Pneumonia kills a child every 39 seconds; India among worst hit countries

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.

Beijing, Feb 9: After making sure everyone's face mask is on and sanitizer is to hand, the Qiao family heads out to Jingshan Park, a former royal sanctuary beside the Forbidden City in China's capital Beijing.

Snow has fallen for a second day, a rare event in the city of 21.5 million that would normally bring hundreds of thousands of people out to take photos and play. But the streets are empty and the parks are so quiet the only sound is of birds chirping.

It's not just Beijing. Shanghai, China's financial hub, and other cities in the world's most populous nation have turned into ghost towns after the government extended a holiday and asked residents not to go out because of the coronavirus.

"We know the situation of the coronavirus is severe. But the epicentre is far away, so we think it should be fine here ... It's a God-given chance to enjoy this family moment with snow and without work," said Mr Qiao, who has an 11-year-old daughter.

The epidemic has killed 722 people and infected nearly 32,000 in China as of February 8. More than three-quarters of the cases are in the central Hubei province where the virus originated - more than 1,000 km (620 miles) from Beijing.

Only a few people are brave enough to come out. A security guard at Jingshan Park said there were less than a third of the number of tourists than usual, even with the rare snowfall.

Even at one of the best spots for snapping photos of snowy Beijing just outside the Forbidden City, there's barely a crowd, while the usual tour buses and groups of people speaking different dialects are nowhere to be seen.

"Last year when it snowed, I took a few hours off work to come down here to take a picture and the crowd was several layers deep," said a man in his 30s who gave his surname as Yang. "But this year, I am not at all worried about finding a space to take a photo. The virus is keeping people indoors."

Security guards along Wangfujing street, a popular pedestrianised shopping area in downtown Beijing, said it was normally so crowded during the holiday period that it was hard to move around.

"Look at it now, there are more security guards and street cleaners than tourists!" said one of the guards.

Businesses, including shops, bars and restaurants, have been severely hit by the epidemic as the government has banned mass gatherings and even group meals in an effort to curb the spread of the coronavirus.

"You would have to wait outside for a table on a normal day," said a waitress at a restaurant with more than 50 tables. Just five were taken at the peak lunch hour.

Only a handful of the more than 100 restaurants along Beijing's famous food street, Guijie, were open, and the remaining outlets were wondering how long they can hold out.

Islamabad, May 24: Pakistan recorded 32 coronavirus-related deaths during the last 24 hours, taking the total number of fatalities in the country to 1,133, the health ministry said on Sunday.

The total number of COVID-19 patients in Pakistan also jumped to 54,601, it said.

Read: Coronavirus India update: State-wise total number of confirmed cases, deaths

Sindh reported the maximum number of 21,645 coronavirus cases, followed by Punjab at 19,557, Khyber-Pakhtukhwa at 7,685, Balochistan at 3,306, Islamabad at 1,592, Gilgit-Baltistan at 619 and Pakistan-occupied Kashmir (PoK) at 197.

According to the health ministry, 17,198 coronavirus patients have recovered and 473,607 tests, including 12,915 in the last 24 hours, have been conducted so far.

The government also issued strict instructions to observe social distancing while offering Eid prayer and asked people to avoid visiting relatives and hosting parties.

Eid congregations were held at open places, mosques and Eidgahs in all major cities and towns while following strict standard operating procedures (SOPs) of social distancing and other precautionary measures.

Pakistan Prime Minister's Special Assistant on Health Zafar Mirza on Friday said the deadly infection would continue to multiply if precautions are not taken.

Earlier this month, the government had announced the lifting of the countrywide lockdown imposed to curb the spread of the virus in phases, even as infections continued to rise in the country.

Prime Minister Imran Khan had cited the economic havoc the virus restrictions had wreaked on citizens as the reason behind the decision.

The prime minister on Saturday urged Pakistanis to forgo traditional Eid festivity in view of the hundreds of fatalities caused by the coronavirus and the lives lost in Friday's plane crash in Karachi.

Ninety-seven people, including nine children, were killed and two passengers miraculously survived a fiery crash when a Pakistan International Airlines plane with 99 travellers on board plunged into a densely populated residential area near the Jinnah International Airport in Karachi. Most of the victims were travelling home to celebrate Eid.