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Archive for the ‘Health’ Category

Scientist admits Sweden could have battled virus better

June 03, 2020

STOCKHOLM (AP) — Sweden’s chief epidemiologist showed contrition Wednesday as criticism mounted over the Scandinavian country’s hotly debated method of fighting the coronavirus, which has resulted in one of the highest death rates per capita in the world.

Sweden has stood out among European nations and the world for the way it has handled the pandemic, not shutting down the country or the economy like others but relying on citizens’ sense of civic duty. Swedish authorities have advised people to practice social distancing, but schools, bars and restaurants have been kept open the entire time. Only gatherings of more than 50 people have been banned.

“I think there is potential for improvement in what we have done in Sweden, quite clearly,” Anders Tegnell of the Public Health Agency told Swedish radio. Sweden, a nation of 10.2 million people, has seen 4,468 deaths linked to COVID-19, which is far more than its Nordic neighbors and one of the highest death rates per capita in the world. Denmark has had 580 coronavirus deaths, Finland has seen 320 and Norway has had 237, according to a tally by Johns Hopkins University.

“If we were to encounter the same disease again, knowing precisely what we know about it today, I think we would settle on doing something in between what Sweden did and what the rest of the world has done,” said Tegnell, considered the architect of the unique Swedish pandemic approach.

Authorities in Sweden, including Tegnell, have been criticized — and have apologized — for failing to protect the country’s elderly and nursing home residents. But Tegnell said Wednesday it was still unclear what the country should have done differently. He also said other nations are unable to tell exactly what measures affected the outcome of their outbreaks because they threw everything at it in one go.

“Maybe we know that now, when you start easing the measures, we could get some kind of lesson about what else, besides what we did, you could do without a total shutdown,” Tegnell said. Asked if the country’s high death toll has made him reconsider his unique approach to the pandemic, Tegnell answered “yes, absolutely.”

“I’m not walking around thinking that we have a real disaster here in Sweden,” Jan Arpi, a 58-year-old sales executive, told The Associated Press. “I think we have it more or less under control, but we have to be even more careful now with the learning we have got from how the virus is spread, especially among the elderly people,”

Sweden’s infection rate is 43.24 deaths per 100,000 inhabitants is lower than Spain’s (58.06), and Italy’s (55.39), but is higher than the reported rates in the United States (32.14) and Brazil (14.29), according to the Johns Hopkins University.

Last week, the country’s former state epidemiologist, Annika Linde, said that in retrospect she believes an early lockdown could have saved lives while political pressure has forced the government to bring forward an investigation into the handling of the crisis.

The moves recommended by Tegnell have made Sweden a bit of a local pariah and didn’t spare the Swedish economy. More than 76,000 people have been made redundant since the outbreak began and unemployment, which now stands at 7.9%, is expected to climb higher.

Finance Minister Magdalena Andersson has said Sweden’s economy, which relies heavily on exports, will shrink 7% in 2020 and the Scandinavian country was headed for “a very deep economic crisis.” Last week, neighboring Norway and Denmark said they were dropping mutual border controls but would keep Sweden out of a Nordic “travel bubble.”

Danes said they will reopen the border next month to residents of neighboring Germany, as well as to Norway and Iceland, as it accelerates the easing of its coronavirus lockdown. However, Denmark, which has a bridge that goes directly to Sweden, has postponed a decision on whether to reopen to Swedish visitors until after the summer.

Jan M. Olsen in Copenhagen, Denmark, contributed to this report.

UK lawmakers queue to vote as Parliament adjusts to COVID-19

June 02, 2020

LONDON (AP) — Prime Minister Boris Johnson’s Conservative government faced a rebellion from some of its own legislators on Tuesday after it summoned Members of Parliament back to London and scrapped a remote-voting system used during a nationwide coronavirus lockdown.

Like millions of other Britons, the country’s 650 lawmakers have largely been working from home during the outbreak. As normal life gradually resumes, the government decreed it was time they came back to the office.

Jacob Rees-Mogg, the government’s leader of the House, said lawmakers should be setting an example by showing up in person as the country gets back to work. “We need to have a proper full-blooded democracy … and that’s what we are getting,” he told lawmakers.

But some legislators said ending the “virtual Parliament” before the outbreak was over would turn those who must stay home because of age, illness or family issues into second-class lawmakers. “I feel both discriminated against and disenfranchised,” said opposition Labour Party lawmaker Margaret Hodge, who like many over-70s, is considered especially vulnerable to the virus and has been urged to stay at home.

“We should be holding the government to account. We can’t if we don’t have the right to vote,” she said. After Britain went into lockdown in late March, Parliament adopted a historic “hybrid” way of working. Only 50 lawmakers at a time were allowed into the House of Commons, while screens were erected around the chamber so others could join debates over Zoom. Votes were held electronically for the first time in centuries of parliamentary history.

But when the House resumed work Tuesday after an 11-day spring recess, the government called time on the brief experiment with virtual voting. With its 80-strong majority in the chamber, the government passed a motion decreeing that henceforth, all votes will have to be held in person.

In the coronavirus era, that’s an unwieldy process. House of Commons Speaker Lindsay Hoyle ruled that the traditional method of voting, in which lawmakers crowd into separate “yes” or “no” lobbies, was unsafe because it would be be impossible to maintain social distancing.

To vote on the government’s motion, lawmakers therefore had to stand in a kilometer-long (half-mile-long) queue that snaked along corridors, through a vaulted hall and around a courtyard. One by one and 2 meters apart (6 1/2 feet), they trooped into the Commons chamber to register their votes — a process that took 45 minutes in all.

Some critics dubbed the unwieldy method a “conga-line Parliament”; others compared it to children filing into class on the first day of school. The government’s opponents argue that it’s too early and too risky to return to Parliament.

Britain has had Europe’s deadliest coronavirus outbreak, with more than 39,000 confirmed deaths. Prime Minister Boris Johnson’s Conservative government is gradually easing the nationwide lockdown, but authorities warn that progress is fragile, and too swift a relaxation could trigger a second wave of infections.

