Geneva, Jun 29 (Canadian-Media): Following are the opening remarks of WHO Director-General, Tedros Adhanom Ghebreyesus's opening remarks at the media briefing on COVID-19.
Tedros Adhanom Ghebreyesus. Image credit: who.int
Tomorrow marks six months since WHO received the first reports of a cluster of cases of pneumonia of unknown cause in China.
The six-month anniversary of the outbreak coincides with reaching 10 million cases and 500,000 deaths.
This is a moment for all of us to reflect on the progress we have made and the lessons we have learned, and to recommit ourselves to doing everything we can to save lives.
Six months ago, none of us could have imagined how our world – and our lives – would be thrown into turmoil by this new virus.
The pandemic has brought out the best and the worst of humanity.
All over the world we have seen heartwarming acts of resilience, inventiveness, solidarity and kindness.
But we have also seen concerning signs of stigma, misinformation and the politicization of the pandemic.
For the past six months, WHO and our partners have worked relentlessly to support all countries to prepare for and respond to this new virus.
Today, we are publishing an updated and detailed timeline of WHO’s response to the pandemic on our website, so the public can have a look at what happened in the past six months in relation to the response.
It illustrates the range of WHO’s work to stop transmission and save lives.
We have worked with researchers, clinicians and other experts to bring together the evolving science and distil it into guidance.
Millions of health workers have enrolled in courses through our OpenWHO.org online learning platform.
We launched the Solidarity Trial, to find answers fast to which drugs are the most effective.
We launched Solidarity Flights, to ship millions of test kits and tons of personal protective equipment to many countries.
We launched the Solidarity Response Fund, which has raised more than US$223 million for the response.
Three major innovative solidarity activities.
And we have worked with the European Commission and multiple partners to launch the ACT Accelerator, to ensure that once a vaccine is available, it’s available to everyone – especially those who are at greatest risk.
On Friday we launched the ACT Accelerator Investment Case, which estimates that more than US$31 billion will be needed to accelerate the development, equitable allocation and delivery of vaccines, diagnostics and therapeutics by the end of next year.
Over the weekend, WHO was proud to partner in the “Global Goal: Unite for Our Future” pledging conference, organized by the European Commission and Global Citizen.
The event mobilized new resources to respond to the COVID-19 pandemic globally, including in support of the ACT Accelerator.
Although a vaccine will be an important long-term tool for controlling COVID-19, there are five priorities that every single country must focus on now, to save lives now.
First, empower communities.
Every individual must understand that they are not helpless – there are things everyone should do to protect themselves and others. Your health is in your hands.
That includes physical distancing, hand hygiene, covering coughs, staying home if you feel sick, wearing masks when appropriate, and only sharing information from reliable sources.
You may be in a low-risk category, but the choices you make could be the difference between life and death for someone else.
Second, suppress transmission. Whether countries have no cases, clusters of cases or community transmission, there are steps all countries can take to suppress the spread of the virus.
Ensure that health workers have access to training and personal protective equipment.
Improve surveillance to find cases.
The single-most important intervention for breaking chains of transmission is not necessarily high-tech and can be carried out by a broad range of professionals. It’s tracing and quarantining contacts.
Many countries actually have used non-health professionals to do contact tracing.
Third, save lives.
Early identification and clinical care saves lives.
Providing oxygen and dexamethasone to people with severe and critical disease saves lives.
And paying special attention to high-risk groups, including elderly people in long-term care facilities, saves lives.
Japan has done this: it has one of the highest populations of elderly people, but its death rate is low, and the reason is what we just said – many countries can do that, they can save lives.
Fourth, accelerate research.
We’ve already learned a lot about this virus, but there’s still a lot we don’t know – and there are still tools we need.
This week we will convene a second meeting to assess progress on research and development and re-evaluate research priorities for the next stage of the pandemic.
And fifth, political leadership.
As we have said repeatedly, national unity and global solidarity are essential to implementing a comprehensive strategy to suppress transmission, save lives and minimize the social and economic impact of the virus.
No matter what stage a country is at, these five priorities – if acted on consistently and coherently – can turn the tide.
WHO will continue to do everything in our power to serve countries with science, solidarity and solutions.
The critical question that all countries will face in the coming months is how to live with this virus. That is the new normal.
Many countries have implemented unprecedented measures to suppress transmission and save lives.
These measures have been successful in slowing the spread of the virus. But they have not completely stopped it.
