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Health

Bhutan adds 10 more coronavirus infections

The ministry of health in Bhutan said on Sunday that 10 more patients have been diagnosed with coronavirus in the country, which marks the largest daily increase in the number of cases in the country, the total number of coronavirus infections in the country stood at 43.

Thimphu:
A Bhutanese student in quarantine in capital Thimphu has tested positive for COVID-19, making it the third case in the country and the first Bhutanese national to be infected, the Health Ministry said Thursday.

As per the ministry, the student has returned from Britain recently and was in quarantine when tested for the virus.

The ministry has initiated contact tracing and most of the contacts were already put under quarantine. Around 25 people were tested for the virus of which only the student was tested positive.

Meanwhile, the country’s health minister has also informed that the ministry has called back the doctors who went abroad. Around 24 have returned and are currently in quarantine centers.

Bhutan currently has only around 3,000 health workers and as per the minister this number will not be able to deliver the services if the country enter into the worst-case scenario. Around 600 backup volunteers have been trained to carry out health screening and the ministry plans to train 5,000 more.

To meet the shortages, the ministry also plans to keep those working in private clinics for backup services. The country also plans to call resigned doctors, nurses and health workers to make up for shortage if faced with worst-case situation.

Health

Phase-1 trial: Adenovirus COVID-19 vaccine found safe, induces immune responses

Trial was carried out on 108 participants aged 18-60 in Wuhan

A phase-1 trial using a single dose of a vaccine (Ad5-nCoV) that uses a recombinant adenovirus type-5 vector that carries the genetic material that codes for spike glycoprotein of novel coronavirus was found to be safe, well-tolerated and able to generate immune responses against the virus. The adenovirus is a weakened common cold virus.

The trial was carried out on 108 participants aged 18-60 years in Wuhan, China, and had 36 participants each in the low, middle and high-dose groups.

The trial did not involve randomisation of participants and did not have a control arm. The results are based on short duration of follow-up. The results were published in the journal The Lancet.

Safety of the vaccine

The most common adverse reaction was pain at the injection site (58 participants or 54%), fever (50 participants), fatigue (47 individuals), headache (42 participants) and muscle pain (18 participants). Most adverse reactions reported were mild or moderate in severity. One participant who was given the higher dose vaccine reported severe fever, along with severe symptoms of fatigue, shortness of breath and muscle pain. However, these adverse reactions persisted for less than 48 hours. No serious adverse event was noted within 28 days post-vaccination.

80% success chance for Oxford vaccine trials, says Serum Institute chief

“As it was a first-in-human study of the adenovirus type-5 vectored COVID-19 vaccine, it was not designed to measure the vaccine efficacy,” they write. But they note that in animal studies, seven out of eight ferrets were protected when challenged by the virus 21 days after immunisation with the vaccine.

Immune responses

The vaccine was found to elicit neutralising antibodies, which peaked at day 28 post-vaccination, while rapid specific T-cell responses peaked at day 14 after vaccination. The antibody response to the vaccine in the high-dose group was slightly greater than that in the middle-dose and low-dose groups.

After 28 days, most participants had a four-fold increase in binding antibodies (35/36, 97% low-dose group; 34/36 (94%) middle-dose group, and 36/36, 100% in high-dose group). Meanwhile, 18 (50%) participants in the low-dose group, 18 (50%) in the middle-dose group, and 27 (75%) in the high-dose group showed neutralising antibodies against the virus.

WHO backs COVID-19 vaccine trials that deliberately infect participants

The vaccine also stimulated a rapid T cell response in the majority of volunteers, which was greater in those given the higher- and middle-doses of the vaccine, with levels peaking at 14 days after vaccination. About 83% (30 of 36) of low-dose participants, 97% (35 of 36) of middle-dose participants and 97% (35 of 36) of high-dose participants developed T cell responses at 14 days.

But 28 days after vaccination, the majority of recipients showed either a positive T cell response or had detectable neutralising antibodies against SARS-CoV-2 (low-dose group 28/36, 78%; middle-dose group 33/36, 92%; high-dose group 36/36, 100%).

Limitations

The pre-existing immunity to adenovirus type-5 vector used in the vaccine, regardless of the vaccine doses, could reduce the immune responses (both neutralising antibodies and T-cell response) to the virus and also lower the peak of the responses, particularly for neutralising antibodies immunity. The high pre-existing immunity might also have a negative effect on the persistence of the vaccine-elicited immune responses, they write. Recipients aged 45-60 years seemed to have lower seroconversion of neutralising antibody, compared with the younger recipients.

In the study, 44-56% of participants had high pre-existing immunity to adenovirus type-5, and had a less positive neutralising antibody and T-cell response to the vaccine, they note.

Only five (25%) participants of 20 in the low-dose group, seven (37%) participants of 19 in the middle dose group, and ten (63%) participants of 16 in the high dose group, who had high pre-existing immunity to adenovirus type-5, had at least a four-fold increase in neutralising antibody titre at day 28 post-vaccination.

