worldwide are living in one of 132 countries with COVID-19 movement restrictions.

The UN agency also spotlighted that the mental health and psychosocial impact of restricted movement, school closures and subsequent isolation are likely to intensify already high levels of stress, especially for vulnerable youth.

At the same time, they maintained that children living under restricted movement and socio-economic decline are in greater jeopardy of violence and neglect. Girls and women are at increased risk of sexual and gender-based violence.

The UNICEF pointed out that in many cases, refugee, migrant and internally displaced children are experiencing reduced access to protection and services while being increasingly exposed to xenophobia and discrimination.

“We have seen what the pandemic is doing to countries with developed health systems and we are concerned about what it would do to countries with weaker systems and fewer available resources,” Fore said.

In countries suffering from humanitarian crises, UNICEF is working to prevent transmission and mitigate the collateral impacts on children, women and vulnerable populations – with a special focus on access to health, nutrition, water and sanitation, education and protection.

To date, the UN agency said it has received USD 215 million to support its pandemic response, and additional funding will help build upon already-achieved results.

Within its response, UNICEF has reached more than 1.67 billion people with COVID-19 prevention messaging around hand washing and cough and sneeze hygiene; over 12 million with critical water, sanitation and hygiene supplies; and nearly 80 million children with distance or home-based learning.

The UN agency has also shipped to 52 countries, more than 6.6 million gloves, 1.3 million surgical masks, 428,000 N95 respirators and 34,500 COVID-19 diagnostic tests, among other items.