Some countries are now experiencing a resurgence of cases as they start to re-open their economies and societies.
Most people remain susceptible. The virus still has a lot of room to move.
We all want this to be over. We all want to get on with our lives.
But the hard reality is: this is not even close to being over.
Although many countries have made some progress, globally the pandemic is actually speeding up.
We’re all in this together, and we’re all in this for the long haul.
We will need even greater stores of resilience, patience, humility and generosity in the months ahead.
We have already lost so much – but we cannot lose hope.
This is a time for renewing our commitment to empowering communities, suppressing transmission, saving lives, accelerating research and political and moral leadership.
But it’s also a time for all countries to renew their commitment to universal health coverage as the cornerstone of social and economic development – and to building the safer, fairer, greener, more inclusive world we all want.
#UN; #IAEA; #Mosquito; #UNHealth
Geneva, Jun 28 (Canadian-Media): The UN nuclear agency (IAEA) has announced a major breakthrough in the bid to scale up technology designed to suppress disease-carrying mosquitos, and bring dengue, yellow fever and Zika under control, UN reports said.
The aedes aegypti mosquito transmits zika, in addition to dengue and chikungunya. Image credit: IAEA
A study has shown that the use of a specialized drone, developed by IAEA and partners, to release tens of thousands of male mosquitoes, sterilized by using radiation, is effective: many of the sterilized males mate with females, who then produce no offspring, reducing the mosquito population over time.
The drones are cheaper than manual ground releases, and cover a much wider area, leading to hopes of a reduction in mosquito-borne diseases almost anywhere: a smaller, lighter version of the drone designed to meet stringent regulations for flights over urban areas, is also being developed.
Find out more by reading the full story here.
#UN; #WHO; #CovidMedicinesForAll
Geneva, Jun 26 (Canadian-Media): More than $31 billion is needed over the next 12 months to develop medicines that will be effective against COVID-19, and make them available to all people, the World Health Organization (WHO) and partners said on Friday.
As part of the information campaign on COVID-19, the commander of the Bangladeshi medical contingent at the UN peacekeeping mission in the Central African Republic, encourages local contractors to wear protection masks. Image credit: MINUSCA
Ahead of a major pledging summit, they updated journalists on a recently announced initiative to speed up production of these treatments, known as the Access to COVID-19 Tools (ACT) Accelerator.
“It’s clear that to bring COVID-19 under control, and to save lives, we need effective vaccines, diagnostics and therapeutics – in unprecedented quantities and at unprecedented speed”, said WHO chief Tedros Adhanom.
Access for all
The ACT-Accelerator was launched at the end of April, bringing together governments, health organizations, scientists, businesses, civil society and philanthropists.
Members work across four pillars: diagnostics, therapeutics, vaccines, and what they call “the health system connector”.
They have outlined a plan that sees low- and middle-income countries receiving 500 million diagnostic tests, 245 million courses of treatments, and two billion vaccine doses, before the end of next year.
Race for a vaccine
WHO this week warned that the global COVID-19 caseload was approaching 10 million. So far, more than 484,000 people have died from the disease.
A safe and effective vaccine is the only way to prevent further spread and transmission of the new coronavirus, according to Dr. Soumya Swaminathan, Chief Scientist at WHO.
Although it normally takes up to 10 years to develop and manufacture a vaccine, the partners are looking to significantly shorten that timeline.
“We’re aiming for 12, maximum of 18 months. And that would be unprecedented”, said Dr. Swaminathan.
“The good news is we have over 200 candidates at some stage of clinical development; about 15 of them are actually now in human clinical trials.”
WHO and partners will need $31.3 billion to achieve their goals. So far, $3.4 billion has been received.
“This is an investment worth making, more than any other we can think of”, said Dr. Ngozi Okonjo-Iweala, one of the two Special Envoys for the ACT-Accelerator.
“If we don’t rally now, the human costs and economic pain will deepen. So, though these numbers sound big, they are not when we think of the alternatives.”
The European Commission will host a pledging summit on Saturday to support the initiative.
It will be followed by a concert organized jointly with the advocacy group Global Citizen, hosted by American actor, Dwayne “The Rock” Johnson.
#UN; #UNICEF; #Covid19; #SouthAsia;
Geneva, Jun 23 (Canadian-Media): Without urgent action, COVID-19 will continue to unravel decades of progress across South Asia, destroying the “hopes and futures of an entire generation”, warns a new report released on Tuesday by the UN Children’s Fund, UNICEF, UN reports said.
