Saturday, March 28, 2020

Power, equality, nationalism: how the pandemic will reshape the world

Covid-19 has intensified the rivalry between the US and China – but it has also strengthened international co-operation. Will nations be more united or divided, more – or less – free?


Simon Tisdall Sat 28 Mar 2020 21.58 GMT
 
US President Donald Trump and China’s President Xi Jinping: 
trade has been a major focus for both men till now, but Covid-19
 is likely to change this dramatically. 
Photograph: Nicolas Asfouri/AFP/Getty


The global impact of the coronavirus pandemic poses a fundamental question: is this one of those historic moments when the world changes permanently, when the balance of political and economic power shifts decisively, and when, for most people, in most countries, life is never quite the same again?

Put more simply, is this the end of the world as we know it? And, equally, could the crisis mark a new beginning?

Genuinely pivotal global moments, watersheds or turning points (pick your own terminology) are actually quite rare. Yet if the premise is correct – that there can be no return to the pre-Covid-19 era – then it poses many unsettling questions about the nature of the change, and whether it will be for better or worse.

For countless individuals and families, normal life has already been upended in previously unimaginable ways. But how will the pandemic influence the future behaviour of nation states, governments and leaders – and their often dysfunctional relationships? Will they work together more closely, or will this shared trauma further divide them?

Some analysts see grounds for optimism, for example in beneficial environmental effects in northern Italy and China. Countries hitherto at odds, such as Iran and the UAE, are cooperating, at least temporarily. In the Philippines, the crisis prompted a ceasefire with Communist rebels. Global interdependence and the importance of collective, multilateral approaches have been vividly underscored.

But there is also a more pessimistic view, typified by Stephen Walt, professor of international relations at Harvard University. “The pandemic will strengthen the state and reinforce nationalism. Governments of all types will adopt emergency measures to manage the crisis, and many will be loath to relinquish these new powers when the crisis is over,” he wrote in Foreign Policy magazine.

Walt continued: “Covid-19 will also accelerate the shift in power and influence from west to east. The response in Europe and America has been slow and haphazard by comparison [with China, South Korea and Singapore], further tarnishing the aura of the western ‘brand’… We will see a further retreat from hyper-globalisation, as citizens look to national governments to protect them and as states and firms seek to reduce future vulnerabilities.

“In short, Covid-19 will create a world that is less open, less prosperous and less free.”

Is Walt right? The cop-out answer is only time will tell. Yet the outcome is not preordained. The responses of everybody, from presidents and prime ministers to ordinary citizens, to the myriad challenges and upheavals arising from the pandemic will help determine what happens next.

It’s a chance to reset both global and personal landscapes. Notwithstanding present feelings of powerlessness, there are choices to be made about what kind of future awaits. After Covid-19, everything could be up for grabs.
Balance of power

After early blunders, China’s government is working hard to turn Covid-19, first detected in Wuhan in November, into a national success story. It claims draconian measures to suppress the disease have largely worked. Now, by offering assistance to Italy and other badly affected countries, China is reinforcing its credentials as a global leader. The virus has become a soft power tool to overtake its superpower rival, the US.

If the US remains absent without leave, China may take the crisis as an opportunity to start setting new rulesMira Rapp-Hooper, US Council on Foreign Relations

“A critical part of this narrative is Beijing’s supposed success in battling the virus. A steady stream of propaganda articles, tweets and public messaging, in a wide variety of languages, touts China’s achievements and highlights the effectiveness of its model of domestic governance,” wrote commentators Kurt Campbell and Rush Doshi in Foreign Affairs magazine.

In contrast, Donald Trump is struggling to dispel a widespread perception of gross incompetence. “The US government’s pandemic leadership has been its own special brand of catastrophe…. [It] has placed its own citizens in unnecessary peril, while sidelining itself from acting as a global crisis leader,” wrote Mira Rapp-Hooper of the US Council on Foreign Relations.

“This domestic and international governance crisis could change the nature of the international order in several ways …. If the US remains absent without leave, China may take the crisis as an opportunity to start setting new rules according to its own global governance vision,” she continued.

