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Jun 13: Requiring the wearing of masks to prevent the spread of the novel coronavirus in areas at the epicenter of the global pandemic may have prevented tens of thousands of infections, a new study suggests.

Mask-wearing is even more important for preventing the virus' spread and the sometimes deadly COVID-19 illness it causes than social distancing and stay-at-home orders, researchers said, in the study published in PNAS: The Proceedings of the National Academy of Sciences of the USA.

Infection trends shifted dramatically when mask-wearing rules were implemented on April 6 in northern Italy and April 17 in New York City - at the time among the hardest hit areas of the world by the health crisis - the study found.

"This protective measure alone significantly reduced the number of infections, that is, by over 78,000 in Italy from April 6 to May 9 and over 66,000 in New York City from April 17 to May 9," researchers calculated.

When mask-wearing went into effect in New York, the daily new infection rate fell by about 3% per day, researchers said. In the rest of the country, daily new infections continued to increase.

Direct contact precautions - social distancing, quarantine and isolation, and hand sanitizing - were all in place before mask-wearing rules went into effect in Italy and New York City. But they only help minimize virus transmission by direct contact, while face covering helps prevent airborne transmission, the researchers say.

"The unique function of face covering to block atomization and inhalation of virus-bearing aerosols accounts for the significantly reduced infections," they said. That would indicate "that airborne transmission of COVID-19 represents the dominant route for infection."

The U.S. Center for Disease Control and Prevention on Friday urged organizers of large gatherings that involve "shouting, chanting or singing to strongly encourage the use of cloth face coverings to lower the risk of spreading the coronavirus."

Sao Paulo, June 20: Brazil’s government confirmed on Friday that the country has risen above 1 million confirmed coronavirus cases, second only to the United States.

The country’s health ministry said that the total now stood at 10,32,913, up more than 50,000 from Thursday. The ministry said the sharp increase was due to corrections of previous days’ underreported numbers.

Brazilian President Jair Bolsonaro still downplays the risks of the virus after nearly 50,000 deaths from COVID-19 in three months, saying the impact of social isolation measures on the economy could be worse than the disease itself.

Specialists believe the actual number of cases in Brazil could be up to seven times higher than the official statistic. Johns Hopkins University says Brazil is performing an average of 14 tests per 1,00,000 people each day, and health experts say that number is up to 20 times less than needed to track the virus.

Official data show a downward trend of the virus in Brazil’s north, including the hard-hit region of the Amazon, a plateau in cases and deaths in the countries’ biggest cities near the Atlantic coast, but a rising curve in the south.

In the Brazilian countryside, which is much less prepared to handle a crisis, the pandemic is clearly growing. Many smaller cities have weaker health care systems and basic sanitation that’s insufficient to prevent contagion.

“There is a lot of regional inequality in our public health system and a shortage of professionals in the interior,” said Miguel Lago, executive director of Brazil’s Institute for Health Policy Studies, which advises public health officials.

That creates many health care deserts, with people going long distances to get attention. When they leave the hospital, the virus can go with them.

The cattle-producing state of Mato Grosso was barely touched by the virus when it hit the nation’s biggest cities in March. Sitting far from the coast, between the Bolivian border and Brazil’s capital of Brasilia, its 33 lakh residents led a mostly normal life until May. But now its people live under lockdown and meat producers have dozens of infected workers.

In Tangará da Serra, a city of 1,03,000 people in Mato Grosso, the mayor decided Friday to forbid the sale of alcoholic drinks for two weeks as an incentive for people to stay home.

Fᢩo Junqueira said the measure was needed after a spike in COVID-19 cases that filled 80% of the city’s 54 intensive care beds. The city has had nearly 300 cases of the disease, plus three fatalities.

In Rondonópolis, only 300 miles away from Tangará da Serra and home to a thriving economy, health authorities closed the local meatpacking industry after 92 cases were confirmed there. The city of 1,44,000 inhabitants counted 21 deaths from the virus and more than 600 cases. The mayor has also decided to limit sales of alcoholic beverages.

Even regions once considered examples of successful efforts against the virus are now struggling.

Porto Alegre, home to about 14 lakh people, had success in slowing the virus’ spread over the last three months. But now its mayor is considering increasing social isolation measures after ICU occupancy in the city jumped to 80% this month.

