Will an old malaria drug help fight the coronavirus?

20/03/2020

A packet of Nivaquine tablets containing chloroquine, a commonly used

 malaria drug that has shown signs of effectiveness against coronavirus,

 according to a study conducted in several Chinese hospitals.

 © Julien Gerard, AFP

Text by:Sébastian SEIBT

Hydroxychloroquine has been used for around 70 years to treat malaria, rheumatic conditions and other ailments. Now its potential use in the fight against coronavirus has become a source of hope for many, following encouraging results from a clinical trial in France on Monday. But experts caution that there is still uncertainty about its effectiveness.

A very old drug is coming back to the fore. The successful testing of hydroxychloroquine for use against the coronavirus in France’s second city Marseille on March 16 created high expectations amid this surging epidemic – especially in light of Donald Trump’s announcement on Thursday that the US Food and Drug Administration has approved its use for this purpose

Didier Raoult, director of a university hospital institute in Marseille, explained that he had conducted a clinical trial in which he treated 25 Covid-19 patients with hydroxychloroquine. After six days, he said, only 25 percent of patients who took this drug still had the virus in their body. By contrast, 90 percent of those who had not taken hydroxychloroquine continued to carry the Covid-19.

In the wake of this announcement, French pharmaceutical giant Sanofi offered to donate millions of Plaquenil (a trade name for hydroxychloroquine) to continue the tests, while the French government’s spokesperson Sibeth Ndiaye hailed the “promising results” and promised to expand clinical trials for this treatment.

Well-known and inexpensive

In France, some pharmacies have reportedly been overwhelmed by demand for the drug over the past few days. However, many voices soon pointed out that people should not jump to the conclusion that hydroxychloroquine is a proven miracle cure.

“This study seems promising, but we have to be really careful before raising hope when it comes to a virus as new as this one, for which we don’t yet have a lot of data,” said Sarah D’Alessandro, a professor of molecular medicine at the University of Milan and a malaria specialist who has worked on hydroxychloroquine.

This drug is regularly touted as a potential solution whenever a new virus appears. One “possibility is that chloroquine may alter the ability of the virus to bind to the outside of a host cell in the first place (which is an essential first step for entry) ”, noted Robin May, a professor of infectious disease at Birmingham University.

Seeing as it has been available and used for decades, hydroxychloroquine is “very well known, inexpensive and can be rapidly produced in large quantities”, D’Alessandro added. In light of these qualities, 25 clinical trials have been conducted or are underway in China to see whether or not this treatment should be used to treat Covid-19 patients. That’s while research was carried out into hydroxychloroquine’s effectiveness against SARS, MERS and Zika when these diseases first flared.

It was a Chinese study published on March 9 that first put the spotlight on this anti-malaria drug in the context of the current pandemic. Researchers at the University of Beijing demonstrated its effectiveness in an in vitro trial – that is to say, an experiment on cells in a laboratory.

‘Difficult’ to interpret results

But when it comes to human trials, the picture is foggier. “Tests on human patients [except for malaria] have so far produced contrasting results that are difficult to interpret,” D’Alessandro observed.

Hence the interest in Didier Raoult’s work in Marseille: he is the first scientist to have carried out trials with human patients that seem to have produced conclusive results. But there are still doubts: the precise data from the clinical trial have not yet been published in a scientific journal, and so have not yet been subject to peer review, noted MedScape, a specialist publication for healthcare professionals.

Another reason for caution is that the trial was “only carried out on a few patients”, D’Alessandro emphasised. The Chinese study on March 9 was criticised by many in the scientific community because it was carried out on a group of “only” 100 patients – four times more than the experiment conducted in Marseille. The French government’s spokesperson highlighted this point, stressing the importance of carrying out trials on a larger scale before trying to reach conclusions on hydroxychloroquine’s effectiveness.

A European programme of large-scale clinical trials was launched on March 12, aiming to test the effectiveness of four treatments that have already proven themselves against other viruses, such as Ebola. Hydroxychloroquine was not chosen.

A particular risk is that it does not work well with other medicines that may be necessary for certain patients with pre-existing health problems, particularly some autoimmune conditions. Hydroxychloroquine also presents risks of poisoning, and can be fatal if incorrectly dosed. Even if this danger is rigorously controlled in a hospital, the risk of an accident cannot be completely ruled out.

However, the French National Institute of Health and Medical Research, which is piloting the European clinical trial programme, has said that if there is additional proof in human patients of hydroxychloroquine’s effectiveness, it could be added to the list of drugs used in Europe’s large-scale clinical trials.

This article was adapted from the original in French.

France sanctions use of chloroquine for certain patients with coronavirus

27/03/2020

Professor Didier Raoult, the head of a university hospital 

institute in Marseilles, France. © france 24 screengrab

The French government has officially sanctioned prescriptions of chloroquine to treat certain coronavirus patients. Speaking about chloroquine, Jérôme Salomon, France's director general of health, said: "This ensures continued treatment of patients who have been treated for several years for a chronic condition with this drug, but also allows a temporary authorization to allow certain patients with coronavirus to benefit from this therapeutic route."

How does the coronavirus compare to the Spanish flu?


Modified: 20/03/2020

Londoners wearing face masks to protect themselves from the 

Spanish flu in early 1919. © Collections La contemporaine

Text by: Stéphanie TROUILLARD

The coronavirus crisis inevitably prompts comparisons with the last epidemic that shook the world: the Spanish flu. Although the Great War overshadowed it in the public consciousness, this outbreak killed at least 30 million people worldwide – with some estimates even putting the figure at 100 million from 1918 to 1919. But are the two epidemics really comparable?

