Trump blasts courts for blocking travel ban, warns of 'peril'

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.

Johannesburg, Feb 22: To meet shortage of skilled nursing staff, private hospitals in South Africa are recruiting senior Indian nurses for their good work ethics and ability to become efficient trainers for the local staff, according to a media report.

A report at a 2018 jobs summit indicated that the country had a shortage of more than 47,000 nurses.

The shortage of the skilled nursing staff has been attributed to several factors, including preference of highly qualified nurses to emigrate or take up contract employment in countries such as the UK, the United Aarb Emirates, Saudi Arabia or New Zealand for want of higher salaries, a report in the weekly Business Times said.

Mediclinic, one of South Africa's largest private hospital groups, confirmed that it is recruiting 150 nurses from India this year.

“To supplement our training, as an internal strategy, we will continue to recruit senior registered nurses from India,” a Mediclinic spokesperson told the Business Times.

Mediclinic started recruiting nurses from India in 2005 but could not provide details about how many among the more than 8,800 nurses it employs at its hospitals are from India.

Another company, Life Healthcare SA, said it employed 135 Indian nurses between 2008 and 2014.

Top managements at the hospital groups lauded senior Indian nurses as being very efficient trainers for local staff.

“But we find that many of them prefer coming here on short-term contracts due to family commitments," a hospital executive said on the basis of anonymity.

The official said that the few who apply for long-term positions are usually young newly-qualified nurses, which is not the group in demand.

“They work hard, with a patient-oriented work ethic, and do not have the nine-to-five approach of many local nurses, especially those who are unionised," the official said.

“We would be very happy to take in more nursing staff from India," the official added.

Washington, May 30: The United States will end its relationship with the World Health Organization over the body’s handling of the coronavirus pandemic, U.S. President Donald Trump said on Friday, accusing the U.N. agency of becoming a puppet of China.

The move to quit the Geneva-based body, which the United States formally joined in 1948, comes amid growing tensions between Washington and Beijing over the coronavirus outbreak. The virus first emerged in China’s Wuhan city late last year.

Speaking in the White House Rose Garden, Trump said Chinese officials “ignored their reporting obligations” to the WHO about the virus - that has killed hundreds of thousands of people globally - and pressured the agency to “mislead the world.”

“China has total control over the World Health Organization despite only paying $40 million per year compared to what the United States has been paying which is approximately $450 million a year,” he said.

Trump’s decision follows a pledge last week by Chinese President Xi Jinping to give $2 billion to the WHO over the next two years to help combat the coronavirus. The amount almost matches the WHO’s entire annual program budget for last year.

Trump last month halted funding for the 194-member organization, then in a May 18 letter gave the WHO 30 days to commit to reforms.

“Because they have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs,” Trump said on Friday.

It was not immediately clear when his decision would come into effect. A 1948 joint resolution of Congress on U.S. membership of the WHO said the country “reserves its right to withdraw from the organization on a one-year notice.”

The World Health Organization did not immediately respond to a request for comment on Trump’s announcement. It has previously denied Trump’s assertions that it promoted Chinese “disinformation” about the virus.

“It’s important to remember that the WHO is a platform for cooperation among countries,” said Donna McKay, executive director of Physicians for Human Rights. “Walking away from this critical institution in the midst of an historic pandemic will hurt people both in the United States and around the world.”

‘ABSOLUTELY CRITICAL’

The United States currently owes the WHO more than $200 million in assessed contributions, according to the WHO website. Washington also gives several hundred million dollars annually in voluntary funding tied to specific WHO programs such as polio eradication, HIV, hepatitis and tuberculosis.

Amesh A. Adalja, a senior scholar at Johns Hopkins Center for Health Security, said that in practice Trump’s decision was unlikely to change the operations of the WHO.

“From a symbolic or moral standpoint it’s the wrong type of action to be taking in the middle of a pandemic and seems to deflect responsibility for what we in the U.S. failed to do and blame the WHO,” said Adalja.

When Trump halted funding to the WHO last month, two Western diplomats said the U.S. suspension was more harmful politically to the WHO than to the agency’s current programs, which are funded for now.

The WHO is an independent international body that works with the United Nations. U.N. Secretary-General Antonio Guterres said last month that the WHO is “absolutely critical to the world’s efforts to win the war against COVID-19.”

When asked about Trump’s decision, a U.N. spokesman said: “We have consistently called for all states to support WHO.”

Trump has long scorned multilateralism as he focuses on an “America First” agenda. Since taking office, he has quit the U.N. Human Rights Council, the U.N. cultural agency, a global accord to tackle climate change and the Iran nuclear deal. He has also cut funding for the U.N. population fund and the U.N. agency that aids Palestinian refugees.

“The WHO is the world’s early warning system for infectious diseases,” said U.S. Representative Nita Lowey, a Democrat who chairs the House Committee on Appropriations. “Now, during a global pandemic that has cost over 100,000 American lives, is not the time to put the country further at risk.”