Rees-Mogg said Parliament was now “a COVID-secure workplace,” with hand sanitizer dispensers and floor markings to help enforce social distancing. But Parliamentary authorities have major concerns. With its crammed chamber and warren of corridors, Parliament was fertile soil for the virus when the outbreak began. Multiple staff and lawmakers fell ill, including Johnson, who ended up in intensive care.

“Asking people to travel from all corners of the U.K. to go to the global hotspot that is London … is gambling with the virus,” said Scottish National Party lawmaker Angus MacNeil, whose Hebridean island constituency is almost as far from London as it’s possible to get in the U.K.

The Commons’ move to end its digital experiment came as Parliament’s upper chamber, the House of Lords, put the finishing touches to a system that will allow its members, whose average age is 70, to vote with their phones.

Faced with mounting opposition, the government offered a partial compromise. Rees-Mogg said that lawmakers who have to stay home for health reasons would be able to ask questions and participate in debates remotely — but not vote.

Conservative lawmaker Robert Halfon, who has cerebral palsy, said the authorities were being “harsh and unbending.” “The MPs who genuinely cannot come in, our democratic rights are being snipped away and we’re being turned into parliamentary eunuchs,” he said.

Halfon likened the government’s attitude to that of Brazilian President Jair Bolsonaro “that COVID is just the sniffles and, if you can’t come in, tough luck, we don’t care. And that to me is entirely wrong.”

Parisians return to cafes; Latin America sees virus surge

June 02, 2020

PARIS (AP) — Parisians returned to the City of Light’s beloved sidewalk cafes as lockdown restrictions eased Tuesday, but health experts expressed deep concerns as several Latin American countries opted to reopen their economies despite a rapid rise in coronavirus cases.

The post-lockdown freedom along Paris’ cobbled streets will be tempered by social distancing rules for the city’s once-densely packed cafe tables. Paris City Hall has authorized outside seating areas only, with indoor seating off-limits until June 22. But the tiny tables will have to be spaced at least 1 meter apart, sharply cutting their numbers.

“It’s amazing that we’re finally opening up, but the outside area is just a fraction of the inside space,” said Xavier Denamur, the owner of five popular cafes and bistros. “It’s a start.” But as Parisians reclaimed the rhythm of city life, health experts warned that virus cases are still rising in Latin America, the world’s latest COVID-19 epicenter.

“Clearly the situation in many South American countries is far from stable. There is a rapid increase in cases and those systems are coming under increasing pressure,” said Dr. Mike Ryan, the executive director of the World Health Organization’s emergencies program.

His warning came as some of Brazil’s hardest-hit cities, including the jungle city of Manaus and the sprawling metropolis of Rio de Janeiro, were starting to allow more business activity. Brazil has reported more than 526,000 infections, second only to the 1.8 million cases reported by the U.S.

Bolivia and Venezuela have also started opening up their economies, Ecuador has resumed flights and shoppers have returned to Colombia’s malls. In Mexico, President Andrés Manuel López Obrador offered a personal note of caution to his country’s gradual roll-back of virus restrictions by opting to drive 1,000 miles instead of flying to promote a key infrastructure project.

Despite its public praise of China, the WHO was deeply frustrated with Chinese authorities for not immediately providing the world body with information it needed to fight the spread of the deadly virus, the Associated Press has found.

Tight controls on information and competition within China’s health services are believed to be why the country delayed releasing the genetic map, or genome, of the virus for more than a week after three different government labs had fully decoded the information.

WHO officials publicly lauded China to coax more information out of the government, but privately complained in the first week of January that China wasn’t sharing enough data to assess how the virus spread between people or what the global risk was, costing valuable time.

As economic fallout from the pandemic slammed economies around the world, more than 225 current and former global VIPs urged the leaders of the Group of 20 major economic powers to back a $2.5 trillion plan to tackle COVID-19 and launch an economic recovery from the pandemic.

They said poor and middle-income countries, which represent nearly 70% of the world’s population, need immediate action. Back in Europe, France on Tuesday put technology to work to check the spread of the virus by rolling out its StopCovid contact-tracing app as neighboring countries including the U.K., Germany and Italy prepared to launch their own versions.

French users can voluntarily download the app on their smartphones. If they test positive, they’ll will be able to notify others who have been in close contact for at least 15 minutes. But in Russia, a flood of complaints has met the app designed to track Moscow’s quarantined coronavirus patients.

The app’s nearly 70,000 registered users were subject to fines if they left their home or if they failed to take a selfie when directed to do so to prove their location. Some people said the app asked for selfies in the middle of the night.

“I don’t mind paying a fine for something I did wrong, but I don’t understand what I’m paying for here,” said Grigory Sakharov who was handed six fines — two of which were given before he installed the app while he was still in the hospital recovering.

Russian authorities, who have handed out 54,000 fines, insisst they have only been issued to those who repeatedly violated quarantine regulations. British lawmakers were returning to Parliament on Tuesday but some are sharply critical of the government’s decision to scrap a remote-voting system used during the country’s lockdown. They worry that an end to the country’s unprecedented but brief experiment with virtual voting will turn those who must stay at home because of age, illness or family responsibilities into second-class lawmakers.

Britain’s Conservative government says lawmakers should be setting an example by showing up in person as the country gets back to work. But critics argue it’s too risky to return to Parliament. “Asking people to travel from all corners of the U.K. to go to the global hot spot that is London … is gambling with the virus,” said Scottish National Party lawmaker Angus MacNeil.

Britain’s statistics agency said the U.K. had 48,106 coronavirus-related deaths up to the week ending May 22. That number dwarfs the government’s daily figures, which are based on initial cause of death assessments and put COVID-related deaths at just above 39,000. The statistics agency numbers are collated from death registrations, which can take a couple of weeks to be issued. Britain is second only to the U.S. in the number of confirmed COVID-19 deaths.

Meanwhile, Professor Neil Ferguson from Imperial College London said he expects levels of coronavirus infections in the U.K. to “remain relatively flat between now and September.” But he told the House of Lords that the “real uncertainty” will be in September — a time when respiratory viruses start spreading more forcefully.

