China coronavirus cases fall, but more imported from abroad

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, Feb 19: US President Donald Trump has said he is "saving the big deal" with India for later and he "does not know" if it will be done before the presidential election in November, clearly indicating that a major bilateral trade deal during his visit to Delhi next week might not be on the cards.

"We can have a trade deal with India. But I'm really saving the big deal for later," he told reporters at Joint Base Andrews Tuesday afternoon (local time).

The US and India could sign a "trade package" during the visit, according to media reports.

Asked whether he expects a trade deal with India before the visit, Trump said, "We're doing a very big trade deal with India. We'll have it. I don't know if it'll be done before the election, but we'll have a very big deal with India."

US Trade Representative Robert Lighthizer, the point-person for trade negotiations with India, is likely to not accompany Trump to India, sources said. However, officials have not ruled it out altogether.

In an apparent dissatisfaction over US-India trade ties, Trump said, "We're not treated very well by India." But he praised Prime Minister Narendra Modi and said he is looking forward to his visit to India.

"I happen to like Prime Minister Modi a lot," Trump said.

"He told me we'll have seven million people between the airport and the event. And the stadium, I understand, is sort of semi under construction, but it's going to be the largest stadium in the world. So it's going to be very exciting... I hope you all enjoy it," he told reporters.

Meanwhile, the US-India Strategic and Partnership Forum (USISPF) in a report said the latest quarterly data depict continuation of overall positive bilateral trade trends. The third quarter data reflects some downslide in growth rates.

"It may be due to several reasons, including the unexpected economic slowdown in India's economic growth, impact of US-China trade war, GSP withdrawal from the US side and retaliatory tariffs on specific US goods from the Indian side," USISPF said.

According to the report, the data available for the first three quarters of 2019 (January-September) pulled the overall growth rate in cumulative bilateral trade down to 4.5 percent from 8.4 percent registered for the first two quarters.

Goods and services trade performance in third quarter was dismal at -2.3 percent, in contrast with the impressive 9.6 percent growth witnessed for the first two quarters of the year; while trade in services was up two percent goods trade dropped five percent, the report said.

The cumulative US-India trade in goods and services (USD 110.9 billion) for the first three quarters of 2019 increased 4.5 percent with US exports and imports growing at four percent and five percent respectively.

The US exported USD 45.3 billion worth of goods and services to India in the first three quarters 2019, up 4 percent from the corresponding period in the previous year; and the US imported USD 65.6 billion worth of goods and services from India, up five percent from the previous year's USD 62.5 billion level for the same period, it said.

The USISPF has projected that the total bilateral trade can touch USD 238 billion by 2025 if the current 7.5 percent average annual rate of growth sustains; however, higher growth rates can result in bilateral trade in the range of USD 283 billion and USD 327 billion.

The US remains the top trading partner for India in terms of trade in goods and services, followed by China. While the bilateral trade between US and India is approximately 62 percent in goods and 38 percent in services, the bilateral trade between India and China is dominated by goods.

China had a huge trade surplus of USD 58 billion with India, indicating Beijing's strength in the Indian market, especially in sectors, such as electronics, machinery, organic chemicals, plastics and medical devices.

The US goods exports to India, in comparison, were mainly concentrated in mineral fuels, precious stones, and aircraft. The US faces tough competition with China in the Indian market in areas such as electronics, machinery, organic chemicals and medical devices.

New York, Apr 5: New York State, the epicentre of the coronavirus pandemic in the US, continued to record the highest count of daily deaths from COVID-19 as a staggering number of 630 people died in a 24-hour period and Governor Andrew Cuomo said the outbreak in the state could peak in about seven days.

The state had recorded the highest single increase in the number of deaths from novel coronavirus in a single day between April 2 and 3 when 562 people had died, one person dying from the viral infection almost every two-and-a-half minutes.

In the 24 hours since April 4, the death toll grew to 630, "all-time increase" up to a total of 3,565, up from 2,935 on Friday morning, Cuomo said.

The daily death toll in New York continues to grow at record numbers as the state remains the most impacted in the US from coronavirus.

Coronavirus cases in New York State now stand at 113,704, out of the country's total number of 312,146. New Jersey, the second most impacted state in the US, has about 30,000 COVID-19 cases.

New York City alone has 63,306 coronavirus patients, up from 57,169 the previous 24 hours, and 2,624 deaths.

Cuomo said the apex in the state, the point where the number of infections on a daily basis hits the high point, is still about 4-8 days away.

"We have been talking about hitting that apex, the high point of the curve. I call it the battle of the mountaintop. That's going to be the number one point of engagement of the enemy," he said.

"But our reading of the projections is we're somewhere in the seven-day range, four, five, six seven, eight day range. Nobody can give you a specific number, which makes it very frustrating to plan when they can't give you a specific number or a specific date, but we're in that range," Cuomo said.

"We are not yet at the apex. Part of me would like to be at the apex and just let's do it. But there's part of me that says it's good that we're not at the apex because we're not yet ready for the apex either, still working on the capacity of the (healthcare) system," the governor said.

Cuomo has expressed anger over the short supply of essential medical equipment for healthcare professionals to help them deal with the surge in coronavirus cases across the state and the country.

He said personal protective equipment (PPE) such as masks, gowns and face shields are in short supply in New York as they are across the country and there is need for companies to make these materials.

"It is unbelievable to me that in the New York State, in the United States of America, we can't make these materials and that we are all shopping China to try to get these materials and we're all competing against each other," he had said earlier.

Cuomo said on Saturday that the state has 85,000 volunteers, including 22,000 from outside the state, and he will also be signing an executive order to allow medical students who were slated to graduate to begin practising, supplementing the state's healthcare professional capacity.

On ventilators, he said the state had ordered 17,000 but there was not enough supply in the federal stockpile to meet this growing demand across the state.    

"China is remarkably the repository for all of these orders - ventilators, PPE, it all goes back to China, which long term we have to figure out why we wound up in this situation where we don't have the manufacturing capacity in this country," he said, adding, "New York has been shopping in China."

The Chinese government helped facilitate a donation of 1,000 ventilators that will arrive at the JFK Airport in the city, he said, as he thanked the Chinese government, Alibaba head Jack Ma, the Jack Ma Foundation, Alibaba co-founder co-founder Joe Tsai and China's Consul General Huang Ping.
In addition, the state of Oregon would deliver 140 ventilators to New York.    

Cuomo has signed an executive order allowing the state to redistribute ventilators and personal protective equipment from hospitals, private sector companies and institutions that don't currently need them and redeploy the equipment to other hospitals with the highest need.
Those institutions will either get their ventilator back or they will be reimbursed and paid for their ventilator so they can buy a new ventilator.
The 2,500-bed facility at the Javits Convention Centre, which was supposed to be used for non-COVID patients, will now be used as COVID-positive facility.

"The federal government will staff that and the federal government with equip that. That is a big deal because that 2,500-bed facility will relieve a lot of pressure on the downstate system as a significant number of beds and that facility has to make that transition quickly and that's what we're focused on," Cuomo said.

Cuomo emphasised that he wants the pandemic to end as soon as possible as it is taking an unprecedented strain on life.

"I want this to be all over. It's only gone on for 30 days since our first case. It feels like an entire lifetime. I think we all feel the same. This stresses this country, this state, in a way that nothing else has frankly, in my lifetime. It stresses us on every level.

The economy is stressed, the social fabric is stressed, the social systems are stressed, transportation is stressed," he said.