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Beijing/Zurich, Mar 4: China has approved the use of Swiss drugmaker Roche's anti-inflammation drug Actemra for patients who develop severe complications from the coronavirus as it urgently hunts for new ways to combat the deadly infection that is spreading worldwide.

China is hoping that some older drugs could stop severe cytokine release syndrome (CRS), or cytokine storms, an overreaction of the immune system which is considered a major factor behind catastrophic organ failure and death in some coronavirus patients.

Actemra, a biologic drug approved in 2010 in the United States for rheumatoid arthritis (RA), inhibits high Interleukin 6 (IL-6) protein levels that drive some inflammatory diseases.

China's National Health Commission said in treatment guidelines published online on Wednesday that Actemra can now be used to treat coronavirus patients with serious lung damage and high IL-6 levels.

Separately, researchers in the country are testing Actemra, known generically as tocilizumab, in a clinical trial expected to include 188 coronavirus patients and running until May 10.

Roche, which donated 14 million yuan ($2.02 million) worth of Actemra during February, said the trial was initiated independently by a third party with the aim of exploring the efficacy and safety of the drug in coronavirus patients with CRS.

It added that there was currently no published clinical trial data on the drug's safety or efficacy against the virus.

More than 3,000 people have died and 93,000 have been infected by the novel coronavirus thought to have originated in Wuhan, China, before spreading to around 90 countries including the United States, Italy, Switzerland, France and Germany.

The Swiss company, for which China is its No. 2 market behind the United States, also makes diagnostic gear to detect the coronavirus.

Since Actemra's approval a decade ago, it has become a go-to drug against other inflammatory conditions, including cytokine storms in cancer patients receiving cell therapies from Novartis and Gilead Sciences.

In 2012 it helped save the life of a young U.S. girl, the first child to be treated for leukaemia with Novatis' Kymriah, from a post-treatment rush of IL-6.

Priced at between $20-30,000 annually for RA according to SSR Health, Roche's medicine is also used for rare juvenile arthritis and giant cell arteritis, or inflammation of the blood vessels.

Wuhan, Apr 15: In the six days after top Chinese officials secretly determined they likely were facing a pandemic from a new coronavirus, the city of Wuhan at the epicenter of the disease hosted a mass banquet for tens of thousands of people; millions began traveling through for Lunar New Year celebrations.

President Xi Jinping warned the public on the seventh day, Janaury 20. But by that time, more than 3,000 people had been infected during almost a week of public silence, according to internal documents obtained by The Associated Press and expert estimates based on retrospective infection data.

That delay from Jan 14 to Jan. 20 was neither the first mistake made by Chinese officials at all levels in confronting the outbreak, nor the longest lag, as governments around the world have dragged their feet for weeks and even months in addressing the virus.

But the delay by the first country to face the new coronavirus came at a critical time — the beginning of the outbreak. China's attempt to walk a line between alerting the public and avoiding panic set the stage for a pandemic that has infected almost 2 million people and taken more than 126,000 lives.

A This is tremendous, a said Zuo-Feng Zhang, an epidemiologist at the University of California, Los Angeles. If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient. We might have avoided the collapse of Wuhan's medical system.

Other experts noted that the Chinese government may have waited on warning the public to stave off hysteria, and that it did act quickly in private during that time.

But the six-day delay by China's leaders in Beijing came on top of almost two weeks during which the national Center for Disease Control did not register any cases from local officials, internal bulletins obtained by the AP confirm. Yet during that time, from Jan 5 to Jan 17, hundreds of patients were appearing in hospitals not just in Wuhan but across the country.

It's uncertain whether it was local officials who failed to report cases or national officials who failed to record them. It's also not clear exactly what officials knew at the time in Wuhan, which only opened back up last week with restrictions after its quarantine.