Authoritarianism and democracy

China’s challenge to US hegemony was already strengthening on many fronts before the Covid-19 crisis erupted. The pandemic may accelerate this shift. For US-allied democracies that value open governance, civil rights and free speech, this is a worrying prospect.

The trend towards centralised, authoritarian rule evident in countries such as India, Brazil and Turkey, and typified by China and Russia, has coincided with the rise of rightwing nationalist-populist governments and parties in Europe. Some are now following China’s lead in attempting to weaponise the virus for political ends.

“The pandemic unquestionably presents an era-defining challenge to public health and the global economy [but] its political consequences are less well-understood,” the independent monitor, International Crisis Group, warned last week. “Unscrupulous leaders may exploit the pandemic to advance their objectives in ways that exacerbate domestic or international crises – cracking down on dissent at home or escalating conflicts with rival states – on the assumption that they will get away with it while the world is otherwise occupied,” the ICG said. 

Hungary’s prime minister, Viktor Orbán, may be tempted
 to use the pandemic to keep his country in a state of 
emergency. Photograph: Isopix/REX/Shutterstock

One example cited by the report was Vladimir Putin’s recent attempt to indefinitely extend his presidency in Russia (although the virus has since forced him to postpone a vote that could have allowed him to stay in power until 2036). Another was a bid by Viktor Orbán, Hungary’s nationalist leader, to renew a state of emergency “that prescribes five-year prison sentences for those disseminating false information or obstructing the state’s crisis response.”

Governments such as Egypt’s have followed China’s example in expelling foreign journalists, restricting media access and curtailing public discussion. Like Boris Johnson and many European leaders, Trump has also assumed emergency powers. From Bolivia, India, Sri Lanka and Iraq to the US, UK and France, elections have been postponed, parliaments suspended, and lockdowns and curfews imposed.

Most people may support such measures in the short term. But what if the crisis is protracted, with a “second wave” running into next year? And what if the new controls are not relaxed or withdrawn after it ends? This is what Harvard’s Stephen Walt meant about the danger of “less free” post-pandemic societies.
Globalisation and multilateralism

Unprecedented government aid packages for businesses and workers, intended to mitigate the disease’s economic and financial impact, have led some analysts to suggest “the state is back” – and that the limits of the postwar neoliberal, free market model have finally been reached.

What the crisis has shown, it is argued, is that when the challenge is truly existential, only the state can offer holistic and equitable solutions. A natural corollary is that the high-water mark of globalisation has arrived. These are radical paradigm shifts. Will they endure?

“The pandemic could be the straw that breaks the camel’s back of economic globalisation,” wrote Robin Niblett, director of the Chatham House thinktank. The architecture of global economic governance established in the 20th century was at risk, he warned, raising the prospect that political leaders may “retreat into overt geopolitical competition”.

For Robert Kaplan of the Eurasia Group, “coronavirus is the historical marker between the first phase of globalisation and the second …. Globalisation 2.0 is about separating the globe into great-power blocs with their own burgeoning militaries and separate supply chains, about the rise of autocracies, and about social and class divides that have engendered nativism and populism …. In sum, it is a story about new and re-emerging global divisions.”

The pandemic is a powerful reminder of two things: the shared challenges of our global village, and the deep inequalities we must grapple with to fight themDavid Miliband, International Rescue Committee

If that’s true, few will mourn the passing of the globalisation era. And support for Kaplan’s theory may be found in increased post-pandemic protectionism if, as some predict, countries attempt to limit future exposure to global threats. The UN warned last week of worldwide food shortages caused by lack of workers, tougher immigration controls, sanctions and tariffs – and called for a new, more open approach.

The weakening of multilateral forums and institutions, evident before the crisis, is another sign of a shrinking world. Trying to revive their collective clout, the wealthy G20 countries belatedly pledged last week to do “whatever it takes” to fight the virus. But it remains largely unclear what that entails in practice, and who will take the lead.
Fragile world

The pandemic and its aftermath could be a game-changer for poorer countries with limited resources and means of recovery, and for refugees and people in conflict zones – but probably not in a good way.

The ICG report is blunt: “The global outbreak has the potential to wreak havoc in fragile states [and] trigger widespread unrest …. If the disease spreads in densely packed urban centres, it may be virtually impossible to control.” This is precisely the fear stalking South Africa’s townships right now.

