Interpol meets to select new president after China’s arrest

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.

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.

London, May 20: The current physical distancing guidelines of 6 feet may be insufficient to prevent COVID-19 transmission, according to a study which says a mild cough in low wind speeds can propel saliva droplets by as much as 18 feet.

Researchers, including those from the University of Nicosia in Cyprus, said a good baseline for studying the airborne transmission of viruses, like the one behind the COVID-19 pandemic, is a deeper understanding of how particles travel through the air when people cough.

In the study, published in the journal Physics of Fluids, they said even with a slight breeze of about four kilometres per hour (kph), saliva travels 18 feet in 5 seconds.

"The droplet cloud will affect both adults and children of different heights," said study co-author Dimitris Drikakis from the University of Nicosia.

According to the scientists, shorter adults and children could be at higher risk if they are located within the trajectory of the saliva droplets.

They said saliva is a complex fluid, which travels suspended in a bulk of surrounding air released by a cough, adding that many factors affect how saliva droplets travel in the air.

These factors, the study noted, include the size and number of droplets, how they interact with one another and the surrounding air as they disperse and evaporate, how heat and mass are transferred, and the humidity and temperature of the surrounding air.

In the study, the scientists created a computer simulation to examine the state of every saliva droplet moving through the air in front of a coughing person.

The model considered the effects of humidity, dispersion force, interactions of molecules of saliva and air, and how the droplets change from liquid to vapour and evaporate, along with a grid representing the space in front of a coughing person.

Each grid, the scientists said, holds information about variables like pressure, fluid velocity, temperature, droplet mass, and droplet position.

The study analysed the fates of nearly 1,008 simulated saliva droplets, and solved as many as 3.7 million equations.

"The purpose of the mathematical modelling and simulation is to take into account all the real coupling or interaction mechanisms that may take place between the main bulk fluid flow and the saliva droplets, and between the saliva droplets themselves," explained Talib Dbouk, another co-author of the study.

However, the researchers added that further studies are needed to determine the effect of ground surface temperature on the behaviour of saliva in air.

They also believe that indoor environments, especially ones with air conditioning, may significantly affect the particle movement through air.

This work is important since it concerns safety distance guidelines, and advances the understanding of the transmission of airborne diseases, Drikakis said.