After surge in COVID-19 cases, Spain reinstates restrictions

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, Apr 17: China denied Friday it had covered up the extent of its coronavirus outbreak, as it responded to growing questions from Western powers led by the United States.

A foreign ministry spokesman acknowledged that the virus's rapid spread had contributed to undercounting that resulted in China raising its death toll earlier Friday, but he added "there has never been any concealment, and we'll never allow any concealment."

The allegations China is too close to the World Health Organization (WHO), were an attempt at "smearing" Beijing, Zhao said.

US President Donald Trump has questioned China's handling of the pandemic and whether it had been completely transparent since the virus emerged in the central city of Wuhan late last year.

On Thursday, British Foreign Secretary Dominic Raab and French President Emmanuel Macron also expressed doubts about China's virus response.

These doubts were spotlighted again on Friday when authorities in Wuhan, which has borne the brunt of Chinese deaths, abruptly raised its death toll by 50 percent -- or 1,290 deaths -- to a new total of 3,869.

That also pushed the nationwide death toll up sharply to 4,632, based on official national data released earlier in the day.

Wuhan authorities cited several reasons for the missed cases, including that the city's medical staff were overwhelmed in the early days as infections climbed, leading to "late reporting, omissions or mis-reporting".

Zhao said such miscounting was to be expected in the initial stages of a major disease outbreak.

US President Donald Trump -- under fire himself for initially denying the seriousness of the pandemic -- has accused the WHO of doing the same and being too trusting of China's assurances over the outbreak.

On Tuesday he announced a suspension of US funding to the world body.

Asked about the US allegations, Zhao defended the WHO and China.

"I think they are all smearing China and cooking up stories about China," he said, without specifying which countries he was referring to.

China has largely brought the contagion under control domestically via tough measures including the unprecedented lockdown of Wuhan and tens of millions of people in surrounding areas, but not before it spread worldwide.

Paris, Apr 17: The number of coronavirus-related deaths in France has increased by 753 to 17,920 over the past 24 hours, with the total case count now standing at 108,847, Jerome Salomon, the head of the state health agency, said on Thursday.

On Wednesday, the country reported a total of 106,206 cases, including a record 1,438 new fatalities. Salomon specified that it was not the daily death toll, as the data had been compiled over the last three-day weekend.

"The total number of victims since March 1 is 17,920," Salomon said at a briefing on Thursday.
He noted that 11,060 of them had died in hospitals, and 6,860 others in social and medical-social facilities.

President Emmanuel Macron on Monday extended nationwide movement restrictions, which had been introduced due to the epidemic, until May 11. Afterwards, the country is set to gradually reopen kindergartens, schools and universities.