But what is clear, experts say, is that China's rigid controls on information, bureaucratic hurdles and a reluctance to send bad news up the chain of command muffled early warnings. The punishment of eight doctors for rumor-mongering, broadcast on national television on Jan. 2, sent a chill through the city's hospitals.

Doctors in Wuhan were afraid, said Dali Yang, a professor of Chinese politics at the University of Chicago. It was truly intimidation of an entire profession. Without these internal reports, it took the first case outside China, in Thailand on Jan 13, to galvanize leaders in Beijing into recognising the possible pandemic before them. It was only then that they launched a nationwide plan to find cases distributing CDC-sanctioned test kits, easing the criteria for confirming cases and ordering health officials to screen patients, all without telling the public.

The Chinese government has repeatedly denied suppressing information in the early days, saying it immediately reported the outbreak to the World Health Organization.

Allegations of a cover-up or lack of transparency in China are groundless, said foreign ministry spokesman Zhao Lijian at a Thursday press conference.

The documents show that the head of China's National Health Commission, Ma Xiaowei, laid out a grim assessment of the situation on Jan. 14 in a confidential teleconference with provincial health officials.

A memo states that the teleconference was held to convey instructions on the coronavirus from President Xi Jinping, Premier Li Keqiang and Vice Premier Sun Chunlan, but does not specify what those instructions were.

The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event, the memo cites Ma as saying.

The National Health Commission is the top medical agency in the country. In a faxed statement, the Commission said it had organised the teleconference because of the case reported in Thailand and the possibility of the virus spreading during New Year travel. It added that China had published information on the outbreak in an open, transparent, responsible and timely manner," in accordance with important instructions repeatedly issued by President Xi.

The documents come from an anonymous source in the medical field who did not want to be named for fear of retribution. The AP confirmed the contents with two other sources in public health familiar with the teleconference. Some of the memo's contents also appeared in a public notice about the teleconference, stripped of key details and published in February.

Under a section titled sober understanding of the situation, the memo said that clustered cases suggest that human-to-human transmission is possible. It singled out the case in Thailand, saying that the situation had changed significantly because of the possible spread of the virus abroad.

With the coming of the Spring Festival, many people will be traveling, and the risk of transmission and spread is high, the memo continued.

Washington, Feb 28: US intelligence agencies are monitoring the global spread of coronavirus and the ability of governments to respond, sources familiar with the matter said on Thursday, warning that there were concerns about how India would cope with a widespread outbreak.

While there are only a few known cases in India, one source said the country's available countermeasures and the potential for the virus to spread given India's dense population was a focus of serious concern.

US intelligence agencies are also focusing on Iran, where the country's deputy health minister has fallen ill during a worsening outbreak.

US Secretary of State Mike Pompeo said on Tuesday the United States was "deeply concerned" Tehran may have covered up details about the spread of coronavirus. A US government source said Iran's response was considered ineffective because the government only has minimal capabilities to respond to the outbreak.

Another source said US agencies were also concerned about the weak ability of governments in some developing countries to respond to an outbreak.

The US House of Representatives Intelligence Committee has received a briefing on the virus from the spy agencies. "The Committee has received a briefing from the IC (intelligence community) on coronavirus, and continues to receive updates on the outbreak on a daily basis," an official of the House Intelligence Committee told Reuters.

"Addressing the threat has both national security and economic dimensions, requiring a concerted government-wide effort and the IC is playing an important role in monitoring the spread of the outbreak, and the worldwide response," the official added.

A source familiar with the activities of the Senate Intelligence Committee, led by Republican Senator Richard Burr and Democratic Senator Mark Warner, said the panel was receiving daily updates. The role of US intelligence agencies in responding to the coronavirus epidemic at this point principally involves monitoring the spread of the illness around the world and assessing the responses of governments.

They are working closely with health agencies, such as the US Center for Disease Control, in sharing information they collect and targeting further intelligence gathering.

One source said US agencies would use a wide range of intelligence tools, ranging from undercover informants to electronic eavesdropping tools, to track the virus' impact.