Phase-2 trial

The researchers will be testing the low- and middle-dose vaccine in phase-2 trials. “We selected doses for the phase-2 study mainly on the basis of the safety profile of the candidate vaccines shown in the participants within seven days and 14 days post-vaccination,” they note.

The phase-2 trial will be a randomised, double-blinded and placebo-controlled trial. The trial has already been initiated in Wuhan to determine if the results can be replicated and to also assess the vaccine for safety up to six months after vaccination. The vaccine will be tested on 500 healthy adults — 250 volunteers will get the middle dose, 125 will get the low dose and 125 will receive a placebo. The trial will include participants aged over 60.R. Prasad : , The Hindu

Health

American’s rescue from Bhutan involves a king, a ventilator and an 8,000-mile journey

NEW DELHI – The 76-year old American tourist arrived at the hospital in Thimphu, the sleepy capital of Bhutan, on a cool day in early March.

His symptoms were perplexing. He complained of stomach trouble and breathlessness, but his vital signs were normal. There was one exception: The level of oxygen in his blood was so low that doctors thought the monitor was malfunctioning. On a hunch, they decided to test him for the novel coronavirus.

Bert Hewitt, a retiree from Maryland with a passion for hiking, would become the first confirmed coronavirus case in Bhutan, a country of 780,000 people nestled in the world’s highest mountains and famous for its pursuit of “gross national happiness.”

Hewitt’s prognosis was not good. He had high blood pressure, and he was a cancer survivor whose spleen had been removed, compromising his immune system. His condition deteriorated rapidly.

In other ways, however, Hewitt would turn out to be exceptionally lucky. His case received personal attention from Bhutan’s beloved king. He was evacuated back to the United States in a Gulfstream jet outfitted with a biocontainment unit. The 8,000-mile journey was so complex that Secretary of State Mike Pompeo later singled it out for praise – especially because the patient was “frankly expected to die.”

Hewitt’s survival is also a source of pride in Bhutan, a young democracy where the monarchy remains revered. The command “from his majesty was to really take care of him,” said Dechen Wangmo, the country’s health minister. “The whole nation was, I think, praying for Bert.”

Hewitt’s odyssey began in mid-February. He and his partner, Sandi Fischer, a 59-year-old psychologist from Los Angeles, planned to travel around India and Bhutan. They took a week-long cruise down the Brahmaputra River in northeastern India, stopping in small villages.

On the last night of the cruise, the staff prepared a sumptuous banquet, but Hewitt’s appetite had vanished. He could not eat a bite.

To reach Bhutan, Hewitt and Fischer flew north toward an unbroken line of Himalayan peaks, then descended into the valley that is home to the country’s only international airport.

Hewitt’s gastrointestinal problems worsened, he said, and he felt breathless. After an outing to the town of Punakha, where the pair mingled with locals at an annual festival, Hewitt could barely walk from the car to a cafe for a cup of tea.

At first, doctors in Thimphu believed Hewitt had a stomach bug. On March 4, he returned to the hospital. Within 24 hours, there was an answer: coronavirus.

For the Bhutanese authorities, it meant the threat they feared had arrived. Health officials rushed to trace Hewitt’s contacts. King Jigme Khesar Namgyel Wangchuck oversaw the process in person, staying through the night, said Dechen Wangmo, the health minister.

By the next morning, 73 direct contacts were moved to quarantine facilities. Another 225 indirect contacts were told to isolate at home. In the northeastern Indian state of Assam, health authorities traced nearly 600 people, including the staff of the river boat.

Hewitt and Fischer were moved to a new wing of Thimphu’s main hospital, which is named after Jigme Dorji Wangchuk, a previous king. The current monarch sent Hewitt a pair of blue silk pajamas and a bedspread.

The king constantly inquired as to the couple’s well-being. In a call with Fischer, he said he hoped to speak with Hewitt, a physicist by training, about black holes one day. “He was lovely and very solicitous and kind,” Fischer said. She also heard from Bhutan’s prime minister, Lotay Tshering, who is himself a doctor. Strangers sent letters and flowers to the hospital.

From his room, Hewitt could see a line of white Buddhist prayer flags fluttering on a ridge. Despite the efforts of a dedicated team of doctors and nurses, he became increasingly ill. The X-rays of his lungs were “horrendous,” Fischer said.

A doctor told Hewitt that the only option was to place him on a ventilator. It would be the last thing he remembered for 10 days.

Back in Maryland, Hewitt’s children were frantic. His elder daughter reached out to the government for help getting her father home. William Walters, deputy chief medical officer for operations at the State Department, approached Phoenix Air, an air charter company in Georgia with expertise in medical evacuations.

The nearest aircraft with a biocontainment unit was in Nairobi. It flew to Bhutan with a crew that included a nurse and a paramedic, a Phoenix executive told a Georgia newspaper. Fischer watched from a hospital window as Hewitt, still on a ventilator, was wheeled into a waiting ambulance. She thought she would never see him again.

The jet stopped in Kolkata, India; Dubai; the Greek island of Crete; Paris; and Newfoundland, Canada, to refuel and take on fresh crew members. None of them were allowed to leave the aircraft during the journey because they were transporting a contagious patient, the Phoenix executive said.