The report said the dramatic global economic slowdown would disrupt trade flows and create unemployment in commodity-exporting poorer countries. “Its implications are especially serious for those caught in the midst of conflict if, as seems likely, the disease disrupts humanitarian aid flows, limits peace operations, and postpones diplomacy.”
Displaced Syrians wait for hot meal in Idlib,
 Syria, last month. The pandemic and global 
economic slowdown will make life in conflict
 zones even harder. Photograph: Burak Kara/Getty

War-afflicted Syrians, Afghans, Somalis, South Sudanese and Yemenis could be especially badly affected. That’s why the UN last week launched an appeal for $2bn in humanitarian aid. Its secretary-general, António Guterres, wants trillions more in global financial stimulus to prevent “millions” of deaths. “Covid-19 is threatening the whole of humanity and the whole of humanity must fight back,” he said.

“The pandemic is a powerful reminder of two things: the shared challenges of our global village, and the deep inequalities we must grapple with to fight them,” said David Miliband, who heads the International Rescue Committee. “Coronavirus is not just a problem for rich countries. We are only as strong as our weakest health system.”

Whether the international community heeds this and similar calls will be a key test.
Resilience and paranoia

The crisis has exposed an endemic lack of resilience, symbolised by chronically under-resourced healthcare systems in even better-off countries. The decision of many governments to call in the armed forces to help with logistics and manpower partly reflects fears that weakening social cohesion may lead to disorder on the streets.

“If governments have to resort to using paramilitary or military forces to quell, for example, riots or attacks on property, societies could begin to disintegrate. Thus the main, perhaps even the sole objective of economic policy today [rather than supporting financial markets] should be to prevent social breakdown,” wrote Branko Milanović, a professor at the London School of Economics.

Yet, looked at differently, this kind of national mobilisation can be seen as a positive development rather than a threat to civil liberties – and as a more beneficial use of military power. In Britain as elsewhere, the call to arms has created new legions of NHS volunteers. This renewed sense of national sharing and identity is a much-needed antidote to the regressive nationalism of recent years.

“Looking ahead, governments will have to decide whether to support more cooperative approaches to handling the crisis, not only in global public health terms but also as a political and security challenge,” the ICG said. “All leaders face pressure to focus on domestic priorities, and in particular to ignore conflict risks in weak states …. But there will be a day after.”

It's possible that, over the longer term, democracies will come out of their shells to find a new type of pragmatic internationalismJohn Ikenberry, Princeton University

While there is concern the pandemic could deepen divisions between countries and, for example, exacerbate anti-migrant sentiment, there is a fighting chance it will boost international cooperation, support for the UN, and a willingness to pursue dialogue rather than military and economic confrontation. The future need not be a globally debilitating US-China fight for supremacy.

Elisabeth Braw of the Royal United Services Institute warns of a moment of extreme geopolitical vulnerability. “The coronavirus is a perfect opportunity for the west’s adversaries to watch how countries cope – or don’t cope – with a major crisis,” she wrote. But John Ikenberry, professor of international affairs at Princeton University, is less fearful, pointing to the US-led recovery after the 1930s Depression.

Intensifying great power rivalry in a fractured, damaged, poorer world might indeed be the future that awaits, Ikenberry suggested. But it was equally possible that, “over the longer term, the democracies will come out of their shells to find a new type of pragmatic and protective internationalism”.

In other words, after the nightmare, a fresh start.
Five events that changed the modern world

Never again: Blood Swept Lands and Seas of Red, 
the ceramic poppies at the Tower of London that marked
 the centenary of the outbreak of the first world war.
 Photograph: Alamy


The Versailles peace conference
The 1919-20 conference that followed the first world war was a historic turning point. It marked the formal demise of the German, Russian and Austro-Hungarian empires, the advance of democratic, representative governance in Europe, and the start of what came to be known as the American or transatlantic century.

The Great Depression
The Great Depression, the biggest worldwide economic calamity of the 20th century, began in the US in 1929 after the Wall Street crash. In the ensuing three years, global GDP fell by about 15% (compared with under 1% in the 2008-09 Great Recession). Things did not really pick up again until the second world war – a drastic remedy.

