COVID-19 Is World’s Biggest Challenge Since World War II, Says UN Secretary General Emergency Response 01/04/2020 • Gauri Saxena & Grace Ren and Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Temporary COVID-19 treatment unit being set up in Central Park, New York City The COVID-19 pandemic is the biggest challenge the world has faced since the Second World War, said United Nations’ Secretary-General Antonio Guterres. He spoke during the launch of a report on the potential socioeconomic impact of the outbreak, Shared Responsibility, Global Solidarity. Speaking from the UN Headquarters in New York on Tuesday, Guterres said that “the new coronavirus disease is attacking societies at their core, claiming lives and people’s livelihoods.” The economic fallout of the outbreak could trigger a recession of unprecedented scale, as up to 25 million jobs could be lost globally as well as a 40% reduction in global foreign direct investment flows. In his statement, Guterres also called upon the G-20 to move ahead with a special Africa initiative, discussed at the extraordinary G20 Summit last week. And he called upon developed countries more generally to bolster health systems and response capacity in lower income nations, saying that, “Otherwise we face the nightmare of the disease spreading like wildfire in the global South with millions of deaths and the prospect of the disease re-emerging where it was previously suppressed. “Millions and millions” could die in Africa without intervention, he later told France 24. Just a day later on Wednesday, the African Development Bank group approved a $2 million emergency grant for countries of the WHO African Region boost surveillance systems, procure and distribute laboratory test kits and reagents, and support coordination mechanisms at national and regional levels. The regional office of WHO Africa reported 3762 confirmed cases and 92 deaths on Tuesday night; South Africa remained the most heavily affected country with 1353 cases but Algeria had the most deaths at 35. The White House Predicts Over 100,000 Coronavirus Deaths in the US Meanwhile, top United States health authorities said that a “best-case scenario” for the pandemic would see the deaths of nearly 100,000 to 240,000 people in the United States. Anthony Fauci and Deborah Birx, leading experts on President Donald Trump’s COVID-19 Task Force, issued the warnings during a White House press conference Tuesday night, with reference to projections produced by the Seattle-based Institute of Health Metrics and Evaluation’s (IHME). Keeping the curve to the lower end of 100,000 deaths or less, will be contingent on effective enforcement of social distancing and other disease control measures, they stressed. Speaking at the press conference, President Trump warned Americans to brace themselves for a “very, very painful two weeks”, as he announced more severe nationwide measures to be implemented to curb the coronavirus. But he also pointed out that in the absence of such measures, the United States could face as many as 12.2 million deaths, according to projections by Imperial College London cited by Birx earlier in the briefing. Officials were quick to point out that the death projections are not static, given that hotspots like New York and New Jersey are pulling the estimates upwards, but in other states, such as California and Washington, authorities have managed to reduce infection transmission. The state of New York has emerged as the epicentre of the pandemic in the United States, recording over 75,000 confirmed cases and over 1,500 deaths, Governor Andrew Cuomo has said that the outbreak is not expected to peak for another three weeks. “I’m tired of being behind this virus. We’ve been behind this virus from day one. We underestimated this virus. It’s more powerful, it’s more dangerous than we expected,” he said in a press briefing earlier in the day. The United States currently has a total of almost 190,000 confirmed cases with over 4,000 deaths. A preliminary report by the US Centres for Disease Control and Prevention (CDC) has estimated that 78% of coronavirus patients admitted in intensive care as well as 94% of those who died in the US had at least one underlying chronic condition. People with diabetes, lung disease and heart disease appear to be at higher risk of severe illness, CDC found, which is consistent with findings from Italy and China. As a vivid symbol of the expanding emergency, Mount Sinai Hospital system in New York City was set to open a field hospital in Central Park, in collaboration with Samaritan’s Purse. The tent hospital units, delivered from North Carolina, will provide overflow capacity for Mount Sinai’s COVID-19 patients, with 68 more beds. Italy Extends Lockdown Measures — Even As Infection Curve Plateaus Italy’s civil protection authority has reported that the number of reported coronavirus infections is rising at a slower rate — the country has recorded daily increases around 4-5% in the past 4 days, which is 3-4 times less than the