As the coronavirus outbreak accelerated after first emerging in the Chinese city Wuhan at the end of 2019, there have been more comparisons with the Spanish flu a century ago.

“People are talking about the Spanish flu right now because at the time, it was shocking; the biggest health crisis the world had ever known in terms of how it affected the demographic balance,” noted Anne Rasmussen, a historian at the EHESS university in Paris. “Of course, there was the Black Death [which caused between 25 and 34 million deaths in Europe from 1347 to 1353], but the Spanish flu was on a much more global scale.”

“But at the same time, the Spanish flu and the coronavirus are not really comparable,” Rasmussen continued. “Things are completely different today. One has to be very careful to avoid using comparisons that create more fear than illumination.”

Two very different diseases

Although the two diseases are both respiratory infections with common symptoms such as a runny nose and fever, they belong to different families of viruses. “Pneumonia and pleurisy caused a lot of death in 1918; people were suffocated – they felt like they were drowning,” said Rasmussen. “With regard to the coronavirus, France’s director general for health Jérôme Salomon emphasised how different it is from the influenza virus; the clinical profile, the severity, the biological signs are all different.”

The coronavirus is also more threatening to very different age groups from those who were hit hardest by the Spanish flu. The former affects the elderly and those with pre-existing medical conditions most severely. By contrast, the latter was most deadly for young adults – a rare phenomenon that continues to intrigue epidemiologists.

“We’re still trying to explain it, especially seeing as we now have the decoded DNA of the 1918 virus,” Rasmussen said. “One factor that may help explain it is that the flu had already circulated over previous decades, particularly during the 1889 epidemic. People who were alive at that point could have found themselves to be partially immunised when the Spanish flu broke out three decades later.”

Another fundamental difference lies in the level of knowledge about the two diseases, Rasmussen said: “At the time of the Spanish flu, people didn’t know the influenza pathogen, and without this knowledge, it wasn’t possible for them to create a vaccine. They knew they were dealing with a flu and that it was contagious, but they weren’t able to see the viruses because they were too small. That subsequently became possible with the electron microscope.”

Scientists did not isolate the particular virus strain that causes influenza in humans until 1933. Of course, scientific knowledge is much more advanced today. “We decrypted the RNA of the coronavirus within a few days, whereas for HIV/AIDS it took a few years,” Rasmussen said.

‘Let’s not create more fear’

The Spanish flu killed more people in 24 weeks than HIV/AIDS killed in 24 years, hitting countries ravaged by the Great War as it accelerated to become an epidemic. It acquired its name not because it originated in Spain – there is not enough epistemological data to definitively pinpoint its place of origin – but because the Spanish media were relatively free to report it in a neutral country, unencumbered by the censorship present in combatant nations.

The disease spread like wildfire in overcrowded army camps and hospitals, then spread to the rest of the world after raging through Europe. Patients did not benefit from modern resuscitation techniques or the antibiotics necessary to treat the complications the disease caused.

There was a divergent range of responses to the epidemic. In France, where the Spanish flu killed 240,000 people, there were bans on some gatherings and some public places were closed – but nothing like the current coronavirus lockdown. The focus was on the war effort.

“They were going through the final stages of the war, with decisive moments in a series of offensives and counter-offensives,” Rasmussen said. “You couldn’t stop people moving around because that would have hindered military operations.”

Despite the terrifying scale of the Spanish flu, it was not until 1948 that the World Health Organization was founded to co-ordinate the prevention and detection of disease outbreaks on a global scale. There were several outbreaks in the ensuing decades: the 1957 Singapore flu, the Hong Kong flu in 1968 and H1N1 in 2009.

“We learned a lot of lessons from each of these epidemics, with a much more efficient monitoring system – and we’re even better prepared today,” Rasmussen said. “Let’s not create more fear; the current state of affairs already provokes enough anxiety. It’s a different world now from the one that saw the Spanish flu. Things are done on a different scale now, with much more research and a much more efficient approach to dealing with diseases. There are great reasons for hope.”

‘What public service is about’: French schools open to children of health workers battling virus

27/03/2020

France shut schools across the country on March 13, 2020,

 to stop the spread of the deadly coronavirus. © Pascal Pavani, AFP

Text by:Benjamin DODMAN

Although French schools are officially shut, some continue to care for the children of key workers on the coronavirus frontline. FRANCE 24 spoke to teachers who volunteer to look after health workers’ offspring even as they grapple with the challenges of home-schooling.

Like many of her colleagues across France, Nathalie Carboni-Latour didn’t think twice about returning to school when the call for volunteers came through.

Located in eastern Paris, her nursery school closed its gates on Friday, March 13, along with more than 61,000 other schools scattered across France. But, as the entire country went into lockdown just days later, the headmistress was soon back at work catering for a specific public: the children of health workers fighting the coronavirus pandemic.

“That’s what public service is about, we’re not just salaried workers,” she says. The idea of offering some support to health professionals on the frontline of the pandemic only made the decision to volunteer more obvious.

Carboni-Latour began by drawing up lists of parents who were eligible for the scheme, while the inspectors of the Paris academy looked for volunteers, giving priority to the teachers for whom it would be easier – and safer – to return to school.

