Doing business in India was 'tough': US Secretary of State on his Bengaluru days

United Nations, May 7: An average of 80,000 COVID-19 cases were reported each day in April to the World Health Organization, the top UN health agency has said, noting that South Asian nations like India and Bangladesh are seeing a spike in the infections while the numbers are declining in regions such as Western Europe.

WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that countries must also be able to manage any risk of the disease being imported into their territories, and communities should be fully educated to adjust to what will be a "new norm".

He said as the countries press forward in the common fight against COVID-19, they should also lay the groundwork for resilient health systems globally.

"More than 3.5 million cases of COVID-19 and almost 250,000 deaths have now been reported to the WHO. Since the beginning of April, an average of around 80,000 new cases have been reported to the WHO every day," Ghebreyesus said in Geneva yesterday.

Asserting that the virus cases were not just numbers, he said: "every single case is a mother, a father, a son, a daughter, a brother, sister or friend".

He said while the numbers are declining in Western Europe, more cases are being reported every day from Eastern Europe, Africa, South-East Asia, the Eastern Mediterranean and the Americas. Even within regions and within countries, there are divergent trends, the agency added.

While some countries are reporting an increase in COVID-19 cases over time, many have seen caseloads rise because they have ramped up testing, the WHO official said.

"We've also seen in Europe and Western Europe a fundamental decrease in the number of cases, but we have seen an associated increase in the number of cases reported in places like the Russian Federation. Southeast, the Western Pacific areas are relatively on the downward trend like Korea and others, but then we do see in South Asia, in places like Bangladesh, in India, some trends towards increase.

"So it's very difficult to say that any particular region is improving or (not improving). There are individual countries within each region that are having difficulties getting on top of this disease and I am particularly concerned about those countries that have (an) ongoing humanitarian crisis," WHO's Executive Director Michael Ryan said.

The death toll due to COVID-19 in India rose to 1,783 while the number of cases climbed to 52,952 on Thursday, registering an increase of 89 deaths and 3,561 cases in the last 24 hours, the Union Health Ministry said.

The number of active COVID-19 cases stood at 35,902 while 15,266 people have recovered, it said.

Noting that while seeing an increase in the number of cases is not good in terms of transmission, WHO's Emerging Diseases and Zoonoses Unit head Maria Van Kerkhove said: "but I don't want to equate that with something (being) wrong".

"I want to equate that with countries are working very hard to increase their ability to find the virus, to find people with the virus, to have testing in place to identify who has COVID-19, and putting into place what they need to do to care for those patients," Kerkhove said.

With more countries considering easing restrictions implemented to curb the spread of the coronavirus, the WHO has again reminded the authorities of the need to maintain vigilance.

"The risk of returning to lockdown remains very real if countries do not manage the transition extremely carefully, and in a phased approach," Ghebreyesus said.

He urged countries to consider the UN agency's six criteria for lifting stay-at-home measures.

That advice includes ensuring surveillance is strong, cases are declining and transmission is controlled. Health systems also must be able to detect, isolate, test and treat cases, and to trace all contacts.

Additionally, the risk of outbreak in settings such as health facilities and nursing homes needs to be minimised, while schools, workplaces and other public locations should have preventive measures in place.

"The COVID-19 pandemic will eventually recede, but there can be no going back to business as usual. We cannot continue to rush to fund panic but let preparedness go by the wayside," he said.

He said the crisis has highlighted the importance of strong national health systems as the foundation of global health security: not only against pandemics but also against the multitude of health threats that people across the world face every day.

"If we learn anything from COVID-19, it must be that investing in health now will save lives later," Ghebreyesus said.

While the world currently spends around USD 7.5 trillion on health annually, the WHO believes the best investments are in promoting health and preventing disease.

"Prevention is not only better than cure, it's cheaper, and the smartest thing to do," he said.

The deadly coronavirus, which originated from the Chinese city of Wuhan in December last year, has infected over 3.7 million people and killed 263,831 people globally, according to a tally by Johns Hopkins University.

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

New Delhi, Jun 18: India on Wednesday took strong exception to China claiming sovereignty over the Galwan Valley in eastern Ladakh, saying its "exaggerated and untenable claims" are contrary to the understanding reached on the issue between the two sides.

Ministry of External Affairs Spokesperson Anurag Srivastava's response came after China claimed that the Galwan Valley in eastern Ladakh is a part of its territory.

"As we have conveyed earlier today, External Affairs Minister and the State Councillor and Foreign Minister of China had a phone conversation on recent developments in Ladakh," Srivastava said late Wednesday night.

"Both sides have agreed that the overall situation should be handled in a responsible manner and that the understandings reached between Senior Commanders on 6th June should be implemented sincerely. Making exaggerated and untenable claims is contrary to this understanding," he said.

Earlier on Wednesday, India delivered a strong message to China that the "unprecedented" incident in the Galwan Valley will have a "serious impact" on the bilateral relationship and held the "pre-meditated" action by Chinese army directly responsible for the violence that left 20 Indian Army personnel dead.

In a telephonic conversation, External Affairs Minister Jaishankar conveyed to his Chinese counterpart Wang Wi India's protest in the "strongest terms" and said the Chinese side should reassess its actions and take corrective steps, the Ministry of External Affairs said.

The Chinese Foreign Ministry, in a statement, said the two sides agreed to "cool down the situation on the ground as soon as possible", and maintain peace and tranquillity in the border area in accordance with the agreement reached so far between the two countries.

The clash in Galwan Valley on Monday night is the biggest confrontation between the two militaries after their 1967 clashes in Nathu La in 1967 when India lost around 80 soldiers while over 300 Chinese army personnel were killed.

The India-China border dispute covers the 3,488-km-long LAC. China claims Arunachal Pradesh as part of southern Tibet, while India contests it.

Prior to the clashes, both sides have been asserting that pending the final resolution of the boundary issue, it is necessary to maintain peace and tranquillity in the border areas.