rates recorded two weeks ago. Silvio Brusaferro, the president of Italy’s Higher Health Institute (ISS) told The Guardian “That doesn’t mean we’ve hit the peak and that it’s over, but that we must start the descent … by applying the measures in force”. In an effort to halt the continued rise in cases, lockdown measures currently in place have been extended till April 13; Italy now has over 105,000 cases, and has reported over 12,000 deaths, one of the highest national death rates from the virus. Over 15,000 people have also recovered. Italy’s Health Minister Roberto Speranza said the new trend was a sign that measures are yielding results, but added it would be “unforgivable to assume this was a definitive defeat” of the virus. Customers queuing in Toulouse, France, as part of social distancing measures taken to reduce crowding in supermarkets during the COVID-19 pandemic. The rate of infection increases in Spain was also stabilizing somewhat following drastic containment measures. María José Sierra of the centre of health emergencies said “generally speaking, we can say that yesterday’s rise in cases, which was around 8%, tells us that we’re carrying on in the stabilisation phase of the pandemic”. The country has seen a dip in daily infection rates from 20% between 15 to 25 March to below 12% since then. However, in neighboring France, new infections rose overnight by 15%. In Switzerland, meanwhile, the Geneva University Hospital (HUG) announced that it was launching a study of serological samples, to be collected from among research volunteers, to examine the extend to which Swiss citizens and residents might be infected with the virus asymptomatically, as well as the degree to which exposure might have conferred immunity. As many as 83,300 cases, and 720 deaths, could be expected in Switzerland by 11 April 2020 researchers from the Swiss Federal Institute of Technology in Zurich predicted in a paper published Wednesday on the preprint server MedRxiv. Switzerland currently has reported 17,139 confirmed cases and 378 deaths, although it is believed that many cases have gone unreported insofar as testing has so far largely been confined to people at high risk and with serious symptoms. For the country of 8.5 million people, this still ranks as one of the highest per-capita disease rates in the world, although deaths have remained comparatively low at about .02% of those confirmed ill. In the absence of social distancing interventions, up to 42.7% of the entire Swiss population would have been infected with COVID-19 by 25 April, the researchers also said. The assessments align with previous studies published on the benefits of “non-pharmaceutical interventions” such as closures and stay-at-home orders on slowing the spread of the virus. Cumulative cases and global distribution. Numbers change rapidly Concerns for Vulnerable Populations Increases As governments take measures to protect their citizens from the rising COVID-19 pandemic, experts were increasingly concerns about potential devastating effects on indigenous peoples, refugees, and others worldwide who lack formal citizenship rights in the countries where they are living. Four UN agencies released a statement Tuesday that called for the protection of those at “heightened risk,” including “refugees, those forcibly displaced, the stateless and migrants.” According to the statement, “many refugees live in overcrowded camps, settlements, makeshift shelters or reception centres, where they lack adequate access to health services, clean water and sanitation.” Up to three-quarters of the world’s 70.8 million forcibly displaced people are hosted in countries where health systems are “already overwhelmed and under-capacitated.” As one example, the 10 cases and 1 death reported so far in war-torn Syria may be a sign of a bigger crisis to come, Mark Lowcock, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator told the Security Council, warned the UN Security Council in a meeting Monday. “That is the tip of the iceberg,” he said in a UN press release, warning that only half of Syria’s hospitals and primary health-care centres were fully functional at the end of 2019. And while the UN has assisted in rehabilitating the Central Public Health Laboratory, pre-positioning medical supplies, and upgrading isolation units around the country; the fragility of the health system and critical supply chains further complicate COVID-19 measures. Cross-border deliveries of aid supplies between Turkey and north-west Syria have more than doubled compared to the same period last year to 2150 trucks per day. Some US $340 million has so far been received by the UN Office of Humanitarian Affairs under a US $500 million funding call. Meanwhile, as confirmed cases soar beyond 12,000 in South America, indigenous tribes in Brazil, Colombia, Ecuador and Peru have taken matters into their own hands in the face of what they call “a historic danger,” as quoted in the Guardian. The Xingu people in Brazil have sealed off roads into their