“Not everyone can volunteer in the present circumstances,” she explains. “Some have their own children to look after or a medical condition that places them at risk. Many teachers also live far out, meaning they would face long journeys on public transport and thus a greater risk of infection.”

‘Infection hubs’

Being able to cycle to work made it easier for Caroline, a nursery school teacher, to volunteer at one of the 28 schools that are still open in the French capital. The fact that her partner can work from home, and thus look after their children, was another precondition.

At her school in southern Paris, four teachers and two headmistresses take it in turns to look after some 15 children of various ages. Other schools, including Carboni-Latour’s, cater to slightly larger groups. The education ministry says more than 28,000 pupils benefited from the scheme nationwide during the first week of lockdown.

“It seemed pretty obvious to me that I should try and help out,” says Caroline. “If it means health professionals are free to look after the sick, then it’s well worth it.”

In countries across the world, school closures and lockdown measures have presented emergency services with a quandary even as they face unprecedented surges in patient numbers. In Italy, the country worst affected by the pandemic and the first to close schools nationwide, many hospital nurses were forced to drop out at a critical time to look after their children. Similar staff shortfalls have been reported in some US states, with hospitals reaching out to temporary staff agencies and exploring other ways to maintain workforce levels as childcare presents a major challenge.

With French emergency rooms already overwhelmed, the Paris education authority has decided to keep some schools – those closest to key hospitals – open on weekends too. Other authorities have also adopted more flexible timetables, but there is a limit to how much flexibility schools operating on skeleton teams can offer.

Cécile Morini-Dornier, who runs a primary school in a rural area in the Seine-et-Marne department, east of Paris, says some health workers expressed interest in the scheme “but had to find another solution, because they leave for work at dawn, when the school is shut”.

Other parents prefer not to expose their children, or other people’s children, to the threat of contagion at school.

“We’re a welcome hub, but we’re also an infection hub,” says the headmistress, noting that the children of health professionals are, by definition, particularly exposed to the virus.

Social distancing for children

The level of protection afforded to teachers varies significantly depending on where they teach. In Paris, teachers’ unions have fought hard to ensure volunteers are given adequate protection, says Carboni-Latour, a member of the SNUipp-FSU union.

“We know the virus spreads easily among children, who often don’t present symptoms, so we are naturally exposed too,” she explains. At her school in the capital’s 20th arrondissement, one teacher has already tested positive for COVID-19, along with a number pupils and parents.

Over in the 14th arrondissement, Caroline and her colleagues are equipped with hand gel, gloves, masks and overalls – a somewhat cumbersome attire when dealing with small children.

“We thought it would be a frightening experience for the pupils, coming to a different school, with different classmates and new teachers who greet them with masks,” says the volunteer, who was surprised to find that most pupils were not the least bit troubled or scared.

In fact the real challenge is quite the opposite: getting children to be a little more circumspect at a time when objects and people are potential virus-carriers. In that respect, there is only so much teachers can do, Caroline explains.

“We’re talking about small children to whom the notion of ‘barrier gestures’ and ‘safe distancing’ are hard to comprehend,” she says. “It’s not like we can push them away when they reach out for us.”

‘We’re inventing rules as we go along’

Elsewhere in France, school workers have complained of a lack of protective gear, venting their frustration on social media. One teacher said she had brought her own mask to school, only to be told to take it off by her headmaster.

In Seine-et-Marne, Morini-Dornier and her colleagues brought their own hand gel to school and scrambled to find other equipment, including “old masks from the days of bird flu”. She laments the education ministry’s failure to come up with a national procurement plan for such basic protection as face masks.

“We’re inventing rules as we go along,” she says of the many different challenges presented by the coronavirus pandemic. “Less than two weeks ago, all we told our pupils was to wash their hands. Now we’re having to rethink the whole way we go about schooling.”

Morini-Dornier juggles her work at the school with the whole new challenge of providing online teaching for the 12.4 million pupils currently under lockdown across France – a mammoth enterprise that soon proved to be even more complex and time-consuming than ordinary classroom teaching.

Teachers across France were naturally incensed this week when the government spokeswoman, Sibeth Ndiaye, quipped that they would not be asked to plug a shortage of manpower at French farms, despite the fact that “teachers are not working at the moment since schools are shut”.

According to the Press Secretary of the French government (@SibethNdiaye), teachers are currently "not working" because schools are closed. How do you say, WTF, en français? https://t.co/3XqbDgJLc6— Michael Stambolis (@mstambolis) March 25, 2020

The gaffe, for which Ndiaye subsequently apologised on Twitter, reflects “the way all too many people view the profession”, sighs Caroline. She says she shares the frustration voiced by health professionals, who have long complained about the neglect suffered by public services – a neglect for which the French, and health workers in particular, are now paying a heavy price.

With experts warning that the pandemic is yet to peak in France, Caroline and her colleagues are bracing for several more weeks of home-schooling and looking after health workers’ children. Already the scheme has been expanded to include the children of key social workers, and more may follow.

“We’ll keep adapting as the needs change,” says Morini-Dornier, whose primary school will soon start welcoming nursery school children too. “At least until we fall ill in turn.”

---30---

Virus prevention measures turn violent in parts of Africa

Issued on: 28/03/2020

Soldiers patrol the streets in an attempt to enforce a 21 day nationwide lockdown, aimed at limiting the spread of coronavirus disease (COVID-19), in Alexandra township, South Africa, March 28, 2020. © Siphiwe Sibeko, Reuters


Police fired tear gas at a crowd of Kenyan ferry commuters as the country’s first day of a coronavirus curfew slid into chaos. Elsewhere, officers were captured in mobile phone footage whacking people with batons.