Early on March 14, more than 30 hours after the jet departed Bhutan, it landed in Maryland. Hewitt was transferred to the University of Maryland Medical Center in Baltimore, where his eldest daughter is the director of care management. Hewitt’s daughter and a spokeswoman for the hospital declined to respond to questions.

During the pandemic, the State Department has helped repatriate more than 85,000 Americans. Only 20 have been covid-19 patients. They include 14 passengers from the Diamond Princess cruise ship in Japan and six others who were evacuated via “dedicated biocontainment missions,” said Walters, the State Department medical official.

While each of the six had a “unique mix of challenges, none have matched the evacuation of the U.S. citizen from Bhutan,” he said. The other medical flights were from Nigeria, Djibouti, Chad and the Congo Republic.

Such evacuations cost upward of $200,000, Walters said, and families undertake to reimburse the government for the price of the journey.

Hewitt was on a ventilator for 10 days. His first memory is waking up with someone pressing on his head and calling his name. Hewitt said that a doctor there told him that “whatever they tried in Bhutan probably saved your life.” After about two weeks, he was transferred to a rehabilitation facility.

At first, he was too weak to press the call button to summon a nurse. Yet to his own surprise, he made a swift recovery. He had left Bhutan with nothing except his passport, which was returned to him in a biohazard bag.

Fischer also ultimately tested positive for the virus but remained asymptomatic. She was the only confirmed case traced back to Hewitt: None of their Bhutanese contacts, including their tour guide and driver, tested positive. Nor did the handful of their contacts tested in India. To date, Bhutan has recorded 15 coronavirus cases in total.

Last week, Hewitt was able to complete his former daily exercise regimen: a five-mile walk up and down hills in the woods next to his home. He and Fischer – who managed to return to California after seven weeks in Bhutan – talk every morning.

Hewitt believes he came within a few days of dying. He is at a loss to explain his recovery. “I still think it’s a miracle I survived,” he said.

An optimist by nature, he used to take a cavalier attitude toward things like travel insurance. “I’ll be a bit more careful in the future,” he said, then laughed. Pandemic or no, there aren’t any trips on the horizon: His daughter, he said, has threatened to confiscate his passport.
by Joanna Slater, The Washington Post

Health

‘Disciplined’ northeast emerges as model of Covid-19 management

NEW DELHI: The northeastern region, which has traditionally been disciplined, has emerged as the model of coronavirus management and the rest of the country should emulate it, Union minister Jitendra Singh said on Saturday.

He said people in the eight northeastern states – Sikkim, Arunachal Pradesh, Mizoram, Manipur, Meghalaya, Nagaland, Tripura and Assam – have been following the lockdown-related guidelines in letter and spirit.

“By tradition and by lifestyle, people of northeastern region are civilised and disciplined. That is why they could very easily follow the lockdown guidelines. There has been no problem in ensuring implementation of the lockdown-related guidelines there,” Singh told PTI.

He said within six years of the Modi government, the northeastern region has emerged as the model for development for the entire country.

“Similarly, during the lockdown due to Covid-19, entire northeast has become model for the whole country to emulate it,” he said, adding that the way people are adhering to these guidelines is commendable.

Singh said five out of eight northeastern states are free from this deadly virus now and Sikkim never had a single case throughout.

“The spread of the deadly virus in the northeastern region by far has been contained by the support of people and the administration. There has been day-to-day monitoring of the situation at the micro and macro level both by the state government and by the Ministry of Development of North Eastern Region (DoNER),” the minister said.

Singh, who holds multiple portfolios, including the minister of state in the Prime Minister’s Office and in DoNER, praised the work being done by women self-help groups in the northeastern region.

“There has been a rich tradition of women self-help groups in the northeastern region. These women help groups have been making masks for people. These masks are such creative and filled with colours that they can go with almost all kinds of clothes,” he said.

Singh said there is no shortage of essential commodities and medical equipment in the entire northeastern region.

“Prime Minister Narendra Modi’s scientific approach towards managing difficult situations guided us to ensure that there is no shortage of essential goods in the northeast, which is geographically important to the nation,” he said.

He said 350 tonnes of necessary goods have been delivered so far in the northeastern region via air cargo.

Singh said the first flight carrying such goods landed there as early as March 30 to ensure that people living in the remote corner of the country do not face any shortage of daily needs.

“I can say very confidently that the whole northeastern region is guiding the entire nation in the efficient ways to contain the pandemic,” he said.

To a question on reports that the Centre was considering reduction in pension, he said these were “manufactured news”.

“Why would the central government think to take such a step that too with pensioners? It is all manufactured news. People with vested interest are using it. There has been no thinking by the government on either stoppage or reduction of pension,” he clarified.

Singh said there also has been manufactured news about the Centre’s move to reduce the age of retirement of central government employees from the existing 60 years, which is “entirely incorrect”.

“There is no move to reduce the retirement age of the central government employees,” said the minister of state for personnel.

There are 48.34 lakh central government employees and 65.26 lakh pensioners.