Worldwide, 6.5 million people have been infected with the virus, which has killed over 375,000, according to a tally by Johns Hopkins University that experts believe is too low because many people died without being tested. The United States has seen over 105,000 deaths and Europe has had nearly 175,000.

South Africa’s coronavirus cases jumped again to more than 35,000 as the country began easing its lockdown. The country has seen cases double roughly every 12 days. As economic fallout slammed economies around the world, more than 225 current and former global VIPs urged the leaders of the Group of 20 major economic powers to back a $2.5 trillion plan to tackle COVID-19 and launch an economic recovery. They said poor and middle-income countries, which represent nearly 70% of the world’s population, need immediate action.

Hadjicostis reported from Nicosia, Cyprus. Reporters from around the world contributed to this report.

China delayed releasing coronavirus info, frustrating WHO

June 02, 2020

(AP) Throughout January, the World Health Organization publicly praised China for what it called a speedy response to the new coronavirus. It repeatedly thanked the Chinese government for sharing the genetic map of the virus “immediately,” and said its work and commitment to transparency were “very impressive, and beyond words.”

But behind the scenes, it was a much different story, one of significant delays by China and considerable frustration among WHO officials over not getting the information they needed to fight the spread of the deadly virus, The Associated Press has found.

Despite the plaudits, China in fact sat on releasing the genetic map, or genome, of the virus for more than a week after three different government labs had fully decoded the information. Tight controls on information and competition within the Chinese public health system were to blame, according to dozens of interviews and internal documents.

Chinese government labs only released the genome after another lab published it ahead of authorities on a virologist website on Jan. 11. Even then, China stalled for at least two weeks more on providing WHO with detailed data on patients and cases, according to recordings of internal meetings held by the U.N. health agency through January — all at a time when the outbreak arguably might have been dramatically slowed.

WHO officials were lauding China in public because they wanted to coax more information out of the government, the recordings obtained by the AP suggest. Privately, they complained in meetings the week of Jan. 6 that China was not sharing enough data to assess how effectively the virus spread between people or what risk it posed to the rest of the world, costing valuable time.

“We’re going on very minimal information,” said American epidemiologist Maria Van Kerkhove, now WHO’s technical lead for COVID-19, in one internal meeting. “It’s clearly not enough for you to do proper planning.”

“We’re currently at the stage where yes, they’re giving it to us 15 minutes before it appears on CCTV,” said WHO’s top official in China, Dr. Gauden Galea, referring to the state-owned China Central Television, in another meeting.

The story behind the early response to the virus comes at a time when the U.N. health agency is under siege, and has agreed to an independent probe of how the pandemic was handled globally. After repeatedly praising the Chinese response early on, U.S. President Donald Trump has blasted WHO in recent weeks for allegedly colluding with China to hide the extent of the coronavirus crisis. He cut ties with the organization on Friday, jeopardizing the approximately $450 million the U.S. gives every year as WHO’s biggest single donor.

In the meantime, Chinese President Xi Jinping has vowed to pitch in $2 billion over the next two years to fight the coronavirus, saying China has always provided information to WHO and the world “in a most timely fashion.”

The new information does not support the narrative of either the U.S. or China, but instead portrays an agency now stuck in the middle that was urgently trying to solicit more data despite limits to its own authority. Although international law obliges countries to report information to WHO that could have an impact on public health, the U.N. agency has no enforcement powers and cannot independently investigate epidemics within countries. Instead, it must rely on the cooperation of member states.

The recordings suggest that rather than colluding with China, as Trump declared, WHO was kept in the dark as China gave it the minimal information required by law. However, the agency did try to portray China in the best light, likely as a means to secure more information. And WHO experts genuinely thought Chinese scientists had done “a very good job” in detecting and decoding the virus, despite the lack of transparency from Chinese officials.

WHO staffers debated how to press China for gene sequences and detailed patient data without angering authorities, worried about losing access and getting Chinese scientists into trouble. Under international law, WHO is required to quickly share information and alerts with member countries about an evolving crisis. Galea noted WHO could not indulge China’s wish to sign off on information before telling other countries because “that is not respectful of our responsibilities.”

In the second week of January, WHO’s chief of emergencies, Dr. Michael Ryan, told colleagues it was time to “shift gears” and apply more pressure on China, fearing a repeat of the outbreak of Severe Acute Respiratory Syndrome that started in China in 2002 and killed nearly 800 people worldwide.

“This is exactly the same scenario, endlessly trying to get updates from China about what was going on,” he said. “WHO barely got out of that one with its neck intact given the issues that arose around transparency in southern China.”

Ryan said the best way to “protect China” was for WHO to do its own independent analysis with data from the Chinese government, because otherwise the spread of the virus between people would be in question and “other countries will take action accordingly.” Ryan also noted that China was not cooperating in the same way some other countries had in the past.

“This would not happen in Congo and did not happen in Congo and other places,” he said, probably referring to the Ebola outbreak that began there in 2018. “We need to see the data…..It’s absolutely important at this point.”

The delay in the release of the genome stalled the recognition of its spread to other countries, along with the global development of tests, drugs and vaccines. The lack of detailed patient data also made it harder to determine how quickly the virus was spreading — a critical question in stopping it.

Between the day the full genome was first decoded by a government lab on Jan. 2 and the day WHO declared a global emergency on Jan. 30, the outbreak spread by a factor of 100 to 200 times, according to retrospective infection data from the Chinese Center for Disease Control and Prevention. The virus has now infected over 6 million people worldwide and killed more than 375,000.

“It’s obvious that we could have saved more lives and avoided many, many deaths if China and the WHO had acted faster,” said Ali Mokdad, a professor at the Institute for Health Metrics and Evaluation at the University of Washington.

However, Mokdad and other experts also noted that if WHO had been more confrontational with China, it could have triggered a far worse situation of not getting any information at all. If WHO had pushed too hard, it could even have been kicked out of China, said Adam Kamradt-Scott, a global health professor at the University of Sydney. But he added that a delay of just a few days in releasing genetic sequences can be critical in an outbreak. And he noted that as Beijing’s lack of transparency becomes even clearer, WHO director-general Tedros Adhanom Ghebreyesus’s continued defense of China is problematic.