Virus prevention measures have taken a violent turn in parts of Africa as countries impose lockdowns and curfews or seal off major cities. Health experts say the virus’ spread, though still at an early stage, resembles the arc seen in Europe, adding to widespread anxiety. Cases across Africa were set to climb above 4,000 late Saturday.

Abuses of the new measures by authorities are an immediate concern.

Minutes after South Africa’s three-week lockdown began Friday, police screamed at homeless people in downtown Johannesburg and went after some with batons. Some citizens reported the police use of rubber bullets. Fifty-five people across the country were arrested. The country leads Africa with more than 1,000 cases.

In an apparent show of force on Saturday, South Africa's military raided a large workers' hostel in the Alexandra township where some residents had defied the lockdown.

In Rwanda, the first country in sub-Saharan Africa to impose a lockdown, police have denied that two civilians shot dead Monday were killed for defying the new measures, saying the men attacked an officer after being stopped.

And Zimbabwe, where police are widely criticized by human rights groups for deadly crackdowns, is set to enter a three-week lockdown on Monday. The country's handful of virus cases already threatens to overwhelm one of the world's most fragile health systems.

In Kenya, outrage over the the actions of police was swift.

“We were horrified by excessive use of police force” ahead of the curfew that began Friday night, Amnesty International Kenya and 19 other human rights groups said in a statement issued Saturday. “We continue to receive testimonies from victims, eyewitnesses and video footage showing police gleefully assaulting members of the public in other parts of the country.”

The tear gas caused hundreds of people trying to reach a ferry in the port city of Mombasa ahead of the overnight curfew to touch their faces as they vomited, spat and wiped away tears, increasing the chance of the virus’ spread, the rights groups said. Even some health workers reported being intimidated as they tried to provide services after the 7 p.m. curfew.

'People must be treated humanely'

The police actions were unacceptable and “brutal,” the Kenya Conference of Catholic Bishops' Justice and Peace Commission said in a separate statement.

“I am appealing to our people to make it very unnecessary for them to engage with police by staying at home,” Kenya's Cabinet secretary for health, Mutahi Kagwe, said. “I am also urging the police that people must be treated humanely.” The country has 38 virus cases.

Kenya’s interior ministry on Saturday replied to criticism in a statement saying the curfew "is meant to guard against an apparent threat to public health. Breaking it is not only irresponsible but also puts others in harm’s way.”

Kenya's government has not said how many people have been arrested. Because courts are also affected by virus prevention measures, all but serious cases will now be dealt with at police stations, the government has said. That means anyone detained for violating curfew faces time in crowded cells.

The Law Society of Kenya will go to court to challenge the curfew on the grounds that it is unconstitutional and has been abused by police, president Nelson Havi said in a statement. The penalty for breaking a curfew is not corporal punishment, he added.

“It is evident that COVID-19 will be spread more by actions of police than of those claimed to have contravened the curfew,” Havi said.

For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

If Kenya goes further and imposes a lockdown, “there is bound to be violence,” said James Shikwati, an economist. People in poor neighborhoods of cities like the capital, Nairobi, will need a way to access food, water and sanitation.

“It will mean for the first day, maybe, they stay indoors," he said. “Then the second day, when they are hungry, they will move out.”

(AP)

Coronavirus: Rush to develop rapid tests

Are enough people being tested for COVID-19 in Germany? Various tests are being developed and brought out onto the global market. There is still no reliable self-testing kit, however.


If you are only coughing, that's not enough. If you want to be tested for SARS-CoV-2, as a rule, you not only have to have symptoms, but you also have to have been in contact with someone who was infected. These are the guidelines of the Robert Koch Institute, Germany's central authority for the identification, surveillance and prevention of infectious diseases.

But didn't the head of the World Health Organization, Tedros Adhanom Ghebreyesus, say, "Test, test, test?" And wouldn't it make sense to test as many people as possible and only then to decide who should be quarantined instead of locking down an entire country? Why the current restrictions?

Christian Drosten, who is head of the Institute of Virology at Berlin's Charite University Hospital and has been advising the German government on coronavirus, recently explained in a regular podcast produced by the German public broadcaster NDR that there were too many people who really have reasons to be tested.

"This has completely used up all the capacity we have," he said.

Limited testing capacity

Currently, there are only estimates as to how many tests are being carried out, and these sometimes contradict themselves. A survey conducted by the Robert Koch Institute of 174 laboratories found that 483,295 tests had been carried out before March 22, mostly in the previous two weeks.

The German Ministry of Health told DW that it was "currently assuming a capacity of at least 300,000 tests a week, a capacity that is being increased continuously."

Read more: Up to 30% of coronavirus cases asymptomatic

Drosten even speaks of estimates suggesting that 500,000 tests are currently being conducted in Germany every week. Roland Stahl from the National Association of Statutory Health Insurance Physicians (KBV) told DW that last week (March 16-22), 266,000 tests had been conducted on outpatients alone, either by GPs consultants, with some 80 labs were sending results to the KBV every week. The KBV says the capacity is limited to 360,000 tests per week.

Public health insurance providers pay about €60 ($66) per test if the criteria of the Robert Koch Institute are fulfilled, said Stahl. But media reports say labs will charge up to €250 per test to those with private health insurance schemes or paying out of their own pocket.