Health

Two doctors infected in Assam; Coronavirus cases rose to 58, death 2

Guwahati: The total number of coronavirus cases in Assam rose to 58 with two junior doctors testing positive for the disease on Friday and the test report of a 16-year-old girl confirmed the infection after her death, Health minister Himanta Biswas Sarma said. Two infected junior doctors are from Guwahati Mediacal College and North Eastern Regional Dental College.

The girl was suffering from fever and a pain in her leg. When her condition deteriorated, she was admitted to B Barooah Cancer Hospital on Thursday where she died later, the minister said at a press conference.

Her sample, taken for COVID-19 testing, and was found to be positive. It is “very unfortunate as she did not get the necessary treatment”, he said.
“We will have to discuss with the Union Health Ministry whether we can declare that she died due to COVID-19 as we did not treat her for the disease. She was found to be positive after her death,” Sarma said.

The Kamrup (Metro) district administration has declared two hostels and areas around the Guwahati Medical College Hospital, the employers’ colony near the B Barooah Cancer Institute where the girl lived with her grandmother and certain areas in Kharghuli and Chandmari as containment zones.

Sarma said of the total cases in the state, 21 are active while 34 have been cured of the disease and one died.

The health minister said that a bus carrying 45 passengers had arrived in Silchar on Wednesday from Rajasthan’s Ajmer.

Three of them tested positive on Friday, taking the the total number of cases related to this particular group to eight. Thirty-three were negative and results of other tests are awaited, he said.

Since the passengers had gone home briefly after screening, several areas in four villages of Cachar district have been declared as containment zones, Sarma said, adding direct and indirect contact tracing was on and 185 people have been quarantined in facilities.

In the last 24 hours, Assam reported a sudden spike in the number of COVID-19 cases. Of the 11 cases reported since Thursday, nine have travel history.

After a post-graduate student of the medicine department of Guwahati Medical College Hospital tested positive for COVID-19, the facility has been closed for new patients and 386 people, including hospital superintendent, doctors, students and several workers, have been quarantined, the health minister said.

Their swab tests have been conducted and the results were expected by Friday night. The medical student was engaged in screening of COVID-19 patients from May 4, Sarma said.

A 55-year-old woman from Kharghuli Hills area of Guwahati has tested positive and admitted to GMCH. Her family members have also been quarantined.

The fourth person to test positive in Guwahati had returned from West Bengal on May 6 along with two others in a personal vehicle. The person has been admitted to Mahendra Mohan Choudhury Hospital while the other two have tested negative, Sarma said.

“This is the second case with travel history to West Bengal and we have asked the police department not to issue passes to those originating their journey from this state, except in humanitarian cases,” the minister said.

Sarma said that three positive cases in Guwahati with no travel or contact history indicates that traces of the novel coronavirus may be prevalent in the city.

“People should, however, not panic but strictly follow the guidelines and report to doctors in case they have influenza-like illness (ILI) and diarrhoea,” he said.

So far, 1,032 people have entered the state since May 6 through check posts at Srirampur and Chagalia along the Assam-West Bengal border from where they proceeded to the five screening centres at Kokrajhar, Guwahati, Tezpur, Jorhat and Silchar.

The minister also said that harassing doctors, nurses and health workers is a non-bailable offence under the Epidemic Control Act and the Disaster Management Act.

Health

South Korea’s COVID-19 success story

On Thursday, the Republic of Korea recorded no locally transmitted COVID-19 cases, prompting praise from UN Secretary-General António Guterres. UN News has been finding out, from two UN colleagues based in the capital, Seoul, how life is changing for the better.

Stephan Klingebiel is Director of UN Development Programme’s (UNDP) Global Policy Centre in Seoul, which fosters partnerships between the Republic of Korea and the developing world. He puts the country’s success down to self-discipline, effective measures and testing.

“Just a few weeks ago, family members and friends in Germany were afraid of my duty station. In the second half of February and early March, when the number of new confirmed Covid-19 cases peaked, South Korea seemed to be a real global hot spot. This impression has changed fundamentally: now, rather than being seen as an epicentre, South Korea seems to be an outstanding example of how to manage the crisis!

What is interesting to highlight is the fact that South Korea never experienced the kind of lockdown which is being implemented in many European and Northern American countries: shops stayed open, but also restaurants and many leisure facilities, such as saunas. It’s true that a lot of people have been working from home, but many companies and institutions never changed the fundamental structure of their working arrangements in the office.

And the Korean approach is highly efficient and effective. When I returned from Germany at the end of March, there was a well-functioning protocol in place. Before I left Frankfurt Airport, I was asked to download an app from the Korean Ministry of Health and Welfare, and a second, from the Ministry of Interior and Safety, once I landed.

Upon arrival, we were escorted outside the building for COVID-19 testing, and boarded a chartered bus to a police facility, to wait for the test results overnight. Food and other amenities were provided, and I received my results the following morning.

After my negative test result, the chartered bus took all the foreign passengers back to the airport, where we were asked not to use any form of public transport to return home (taxis are checked to make sure there are no arrival passengers using them). When I got home, I had to report back on my health status every day. I was also given a grocery box and a basic set of masks and hand sanitizer!”