reserve and are urging locals to leave only for emergencies, as the country’s number of confirmed cases topped 5500 and deaths rose to over 200. In Colombia, which has almost 900 confirmed cases so far, tribes have been self-isolating and outlawing visits to their ancestral lands while collaborating with local governments to procure adequate supplies. Isolated tribes living in areas with fragile health systems, are particularly susceptible to acute, highly infectious diseases. Outbreaks of measles, smallpox and flu viruses had a long track record of “decimating” indigenous communities. Some countries are taking more widespread social welfare measures for vulnerable populations. Indian Prime Minister Narendra Modi announced a US$24 billion welfare package to provide free food rations for 800 million disadvantaged people, cash transfers to 204 million poor women, and free cooking gas for 80 million households for the next 3 months. Health Experts Revisit Benefits of Wearing Masks in Public As the intensity of coronavirus infections rises in many parts of the world, health experts are beginning to reconsider whether the general public should wear face masks after all. Until now, the World Health Organization as well as the US Centers for Disease Control and Prevention (CDC) have recommended the use of face coverings only for the sick or for health workers treating those who might be ill. However, CDC director Robert Redfield said that this recommendation is currently under review. The US CDC recommendation under consideration would specifically recommend fabric masks, or do-it-yourself type masks for the general public, reports the Washington Post. Medical grade masks such as surgical masks or N95 respirators – which are in desperately short supply around the world – would still be restricted to use by healthcare workers. At his press briefing on Tuesday, even President Trump has encouraged the public to cover their faces with scarves when they go out, so that masks may be reserved for healthcare workers. “I can tell you that the data and this issue of whether it’s going to contribute [to prevention] is being aggressively reviewed as we speak,” Redfield told NPR in an interview. Many prominent healthcare experts have weighed in on the issue, including former FDA Commissioner Scott Gottlieb. In a paper he published with American Enterprise Institute, a conservative US policy think tank, Gottlieb recommended supplementing social distancing measures with the widespread use of facemasks, citing the large numbers of asymptomatic cases that go undetected. “Face masks will be most effective at slowing the spread of SARS-CoV-2 if they are widely used, because they may help prevent people who are asymptomatically infected from transmitting the disease unknowingly”, says Gottlieb, citing South Korea and Hong Kong as places where facemasks were widely used, and managed to successfully control the outbreaks. Similarly, other individual experts have advocated for the use of facemasks as a socially responsible insurance policy. And countries are beginning to act as well. Israel’s Prime Minister Benjamin Netanyahu on Wednesday issued a new order that anyone leaving their homes should wear a mask “or other face covering”, making it the first country outside China to adopt mandatory mask usage while out in public. Hungary this week also ordered people visiting supermarkets to wear facemasks in order to risk infection spread in venues that often remain crowded with customers. Street scene in France. Universal masking being reconsidered. Tobacco Industry Joins the COVID-19 Vaccine Race British American Tobacco (BAT), the world’s second largest cigarette maker, announced that it would launch an effort to develop a COVID-19 vaccine using tobacco plants, joining a global effort that has generated over 90 potential vaccine candidates so far. Using plant-based production, the company claimed in a press release that between 1-3 million doses of vaccine could be manufactured per week by June. The process works by first identifying and cloning an antigen – an immune-response generating portion of SARS-CoV-2, the virus that causes COVID-19 – into a tobacco plant. The antigen can then be purified from grown and harvested tobacco plants in as little as 6 weeks. The tobacco plant production method was used by BAT’s US bio-tech subsidiary, Kentucky BioProcessing (KBP), to successfully manufacture the Ebola treatment ZMapp in 2014. “KBP has been exploring alternative uses of the tobacco plant for some time. One such alternative use is the development of plant-based vaccines,” said David O’Reilly, director of Scientific Research at BAT. “We are committed to contributing to the global effort to halt the spread of COVID-19 using this technology.” However, the SARS-CoV-2 antigen that would supposedly be purified and used for the production, is still being evaluated in preclinical tests. Image Credits: Samaritan's Purse, Wikimedia Commons: Alteo31300. 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