It is one of the peculiarities of Germany's health care system that the KBV is only collecting data on tests carried out by registered doctors. It has no information on how many tests are being carried out by hospitals or other local health authorities. However, it must be just over 200,000 if the entire figure is half a million. This would also correspond to the data of the German Ministry of Health.

How fast is fast enough?

This means Germany is testing on a relatively large scale and thus can well bear comparison to South Korea, which was able to stem the rate of infection by conducting a huge number of tests, all without imposing national lockdowns.

Read more: US approves 45-minute coronavirus test

In Germany so far, most of the tests being conducted are PCR tests, which detect the virus itself and are considered to be particularly accurate. The test takes about five hours in the laboratory, but patients still have to wait a couple of days for results, as the samples have first to be sent to the lab by the doctor. In addition, the tests cannot be analyzed fully automatically, meaning that they cannot be processed round the clock, as the lab staff is lacking.


In Germany, testing for coronavirus has so far used the polymerase chain reaction technique

But it would, of course, be good to test more and to test faster, which is what scientists are working towards, both state and private providers. Hardly a day goes by without a company introducing a new, simpler or faster test.

My test, my machine

On Thursday, Bosch Healthcare Solutions announced that it had developed a rapid test that could deliver results in 2.5 hours. It is a fully automated PCR test that just involves putting a swab into a cartridge, which a machine then analyzes.

The snag is that this machine has to be a Bosch device from its Vivalytic series. Bosch Healthcare Solutions spokesman Thomas Berroth explained to DW that because the device was brand-new and had only been given the green light in February, there are currently only a "few dozen" operating in the country.

Biotech firm develops sought-after rapid test

From the company's point of view, the fact that this analysis device can deliver such rapid results for coronavirus is a good selling point. DW could not find out how much they cost. They are due to come out on the market next month, targeted at hospitals and labs, not registered doctors.

Other companies are also designing rapid PCR tests that work with similar cartridges and special, mostly in-house analytical devices. The US firm Cepheid has developed a rapid test that takes 45 minutes, according to its own data, and the Dutch pharmaceuticals holding Qiagen has come up with a test that takes one hour.

Large-scale rapid testing

Apart from the PCR tests, there are also rapid tests that detect viral antigens, which trigger the body to produce antibodies. These tests are simple and very fast, delivering results in 15 minutes or less. Though not as accurate as PCR tests, experts say that their sensitivity is relatively high.

South Korea has been using these tests a lot as they can be carried out on a large scale in a short amount of time. Drosten predicts that they will probably be introduced in Germany as well and might eventually take over from PCR tests if they are available in larger numbers.

But whether test results take one or five hours, the main problem remains: If there is no analytical device on hand when a swab is taken, samples still have to be sent elsewhere for analysis, and this simply takes time.

PCRs, antigens and antibodies

Rapid tests that detect antibodies are even faster and simpler, but they are a very different category. They do not detect the virus itself as PCR tests do but analyze the body's reaction to infection. A person who is infected will develop antibodies after about 10 days.

The disadvantage of these tests is that they are of no use in the early infection phase. The advantage, says Drosten, is that they can answer the question of how many people were infected "without noticing that they had the disease or without taking it seriously because they just had a bit of a sore throat. But if these people test positive for antibodies, we can assume that they are now immune."

So they don't need to be quarantined unnecessarily and also contribute to herd immunity. They are the "60 to 70% of the population that will have to have been infected with the virus before the pandemic can come to a halt," according to Drosten.

The next big thing

He also says that it is important to have access to reliable data on this score so as to better predict how the virus might unfold. "These will be the next big pillar of information," says Drosten, aside from the daily announcements of infections and deaths. "But these antibody tests have only just been developed and there are only a few companies that can supply them in large quantities."

Accuracy is also a problem. The tests have to detect antibodies for SARS-CoV-2 without simply identifying antibodies for other harmless coronaviruses. "At the moment, these tests are still in the development and licensing phase and not yet available," said the Robert Koch Institute.

Testing, testing, testing

Drosten has predicted that these tests will be introduced across the board within two to three months. However, they will still be of no use for testing people in the early stages of infection.

Making money with tests

What is certain is that there is money to be earned with these tests. Anybody who offers for sale a self-testing kit that is as easy to use as pregnancy tests could make a fortune at the moment. There are already many test kits being sold online, many of them produced by Chinese companies. Christian Drosten warned in the NDR podcast that they should be seen "with caution," as not enough studies had been conducted to validate them.


If coronavirus tests were only as simple as pregnancy tests ...

This week, the South Korean firm Celltrion announced that it was developing an antibody-based self-testing diagnostics kit that would deliver results in 20 minutes. But it will not come out on the market until this summer.

Money can also be made with regular tests that take longer, however. The South Korean company SolGent received a license for a test kit in February that delivers results in two hours, which it is now selling all over the world.

Early this week, the company announced that it would sell 30,000 test kits to the Munich-based Synlab Group. According to the Korea Times, a million tests have been ordered by various US states, too.

---30---

OFW TFW

Coronavirus: Demand for Filipino nurses increases in Europe
Germany's alleged attempt to fly in Filipino nurses to provide assistance to COVID-19 patients has irked many in the Philippines. The country is facing a shortage of health workers as it tries to combat the disease.


The German news agency dpa reported last week that Berlin planned to bring in at least 75 Filipino nurses to Germany to assist in the country's fight against the novel coronavirus.

