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Islamabad, Jun 10: The World Health Organization has told Pakistan it should implement "intermittent" lockdowns to counter a surge in coronavirus infections that has come as the country loosens restrictions, officials said.

Since the start of Pakistan's outbreak in March, Prime Minister Imran Khan opposed a nationwide lockdown of the sort seen elsewhere, arguing the impoverished country could not afford it.

Instead, Pakistan's four provinces ordered a patchwork of closures, but last week Khan said most of these restrictions would be lifted.

Health officials on Wednesday declared a record number of new cases in the past 24 hours. The country has now confirmed a total of more than 113,000 cases and 2,200 deaths -- though with testing still limited, real rates are thought to be much higher.

"As of today, Pakistan does not meet any of the pre-requisite conditions for opening the lockdown", the WHO said in a letter confirmed by Pakistan officials on Tuesday.

Many people have not adopted behavioural changes such as social distancing and frequent hand-washing, meaning "difficult" decisions will be required including "intermittent lockdowns" in targeted areas, the letter states.

Some 25 percent of tests in Pakistan come back positive for COVID-19, the WHO said, indicating high levels of infection in the general population.

The health body recommended an intermittent lockdown cycle of two weeks on, two weeks off.

Responding to the WHO's letter, Zafar Mirza, the prime minister's special advisor for health, said the country had "consciously but gradually" eased lockdowns while enforcing guidelines in shops, mosques and public transport.

"We have to make tough policy choices to strike a balance between lives and livelihoods," Mirza said Wednesday.

Punjab's provincial health minister Yasmin Rashid, who received the WHO's letter, said the provincial government had already given "orders to take strict action against those violating" virus guidelines.

Hospitals across Pakistan say they are at or near capacity, and some are turning COVID-19 patients away.

WHO Director-General Tedros Adhanom Ghebreyesus said Monday that 136,000 cases had been reported in the previous 24 hours, "the most in a single day so far", with the majority of them in South Asia and the Americas.

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.

Jan 30: The death toll rose to 170 in the new virus outbreak in China on Thursday as foreign evacuees from the worst-hit region begin returning home under close observation and world health officials expressed “great concern” that the disease is starting to spread between people outside of China.

Thursday’s figures cover the previous 24 hours and represent an increase of 38 deaths and 1,737 cases for a total of 7,711. Of the new deaths, 37 were in the epicenter of the outbreak in Hubei province and one in the southwestern province of Sichuan.

The news comes as the 195 Americans evacuated from Wuhan, the Hubei province city of 11 million where the outbreak originated, are undergoing three days of testing and monitoring at a Southern California military base to make sure they do not show signs of the virus.

A group of 210 Japanese evacuees from Wuhan landed Thursday at Tokyo’s Haneda airport on a second government chartered flight, according to the foreign ministry. Reports said nine of those aboard the flight showed signs of cough and fever. Three of the 206 Japanese who returned on Wednesday tested positive for the new coronavirus, Prime Minister Shinzo Abe said during a parliamentary session. Two of them showed no symptoms of the disease.

France, New Zealand, Australia and other countries are also pulling out their citizens or making plans to do so.

The World Health Organization emergencies chief said the few cases of human-to-human spread of the virus outside China — in Japan, Germany, Canada and Vietnam — were of “great concern” and were part of the reason the U.N. health agency’s director-general was reconvening a committee of experts on Thursday to assess whether the outbreak should be declared a global emergency.

The new virus has now infected more people in China than were sickened there during the 2002-2003 SARS outbreak.

Dr. Michael Ryan spoke at a news conference in Geneva on Wednesday after returning from a trip to Beijing to meet with Chinese President Xi Jinping and other senior government leaders. He said China was taking “extraordinary measures in the face of an extraordinary challenge” posed by the outbreak.

To date, about 99% of the cases are in China. Ryan estimated the death rate of the new virus at 2%, but said the figure was very preliminary. With fluctuating numbers of cases and deaths, scientists are only able to produce a rough estimate of the fatality rate and it’s likely many milder cases of the virus are being missed.

In comparison, the SARS virus killed about 10% of people who caught it. The new virus is from the coronavirus family, which includes those that can cause the common cold as well as more serious illnesses such as SARS and MERS.

Scientists say there are many questions to be answered about the new virus, including just how easily it spreads and how severe it is.

In a report published Wednesday, Chinese researchers suggested that person-to-person spread among close contacts occurred as early as mid-December.

“Considerable efforts” will be needed to control the spread if this ratio holds up elsewhere, researchers wrote in the report, published in the New England Journal of Medicine.

More than half of the cases in which symptoms began before Jan. 1 were tied to a seafood market, but only 8% of cases after that have been, researchers found. They reported the average incubation period was five days.