“It’s definitely damaged WHO’s credibility,” said Kamradt-Scott. “Did he go too far? I think the evidence on that is clear….it has led to so many questions about the relationship between China and WHO. It is perhaps a cautionary tale.”

WHO and its officials named in this story declined to answer questions asked by The Associated Press without audio or written transcripts of the recorded meetings, which the AP was unable to supply to protect its sources.

“Our leadership and staff have worked night and day in compliance with the organization’s rules and regulations to support and share information with all Member States equally, and engage in frank and forthright conversations with governments at all levels,” a WHO statement said.

China’s National Health Commission and the Ministry of Foreign Affairs had no comment. But in the past few months, China has repeatedly defended its actions, and many other countries — including the U.S. — have responded to the virus with even longer delays of weeks and even months.

“Since the beginning of the outbreak, we have been continuously sharing information on the epidemic with the WHO and the international community in an open, transparent and responsible manner,” said Liu Mingzhu, an official with the National Health Commission’s International Department, at a press conference on May 15.

The race to find the genetic map of the virus started in late December, according to the story that unfolds in interviews, documents and the WHO recordings. That’s when doctors in Wuhan noticed mysterious clusters of patients with fevers and breathing problems who weren’t improving with standard flu treatment. Seeking answers, they sent test samples from patients to commercial labs.

By Dec. 27, one lab, Vision Medicals, had pieced together most of the genome of a new coronavirus with striking similarities to SARS. Vision Medicals shared its data with Wuhan officials and the Chinese Academy of Medical Sciences, as reported first by Chinese finance publication Caixin and independently confirmed by the AP.

On Dec. 30, Wuhan health officials issued internal notices warning of the unusual pneumonia, which leaked on social media. That evening, Shi Zhengli, a coronavirus expert at the Wuhan Institute of Virology who is famous for having traced the SARS virus to a bat cave, was alerted to the new disease, according to an interview with Scientific American. Shi took the first train from a conference in Shanghai back to Wuhan.

The next day, Chinese CDC director Gao Fu dispatched a team of experts to Wuhan. Also on Dec. 31, WHO first learned about the cases from an open-source platform that scouts for intelligence on outbreaks, emergencies chief Ryan has said.

WHO officially requested more information on Jan. 1. Under international law, members have 24 to 48 hours to respond, and China reported two days later that there were 44 cases and no deaths.

By Jan. 2, Shi had decoded the entire genome of the virus, according to a notice later posted on her institute’s website.

Scientists agree that Chinese scientists detected and sequenced the then-unknown pathogen with astonishing speed, in a testimony to China’s vastly improved technical capabilities since SARS, during which a WHO-led group of scientists took months to identify the virus. This time, Chinese virologists proved within days that it was a never-before-seen coronavirus. Tedros would later say Beijing set “a new standard for outbreak response.”

But when it came to sharing the information with the world, things began to go awry.

On Jan. 3, the National Health Commission issued a confidential notice ordering labs with the virus to either destroy their samples or send them to designated institutes for safekeeping. The notice, first reported by Caixin and seen by the AP, forbade labs from publishing about the virus without government authorization. The order barred Shi’s lab from publishing the genetic sequence or warning of the potential danger.

Chinese law states that research institutes cannot conduct experiments on potentially dangerous new viruses without approval from top health authorities. Although the law is intended to keep experiments safe, it gives top health officials wide-ranging powers over what lower-level labs can or cannot do.

“If the virologist community had operated with more autonomy….the public would have been informed of the lethal risk of the new virus much earlier,” said Edward Gu, a professor at Zhejiang University, and Li Lantian, a PhD student at Northwestern University, in a paper published in March analyzing the outbreak.

Commission officials later repeated that they were trying to ensure lab safety, and had tasked four separate government labs with identifying the genome at the same time to get accurate, consistent results.

By Jan. 3, the Chinese CDC had independently sequenced the virus, according to internal data seen by the Associated Press. And by just after midnight on Jan. 5, a third designated government lab, the Chinese Academy of Medical Sciences, had decoded the sequence and submitted a report — pulling all-nighters to get results in record time, according to a state media interview. Yet even with full sequences decoded by three state labs independently, Chinese health officials remained silent. The WHO reported on Twitter that investigations were under way into an unusual cluster of pneumonia cases with no deaths in Wuhan, and said it would share “more details as we have them.”

Meanwhile, at the Chinese CDC, gaps in coronavirus expertise proved a problem.

For nearly two weeks, Wuhan reported no new infections, as officials censored doctors who warned of suspicious cases. Meanwhile, researchers found the new coronavirus used a distinct spike protein to bind itself to human cells. The unusual protein and the lack of new cases lulled some Chinese CDC researchers into thinking the virus didn’t easily spread between humans — like the coronavirus that casues Middle East respiratory syndrome, or MERS, according to an employee who declined to be identified out of fear of retribution.

Li, the coronavirus expert, said he immediately suspected the pathogen was infectious when he spotted a leaked copy of a sequencing report in a group chat on a SARS-like coronavirus. But the Chinese CDC team that sequenced the virus lacked specialists in the molecular structure of coronaviruses and failed to consult with outside scientists, Li said. Chinese health authorities rebuffed offers of assistance from foreign experts, including Hong Kong scientists barred from a fact-finding mission to Wuhan and an American professor at a university in China.

On Jan. 5, the Shanghai Public Clinical Health Center, led by famed virologist Zhang Yongzhen, was the latest to sequence the virus. He submitted it to the GenBank database, where it sat awaiting review, and notified the National Health Commission. He warned them that the new virus was similar to SARS and likely infectious.

“It should be contagious through respiratory passages,” the center said in an internal notice seen by the AP. “We recommend taking preventative measures in public areas.”

On the same day, WHO said that based on preliminary information from China, there was no evidence of significant transmission between humans, and did not recommend any specific measures for travelers.