The "Hessische Krankenhausgesellschaft," an association of over 150 hospitals in the German state of Hesse, reportedly said they "received a special permit" to fly in the Filipino nurses.

The news sparked anger in the Philippines, which is struggling to cope with the COVID-19 cases, hampered by a weak public health system. The Southeast Asian country's Labor Secretary Silvestre Bello told DW that the move had been put on hold until further notice. "Our nurses are needed more at home," Bello said.


Filipino nurses are coveted by German health authorities

Expected spike in COVID-19 cases

The Philippines has recorded over 550 coronavirus cases so far, but health experts say the number could be much higher due to limited testing facilities in the country. The virus could spread exponentially in the country in the coming weeks, they warn.

According to the online news agency Rappler, the Philippines has only conducted about 12 COVID-19 tests for every million people, falling far behind regional neighbors like Malaysia — 422 people per million — and Vietnam — 159 people per million.

Philippine authorities are bracing for a spike in coronavirus cases following a scheduled increased testing after the country procured 100,000 testing kits last Saturday.

Underpaid and undervalued

Earlier this week, private hospitals in Manila announced they couldn't take in more coronavirus patients as they had reached full capacity.

Read more: Coronavirus: How Japan keeps COVID-19 under control

The Philippine Health Department has made an urgent call for nurses to sign up as volunteers to look after COVID-19 patients. Some experts are highly critical of the Health Ministry's move.

"Asking nurses to volunteer is uncalled for. It is an example of the neglect and exploitation our nurses face," Maristela Abenojar, president of the Filipino Nurses United (FNU) association, told DW.

The average salary for nurses in a government hospital is around $250 (€228) to $350 (€319) per month. In private hospitals, it ranges from $200 to $250 per month. Last year, the Supreme Court set the minimum monthly salary for nurses in public hospitals at $600 per month. "It has not been implemented," said Abenojar.

DW visited a public health center in Manila last month and found out that only two nurses were tending to around 100 patients in the hospital's general admissions ward.

"A nurse's shift can stretch from eight hours to 16, sometimes even more. Nurses' work is also not valued in the country," said Abenojar.

Greener pastures elsewhere


Many nurses in the Philippines are keen to escape their dire working conditions

Inadequate salaries and bad working conditions drive Filipino nurses to seek employment in other countries, including Europe, the Middle East and the US. In 2013, the Philippines and Germany signed an agreement that allows Filipino health workers to get an employment in Germany.

"You can't blame our nurses for leaving the county. The government needs to improve their working conditions and increase their salaries so that they can stay," said Abenojar.

Janina Santos graduated in nursing in 2009 but works as a researcher to support her family. "I can't afford to work as a nurse," she told DW.

Last week, the government approved a pay-out of $2,000 for health workers who may contract COVID-19 and $20,000 for the families of those who die from the disease.

"The government is finally recognizing the value of nurses, but what good is money when a nurse falls sick or dies?" Santos said.

---30---

Opinion: How many deaths can we afford?

Just two weeks into this crisis some are actually calculating how many deaths society can accept to salvage the economy. For DW's Henrik Böhme, this is unacceptable.


It's a question to which there is no answer — at least, to which I have no answer. But some people seem to think they know it. There's an unnerving debate going on about what we should consider more important: protecting the health of every single individual, or protecting the economy from a devastating crisis.

For decades, I have written about the economic impacts of crises of all kinds, including the 9/11 attacks or the collapse of Lehman Brothers. I even experienced the fall of an entire system — that of communist East Germany — in 1989. And now there's this virus, still invisible and unknown. It is this unfamiliarity that makes it so dangerous and also that makes us so anxious. So anxious that we accept lockdowns, restrictions to our freedom of movement and social-distancing measures. Economic and public life has ground almost to a halt, giving rise to images resembling those of an apocalypse. Rush hour no longer exists.

Read more: Coronavirus sledgehammers global job markets

Huge stimulus packages

We're beginning to juggle bigger numbers than during the global financial crisis. The US has passed a $2 trillion (€1.8 trillion) relief package, and the European Central Bank has launched a €750 billion Pandemic Emergency Purchase Program. Such packages are being announced all over the world.

So now the question many are asking is, of course: Who will pay for them? Is it going to be like after the financial crisis when all states were in debt up to their necks? With the consequence that they introduced austerity measures and slashed spending with a devastating effect on social welfare, health care systems, education and investments. Credible medical studies conducted in Britain show that many thousands of people additionally died of cancer between 2008 and 2010 because they did not receive adequate treatment, partly as a result of such austerity measures.



CORONAVIRUS: EUROPE ON LOCKDOWN

Paris on lockdown

Activity on the bustling streets of Paris came to a complete halt after France announced a nationwide lockdown last Tuesday. People are not allowed to leave their homes, unless it is for a sanctioned reason such as buying food, visiting a doctor or going to work. The mayor of Paris, however, has called for stricter confinement measures as the number of infections increases worldwide.

Hard words

Now, once again, we're talking about trade-offs. How many dead people can or do we want to afford? Or, to put it differently: How much is a human life worth to us? Are we even allowed to make such calculations, as private equity manager and former manager of Goldman Sachs' Germany operation, Alexander Dibelius, has been doing? Dibelius has publicly wondered whether it is right to protect the 10% of the population that is at particularly high risk from coronavirus while allowing the economy to be affected so badly that the fundamentals of our affluent societies could end up with permanent damage.