“Thursday was the first time in 72 days that the number of local COVID-19 infections in Korea reached zero: even taking into account the “imported” cases, the number of confirmed patients has remained steady at around ten per day for the past two weeks.

However, it’s rare to see people without masks on, and the elderly, as well as families with young kids like myself, are staying at home as much as possible. Schools are closed, so my son opens his computer each morning to attend his online classes.

I continue to do my groceries, shopping, dry cleaning and food delivery online via mobile apps, and I wore a mask to the recent country-wide national assembly election, where voters had their temperature taken, and their hands disinfected. They were instructed to stand one metre apart, and given plastic gloves before casting our ballots.

However, with the warmer Spring weather, social distancing is gradually waning in my neighborhood, especially among the young and healthy: South Korea was never under a major lockdown – only voluntary, intensive social distancing – and the streets, shops, restaurants and buses have begun bustling again. Masks, once so difficult to get a hold of, are now easy to buy. Online church services have gone offline as people return to services, and gyms and bars have re-opened.

We all knew very clearly, thanks to the daily government news briefings, emergency alerts, web and mobile-based apps, and GPS trackers, what symptoms to be wary of, what to do and where to go for testing, which neighbourhood pharmacy carried masks that day, and which “infection locations” to avoid visiting.

This inundation of real-time public information is what has really helped South Korea throughout this crisis.

Health

Russia nears grim milestone of 100,000 cases; Spain sees daily death rate rise again

Russia nears grim milestone of 100,000 cases; Spain sees daily death rate rise again

China reported 22 new cases as of April 28, according to its National Health Commission, bringing the country’s total to 82,858 cases.
Mexico reported an increase of 1,223 new cases, taking its tally to 16,752.
The coronavirus has now infected more than 1 million people in the United States as the nation grapples with roughly a third of all global cases — making it the worst outbreak in the world, according to data compiled by Johns Hopkins University.
Global cases: At least 3,113,447.
Global deaths: At least 216,930.
Most cases reported: United States (1,011,877), Spain (232,128), Italy (201,505), France (169,053), and United Kingdom (162,350).
The data above was compiled by Johns Hopkins University as of 8:30 a.m. Beijing time.
All times below are in Beijing time.
Most of Spain has virus reproduction rate of below 1, health official says
Almost all areas of Spain have a coronavirus reproduction rate, known as the ‘R’ number, below 1, the head of health emergencies Fernando Simon said Wednesday, Reuters reported.

“Right now, almost all areas in the country have a reproduction number below 1,” Simon told reporters in an online briefing. The reproduction rate refers to the number of people that an infected individual goes on to infect.

If the reproduction number is not below 1 on average, he said, Spain cannot consider easing mobility restrictions. — Holly Ellyatt

Russia’s crisis response center reported 99,939 cases of the coronavirus on Wednesday, having reported an additional 5,841 cases in the last 24 hours.

The total number of reported fatalities remains relatively low, however, at 972 deaths. Russia says it has carried out 3.3 million tests. On Tuesday, President Vladimir Putin extended the national “non-working” month through to May 11. He also warned that Russia had not yet seen the peak of the virus. — Holly Ellyatt

Premium: COVID-19 treatment facility at Vinogradov City Clinical Hospital No 64 in Moscow
Physicians Tatyana Lesnykh (L) and Denis Medvedev put on protective gear ahead of entering the Red Zone of the COVID-19 treatment facility at Vinogradov City Clinical Hospital No 64.

Spain’s daily death toll rises again, with 325 fatalities reported
Spain’s daily death toll has risen again Wednesday with the health ministry reporting 325 deaths Wednesday, up from 301 reported the day before.

The overall death toll from the virus rose by 453 to 24,275, however, as additional data was added from previous days, Reuters reported.

The country now has 212, 917 cases of the virus, the ministry said, up 2,144 from the previous day. — Holly Ellyatt

4:30 pm: Malaysia reports 94 new coronavirus cases but no new deaths
Malaysia reported 94 new coronavirus cases on Wednesday with no new deaths, the health ministry said. The country has so far recorded a total of 5,945 infections, with 100 fatalities in all, Reuters reported. — Holly Ellyatt

3:50 pm: Sweden’s economy to shrink 7% in 2020, think tank says
Sweden’s economy is set to shrink 7% this year and unemployment rise to 10.2%, a leading think tank has said Wednesday as the effects of the coronavirus outbreak start to impact the country.

“The global economy is developing worse than expected which is hitting Swedish export companies,” the National Institute for Economic Research (NIER) said in a statement.

“Developments in April indicate that the Covid-19 pandemic will hit the Swedish economy much harder than anticipated” in an economic report released by the think tank in early April. — Holly Ellyatt

3:30 pm: Italy’s credit rating downgraded to one notch above junk by Fitch
Italy’s credit rating has been downgraded to one notch above junk level by Fitch ratings agency as the coronavirus hurts Italy’s already fragile economy further.

Fitch downgraded Italy’s credit rating from ‘BBB’ to ‘BBB-’, just one level above its junk rating, reflecting increasing doubts around Italy’s credit-worthiness as it tries to recover from the economic and societal damage inflicted by the coronavirus.