The next day, the Chinese CDC raised its emergency level to the second highest. Staffers proceeded to isolate the virus, draft lab testing guidelines, and design test kits. But the agency did not have the authority to issue public warnings, and the heightened emergency level was kept secret even from many of its own staff.

By Jan. 7, another team at Wuhan University had sequenced the pathogen and found it matched Shi’s, making Shi certain they had identified a novel coronavirus. But Chinese CDC experts said they didn’t trust Shi’s findings and needed to verify her data before she could publish, according to three people familiar with the matter. Both the National Health Commission and the Ministry of Science and Technology, which oversees Shi’s lab, declined to make Shi available for an interview.

A major factor behind the gag order, some say, was that Chinese CDC researchers wanted to publish their papers first. “They wanted to take all the credit,” said Li Yize, a coronavirus researcher at the University of Pennsylvania.

Internally, the leadership of the Chinese CDC is plagued with fierce competition, six people familiar with the system explained. They said the agency has long promoted staff based on how many papers they can publish in prestigious journals, making scientists reluctant to share data.

As the days went by, even some of the Chinese CDC’s own staff began to wonder why it was taking so long for authorities to identify the pathogen.

“We were getting suspicious, since within one or two days you would get a sequencing result,” a lab technician said, declining to be identified for fear of retribution.

On Jan. 8, the Wall Street Journal reported that scientists had identified a new coronavirus in samples from pneumonia patients in Wuhan, pre-empting and embarrassing Chinese officials. The lab technician told the AP they first learned about the discovery of the virus from the Journal.

The article also embarrassed WHO officials. Dr. Tom Grein, chief of WHO’s acute events management team, said the agency looked “doubly, incredibly stupid.” Van Kerkhove, the American expert, acknowledged WHO was “already late” in announcing the new virus and told colleagues that it was critical to push China.

Ryan, WHO’s chief of emergencies, was also upset at the dearth of information.

“The fact is, we’re two to three weeks into an event, we don’t have a laboratory diagnosis, we don’t have an age, sex or geographic distribution, we don’t have an epi curve,” he complained, referring to the standard graphic of outbreaks scientists use to show how an epidemic is progressing.

After the article, state media officially announced the discovery of the new coronavirus. But even then, Chinese health authorities did not release the genome, diagnostic tests, or detailed patient data that could hint at how infectious the disease was.

By that time, suspicious cases were already appearing across the region.

On Jan. 8, Thai airport officers pulled aside a woman from Wuhan with a runny nose, sore throat, and high temperature. Chulalongkorn University professor Supaporn Wacharapluesadee’s team found the woman was infected with a new coronavirus, much like what Chinese officials had described. Supaporn partially figured out the genetic sequence by Jan. 9, reported it to the Thai government and spent the next day searching for matching sequences.

But because Chinese authorities hadn’t published any sequences, she found nothing. She could not prove the Thai virus was the same pathogen sickening people in Wuhan.

“It was kind of wait and see, when China will release the data, then we can compare,” said Supaporn.

On Jan. 9, a 61-year-old man with the virus passed away in Wuhan — the first known death. The death wasn’t made public until Jan. 11.

WHO officials complained in internal meetings that they were making repeated requests for more data, especially to find out if the virus could spread efficiently between humans, but to no avail.

“We have informally and formally been requesting more epidemiological information,” WHO’s China representative Galea said. “But when asked for specifics, we could get nothing.”

Emergencies chief Ryan grumbled that since China was providing the minimal information required by international law, there was little WHO could do. But he also noted that last September, WHO had issued an unusual public rebuke of Tanzania for not providing enough details about a worrisome Ebola outbreak.

“We have to be consistent,” Ryan said. “The danger now is that despite our good intent…especially if something does happen, there will be a lot of finger-pointing at WHO.”

Ryan noted that China could make a “huge contribution” to the world by sharing the genetic material immediately, because otherwise “other countries will have to reinvent the wheel over the coming days.”

On Jan. 11, a team led by Zhang, from the Shanghai Public Health Clinical Center, finally published a sequence on virological.org, used by researchers to swap tips on pathogens. The move angered Chinese CDC officials, three people familiar with the matter said, and the next day, his laboratory was temporarily shuttered by health authorities.

Zhang referred a request for comment to the Chinese CDC. The National Health Commission, which oversees the Chinese CDC, declined multiple times to make its officials available for interviews and did not answer questions about Zhang.

Supaporn compared her sequence with Zhang’s and found it was a 100% match, confirming that the Thai patient was ill with the same virus detected in Wuhan. Another Thai lab got the same results. That day, Thailand informed the WHO, said Tanarak Plipat, deputy director-general of the Department of Disease Control at Thailand’s Ministry of Public Health.

After Zhang released the genome, the Chinese CDC, the Wuhan Institute of Virology and the Chinese Academy of Medical Sciences raced to publish their sequences, working overnight to review them, gather patient data, and send them to the National Health Commission for approval, according to documentation obtained by the AP. On Jan. 12, the three labs together finally published the sequences on GISAID, a platform for scientists to share genomic data.

By then, more than two weeks had passed since Vision Medicals decoded a partial sequence, and more than a week since the three government labs had all obtained full sequences. Around 600 people were infected in that week, a roughly three-fold increase.

Some scientists say the wait was not unreasonable considering the difficulties in sequencing unknown pathogens, given accuracy is as important as speed. They point to the SARS outbreak in 2003 when some Chinese scientists initially — and wrongly — believed the source of the epidemic was chlamydia.

“The pressure is intense in an outbreak to make sure you’re right,” said Peter Daszak, president of the EcoHealthAlliance in New York. “It’s actually worse to go out to go to the public with a story that’s wrong because the public completely lose confidence in the public health response.”

Still, others quietly question what happened behind the scenes.

Infectious diseases expert John Mackenzie, who served on a WHO emergency committee during the outbreak, praised the speed of Chinese researchers in sequencing the virus. But he said once central authorities got involved, detailed data trickled to a crawl.

“There certainly was a kind of blank period,” Mackenzie said. “There had to be human to human transmission. You know, it’s staring at you in the face… I would have thought they would have been much more open at that stage.”