The battle of Stalingrad
Fought on the banks of the Volga in southern Russia in 1942-43, the close to seven-month battle, the biggest in history, proved to be a pivotal moment in the second world war in Europe. For the first time, Hitler’s armies were halted and beaten, and the myth of German invincibility destroyed. About 2 million combatants died.

The fall of the Berlin Wall

The peaceful fall in 1989 of the Berlin Wall, the actual and symbolic dividing line between the Soviet bloc and the west, in effect ended the 44-year-long cold war. The ensuing implosion of the Soviet Union triggered the collapse of Russian-backed regimes around the world, leading the US to proclaim itself the sole global superpower.

The 9/11 attacks
The attacks launched by al-Qaida on New York and Washington DC in September 2001 punctured American illusions of invulnerability and prompted George W Bush to declare a “global war on terror”. This led directly to the US invasions of Afghanistan and Iraq, and the ensuing expansion of anti-western jihadism typified by Islamic State.


Is factory farming to blame for coronavirus?
The Observer
Coronavirus outbreak

Scientists are tracing the path of Sars-CoV-2 from a wild animal host – but we need to look at the part played in the outbreak by industrial food production

Laura Spinney Sat 28 Mar 2020 
 
A Chinese poultry farm. China stepped up
 surveillance after bird flu outbreaks. 
Photograph: China Photos/Getty Images


Where did the virus causing the current pandemic come from? How did it get to a food market in Wuhan, China, from where it is thought to have spilled over into humans? The answers to these questions are gradually being pieced together, and the story they tell makes for uncomfortable reading.

Let’s start at the beginning. As of 17 March, we know that the Sars-CoV-2 virus (a member of the coronavirus family that causes the respiratory illness Covid-19) is the product of natural evolution. A study of its genetic sequence, conducted by infectious disease expert Kristian G Andersen of the Scripps Research Institute in La Jolla, California, and colleagues, rules out the possibility that it could have been manufactured in a lab or otherwise engineered. Puff go the conspiracy theories.

The next step is a little less certain, but it seems likely that the original animal reservoir for the virus was bats. Andersen’s team showed – like the Chinese before them –that the sequence of Sars-CoV-2 is similar to other coronaviruses that infect bats.

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Since other bat coronaviruses have transited to humans via an intermediate animal host, it seems likely that this one did too. That animal was probably one that some Chinese people like to eat, and that is therefore sold in “wet” markets (those that sell fresh meat, fish, seafood and other produce). This animal may have been the scaly mammal called a pangolin. That can’t be conclusively proved, but several groups have found sequence similarities between Sars-CoV-2 and other coronaviruses that infect pangolins.

If this is indeed the route the virus took to humans, it has two critical interfaces: one between us and the intermediate host, possibly a pangolin, and one between that host and bats. Most of the attention so far has been focused on the interface between humans and the intermediate host, with fingers of blame being pointed at Chinese wet markets and eating habits, but both interfaces were required for the pandemic to ignite. So where and how did the spillover from the bat to the pangolin – or other wild or semi-wild intermediate host – occur?

“Our study does not directly shed light on the geographical origin of the virus,” says Andersen. “However, all the available evidence shows that it was inside China.”

Case closed then, and President Trump is right to call Sars-CoV-2 the “Chinese virus”. Well, no, because if you want to understand why this pandemic happened now and not, say, 20 years ago – since Chinese people’s taste for what we in the west consider exotic fare is not new – you have to include a number of other factors. “We can blame the object – the virus, the cultural practice – but causality extends out into the relationships between people and ecology,” says evolutionary biologist Rob Wallace of the Agroecology and Rural Economics Research Corps in St Paul, Minnesota.