The ratings agency said the downgrade reflects “the significant impact of the global COVID-19 pandemic on Italy’s economy and the sovereign’s fiscal position.” — Holly Ellyatt

3:20 pm: Coronavirus pandemic shows that AI could be over-hyped
The world is facing its biggest health crisis in decades but one of the world’s most promising technologies — artificial intelligence (AI) – isn’t playing the major role some may have hoped for.

Renowned AI labs at the likes of DeepMind, OpenAI, Facebook AI Research, and Microsoft have remained relatively quiet as the coronavirus has spread around the world.

In fact, AI’s role in this pandemic is likely to be more nuanced than some may have anticipated. Read more here. — Sam Shead

3:15 pm: Singapore preliminarily confirms 690 new cases
Singapore on Wednesday preliminarily confirmed 690 new cases of the coronavirus, the country’s health ministry said.

GP: Singapore coronavirus 200214
People wearing protective surgical masks walk along the Merlion Park, a major tourist attraction in Singapore.
Maverick Asio l SOPA Images l LightRocket via Getty Images
That takes the total number of infected people in the country to 15,641.

Most of the new cases have been linked to infection clusters in dormitories that house foreign workers, who are typically men from other Asian countries, carrying out labor-intensive jobs to support their families back home.

Singapore has one of the highest number of coronavirus cases in Asia. — Huileng Tan

1:55 pm: Pandemic will likely end the strong profit growth in Singapore banks
After a strong run last year, the profitability of Singapore banks is expected to fall sharply in 2020.

That’s due to the coronavirus pandemic, as well as a crash in oil prices that brought down some of the major energy traders in the Asian financial center.

A glimpse of that earnings hit could come this week as DBS Group Holdings, the largest bank in Singapore and Southeast Asia, is scheduled to release its first-quarter financial report card on Thursday. DBS’ earnings release will be followed by United Overseas Bank next Wednesday, and Oversea-Chinese Banking Corp next Friday.

Estimates by Refinitiv showed that net profit at all three banks could fall by more than 20% in the first quarter, and DBS is expected to take the largest hit of a 32% decline. — Yen Nee Lee

1:45 pm: Pakistan central bank governor says virus outbreak ‘interrupted’ economic turnaround
The Covid-19 outbreak has disrupted Pakistan’s efforts to turn its economy around, the country’s central bank governor said.

Policymakers were “in the midst of telling a story, a story to international stakeholders as well as to domestic stakeholders. The key message of the story was that our economic problems are … profoundly behind us,” Reza Baqir told CNBC’s Nancy Hungerford on “Street Signs.”

“When Covid struck, it has interrupted the story,” Baqir said, adding Pakistan’s aim in dealing with the outbreak is to “provide appropriate prudent policy responses.” In April, the State Bank of Pakistan slashed its key policy rate by 200 basis points.

Last year, the International Monetary Fund had approved a three-year, $6 billion loan package to Pakistan as it faced mounting debt and a potential balance of payment crisis. In exchange, the government was expected to implement reforms and tough austerity measures.

In April, the IMF also approved $1.386 billion in emergency financing to Pakistan due to the economic impact from the pandemic, Reuters reported. — Saheli Roy Choudhury

1:40 pm: Thailand reports 9 new cases, no deaths
Thailand on Wednesday reported 9 new coronavirus cases, taking the total number of infected people to 2,947, Reuters reported, citing Taweesin Wisanuyothin, a spokesman of the government’s Centre for Covid-19 Situation Administration.

There were no additional deaths, and the toll stood at 54. It was the third day the country reported single-digit increases in infection numbers, Reuters reported, citing Taweesin.

Chart: Coronavirus breakdown 200429
On Tuesday, the Thai government extended the country’s state of emergency for another month till May 31. A 10 p.m. to 4 a.m. curfew was also extended.

Authorities are planning to allow some businesses in the capital of Bangkok to reopen in the next few days or weeks, Reuters reported, citing an official. — Huileng Tan

12:10 pm: Germany reports 1,304 new cases, 202 deaths
Germany reported 1,304 new coronavirus cases, taking the total number of infected people to 157,641.

There were 202 more deaths, taking the toll to 6,115, according to the Robert Koch Institute.

Germany’s coronavirus infection rate has reportedly edged up, prompting the head of the country’s infectious diseases institute to urge people to stay at home as much as possible amid a relaxation of lockdown measures.

Germany’s virus reproduction rate, called the “R” rate or value, is now at 1.0 in Germany, according to Lothar Wieler, the president of the Robert Koch Institute, having risen from 0.7 earlier this month. — Huileng Tan

10:40 am: China to hold annual meeting two months later than planned
China’s parliament will hold its annual meeting on May 22 — two months later than originally planned due to the pandemic, according to the official Xinhua news agency.

It said the 13th National People’s Congress to be held in Beijing can now go on as the coronavirus situation in the country has improved, according to the report.