Twelve-year-old boy in Dhaka, capital of Bangladesh, sorts through hazardous plastic waste without any protection, working to support his family amidst the lockdown.
Image credit: © UNICEF/Parvez Ahmad
Lives Upended, notes that the rapidly advancing coronavirus pandemic, expanding across a region that is home to a quarter of the world’s population, is particularly affecting health and educational advances for children.
“The side-effects of the pandemic across South Asia, including the lockdown and other measures, have been damaging for children in numerous ways”, said Jean Gough, UNICEF Regional Director for the vast region. “But the longer-term impact of the economic crisis on children will be on a different scale entirely”.
The report illustrates the disastrous toll of the virus on some 600 million South Asian children, such as growing food insecurity and the disruption of immunization, nutrition and other vital health services, that could be potentially life-threatening for around 459,000 over the next six months.
Meanwhile, school closures have pushed more than 430 million children into remote learning, which has only partially filled the gap as many households in rural areas lack both internet access and electricity.
At the same time, concerns are heightening that some disadvantaged students may join the nearly 32 million children who were already out of school, before COVID-19 struck.
This all comes against a backdrop of children struggling with depression and a surge in calls to help hotlines, as they suffer violence and abuse during home confinement.
The report notes that life-saving vaccination campaigns against measles, polio and other diseases must resume, along with work to help an estimated 7.7 million children – more than half the global total – who are suffering from severe wasting, which impairs physical and mental development.
Moreover, as soon as possible, schools should reopen with adequate handwashing and other physical distancing precautions in place.
The economic shock triggered by COVID-19 is hitting families hard across the region, with large-scale job losses, wage cuts and remittance losses from overseas workers and through tourism.
According to UNICEF projections, as many as 120 million more children could be pushed into poverty and food insecurity over the next six months, joining some 240 million children already classified as poor.
To mitigate the impact, the report maintains that Governments should immediately direct more resources towards social protection schemes, including emergency universal child benefits and school feeding programmes.
“Putting such measures in place now will help the countries of South Asia transition faster from the humanitarian crisis caused by COVID-19 to a resilient and sustainable development model, with long term benefits for child wellbeing, the economy, and social cohesion”, said Ms. Gough.
Tackling COVID-related issues affecting children
• Provide personal protective equipment (PPE) to health and social services staff.
• Scale up home learning solutions for those without internet access, such as using more paper and mobile phone-based materials.
• Address widescale need for water, toilets and hygiene services in schools and health care facilities.
• Work with religious leaders and others to address pandemic-driven myths and hate-speech.
#UN; #UNHealth; #Covid19Pandemic; #UrbanCentres
Geneva, Jun 19 (Canadian-Media): The world is entering “a new and dangerous phase” of the COVID-19 pandemic, as infection rates continue to climb, the World Health Organization (WHO) said on Friday, UN reports said.
Elderly women sit on a wall in Hranitne, eastern Ukraine's frontline community. Image credit: © UNICEF/Artem Getman
More than 150,000 new cases of the disease were reported on Thursday: the highest single daily total so far.
Most were in the Americas, though “large numbers” came from South Asia and the Middle East.
“The world is in a new and dangerous phase.
Many people are understandably fed up with being at home. Countries are understandably eager to open up their societies and economies”, WHO chief Tedros Adhanom Ghebreyesus told journalists.
“But the virus is still spreading fast, it’s still deadly, and most people are still susceptible.”
Globally, there were nearly 3.4 million cases of COVID-19 as of Friday, including more than 450,000 deaths.
Tedros repeated his call for countries and people to remain vigilant against the disease, and to continue efforts focused on containing the disease, including though testing and contact tracing.
COVID-19 and refugees
WHO’s support and technical guidance has been “invaluable” in guarding against widespread COVID-19 infections in refugee camps, the UN High Commissioner has said.
Filippo Grandi was a guest at the briefing, held on the eve of World Refugee Day, marked on Saturday.
He revealed that humanitarians initially feared there would be “catastrophic outbreaks” in camps, where it is difficult to practice physical distancing, among other factors.
So far this has not occurred, he said, although cases of COVID-19 and “small outbreaks” have been reported.
“I think this is also due to the fact that in many of these situations, we had time to prepare, and there is where our cooperation with WHO has been invaluable”, he said.
“Because it is WHO…that has provided us, throughout these difficult months, with leadership and technical guidance without which we would not have been able to achieve whatever we have been able to achieve.”