On Jan. 13, WHO announced that Thailand had a confirmed case of the virus, jolting Chinese officials.

The next day, in a confidential teleconference, China’s top health official ordered the country to prepare for a pandemic, calling the outbreak the “most severe challenge since SARS in 2003”, as the AP previously reported. Chinese CDC staff across the country began screening, isolating, and testing for cases, turning up hundreds across the country.

Yet even as the Chinese CDC internally declared a level one emergency, the highest level possible, Chinese officials still said the chance of sustained transmission between humans was low.

WHO went back and forth. Van Kerkhove said in a press briefing that “it is certainly possible there is limited human-to-human transmission.” But hours later, WHO seemed to backtrack, and tweeted that “preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission” – a statement that later became fodder for critics.

A high-ranking official in WHO’s Asia office, Dr. Liu Yunguo, who attended medical school in Wuhan, flew to Beijing to make direct, informal contacts with Chinese officials, recordings show. Liu’s former classmate, a Wuhan doctor, had alerted him that pneumonia patients were flooding the city’s hospitals, and Liu pushed for more experts to visit Wuhan, according to a public health expert familiar with the matter.

On Jan. 20, the leader of an expert team returning from Wuhan, renowned government infectious diseases doctor Zhong Nanshan, declared publicly for the first time that the new virus was spreading between people. Chinese President Xi Jinping called for the “timely publication of epidemic information and deepening of international cooperation.”

Despite that directive, WHO staff still struggled to obtain enough detailed patient data from China about the rapidly evolving outbreak. That same day, the U.N. health agency dispatched a small team to Wuhan for two days, including Galea, the WHO representative in China.

They were told about a worrying cluster of cases among more than a dozen doctors and nurses. But they did not have “transmission trees” detailing how the cases were connected, nor a full understanding of how widely the virus was spreading and who was at risk.

In an internal meeting, Galea said their Chinese counterparts were “talking openly and consistently” about human-to-human transmission, and that there was a debate about whether or not this was sustained. Galea reported to colleagues in Geneva and Manila that China’s key request to WHO was for help “in communicating this to the public, without causing panic.”

On Jan. 22, WHO convened an independent committee to determine whether to declare a global health emergency. After two inconclusive meetings where experts were split, they decided against it — even as Chinese officials ordered Wuhan sealed in the biggest quarantine in history. The next day, WHO chief Tedros publicly described the spread of the new coronavirus in China as “limited.”

For days, China didn’t release much detailed data, even as its case count exploded. Beijing city officials were alarmed enough to consider locking down the capital, according to a medical expert with direct knowledge of the matter.

On Jan. 28, Tedros and top experts, including Ryan, made an extraordinary trip to Beijing to meet President Xi and other senior Chinese officials. It is highly unusual for WHO’s director-general to directly intervene in the practicalities of outbreak investigations. Tedros’ staffers had prepared a list of requests for information.

“It could all happen and the floodgates open, or there’s no communication,” Grein said in an internal meeting while his boss was in Beijing. “We’ll see.”

At the end of Tedros’ trip, WHO announced China had agreed to accept an international team of experts. In a press briefing on Jan. 29, Tedros heaped praise on China, calling its level of commitment “incredible.”

The next day, WHO finally declared an international health emergency. Once again, Tedros thanked China, saying nothing about the earlier lack of cooperation.

“We should have actually expressed our respect and gratitude to China for what it’s doing,” Tedros said. “It has already done incredible things to limit the transmission of the virus to other countries.”

Finland in pain as border closure blocks Russian tourists

June 01, 2020

HELSINKI, Finland (AP) — Finns in the Nordic nation’s eastern border region say they haven’t seen anything like this since the 1991 collapse of the Soviet Union. The closure of Finland’s border with Russia amid the coronavirus pandemic has put an abrupt stop to visits by the nearly 2 million Russian tourists who prop up the local economy each year.

Finland shares a 1,340-kilometer (832-mile) land border with Russia complete with several crossing points in what is one of the European Union’s longest external borders. It was shut down both by Helsinki and Moscow in mid-March due to the pandemic.

Given Russia’s sustained infection rate, there is little hope that the border will be opened for Finland’s summer tourism season — and many believe the border will likely remain shut even longer. “It definitely has had a big effect. You just wouldn’t imagine such risks relate to the border anymore in the year 2020,” said Petteri Terho, spokesman for the Zsar Outlet Village, a large upscale shopping area catering to both Finns and Russians near the Vaalimaa border station, the busiest crossing point between the two nations.

The closure has caused cross-border tourism to the South Karelia region, entry point to Finland’s picturesque lake district that is a favorite of locals and Russian tourists alike, to collapse overnight.

Above all, it has deprived local businesses of an estimated 25 million euros ($28 million) for every month the border remains closed. Finland has seen 6,859 cases of COVID-19 and 320 deaths but most have been in and around Helsinki, the capital. But in the South Karelia region, 250 kilometers (155 miles) northeast of Helsinki, only 24 positive cases have been diagnosed, with no fatalities so far.

Russia has over 405,000 coronavirus infections, the third-highest number in the world. It has reported 4,693 virus deaths, a figure experts call a significant undercount of the true situation.

“This is a whole new situation for all of us,” said Katja Vehvilainen of the Imatra Region Development Company, a local Finnish business promotion agency, adding that the South Karelia region enjoyed a growth of 15% in tourism last year. “The corona situation has unfortunately completely changed the direction.”

Still, locals remain unfazed, given Finland’s long history of dealing with the ups and downs of Russian tourism in the wake of its neighbor’s political and economic upheavals. The last tourism crisis hitting South Karelia took place in 2014-2015 when the value of the Russian rouble plunged against the euro, instantly denting visits by Russians.

“It looks pretty bad now,” said Markku Heinonen, development manager for the city of Lappeenranta, the region’s biggest center with 73,000 residents. “But the previous crises (with Russian tourism) have taught companies to prepare for something like this.”

The region hosted 1.9 million foreign tourists last year, most coming from Russia for shopping daytrips or longer holidays to enjoy spas, restaurants and lakeside cottages in an area known for its pristine beauty.