Is it possible to be any colder or more calculating? And this from a man who studied medicine and was a surgeon. What about the Hippocratic oath? What more is needed than the haunting and vivid pictures from Italy? Pictures of doctors who have to decide whom to treat and whom to let die. Pictures of a collapsing health system.

This is what this showdown is mostly about: preventing such collapse. For if hospitals in Germany or other countries go through what Italian hospitals have experienced, a lot of other people will die as well as coronavirus patients, such as those who have suffered heart attacks or strokes. These deaths may well be mere collateral damage for Dibelius, like the million deaths and more that Imperial College London has forecast for the US. I have a question for this medic-cum-banker: Have you read about the 20-year-old medical students in the French city of Mulhouse who had to pack the dead into body bags and transport them away?

Read more: Coronavirus: German doctors lay down life-or-death guidelines

Many affected

Of course, the fact that the economy has slowed down is a huge problem. It is a problem for local bars, which can barely keep themselves above water even in good times. It's a problem for freelance theater directors who won't have any performances for half a year. For people in event management, for caterers. The list is endless.

It's also a huge problem for big companies such as Lufthansa, because right now flying is not the best business model. Or for Volkswagen, which has stopped production even though it had planned to launch a new electric car with great fanfare in summer. But this, too, shows how big the crisis really is: Although VW and many other carmakers have shut their factories because their workers' health has priority, they have recently been producing only for the stockpile, because no one wants to buy cars at the moment.

Illegitimate calculation

Yes, the virus is eating away at our systems, at our society, restricting our freedoms, giving us the feeling we are no longer in control, shaking our belief in the fact that we have a solution for every problem and heralding another big recession.

Still, we are not allowed to make such calculations. We are not allowed to sort out human beings. We cannot lock older people away so that the economy grows again (and in any case, young people are also dying from the virus). Scientists are, of course, aware of their responsibility; they can see the social and economic damage the current measures are causing and will adjust them accordingly.

No, we have to weather this temporary and brief pause together. We have to look after the little flower of solidarity that has emerged in this crisis in the midst of what is an extremely egoistic society. Solidarity is the real weapon against the coronavirus.

The economy will find its feet again — I'm sure of that.

---30---

Don't forget climate threat, Earth Hour activists urge

Lights are off for Earth Hour around the globe as activists try to put climate disruption back on the agenda. Experts readying for the next UN summit in Glasgow admit mass travel by delegates will need a rethink.

Sydney's Opera House and Harbour Bridge darkened lights for an hour on Saturday, kicking off a global sequence that left Abu Dhabi's Grand Mosque, Berlin's Brandenburg Gate and the Eiffel Tower in Paris in the dark.

The initiative, started in 2007 by the environmental group WWF, asks firms, local authorities and people to douse lights briefly from 8:30 p.m. local time.

More than 100 landmarks were expected to take part in the event, with 360 cities set to participate in Germany. Locked down by the coronavirus pandemic in many locations, participants have instead shared photos and videos online. Artists also performed via social media.

All mass events have been canceled to slow the spread of the COVID-19 pandemic.

Read more: Will it soon be too late to save the climate?

Coronavirus leads to dramatic decrease in CO2 emissions

'Rethink our strategy'

"It's a time to really rethink our strategy," said Katie Eder of the youth alliance Future Coalition, which is helping to coordinate Earth Hour.

"We are really looking at this as a way to reimagine what a social movement can look like in a digital age," said Eder.

Glasgow, Scotland is due to host the United Nation's next climate summit in November, COP26, the 26th on tackling climate disruption blamed on fossil fuels.

Host Britain, itself facing a traumatic COVID-19 outbreak, said Friday it was keeping summit planning "under careful review" and was in frequent contact with the UN climate agency in Bonn and partners, including pandemic-hit Italy.

"Other means such as video and phone conferences" may become essential for pre-COP26 planning meetings, a British spokeswoman told Reuters. Talks are also planned for Bonn in early June on advancing the COP26 agenda.

Read more: Coronavirus and climate change: A tale of two crises

Reduce travel 'footprint'

Dhaka-based climate expert Saleemul Huq said it was time to consider new ways of organizing the international climate process, taking into account complex logistics and reducing the carbon footprint.

"We need to be thinking innovatively about making these kinds of global meetings more efficient in terms of outcomes and less dependent on thousands of people from all over the world flying into one city," said Huq.



CATASTROPHES TRIGGERED BY WARMING OCEANS
A California day at the South Pole

In Antarctica, scientists measured temperatures on par with Los Angeles. In February, a record 18.3 degrees Celsius (64.9 degrees Fahrenheit) was measured at the Argentinean research station Esperanza Base in the north Antarctic. This was the highest temperature since measurements began there, according to NASA. The warm weather led to quickly developing melt ponds (pictured right).

Too early to decide on Glasgow

But Nairobi-based climate expert Mohamed Adow said — while it was too early to decide on delaying the Glasgow summit — single-place summits involving many thousands were needed for the quick flow of decision-making.

Climate diplomacy was difficult when officials, for example, in Africa, lacked online access or had poor connection quality, said Anna Schulz of the London-based International Institute for Environment and Development.

Huq said the main task for COP26 would be to accelerate the unfinished work of phasing out fossil fuels and protecting people from climate impacts.

