Climate activist Greta Thunberg wins Sweden’s 'alternative Nobel Prize'

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.

The head of the World Health Organisation on Tuesday warned the novel coronavirus was a "very grave threat" for the world as he opened a conference to combat the epidemic.

"With 99% of cases in China, this remains very much an emergency for that country, but one that holds a very grave threat for the rest of the world," Tedros Adhanom Ghebreyesus said in Geneva.

Some 400 scientists will review how the virus is transmitted and possible vaccines at the two-day forum.

"What matters most is stopping the outbreak and saving lives. With your support, that's what we can do together," Tedros said.

The virus, first identified in China on December 31, has killed more than 1,000 people, infected over 42,000 and reached some 25 countries.

Participants will also discuss the source of the virus, which is thought to have originated in bats and reached humans via another animal such as snakes or pangolins.

There is no specific treatment or vaccine against the virus, which can cause respiratory failure.

Tedros, who has repeatedly urged countries affected to share their data, called for global "solidarity".

"That is especially true in relation to the sharing of samples and sequences. To defeat this outbreak, we need open and equitable sharing, according to the principles of fairness and equity," he said.

"We hope that one of the outcomes of this meeting will be an agreed roadmap for research around which researchers and donors will align," Tedros said.

Several companies and institutes in Australia, China, France, Germany and the United States are racing to develop a vaccine -- a process that normally takes years.

Asked whether scientists from Taiwan would be allowed to take part in this week's Geneva conference, WHO officials said that they would do so but only online -- along with colleagues from other parts of China.

While the WHO does not deal with Taiwan directly and only recognises Beijing, Taiwan was often allowed to attend annual assemblies and sideline meetings as an observer.

But in recent years it has been frozen out as Beijing takes an increasingly combative stance towards democratic Taiwan, which it considers its own territory.

Washington, Mar 29: The number of known coronavirus US cases soared well past 115,000, with more than 1,900 dead, as President Donald Trump said on Saturday he was considering imposing a quarantine on the hard hit New York region.

American healthcare workers in the trenches of the pandemic are appealing for more protective gear and equipment to treat a surge in patients that is already pushing hospitals to their limits in virus hot spots such as New York City, New Orleans and Detroit.

Trump told reporters he could order a quarantine on three states, New York, New Jersey and Connecticut, which between them have recorded at least 64,000 infections and 895 deaths.

He also appeared to soften his previous comments calling for the US economy to be swiftly reopened. Asked whether he thought the United States would restart by Easter Sunday, April 12, Trump replied, "We'll see, what happens."

New York Governor Andrew Cuomo said he had no details on any possible quarantine order for his state, telling a briefing: "I don't even know what that means. I don't know how that would be legally enforceable, and from a medical point of view I don't know what you would be accomplishing."

He said New York was postponing its presidential primary election to June 23, from April 28.

As the crisis deepened, nurses at Jacobi Medical Center in New York's borough of the Bronx protested outside the hospital on Saturday, saying supervisors asked them to reuse personal protective equipment, including masks. Some held signs with slogans including "Protect our lives so we can save yours."

"The masks are supposed to be one-time use," one nurse said, according to videos posted online. "Now, all of a sudden the CDC (Centers for Disease Control and Prevention) is saying that it's fine for us to reuse them. These choices are being made not based on science. They're being made based on need."

One resident at New York Presbyterian Hospital said they were issued with just one mask.

"This is your mask forever. You can bring it home with you. Here's how you can clean your mask," said the resident, who asked not to be named because he was not authorized to speak to the media. "It's not the people who are making these decisions that go into the patients' rooms."

Doctors are also especially concerned about a shortage of ventilators, machines that help patients breathe and are widely needed for those suffering from COVID-19, the pneumonia-like respiratory ailment caused by the highly contagious novel coronavirus.

Hospitals have also sounded the alarm about scarcities of drugs, oxygen tanks and trained staff.

By Saturday afternoon, the US number of cases stood at 115,842 with at least 1,929 deaths, according to a Reuters tally. The United States has had the most recorded cases of any country since its count of infections eclipsed those of China and Italy on Thursday.

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As shortages of key medical supplies abounded, desperate physicians and nurses were forced to take matters into their own hands.

New York-area doctors say they have had to recycle some protective gear, or even resort to bootleg suppliers.

Dr. Alexander Salerno of Salerno Medical Associates in northern New Jersey described going through a "broker" to pay $17,000 for masks and other protective equipment that should have cost about $2,500, and picking them up at an abandoned warehouse.

"You don't get any names. You get just phone numbers to text," Salerno said. "And so you agree to a term. You wire the money to a bank account. They give you a time and an address to come to."

Nurses at Mount Sinai Hospital in New York said they were locking away or hiding N95 respirator masks, surgical masks and other supplies that are prone to pilfering if left unattended.

"Masks disappear," nurse Diana Torres said. "We hide it all in drawers in front of the nurses' station."

One nurse at Westchester Medical Center, in the suburbs of the city, said colleagues have begun absconding with scarce supplies without asking, prompting better-stocked teams to lock masks, gloves and gowns in drawers and closets.

An emergency room doctor in Michigan, an emerging epicenter of the pandemic, said he was wearing one paper face mask for an entire shift due to a shortage and that hospitals in the Detroit area would soon run out of ventilators.

"We have hospital systems here in the Detroit area in Michigan who are getting to the end of their supply of ventilators and have to start telling families that they can't save their loved ones because they don't have enough equipment," the physician, Dr. Rob Davidson, said in a video posted on Twitter.

Sophia Thomas, a nurse practitioner at DePaul Community Health Center in New Orleans, where Mardi Gras celebrations late last month fueled an outbreak in Louisiana's largest city, said the numbers of coronavirus patients "have been staggering."

In the nation's second-largest city, Los Angeles Mayor Eric Garcetti said spiking cases were putting Southern California on track to match New York City's infection figures in the next week.