Lappeenranta, a key center for wood products, has been dealing with Russia since it was founded in 1649. It’s just 20 kilometers (12 miles) from the border station of Nuijamaa. From there, it’s mere 180 kilometers (112 miles) to Russia’s second city of St. Petersburg, whose population of nearly 5.5 million equals the entire population of Finland.

“Our business has dried up almost completely. One can say it melted away in one day (after the border closure),” said Mohamad Darwich, who runs the Laplandia Market, a grocery store catering to Russian tourists near the Nuijamaa border post.

Darwich, who arrived in Finland from Russia in 1992 after studying in St. Petersburg, listed fresh fish, cheese and dishwashing liquid among the most popular items bought by Russian visitors. He has reopened the store now for locals and hopes the border will be reopened by October at the latest “under an optimistic scenario.”

Citing a recent study, Heinonen said if the border stays closed until the end of the year or even beyond — a worst-case scenario — the South Karelia region is estimated to lose at least 225 million euros ($247 million) in tourism income this year and risks losing about 900 jobs, a large number in this region.

Locals are now eyeing domestic or European visitors as possible substitutes for the missing Russians this year. Ryanair, which suspended its European routes from Lappeenranta until further notice due to the pandemic, has indicated it’s ready to resume some flights in July, which could bring in western European tourists. But even the Irish airline has largely catered to Russian clients living near the Finnish border who used the Lappeenranta airport.

“There are plenty of summer cottages in the area and holidaying Finns around, so domestic travel is absolutely crucial for us,” said Terho, the Zsar Outlet Village spokesman. He said the venue reopened Saturday with high hopes following the Finnish government’s gradual relaxation of coronavirus lockdown restrictions.

UN forced to cut aid to Yemen, even as virus increases need

June 01, 2020

CAIRO (AP) — Aid organizations are making an urgent plea for funding to shore up their operations in war-torn Yemen, saying they have already been forced to stop some of their work even as the coronavirus rips through the country.

Some 75% of U.N. programs in Yemen have had to shut their doors or reduce operations. The global body’s World Food Program had to cut rations in half and U.N.-funded health services were reduced in 189 out of 369 hospitals nationwide.

“It’s almost impossible to look a family in the face, to look them in the eyes and say, ‘I’m sorry but the food that you need in order to survive we have to cut in half,’” Lise Grande, resident U.N. coordinator for Yemen, told The Associated Press.

The dwindling funds are the result of several factors, but among the top reasons is obstruction by Yemen’s Houthi rebels, who control the capital, Sanaa, and other territories. The United States, one of the largest donors, decreased its aid to Yemen earlier this year, citing interference by the Houthis.

It’s yet to be seen whether the Houthis will allow monitoring and oversight or give U.N. agencies the space to operate. A U.N. pledging conference for Yemen on Tuesday seeks $2.41 billion to cover essential activities from June to December.

Grande said the Houthis are working to become more transparent, and that she hopes this will encourage donor countries to give aid. Her optimism, however, comes as the Houthis face heavy criticism for suppressing information about the number of COVID-19 cases and fatalities in areas they control, while putting no mitigation measures in place.

Tuesday’s conference will be co-hosted for the first time by Saudi Arabia — a major player in Yemen’s civil war since it first unleashed a bombing campaign in 2015 to try to push back the Iranian-backed Houthis who had seized the northern half of the country.

Critics question the Saudis’ high-profile role in rallying humanitarian support even as they continue to wage a war — as do the Houthis — that has created the world’s worst humanitarian crisis. Maysaa Shuja al-Deen, a Yemeni researcher and a non-resident fellow at the Sana’a Center for Strategic Studies, said the kingdom is trying to repair its international image by changing the conversation.

Saudi Arabia “has always tried to change the narrative of the war and present itself as a backer of the legitimate government, not part of the conflict,” she said. In past years, the kingdom has been one of the top donors for U.N. humanitarian aid operations in Yemen. The Saudi ambassador to Yemen, Mohammed al-Jaber, said the kingdom will allocate half a billion dollars this year to support U.N. programs, including $25 million for a COVID-19 response plan.

The U.N. itself has also investigated allegations of corruption and diversion of aid in Yemen in its own ranks. Reports indicate that the coronavirus is spreading at an alarming rate throughout the country.

Among the slashed programs is financial support to thousands of health workers who haven’t received salaries from the government for nearly three years. Grande said that just a week before the first coronavirus case was announced in Yemen, aid agencies had to stop paying health workers.

Without salaries, medical staff won’t be able to provide health services to patients amid the pandemic. The U.N. received around $3.6 billion in 2019 in international donations for its campaign, short of its $4.2 billion goal. For its 2020 plan, it has so far received only 15% out of the needed $3.5 billion.

Yemen has been caught in a grinding war since 2014 when Houthi rebels descended from their northern enclave and took over Sanaa, forcing the internationally recognized president to flee. In the spring of 2015, a U.S.-backed, Saudi-led coalition began a destructive air campaign to dislodge the Houthis while imposing a land, sea and air embargo on Yemen.

The air war and fighting on the ground has killed more than 100,000 people, shut down or destroyed half of Yemen’s health facilities, and driven 4 million Yemenis from their homes. Cholera epidemics and severe malnutrition among children have led to thousands of additional deaths.

As the war enters its sixth year, with no sign of a viable cease-fire, the suffering looks set to continue. Fighting has continued unabated along several front lines in Yemen, including in Marib, an oil-rich eastern province, threatening new waves of displacement.

The U.N.’s massive aid program, totaling $8.35 billion since 2015, is vital to keeping many Yemenis alive. Ten million people are on the brink of famine and 80% of the 30 million population are in need of aid, according to the U.N.

With the coronavirus spreading, more money is needed. Since April, authorities in areas controlled by Yemen’s internationally recognized government reported 283 cases, including 85 deaths. The Houthis declared only four cases, including one death.

The World Health Organization believes that there is a significant underestimation of the outbreak, which could further hinder efforts to get supplies into Yemen that are needed to contain the virus. Richard Brennan, the WHO’s regional emergency director, told the AP that he believes the deaths are in the hundreds and cases in the thousands, based on what he’s heard from numerous health care providers. But he said the lack of funding means the organization’s health programs are hanging by a thread.