Read more: Corona stimulus plans overlook 'historic' chance for climate crisis

Pandemic shows action possible: Thunberg

Prominent Swedish youth activist Greta Thunberg, herself in isolation in Stockholm with a suspected case of COVID-19, said Tuesday the world's reactions to the pandemic showed that rapid action on climate change was possible.

"The coronavirus is a terrible event … there is no positive to come out of it," said Thunberg.

"But it also shows one thing: That once we are in a crisis, we can act to do something quickly, act fast," she said. "We can do it online and at home. We just need to be creative and find new ways."

In 2019, the youth climate strike movement that Thunberg inspired brought millions of citizens, young and old, onto streets around the world.

ipj/aw (Reuters, dpa, epd, AP)

• • 
    

  More frequent and stronger storms

  As oceans warm, the intensity of tropical cyclones will increase. The hurricane or typhoon season will last longer and there will be significantly more hurricanes, especially in the North Atlantic and the northeast Pacific. Extreme weather conditions will result in extremely destructive storms in the future, even in regions that have so far been spared.
• 
  

Grassroots 3D printing efforts help produce medical safety gear


Budmen Industries, a company that makes 3D printers in Syracuse, N.Y., has converted to making face shields for medical staff. Photo courtesy of Budmen Industries

March 26 (UPI) -- Community efforts to make medical protective equipment on 3D printers have sprung up around the United States in the last week to respond to urgent shortages caused by the coronavirus.

As major manufacturers -- such as Ford Motors, 3M and General Electric -- announce projects to produce safety equipment, schools, dentists and 3D printing shops from Montana to New York have launched their own efforts using high-tech printers.

Many hospitals have asked their staffs to reuse protective equipment, such as masks, gowns, gloves and face shields, and physicians report that existing supplies could run out in many places in days, according to the American Medical Association.

"Just about every night, I'm on the phone with a couple of doctors I've been in contact with to see what we can do," said Isaac Budmen, owner of a small company that makes 3D printers, Budmen Industries, in Syracuse, N.Y.

Budmen raised $10,000 on the GoFundMe website in a week and has printed the headbands and frames for more than 600 face shields since then.

He bought plastic sheets for the shield portion and estimates each face shield is now costing about $5 apiece. The community embraced the project, with the Greater Syracuse Soundstage, a film studio, now allowing limited crews of four at a time to assemble the shields.

In many cases, entrepreneurs like Budmen have created their own designs for items they are printing, but medical supply companies have released designs for some parts.


The Department of Defense's additive manufacturing initiative, America Makes, launched a new effort Wednesday to provide designs and to connect medical institutions with 3D printers.

Printing masks has proven more difficult for the industry, according to neurosurgeon Marlin Richardson at the Billings Clinic in Montana.

He and a local dentist, Spencer Zaugg, decided to design their own mask that uses pieces of existing surgical masks as the air filter. That way, local supplies of masks can be extended.

RELATED Face masks shake up Korean cosmetics industry

"A notice had gone up at the hospital that we had limited supplies and were going to using one mask per day. That's very unusual. We usually change masks for every patient," Richardson said.

Padding and straps for the masks are needed, and Richardson said the community has responded by sewing and making those.

He and Zaugg are working on a better design for a higher-quality respirator mask.

The Billings Clinic is now seeking out every 3D printer in the community, including all of them at Billings public schools, Rocky Mountain College and Montana State University-Billings. A Billings area company that makes industrial filters, Flowmark/HighTech, plans to provide 20,000 pieces of filter material for the project.

Other 3D printing companies that are making equipment include Voodoo Manufacturing in Brooklyn, N.Y., which says it has converted 200 3D printers to make protective equipment and replacement parts for ventilators.

"To minimize the risk of infection, we have divided our production team into sub-teams, which work separately and use good sanitation practices," Voodoo said in a statement.

Markforged, based near Boston, has printed face shields and swabs for test kits and sent them to hospitals where they are being tested, founder Greg Mark said.

"What we've found is that 20 printers can print 14,000 swabs a day," Mark said. "We have assembled a task force within Markforged to identify the biggest impact initiatives our technology can solve."

Kosovo PM becomes 1st world leader ousted over coronavirus response

Kosovo Prime Minister Albin Kurti, pictured here at his inauguration on February 3, was ousted by a no-confidence vote. File Photo by Valdrin Xhemaj/EPA-EFE

March 26 (UPI) -- Kosovo Prime Minister Albin Kurti has become the first world leader ousted for their response to the coronavirus outbreak.

Lawmakers in Pristina voted Kurti out of office Wednesday stemming from disagreements with his handling of the crisis. He assumed office on February 3.

Parliament ousted Kurti, leader of the left-wing Vetevendosje Party, on a vote called by the center-right LDK, a minority portion of the governing coalition that also took power just last month.

The move leaves Kosovo without stable leadership after an emergency curfew was imposed by Kurti Monday to help stem the outbreak. The former Serbian province had reported 71 COVID-19 cases as of Wednesday, according to Johns Hopkins University.

The restrictions ordered by Kurti limit public and private gatherings and prohibit the movement of private vehicles and citizens throughout much of the day and overnight.

Kurti's political rival, President Hashim Thaci, denounced the measures as unconstitutional and said only an emergency declaration could justify them. Under such emergencies, the largely ceremonial presidency is granted special powers.

The dispute led the LDK to file a no-confidence motion, which passed with 82 votes Wednesday in the 120-seat assembly.

Kurti, however, said he will remain in a caretaker capacity until new elections are held.