Sri Lankan court bars Rajapaksa from acting as PM

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.

UN, May 26: Countries could see a "second peak" of coronavirus cases during the first wave of the pandemic if lockdown restrictions were lifted too soon, the World Health Organization (WHO) has warned.

Mike Ryan, the WHO's head of emergencies, told a briefing on Monday that the world was "right in the middle of the first wave", the BBC reported.

He said because the disease was "still on the way up", countries need to be aware that "the disease can jump up at any time".

"We cannot make assumptions that just because the disease is on the way down now that it's going to keep going down," Ryan said.

There would be a number of months to prepare for a second peak, he added.

The stark warning comes as countries around the world start to gradually ease lockdown restrictions, allowing shops to reopen and larger groups of people to gather.

Experts have said that without a vaccine to give people immunity, infections could increase again when social-distancing measures are relaxed.

Ryan said countries where cases are declining should be using this time to develop effective trace-and-test regimes to "ensure that we continue on a downwards trajectory and we don't have an immediate second peak".

Also on Monday, Tedros Adhanom Ghebreyesus, WHO Director-General, said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to "a temporary pause", while the safety data of the the anti-malaria drug was being reviewed.

According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalized, reports Xinhua news agency.

The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate.

"The Executive Group of the Solidarity Trial, representing 10 of the participating countries, met on Saturday (May 23) and has agreed to review a comprehensive analysis and critical appraisal of all evidence available globally," Tedros said in a virtual press conference.

The developments come as the total number of global COVID-19 cases has increased to 5,508,904, with 346,508 deaths, according to the Johns Hopkins University.

Jul 17: US President Donald Trump has said that he wants to do everything possible to keep peace for the people of India and China, according to his spokesperson

Over the past several weeks, the Trump administration has come out in support of India against China.

“He (Trump) said I love the people of India and I love the people of China and I want to do everything possible to keep the peace for the people,” White House Press Secretary Kayleigh McEnany told reporters at a news conference here on Thursday.

She was responding to a question on Trump’s message to India, which recently had a standoff with China in eastern Ladakh along the Line of Actual Control.

Earlier in the day, White House Economic Advisor Larry Kudlow described India as a great ally, saying President Trump is a great friend of Prime Minister Narendra Modi.

On Wednesday, Secretary of State Mike Pompeo said that India has been a great partner of the US.

“India has been a great partner… They are an important partner of ours. I have a great relationship with my foreign minister counterpart. We talked frequently about a broad range of issues. We talked about the conflict they had along the border with China. We've talked about the risk that emanates from the Chinese telecommunication infrastructure there,” Pompeo told reporters in response to a question.

Travelling in Europe, US National Security Advisor Robert O’Brien told reporters that China has been very aggressive with India.

O’Brien said that India is a democracy and is a great friend of the United States. Prime Minister “Modi and President Trump have a super relationship,” he said.

“In fact, it was the last foreign trip that I took with the president before the COVID-19 crisis hit, was to India, and we had a great reception of the Indian people there. We have a lot in common with them, we speak English, we're democracies. We've got a growing, very strong relationship with India,” O’Brien said.

Welcoming the White House statement, Al Mason, co-chair of the Trump Victory Indian American Finance Committee, said that unlike his predecessor, President Trump has come out openly in support of India.

“Most of the Indian-Americans have observed that every earlier president - be it a Democrat or Republican, like Clinton or Bush Senior or Bush Jr or Obama have been very scared to side with India openly, for fear of hurting China.

“Only President Trump has had the courage to say that… I love India, America respects India… US stands with India - and that also, to over one billion Indians in India at the Namaste Trump rally held in India… and that too… near India’s neighbour China,” Mason said in a statement.

“And he is consistent in his love for India and Indian-Americans,” he added.