The International Rescue Committee, an aid group, said Yemen is conducting just 31 tests per one million people, among the world’s lowest scores. With increasing needs and fewer funds, the U.N. refugee agency will have to stop cash assistance and shelter programs for more than 50,000 displaced families by August, said spokeswoman Heba Kanso. She said the agency will be forced to end its partnership with dozens of Yemeni NGOs that will have let go more than 1,500 national staff.

Relief agencies worry that donors will give less as many countries struggle their own virus outbreaks. But they warn that the world’s worst humanitarian crisis can indeed get much worse. “The world’s attention is diverted elsewhere and these are the vulnerable among the most vulnerable on the planet, and we need a commitment,” said Brennan.

Protests spark virus fears in US; South Korea sees new cases

June 01, 2020

MIAMI (AP) — Protests around the U.S. against police brutality have sparked fears of a further spread of the coronavirus, while South Korea is reporting a steady rise in cases around the capital after appearing to bring the outbreak under control.

The often-violent protests over the death of George Floyd, a black man who was pinned at the neck by a white Minneapolis police officer, are raising fears of new virus outbreaks in a country that has more confirmed infections and deaths than any other.

The protests come as more beaches, churches, mosques, schools and businesses reopen worldwide, increasing the risk of cross-infections. South Korea has reported 238 cases of the coronavirus over the past five days, most of them in the Seoul metropolitan area, causing alarm in a country that had eased up on social distancing and started to send millions of children back to school. Hundreds of infections have been linked to nightspots, restaurants and a massive e-commerce warehouse near Seoul. The 35 new cases reported Monday include 30 around Seoul.

Protests over Floyd’s death have shaken the U.S. from New York to Los Angeles. Demonstrators are packed cheek by jowl, many without masks, many chanting, shouting or singing. The virus is dispersed by microscopic droplets in the air when people cough, sneeze, talk or sing.

“There’s no question that when you put hundreds or thousands of people together in close proximity, when we have got this virus all over the streets … it’s not healthy,” Maryland Gov. Larry Hogan said Sunday on CNN’s “State of the Union.”

The U.S. has seen more than 1.7 million infections and over 104,000 deaths in the pandemic, which has disproportionately affected racial minorities in a nation that does not have universal health care.

In London, thousands of people marched Sunday, chanting “No justice! No peace!” while carrying signs reading “Justice for George Floyd” and “Racism is a global issue.” Britain has had nearly 38,500 virus deaths, the second-most in the world after the United States.

Other protests were held in Berlin and Copenhagen, Denmark. Around 6.1 million infections have been reported worldwide, with about 370,000 people dying, according to a tally by Johns Hopkins University. The true death toll is believed to be significantly higher, since many victims died of the virus without ever being tested.

China, where the global pandemic is believed to have originated late last year, reported 16 new cases on Monday, all in travelers newly arrived from abroad. Eleven of those arrived in the southwestern city of Chengdu on Friday aboard the same flight from Cairo, the Chengdu city government said in a statement.

With local transmissions having fallen to virtually zero, much of China has reopened for business and Monday saw the further restart of classes in middle and high schools. Kindergartners and fourth- and fifth-graders will be allowed back next week as part of a staggered opening to prevent the further spread of the virus.

South African President Cyril Ramaphosa says that China has pledged to make available 30 million COVID-19 testing kits per month to African countries, which are facing a shortage of the materials to test for the disease.

The U.S. has sent to Brazil more than 2 million doses of a malaria drug touted by President Donald Trump as potentially protecting against and treating the coronavirus, despite a lack of scientific evidence. Brazil, Latin America’s hardest-hit country, continues to see a surge in virus cases, and last week Trump announced that the U.S. was restricting travel from the country.

Traffic jams and crowds of commuters are back in the Philippine capital, which shifted to a more relaxed quarantine in a high-stakes gamble to slowly reopen the economy while fighting the coronavirus outbreak.

The situation continues to worsen in India, where 230 new deaths were reported Monday, bringing the country’s total to 5,394, even as it eases restrictions on shops and public transport in more states beginning Monday. Subways and schools remain closed.

Neighboring Bangladesh also restarted bus, train, ferry and flight services Monday. The impoverished country’s government says a gradual reopening is crucial to reviving the economy amid forecasts that economic growth is likely to plunge, leaving millions jobless.

In Saudi Arabia, mosques reopened Sunday for the first time in more than two months, but Islam’s holiest site in Mecca remained closed. In Jerusalem, throngs of worshippers waited outside the Al-Aqsa Mosque before it reopened. Many wore surgical masks and waited for temperature checks as they entered.

In Bogota, Colombia’s capital, authorities were locking down an area of nearly 1.5 million people as cases continued to rise, while Egypt on Sunday reported its highest-ever number of infections and deaths from the virus — 46 over the previous 24 hours, with 1,536 confirmed cases.

In Spain, Prime Minister Pedro Sánchez said Sunday that he would ask Parliament for a final two-week extension of the nation’s state of emergency that is set to expire on June 7. That allows the government to keep ordering lockdown measures to control its coronavirus outbreak, which has claimed at least 27,000 lives, many of them in overwhelmed nursing homes.

“We have almost reached safe harbor,” Sánchez said. During a Mass at the Vatican to mark Pentecost Sunday, Pope Francis cautioned people against being pessimistic as they emerge from coronavirus lockdowns.

Italy on Sunday registered 355 new coronavirus cases and 75 deaths, some of the lowest such numbers since the nation’s lockdown against the pandemic began in early March. Two hospitals for coronavirus patients were opened in Istanbul as Turkey’s number of new cases fell to its lowest since the peak of the outbreak.

And at California’s Yosemite National Park, closed to the public for nearly three months, student journalists who put out the Yosemite Valley School newspaper are charming their community with stories of cleaner water and more active and abundant wildlife.

Kirka reported from London and Gorondi reported from Budapest, Hungary. AP reporters from around the world contributed to this report.

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