4 lakh staff will go without pay, 3.8 lakh ‘on leave’ as US shutdown begins

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.

Beijing, Jan 24: As China stepped up measures to control the spread of coronavirus, locking down Wuhan and Huanggang cities in the Hubei province where several Indians live, the Indian Embassy here has set up hotlines for their assistance.

Chinese officials assured all assistance, including food supply, to the Indians who stayed put in the province, the Indian Embassy here said in a press release on Thursday.

Wuhan and its surrounding area became the epicentre of the coronavirus outbreak as the confirmed cases climbed to over 600 mostly from the city and the province with 17 deaths so far.

China has virtually sealed Wuhan and Huanggang cities, halting all public transport, including flight services, and advised people to stay at home and follow the precautions. The two cities put together have a population of over 17 million people.

Chinese officials said the measures have been taken to prevent the spread of the virus to other cities and the world.

Concerns arose for India too as about 700 Indian students, mostly studying medicine in different Chinese universities, resided in Wuhan and its neighbouring areas.

While many of them were believed to have left home for the Chinese New Year holidays, others remained in the city to complete their academic work. However, the exact number is not yet known.

“The Embassy of India has been receiving queries from Indians in Hubei province as well as their relatives in India in connection with the evolving situation of coronavirus infection in China,” the embassy press release said.

The embassy is in touch with relevant Chinese authorities in Beijing and Wuhan as well as Indians in Hubei Province, especially in Wuhan, it said.

“We are closely monitoring the evolving situation in China, including the advisories issued by the World Health Organisation (WHO),” the embassy said.

According to the embassy, Chinese authorities have assured all assistance to residents of Wuhan, including food supply.

“At present, it is reported that supermarkets (particularly those that are government-run) and e-commerce services, including food delivery, continue to remain operational in Wuhan,” it said.

The embassy has started two hotlines for those who wish to get in touch with the Mission in this regard in the following phone numbers:              +8618612083629 and +8618612083617.

“All are advised to also keep track of the embassy's social media accounts (Twitter:@EoIBeijing; Facebook: India in China) for updates on this evolving situation,” the release said.

Meanwhile, the Chinese Foreign ministry said all assistance would be provided to consular officials of the foreign missions to ensure the safety of the foreigners in the country.

Asked whether China would consider any request from the respective countries to move their citizens out of Wuhan, Chinese Foreign Ministry spokesman Geng Shuang said, “We always help foreign consular officials in China in their official jobs, we offer them all the assistance and convenience necessary and we work to guarantee foreign citizens' legitimate rights and interest in China.”

He said while specific detailed would be provided by local officials, China in principle, has always handled issues according to domestic laws, international laws and bilateral consular agreements.

Seoul, Apr 26: A train presumed to belong to North Korean's Kim Jong-un has been spotted at a station in the state's eastern coastal town of Wonsan amid speculation about the leader's health, a US monitor said on Sunday, citing commercial satellite imagery on the region, Yonhap news agency reported.

According to 38 North-- a website devoted to analysis about North Korea, the imagery showed a train "probably belonging to Kim Jong Un parked at the Leadership Railway Station servicing his Wonsan compound since at least April 21."

"The approximately 250-metre long train, although partially covered by the station's roof, can be seen at a railway station reserved for use by the Kim family. It was not present on April 15 but was present on both April 21 and 23," it said.

"The train's presence does not prove the whereabouts of the North Korean leader or indicate anything about his health, but it does lend weight to reports that Kim is staying at an elite area on the country's eastern coast," it added.

The report came as rumours about his health have spread as Kim apparently skipped an important annual visit to the Kumsusan Palace of the Sun on the occasion of the April 15 birthday of late state founder and his grandfather, Kim Il-sung.

CNN intensified the speculation by reporting earlier last week that the United States is looking into intelligence that Kim is "in grave danger" after surgery.

Seoul officials have disputed recent media reports about Kim, saying there have been no unusual signs from the North. Some said that Kim is presumed to be staying in Wonsan for unspecified reasons.

Washington has also dismissed the reports, with US President Donald Trump calling such reports "incorrect" in a press briefing late last week.

On Saturday, other media reports stated that China has dispatched a team of medical doctors and officials to North Korea "to advise on" Kim, citing multiple unnamed people familiar with the situation.

North Korea's state media, however, has not made any mention of Kim's public activity for two weeks since he was last seen in April 11 presiding over a major party meeting, though it has reported on his handling of routine state affairs, such as sending diplomatic letters.
But not all speculation has proven to be false.

When he was absent from public for about a month in 2014, speculation arose about his health and a political crisis in the secretive state. He later reemerged with a cane and a limp reportedly after having a cyst removed from his ankle.

The 36-year-old leader is known to have various health problems apparently caused by obesity and heavy smoking. He took office as leader of the communist state after his father, Kim Jong-il, died of a heart attack in late 2011.