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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.

Washington, May 30: President Donald Trump said Friday he would strip several of Hong Kong's special privileges with the United States and bar some Chinese students from US universities in anger over Beijing's bid to exert control in the financial hub.

In a day of concerted action, the United States and Britain also raised alarm at the UN Security Council over a controversial new security law for Hong Kong, angering Beijing which said the issue had no place at the world body.

In a White House appearance that Trump had teased for a day, the US president attacked China over its treatment of the former British colony, saying it was "diminishing the city's longstanding and proud status."

"This is a tragedy for the people of Hong Kong, the people of China and indeed the people of the world," Trump said.

Trump also said he was terminating the US relationship with the World Health Organization, which he has accused of pro-China bias in its management of the coronavirus crisis.

But Trump was light on specifics and notably avoided personal criticism of President Xi Jinping, with whom he has boasted of having a friendship even as the two powers feud over a rising range of issues.

"I am directing my administration to begin the process of eliminating policy that gives Hong Kong different and special treatment," Trump said.

"This will affect the full range of agreements, from our extradition treaty to our export controls on dual-use technologies and more, with few exceptions," he said.

Secretary of State Mike Pompeo on Wednesday informed Congress that the Trump administration would no longer consider Hong Kong to be separate under US law, but it was up to Trump to spell out the consequences.

China this week pressed ahead on a law that would ban subversion and other perceived offenses against its rule in Hong Kong, which was rocked by months of massive pro-democracy protests last year.

US restricts students

In one move that could have long-reaching consequences, Trump issued an order to ban graduate students from US universities who are connected to China's military.

"For years, the government of China has conducted elicit espionage to steal our industrial secrets, of which there are many," Trump said.

Hawkish Republicans have been clamoring to kick out Chinese students enrolled in sensitive fields. The FBI in February said it was investigating 1,000 cases of Chinese economic espionage and technological theft.

But any move to deter students is unwelcome for US universities, which rely increasingly on tuition from foreigners and have already been hit hard by the COVID-19 shutdown.

China has been the top source of foreign students to the United States for the past decade with nearly 370,000 Chinese at US universities, although Trump's order will not directly affect undergraduates.

Critics say Trump has been eager to fan outrage about China to deflect attention from his own handling of the coronavirus pandemic that has killed more than 100,000 people in the United States, the highest number of deaths of any country.

Chuck Schumer, the top Democrat in the Senate, called Trump's announcement "just pathetic."

Eliot Engel, a Democrat who heads the House Foreign Affairs Committee, noted that Trump treaded lightly on Hong Kong during last year's protests as he sought a trade deal with Xi.

"Now, the president wants to shift the blame for his failures onto China, so he's doing the right thing for the wrong reason," Engel said.

Trump's order could also trigger retaliation. China in March expelled US journalists after the Trump administration tightened visa rules for staff at Chinese state media.

Clash at UN

The United States and Britain earlier in the day urged China to reconsider the Hong Kong law during talks at the UN Security Council, where China wields a veto -- making any formal session, let alone action against Beijing, impossible.

The Western allies raised Hong Kong in an informal, closed-door videoconference where China cannot block the agenda.

They said China was violating an international commitment as the 1984 handover agreement with Britain, in which Beijing promised to maintain the financial hub's separate system until at least 2047, was registered with the United Nations.

"The United States is resolute, and calls upon all UN members states to join us in demanding that the PRC immediately reverse course and honor its international legal commitments to this institution and to the Hong Kong people," said US Ambassador Kelly Craft, referring to the People's Republic of China.  

China demanded that the United States and Britain "immediately stop interfering in Hong Kong affairs," saying the law did not fall under the Security Council's mandate.

"Any attempt to use Hong Kong to interfere in China's internal matters is doomed to fail," warned a statement from China's UN mission.

"There was no consensus, no formal discussion in the Security Council, and the US and the UK's move came to nothing," it said.

Washington, May 27: Most viruses and other germs do not spread easily on flights, the US Center for Disease Control and Prevention has said in its COVID-19 guidelines which do not recommend following social distancing between two passengers inside a plane or keeping the middle seat unoccupied.

As a result of coronavirus pandemic, air traffic inside the US has come to a near halt. Air traffic is said to be down to about 90 per cent. For all travellers coming from overseas, the Center for Disease Control and Prevention (CDC) has recommended 14 days quarantine.

"Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on aeroplanes," the CDC has said in its set of COVID-19 guidelines for air travellers.

However, it noted that the air travellers were not risk-free especially in the time of the coronavirus pandemic and recommended Americans to avoid travel as far as possible.

"Air travel requires spending time in security lines and airport terminals, which can bring you in close contact with other people and frequently touched surfaces," it said.

"Social distancing is difficult on crowded flights, and you may have to sit near others (within six feet), sometimes for hours. This may increase your risk for exposure to the virus that causes COVID-19," the CDC said.

But instead of recommended social distancing inside commercial planes, the CDC has advised a series of preventive and hygienic measures to be taken by the airlines pilot and crew to prevent the spread of coronavirus.

The US Department of Transportation and Federal Aviation Administration in its latest safety alerts for operators on May 11 said that air carriers and crews conducting flight operations having a nexus to the US, including both domestic and foreign air carriers, should follow CDC's occupational health and safety guidance.

The CDC issued its guidelines in first guidelines for the airlines and airline crew on March and again in May.

The CDC, which has issued an exhaustive social guideline measures in various sections, is silent on keeping the middle seat of a plane unoccupied so as to maintain the six feet distance between two passengers.

It calls for the plane crew to report to the CDC a traveller with specific COVID-19 symptoms like fever, persistent cough, difficulty in breathing and appearing unwell.

Asking the airlines and cabin crew to review infection control guidelines for cabin crew, the CDC recommends several measures for cabin crew to protect themselves and others, manage a sick traveller, clean contaminated areas, and take actions after a flight.

Prominent among them include washing hands often with soap and water for at least 20 seconds, particularly after assisting sick travellers or touching potentially contaminated body fluids or surfaces and use of alcohol-based hand sanitizer (containing at least 60 per cent alcohol) if soap and water are not available.

Airlines should consider providing alcohol-based hand sanitizer to cabin and flight crews for their personal use, it said.

The CDC guidelines do not recommend following social distancing inside a plane between two passengers or keeping the middle seat unoccupied. But it asks to minimise contact between passengers and cabin crew and the sick person.

"If possible, separate the sick person from others (by a distance of 2 meters or 6 feet, ideally) and designate one crew member to serve the sick person. Offer a facemask, if available and if the sick person can tolerate it. If a facemask is not available or cannot be tolerated, ask the sick person to cover their mouth and nose with tissues when coughing or sneezing," said the CDC guidelines.

If no symptomatic passengers were identified during or immediately after the flight, the CDC recommends airlines to follow routine operating procedures for cleaning aircraft, managing solid waste, and wearing PPE.

"If symptomatic passengers are identified during or immediately after the flight, routine cleaning procedures should be followed, and enhanced cleaning procedures should also be used," it said.

Clean porous (soft) surfaces (e.g, cloth seats, cloth seat belts) at the seat of the symptomatic passengers and within 6 feet of the symptomatic passengers in all directions, it added.