The closed Huanan Seafood Wholesale Market
 in Wuhan, in China’s Hubei Province, in January.
 Photograph: Noel Celis/AFP via Getty Images


Starting in the 1990s, as part of its economic transformation, China ramped up its food production systems to industrial scale. One side effect of this, as anthropologists Lyle Fearnley and Christos Lynteris have documented, was that smallholding farmers were undercut and pushed out of the livestock industry. Searching for a new way to earn a living, some of them turned to farming “wild” species that had previously been eaten for subsistence only. Wild food was formalised as a sector, and was increasingly branded as a luxury product. But the smallholders weren’t only pushed out economically. As industrial farming concerns took up more and more land, these small-scale farmers were pushed out geographically too – closer to uncultivable zones. Closer to the edge of the forest, that is, where bats and the viruses that infect them lurk. The density and frequency of contacts at that first interface increased, and hence, so did the risk of a spillover.

It’s true, in other words, that an expanding human population pushing into previously undisturbed ecosystems has contributed to the increasing number of zoonoses – human infections of animal origin – in recent decades. That has been documented for Ebola and HIV, for example. But behind that shift has been another, in the way food is produced. Modern models of agribusiness are contributing to the emergence of zoonoses.


Take flu, a disease that is considered to have high pandemic potential, having caused an estimated 15 pandemics in the past 500 years. “There is clearly a link between the emergence of highly pathogenic avian influenza viruses and intensified poultry production systems,” says spatial epidemiologist Marius Gilbert of the Université Libre de Bruxelles in Belgium.

A pangolin, the scaly mammal thought to be
 a possible intermediate host for the coronavirus.

The reasons, many of which were documented in Wallace’s 2016 book Big Farms Make Big Flu, include the density with which chickens, turkeys or other poultry are packed into factory farms, and the fact that the birds in a given farm tend to be near genetic clones of one another – having been selected over decades for desirable traits such as lean meat. If a virus gets introduced into such a flock, it can race through it without meeting any resistance in the form of genetic variants that prevent its spread. Both experimental manipulations and observations in the real world have demonstrated that this process can result in a ratcheting up of the virus’s virulence. If it then spills over into humans, we are potentially in trouble.

In a paper published in 2018, Gilbert’s group reviewed historical “conversion events”, as they call them – when a not-very-pathogenic avian flu strain became much more dangerous, and found that most of them had occurred in commercial poultry systems, and more frequently in wealthy countries. Europe, Australia and the US had generated more of them than China.

That doesn’t let China off the hook. Two highly pathogenic forms of avian flu – H5N1 and H7N9 – have emerged in that country in recent decades. Both infect humans, though not easily (yet). The first human cases of H7N9 were reported in 2013, and there were small annual outbreaks thereafter. But, says Gilbert, “nothing was done until the virus turned out to be pathogenic for chickens as well. Then it became an important economic issue and China started to mass-vaccinate its poultry against H7N9, and that ended the transmission to humans.”

A banner reading ‘We are all pangolins’ hangs 
on a balcony in Bordeaux, France. The entire 
country has been on coronavirus lockdown 
since 16 March. 
Photograph: Nicolas Tucat/AFP via Getty Images

China is one of the world’s major exporters of poultry, but its poultry industry is not wholly Chinese-owned. After the recession of 2008, for example, New York-based investment bank Goldman Sachs diversified its holdings and moved into Chinese poultry farms. So if China has its share of responsibility for spillover events, it isn’t alone. That is why Wallace insists on talking about relational geographies rather than absolute geographies, when it comes to identifying the causes of disease. Or as he puts it: “Follow the money.”

Not everybody sees a straightforward link between factory farming and new and dangerous forms of flu. Michael Worobey, an evolutionary biologist at the University of Arizona, points out that before they were brought into factory farms, poultry were kept outside. The factory model may ramp up virulence, he says, but it probably protects a flock from being infected by a virus in the first place.

Still, Worobey doesn’t doubt that farming and other human-animal interactions have shaped our disease ecology. His group collects the sequences of flu viruses from a range of animal hosts, including humans, and plots them on a family treeto try to understand how flu has evolved over time. Flu is constantly mutating – that’s the reason the seasonal flu vaccine has to be updated each year – but it mutates at different rates in different hosts, which means that his flu family tree is informative both about the parentage and intermediate host of each strain and about the approximate timing of past spillover events.