Globally, nearly 80 million people have fled their homes due to conflict or persecution, according to the latest report by the UN refugee agency, UNHCR, which Mr. Grandi heads.
He told journalists that most refugees actually live in host communities, not camps, some of which have been “devastated” by the pandemic.
“I’m thinking of Latin America, where 17, 18 countries host more than four million Venezuelans on the move,” he said.
“I’m thinking of many urban centres in Africa that are host to large refugee populations. I’m thinking of Afghans in Pakistan and Iraq, that live - share facilities and accommodation - with communities that have been impacted very severely by COVID.”
Welcoming early results on use of dexamethasone in sickest COVID-19 patients, WHO warns it’s ‘no cure-all’
#UN; #WHO; #dexamethasone; #ViralReplication
Geneva, Jun 17 (Canadian-Media): The UN World Health Organization (WHO) on Wednesday hailed news from the United Kingdom that a common steroid, dexamethasone, can potentially help save the lives of patients with severe cases of COVID-19, but it warned that it is by no means a cure-all, UN reports said.
Patients wait in a corridor at the Severo Ochoa Hospital in Madrid, which is on the front line of the battle against COVID-19. Image credit: Luis Díaz Izquierdo
Early findings suggest that, for hospitalized coronavirus patients on oxygen, dexamethasone – a low-cost prescription anti-inflammatory drug that is available worldwide – can reduce COVID-19 mortality by about one-fifth.
For those on ventilators, mortality is reduced by one-third, according to a University of Oxford team of researchers that compared about 2,000 patients treated with the steroid with 4,000 who were not.
“This is very welcome news for those patients with severe illness,” said WHO Director-General Tedros Adhanom Ghebreyesus during a virtual media briefing from Geneva.
But he emphasized that dexamethasone was shown to have no beneficial effect for those with milder symptoms who do not need respiratory support.
“These drugs should only be used under close clinical supervision,” he said, as the WHO put the number of COVID-19 fatalities worldwide at 434,796 as of Tuesday out of more than reported 7.94 million cases.
Michael Ryan, Executive Director of the WHO’s Health Emergencies Programme, said the WHO is waiting for further details before it can draw up clinical guidelines to share with public health authorities around the world.
“This is not for mild cases. This is not for prophylaxis,” Dr. Ryan said, warning that dexamethasone is associated with viral replication.
Its potential for dealing with COVID-19 is just one of many breakthroughs that must be achieved on the road to effectively defeating the virus, he added.
Through the WHO’s global research and innovation forum on COVID-19, hundreds of researchers from around the world are racing to come up with quality diagnostics, therapeutics and vaccines for the coronavirus.
One of its priorities is to investigate the potential of existing medicines like dexamethasone and remdesivir, a relatively new Ebola drug that appears to reduce the duration of coronavirus symptoms from 15 days to 11 days.
While COVID-19 is touching every corner of the world, Mr. Tedros stressed the need to remain focused as well on essential public health concerns such as malaria, tuberculosis and HIV-AIDS.
In that regard, he announced that the UN health agency and its partners have come up with a fresh roadmap for an integrated approach to neglected tropical diseases – a category that includes 20 diseases including elephantiasis, sleeping sickness, leprosy, trachoma and intestinal worms.
“These diseases disfigure, disable and can kill,” he said, “and they strike hardest in places of poverty and in remote areas where access to quality health services is extremely limited.”
Fielding journalists’ questions, Mr. Tedros noted the speed at which COVID-19 has spread across the planet, from 85,000 cases reported in the first two months of the pandemic to six million since mid-April.
Solidarity needed to combat virus, a “fast-moving killer” “This virus is very dangerous. It moves fast and it’s a killer,” the Director-General said, adding: “Only by moving faster can we defeat it - and that requires unity and solidarity.”
Dr. Ryan said that the outbreak in Brazil – the hardest-hit nation in Latin America, with 867,624 cases and 43,332 fatalities as of Tuesday – said there are signs that the situation is stablizing.
But he warned that “it is (still) a moment of extreme caution” and urged Brazilians to double down and stay focused on social distancing, personal hygiene and supporting vulnerable groups including minority communities and the poor.
Maria Van Kerkhove, the WHO’s technical lead on the COVID-19 pandemic, meanwhile said that governments must depend on solid data in determining how, when and where to ease restrictions on movement and public gatherings – and to be ready to reinstate them, hopefully temporarily.