We were already making projections for schools to come back, Mayor Nelson Marchezan Jr. told The Associated Press. Now the trend is to impose more restrictions. Outside Sao Paulo city, five regions of the state’s countryside will have to close shops starting Monday due to a rise in coronavirus cases. Governor João Doria announced the decision Friday.

Dr. Mike Ryan, the World Health Organization’s executive director, said at a news conference that Brazil needs to increase its efforts to stop the spread of infections.

“The epidemic is still quite severe in Brazil. I believe health workers are working extremely hard and under pressure to be able to deal with the number of cases that they see on a daily basis,” Dr. Ryan said.

“Certainly the rise is not as exponential as it was previously, so there are some signs that the situation is stabilising. But we’ve seen this before in other epidemics in other countries.”

Margareth Dalcolmo, a clinical researcher and professor of respiratory medicine at the state-funded Oswaldo Cruz Foundation in Rio de Janeiro, believes the reopening in major cities and the virus traveling by road into Brazil’s heartland will keep the pressure on the country’s health system.

“The risk in the interior now is very big,” she said. “Our health system just can’t solve the most serious cases of COVID in many places of the countryside.”

Wuhan, Feb 9: President Xi Jinping strode onstage before an adoring audience in the Great Hall of the People in Beijing less than three weeks ago, trumpeting his successes in steering China through a tumultuous year and promising "landmark" progress in 2020.

"Every single Chinese person, every member of the Chinese nation, should feel proud to live in this great era," he declared to applause on the day before the Lunar New Year holiday. "Our progress will not be halted by any storms and tempests."

Xi made no mention of a dangerous new coronavirus that had already taken tenacious hold in the country. As he spoke, the government was locking down Wuhan, a city of 11 million people, in a frantic attempt to stop the virus spreading from its epicenter.

The coronavirus epidemic, which has killed more than 800 people in China as of Sunday and sickened tens of thousands, comes as Xi has struggled with a host of other challenges: a slowing economy, huge protests in Hong Kong, an election in Taiwan that rebuffed Beijing and a protracted trade war with the United States.

Now Xi faces an accelerating health crisis that is also a political one: a profound test of the authoritarian system he has built around himself over the past seven years. As the Chinese government struggles to contain the virus amid rising public discontent with its performance, the changes that Xi has ushered in could make it difficult for him to escape blame.

"It’s a big shock to the legitimacy of the ruling party. I think it could be only second to the June 4 incident of 1989. It’s that big," said Rong Jian, a writer about politics in Beijing, referring to the armed crackdown on Tiananmen Square protesters that year.

"There’s no doubt about his control over power," he added, "but the manner of control and its consequences have hurt his legitimacy and reputation."

Xi himself has recognized what is at stake, calling the outbreak "a major test of China’s system and capacity for governance."

Yet as China’s battle with the coronavirus intensified, Xi put the country’s No. 2 leader, Li Keqiang, in charge of a leadership group handling the emergency, effectively turning him into the public face of the government’s response. It was Li Keqiang who traveled to Wuhan to visit doctors.

Xi, by contrast, receded from public view for several days. That was not without precedent, though it stood out in this crisis, after previous Chinese leaders had used times of disaster to try to show a more common touch. State television and newspapers almost always lead with fawning coverage of Xi’s every move.

That retreat from the spotlight, some analysts said, signaled an effort by Xi to insulate himself from a campaign that may falter and draw public ire. Yet Xi has consolidated power, sidelining or eliminating rivals, so there are few people left to blame when something goes wrong.

"Politically, I think he is discovering that having total dictatorial power has a downside, which is that when things go wrong or have a high risk of going wrong, then you also have to bear all the responsibility," said Victor Shih, an associate professor at the University of California San Diego who studies Chinese politics.

Much of the country’s population has been told to stay at home, factories remain closed, and airlines have cut service. Experts warn that the coronavirus could slam the economy if not swiftly contained.

The government is also having trouble controlling the narrative. Xi now faces unusually sharp public discontent that even China’s rigorous censorship apparatus has been unable to stifle entirely.

The death of an ophthalmologist in Wuhan, Dr. Li Wenliang, who was censured for warning his medical school classmates of the spread of a dangerous new disease in December, has unleashed a torrent of pent-up public grief and rage over the government’s handling of the crisis. Chinese academics have launched at least two petitions in the wake of Li’s death, each calling for freedom of speech.