The National People’s Congress, with about 3,000 delegates, typically gathers for a session lasting at least 10 days in Beijing, to pass legislation and unveil key economic targets for the year. — Weizhen Tan

9:55 am: Australia to ramp up coronavirus testing
Australia is set to begin widespread testing after securing 10 million Covid-19 test kits, according to a Reuters report citing Health Minister Greg Hunt. The state of Victoria, for instance, said it would set up mobile centers for people to do testing in their homes, offices and while shopping.

The country plans to expand testing this week to those who are not showing symptoms, the report said. The government has said such testing is essential for lifting restrictions and lockdowns. Australia has already started to gradually reopen. — Weizhen Tan

9:10 am: UK start-ups raised $825 million during virus lockdown, but less deals are being made
New research suggests British start-ups have raised £663 million ($825 million) since the coronavirus lockdown began in the country, shrugging off the economic downturn in the process.

The study — carried out by workspace provider Plexal and start-up database Beauhurst — focused on funding rounds between March 23 and April 27, analyzing nearly 30,000 businesses.

It found that British start-ups raised 34% more this year than they did during the same period last year. The rise is thought to be a result of investors allocating additional funding to ensure the survival of start-ups in their portfolio. — Sam Shead

8:25 am: China reports 22 new cases, no deaths
China reported 22 new cases as of April 28, according to its National Health Commission (NHC). It attributed 21 cases to travelers coming from overseas. That takes the country’s total to 82,858 cases, according to government data.

There were no new deaths, with total fatalities remaining at 4,633, according to the NHC.

Chart: Coronavirus mainland China 200429
Separately, there were 26 new asymptomatic cases, where people tested positive for the virus but did not show any symptoms. That brings its number of asymptomatic cases currently under medical observation to 993, the NHC said. — Weizhen Tan

8:10 am: Mexico reports jump of 1,223 new cases
Mexico reported an increase of 1,223 new cases, taking its tally to 16,752, according to Reuters.

The country said there were 135 more deaths, to a total of 1,569 fatalities, the report said. According to Mexico’s government, the actual number of infections is significantly higher than confirmed cases. — Weizhen Tan

Health

Coronavirus spread must be stopped in Asia’s ‘biggest slum’ to save India

BBC News
The garment trader lived in Dharavi where more than half-a-million people are spread over 2.5 grubby sq km, which is less than a square mile. (Imagine a population larger than Manchester living in an area smaller than Hyde Park and Kensington Gardens.) The slum was the inspiration for the Oscar-winning Slumdog Millionaire film and city planners from all over the world have studied its throbbing economy and society.

The local doctor examined the man and he left with a prescription for cough syrup and paracetamol. Three days later, the man turned up at the Sion Hospital close to home. His fever had climbed and the cough was getting worse. He said he had no travel history, so doctors gave him more cough syrup and sent him home once again.

On 29 March, the man returned to the hospital with signs of respiratory distress. Doctors admitted him, and promptly sent swabs for the Covid-19 test.

Three days later, the results arrived – he had tested positive. His condition deteriorated sharply and doctors tried to move him to a bigger hospital already treating Covid-19 patients.

It was too late: he died that evening.

That garment trader was the first Covid-19 patient from Dharavi. People living in this packed-to-the gills slum city suffer from all the common diseases afflicting Mumbai, one of the world’s most densely-populated cities, from diarrhoea to malaria.

But an outbreak of coronavirus in a place where social distancing is an oxymoron could easily turn into a grave public health emergency and overwhelm the city’s stretched public health system.

Nobody realises this more than the officials racing to track and contain the infection.

Patient No 1 of Dharavi lived with his eight-member family – his wife, four daughters, and two sons – in a poky 420 sq ft one-room apartment in a low-rise slum tenement ringed by squalid shanties.

“When we asked his family, they told us the man had no recent travel history and only went to the local mosque,” Kiran Dighavkar, an assistant municipal commissioner in charge of the area, told me.

But there was a twist in the tale.

The man owned another apartment in the same complex. There he hosted five people who had reportedly arrived from Delhi after attending a conference in early March organised by Tablighi Jamaat, a religious movement that has followers in more than eight countries including Indonesia, Malaysia and the US.

Dharavi lockdown
Hundreds of people who attended the religious event in the capital set off several Covid-19 clusters across the country and are now linked to some 650 cases across 14 states.

The police believe the five men lived in the Dharavi apartment for two days – between 19 and 21 March- before they left for Kerala. “We are trying to trace these people,” said Mr Dighavkar.

“We have to find out the source of infection. How did this man get the infection and from whom? And we have to contain this infection by taking aggressive steps,” he said.

The family of the deceased trader insists he didn’t have a passport, something that the police are sceptical of. So they are trying to dig out his mobile phone records to find out more about his movements.

For the moment, the race is to ensure that the infection is contained. So 308 apartments and 80 shops in nine six-storey buildings in the complex where the trader lived have been completely sealed. Some 2,500 residents have been put under home quarantine. Food rations are being supplied. Health workers have disinfected the apartments with household bleach. Swabs of eight ‘high-risk’ occupants of the building – the trader’s family and an acquaintance in the building – were sent for testing.

More than 130 residents above the age of 60 and another 35 who are suffering from unrelated respiratory diseases are being closely watched for Covid 19 symptoms.