It’s possible – though by no means certain – that flu first became a disease of humans after the Chinese domesticated ducks about 4,000 years ago – drawing that animal reservoir into human communities for the first time. But humans can also catch flu from, and give flu to, pigs – another animal we have lived alongside for millennia. A few years ago, Worobey suggested – controversially – that birds might not always have been the main intermediate host for human flu viruses. Until about a century ago, he reported, people may have caught flu from horses. Around the time that motor vehicles supplanted horses as transport, poultry farming was expanding in the western hemisphere, and it’s possible, Worobey argued, that birds then took over as the main intermediate host of flu for humans.

Not everyone buys that scenario. Wendy Barclay, a virologist at Imperial College London, says that if horses were once the main intermediate host for flu, “most avian viruses would contain the mammalian adaptation”, and they don’t. David Morens of the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, thinks that it is more likely that the horse was a temporary detour, and that the main intermediate host of flu for humans has always been birds – especially wild ones. But all agree that humans have shaped these host-pathogen relationships, through our use of land and other animal species. And as Worobey points out, the sheer size of the human population today means that in the 21st century, we are doing so on an unprecedented scale. He estimates, for example, that domesticated ducks probably outnumber wild ones by now.

Traders selling bat meat at a market in Tomohon 
City, Indonesia. 
Photograph: Ronny Adolof Buol/Sijori 
Images via Zuma Wire/Rex/Shutterstock


And we’re not just talking about birds. Gilbert believes a ratcheting up of viral virulence is happening in pig herds, too. Porcine reproductive and respiratory syndrome (PRRS), a disease of pigs that was first described in the US in the late 1980s, has since spread to herds across the worldand strains detected recently in China are more virulent than the early American ones. A 2015 study carried out by Martha Nelson of the US National Institutes of Health and colleagues mapped the genetic sequences of swine flu viruses and found that Europe and the US – the largest global exporters of pigs – are also the largest exporters of swine flu.

There have been claims on social media, sometimes posted by vegans, that if we ate less meat there would have been no Covid-19. Interestingly, some of these have been blocked by mainstream news organisations as “partly false”. But the claims are also partly true. Though the links they draw are too simplistic, the evidence is now strong that the way meat is produced – and not just in China – contributed to Covid-19.

It is clear that to prevent or at least slow the emergence of new zoonoses, as Fearnley and Lynteris have argued, China’s wet markets will need to be better regulated. But we also need to look behind those markets, at how our food is produced globally.

Though it may not feel like it now, Wallace says, we have been lucky with Sars-CoV-2. It appears to be far less lethal that either H7N9 – which kills around a third of those it infects – or H5N1, which kills even more. This gives us an opportunity, he says, to question our lifestyle choices – because chicken isn’t cheap if it costs a million lives – and vote for politicians who hold agribusiness to higher standards of ecological, social and epidemiological sustainability. “Hopefully,” he says, “this will change our notions about agricultural production, land use and conservation.”
Wild animals reclaim cities deserted by coronavirus
26/03/2020

IN THE PAPERS © FRANCE 24

By:Dheepthika LAURENT

IN THE PAPERS - Thursday, March 26: We take a look at wild animals reclaiming deserted cities and anger in the Spanish press as the death toll from coronavirus rises.

There's anger in the Spanish papers as the death toll from coronavirus surpasses that of China with over 3,400 mortalities. After 738 deaths were recorded on Wednesday, the Spanish daily ABC says the government knew about the risk of the virus in late February but continued to allow public events. Now, it says, they must be held responsible for their "mistakes and abuses".

The US Senate, meanwhile, approved an historic $2 trillion stimulus package to help struggling businesses impacted by coronavirus. But not everyone's approving. One columnist for the Washington Post is pretty critical of the move, calling it a make-believe world to think the government can help everyone and saying it marks the US’s move from free market capitalism to democratic socialism.


Finally, French daily Libération looks at how wild animals have reclaimed deserted cities. A puma was spotted roaming in the Chilean capital of Santiago recently. In Italy and Spain, wild boars have returned; on the Italian island of Sardinia, dolphins have come back in the absence of ferries and in the empty French ski resort of Courchevel, a wolf was recently spotted. Proof that humans' misfortune is an opportunity for animals!

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.”

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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.


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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.

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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.

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