State media still portray Xi as ultimately in control, and there’s no sign that he faces a serious challenge from within the party leadership. The crisis, though, has already tainted China’s image as an emerging superpower — efficient, stable and strong — that could eventually rival the United States.

How much the crisis might erode Xi’s political standing remains to be seen, but it could weaken his position in the long run as he prepares to take a likely third term as Communist Party general secretary in 2022.

In 2018, Xi won approval to remove the constitutional limits on his term as the country’s president, making his plan for another five-year term seem all but certain.

If Xi comes out of this crisis politically insecure, the consequences are unpredictable. He may become more open to compromise within the party elite. Or he may double down on the imperious ways that have made him China’s most powerful leader in generations.

"Xi’s grip on power is not light," said Jude Blanchette, the Freeman Chair in China Studies at the Center for Strategic and International Studies.

"While the ham-fisted response to this crisis undoubtedly adds a further blemish to Xi’s tenure in office," Blanchette added, "the logistics of organizing a leadership challenge against him remain formidable."

In recent days, despite a dearth of public appearances, state media have portrayed Xi as a tireless commander-in-chief. This week they began calling the government’s fight against the virus the "people’s war," a phrase used in the official readout of Xi’s telephone call with President Donald Trump on Friday.

There are increasing signs that the propaganda this time is proving less than persuasive.

The Lunar New Year reception in Beijing where Xi spoke became a source of popular anger, a symbol of a government slow to respond to the suffering in Wuhan. Xi and other leaders appear to have been caught off guard by the ferocity of the epidemic.

Senior officials would almost certainly have been informed of the emerging crisis by the time national health authorities told the World Health Organization on Dec. 31, but neither Xi nor other officials in Beijing informed the public.

Xi’s first acknowledgment of the epidemic came Jan. 20, when brief instructions were issued under his name. His first public appearance after the lockdown of Wuhan on Jan. 23 came two days later, when he presided over a meeting of the Communist Party’s top body, the Politburo Standing Committee, which was shown at length on Chinese television. "We’re sure to be able to win in this battle," he proclaimed.

Back then, the death toll was 106. As it rose, Xi allowed other officials to take on more visible roles. Xi’s only appearances have been meeting foreign visitors in the Great Hall of the People or presiding over Communist Party meetings.

On Jan. 28, Xi met with the executive director of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, and told Tedros that he "personally directed" the government’s response. Later reports in state media omitted the phrase, saying instead that Xi’s government was "collectively directing" the response.

Since nothing about how Xi is portrayed in state media happens by accident, the tweak suggested a deliberate effort to emphasize shared responsibility.

Xi did not appear on official broadcasts again for a week — until a highly scripted meeting Wednesday with the authoritarian leader of Cambodia, Hun Sen.

There is little evidence that Xi has given up power behind the scenes. Li Keqiang, the premier in formal charge of the leadership group for the crisis, and other officials have said that they take their orders from Xi. The group is filled with officials who work closely under Xi, and its directives emphasize his authority.

"The way the epidemic is being handled now from the top just doesn’t fit with the argument that there’s been a clear shift toward more collective, consultative leadership," said Holly Snape, a British Academy Fellow at the University of Glasgow who studies Chinese politics.

The scale of discontent and the potential challenges for Xi could be measured by repeated references online to the nuclear accident at Chernobyl. Many of them came under the guise of viewer reviews of the popular television miniseries of the same name, which is still available for streaming inside China.

"In any era, any country, it’s the same. Cover everything up," one reviewer wrote.

The Soviet Union of 1986, however, was a different country than China in 2020.

The Soviet state was foundering when Chernobyl happened, said Sergey Radchenko, a professor of international relations at Cardiff University in Wales who has written extensively on Soviet and Chinese politics.

"The Chinese authorities, by contrast, are demonstrating an ability to cope, a willingness to take unprecedented measures — logistical feats that may actually increase the regime’s legitimacy," he added.

Radchenko compared Xi’s actions to those of previous leaders in moments of crisis: Mao Zedong after the Cultural Revolution or Deng Xiaoping after the Tiananmen Square crackdown.

"He’s doing what Mao and Deng would have done in similar circumstances: stepping back into the shadows while remaining firmly in charge."