Fearing an outbreak, authorities have taken over the 50-bed Sion Hospital, and quickly set up a 300-bed quarantine facility in a neighbouring sports complex. Protective gear has been given to doctors and nurses at the hospital.

Yet all this may not be enough to prevent an outbreak.

On Thursday, a 35-year-old doctor working with a private hospital and living in the slum tested positive for the virus. Municipality workers scrambled to isolate and seal 300 people living in the doctor’s building. They have also identified 13 high-risk contacts in the building and sent their swabs for testing. The doctor told officials that two nurses in his hospital had tested positive for the virus. And at the weekend, a 30-year-old woman inside the same building complex as the trader, a 60-year-old man, who owns a metal fabrication shop and a 21-year-old male lab technician, tested positive.

“We are still able to try to contain the infection of the gated slum colonies. But there are the slums outside, and if we get cases there, we can’t isolate them at home, and have to send even the high-risk cases to the sports complex quarantine centre,” says Mr Dighavkar.

If that happens, the struggle to contain the infection will turn into a messy battle. The local hospital and makeshift quarantine will be easily overrun by cases.

Dharavi and Mumbai
Testing will have to be stepped up and results will have to arrive in time. After the first two cases – the trader and the doctor – 21 samples were collected from the slum. After more than 48 hours, the results of only seven have come in. The state-run hospital where the testing is being done says it is swamped by samples. Another 23 samples were picked up after the two new cases and sent to the lab on Saturday. It is not clear when the results will arrive.

“We are losing time because of the delay in results. It also delays shifting people who test positive into isolation,” Virendra Mohite, the medical officer, who is leading the health teams in the slum, told me.

These are some of the real challenges to contain a massive outbreak of a disease in a unique, otherwise self-contained slum, which is home to fishermen, potters, furniture makers, garment makers, tailors, accountants, waste recyclers and even some of Mumbai’s edgiest rappers. Dharavi, writer Annie Zaidi once observed, is a place full of “stories of desperation and grit, initiative and very, very hard work.”

Now it faces its most daunting challenge of preventing a cataclysmic wave of contagion.

Health

Coronavirus: Bengaluru docs get nod for plasma therapy clinical trials

BENGALURU: Two research proposals from Karnataka to study the
potential use of convalescent plasma therapy in treating coronavirus
infection are awaiting approval of the Drug Controller General of India
(DCGI). One was sent three weeks ago by a team of doctors attached to a
private hospital in Bengaluru. The other was forwarded as a collective
request recently by dedicated Covid-19 government hospitals.
Plasma is the almost clear liquid part of the blood. (About 55% of our
blood is plasma.) The plasma of somebody who has overcome an illness
contains antibodies, protective proteins that fight disease and antigens
like viruses. This is called convalescent plasma.

Globally, the hope is that a transfusion of convalescent plasma, derived from a person who has fully recovered from
coronavirus, could boost the ability of critically ill Covid-19 patients to fight the virus. The therapy is being tested in the US,
China, South Korea, Canada and some other countries. To date, there is no definitive research on its effectiveness in tackling
coronavirus or on any drawbacks. There are some encouraging signs, which is why countries are examining its use.
Early movers

The said approach is being tested in Delhi. In Mumbai, a person who recovered from Covid-19 has donated blood at BYL Nair
Hospital.
Doctors from the immunobiology wing of HCG Cancer Centre, Bengaluru, have sought DCGI’s approval to start experimental
use of the therapy. “There are three categories of Covid-19 patients: those who are asymptomatic, those (2A) who are
vulnerable for further disease progression and those (2B) with significant symptoms, and people battling severe comorbidities
like respiratory distress. It’s the third category which needs convalescent plasma therapy,” said Dr Vishal Rao US, associate
dean, Centre of Academics & Research, HCG Cancer Centre. “We have moved a research application to DCGI and ICMR [Indian
Council of Medical Research] parallelly, seeking permission to start clinical trials with the Karnataka government.”
A fee of Rs 3 lakh has to be paid while filing a research application with DCGI. “A research institute or a hospital must seek
approval for conducting studies and clinical trials on plasma therapy on its own, and the state governments hardly have a role
to play here,” said a senior researcher from Bengaluru, adding that DGCI should review the applications quickly considering the
severity of the crisis.
Doctors at dedicated Covid-19 government hospitals have also been discussing the potential use of plasma therapy. “In some
countries, plasma therapy is said to have helped severely ill Covid-19 patients. We have written to the Bangalore Medical
College and Research Institute,” said Dr C Nagaraja, director, Rajiv Gandhi institute of Chest Diseases, the first nodal centre in
Karnataka for treating Covid-19 patients.
BMCRI has sent a research request on behalf of Covid-19 hospitals in Bengaluru to central agencies. “The ethical committee of
BMCRI has approved it. It was sent to the medical education department for further forwarding to DCGI,” said Dr CR Jayanthi,
dean and director, BMCRI.
Jawaid Akhtar, additional chief secretary, state health and family welfare department, confirmed some government institutions
had sought permission for plasma therapy research. “We have forwarded the requisition to DCGI and ICMR,” he said.