China didn't warn of pandemic for six crucial days, reveal secret documents

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.

Fifty-six journalists were killed in 2019 and most of them died outside conflict zones, a United Nations spokesperson said.

The number dropped by nearly half from the year 2018, but perpetrators enjoyed almost total impunity, Xinhua news agency quoted Stephane Dujarric, spokesperson for UN Secretary-General Antonio Guterres, as saying on Monday citing Unesco figures.

The figure was published in the 'Unesco Observatory of Killed Journalists' on Monday.

In total, Unesco recorded 894 journalist killings in the decade from 2010 to 2019, an average of almost 90 per year. The number in 2019 was 99.

Journalists were murdered in all regions of the world, with Latin America and the Caribbean recording 22 killings, the highest number, followed by 15 in Asia-Pacific, and 10 in Arab States.

"The figures show that journalists not only suffer extreme risks when covering violent conflict, but that they are also targeted when reporting on local politics, corruption and crime - often in their hometowns," the Unesco said.

Almost two thirds (61 per cent) of the cases in 2019 occurred in countries not experiencing armed conflict, a notable spike in a wider trend in recent years, and a reversal of the situation of 2014, when this figure was one third.

More than 90 per cent of cases recorded in 2019 concerned local journalists, consistent with previous years, it added.

In response to these figures, Audrey Azoulay, the Director-General of Unesco, said: "Unesco remains deeply troubled by the hostility and violence directed at all too many journalists around the world.

"As long as this situation lasts, it will undermine democratic debate."

Istanbul, Jul 11: Turkish President Recep Tayyip Erdogan announced Friday that the Hagia Sophia, one of the architectural wonders of the world, would be reopened for Muslim worship, sparking fury in the Christian community and neighbouring Greece.

His declaration came after a top Turkish court revoked the sixth-century Byzantine monument's status as a museum, clearing the way for it to be turned back into a mosque.

The UNESCO World Heritage site in historic Istanbul, a magnet for tourists worldwide, was first constructed as a cathedral in the Christian Byzantine Empire but was converted into a mosque after the Ottoman conquest of Constantinople in 1453.

The Council of State, Turkey's highest administrative court, unanimously cancelled a 1934 cabinet decision to turn it into a museum and said Hagia Sophia was registered as a mosque in its property deeds.

The landmark ruling could inflame tensions not just with the West and Turkey's historic foe Greece but also Russia, with which Erdogan has forged an increasingly close partnership in recent years.

'Millions of Christians not heard'

Greece swiftly branded the move by Muslim-majority Turkey an "open provocation to the civilised world".

"The nationalism displayed by Erdogan... takes his country back six centuries," Culture Minister Lina Mendoni said in a statement.

The Russian Orthodox Church was equally scathing.

"The concern of millions of Christians were not heard," Church spokesman Vladimir Legoida told Interfax news agency.

The decision "shows that all pleas regarding the need to handle the situation extremely delicately were ignored," he said.

UNESCO chief Audrey Azoulay said she "deeply regrets" the decision made without prior dialogue with the UN's cultural agency.

The move was also condemned by the US Commission on International Religious Freedom, which said it was an "unequivocal politicisation" of the monument.

Hagia Sophia, which stands opposite the impressive Sultanahmet Mosque -- often called the Blue Mosque, has been a museum since 1935 and open to believers of all faiths.

Transforming it from a mosque was a key reform under the new republic born out of the ashes of the Ottoman Empire.

Sharing a presidential decree which named Hagia Sophia as a "mosque", Erdogan announced its administration would be handed over to Turkey's religious affairs directorate known as Diyanet.

"May we be blessed," he commented. The decree was published on the official gazette.

Erdogan has in recent years placed great emphasis on the battles which resulted in the defeat of Byzantium by the Ottomans, with lavish celebrations held every year to mark the conquest.

Muslim clerics have occasionally recited prayers in the museum on key anniversaries or religious holidays.

"The decision is intended to score points with Erdogan's pious and nationalist constituents," said Anthony Skinner of the risk assessment firm Verisk Maplecroft.

"Hagia Sophia is arguably the most conspicuous symbol of Turkey's Ottoman past -- one which Erdogan is leveraging to strengthen his base while snubbing domestic and foreign rivals," he told AFP.

'Chains broken'

A few hundred Turks carrying Turkish flags gathered outside Hagia Sophia shouting "Chains broken, Hagia Sophia reopened".

Police heightened security measures around the building, according to AFP journalists.

"It's been a dream since we were kids," said Erdal Gencler, an Istanbul resident.

"(Hagia Sophia) finds its true purpose again. We are very excited, proud, and hopeful that there will be beautiful services here," he added.

Fatma, a woman with tearful eyes, said: "Of course I am crying. (Hagia Sophia) belongs to us."

Ahead of the court decision, Justice Minister Abdulhamit Gul shared a picture of Hagia Sophia on his official Twitter account, with a message: "Have a good Friday."

Finance Minister Berat Albayrak, Erdogan's son-in-law, tweeted that Hagia Sophia would be reopened to Muslim worship "sooner or later", referring to a quote from Turkish poet Necip Fazil Kisakurek.

The Council of State had on July 2 debated the case brought by a Turkish group -- the Association for the Protection of Historic Monuments and the Environment, which demanded Hagia Sophia be reopened for Muslim prayers.

Since 2005, there have been several attempts to change the building's status. In 2018, the Constitutional Court rejected one application.

Despite occasional protests outside the site by Islamic groups, Turkish authorities had until now kept the building as a museum.