#UN; #WHO; #Influenza; #COVID19
Geneva, June 15 (Canadian-Media): Despite the ongoing global response to COVID-19, the world cannot lose sight of the significant public health risk posed by influenza, which affects every country every year and takes its own deadly toll, World Health Organization (WHO) Director General, Tedros Adhanom Ghebreyesus, said on Monday.
A nurse in Boliva holds up a dose of flu vaccination. Image credit: UNICEF/Carola Andrade
“As we enter the southern hemisphere influenza season…we must ensure influenza remains a top priority”, the agency chief said during his media briefing.
“Co-circulation of COVID-19 and influenza can worsen the impact on health systems that are already overwhelmed.”
Globally, more than 7.8 million cases of COVID-19 and more than 430,000 deaths caused by the virus have been reported to WHO to date, he said. More than 100,000 cases have been reported each day for the last two weeks – almost 75 per cent of them from 10 countries in the Americas and South Asia.
“Countries must stay alert to the possibility of resurgence,” he said. Just last week, China reported a new cluster of cases in Beijing after more than 50 days without a single case in the city. With more than 100 cases now confirmed, the origin and extent of the outbreak are being investigated.
‘Highly Functional’ System
At the same time, he said more than 500 million people are vaccinated against flu each year, based on recommendations made by WHO on the composition of flu vaccines. To know which viruses are circulating, WHO relies on information reported by 125 countries through the Global Influenza Surveillance and Reporting System, which the agency uses to make recommendations for the composition of flu vaccines.
“The infrastructure, people, skills and experience built up through [this system], WHO Collaborating Centres and National Influenza Centres have been the foundation for detecting COVID-19”, Tedros explained. However, the system – in place since 1952 - is experiencing significant challenges, with flu surveillance either suspended or declining in many countries, and a “sharp” decline seen in the sharing of flu information and viruses, due to the COVID-19 pandemic.
Dramatic fall in flu testing
Compared with the last three years, there has been a dramatic decrease in the number of specimens tested for influenza globally, Tedros said, along with a 62 per cent drop in virus shipments to WHO Collaborating Centres and a 94 per cent fall in the number of flu viruses with genetic sequence data uploaded to the Surveillance and Response database.
“These decreases due to a combination of issues, including the repurposing of staff and supplies, overburdened laboratories and transport restrictions”, he said. The disruptions could lead to the loss of capacities for detecting and reporting new influenza viruses with pandemic potential.
Tedros pointed to WHO guidance on how to integrate surveillance for COVID-19 into routine influenza surveillance as an efficient a way to track the two respiratory illnesses. “This is not only cost-effective”, he said. “It’s also essential for protecting the world against the next flu season.”
Wenqing Zhang, Director of WHO’s Global Influenza Programme, agreed that there will always be competing disease priorities or threats. “But influenza is always there”, she said.
“This is really a very solid and highly functional foundation…to monitor influenza.”
Every COVID-19 case must be tracked
More broadly, Maria Van Kerkhove, technical lead on COVID-19, fielded questions on safely handling protests taking place in many countries. It is important to consider whether the area is one of active virus transmission and whether there are ways to keep people physically distanced. If someone falls ill, a system must be in place to quickly detect and monitor any subsequent cases.
“Any opportunity where people are in crowded places and the virus is present, and appropriate proper measures are not in place, the virus can transmit”, she clarified. “Every single case of COVID-19 is significant and must be followed up and cared for appropriately.”
New clusters, always a concern
To that point, Dr. Michael Ryan, Executive Director of WHO’s Health Emergencies Programme, said the emergence of new clusters always raises a concern, especially when the driver is not recognized. WHO recommends taking immediate measures that involve investigating thoroughly, testing, isolating and quarantining contacts. These efforts have led to virus containment, whether related to religious communities, markets, migrant dormitories or other settings.
Countries must stay alert to the possibility of resurgence -- WHO chief
Beijing is a dynamic and connected city, he added, and the level of concern is reflected in the response of Chinese authorities to the latest outbreak, in the capital. A WHO team based in Beijing, led by country representative and supported by epidemiologists permanently embedded there, are working with China’s Center for Disease Control and Prevention. WHO may supplement its country office in the coming days as the investigation develops.
As to the risks of air travel, he said WHO is advising the International Civil Aviation Organization (ICAO) and the International Air Transport Association and will issue considerations for travellers in the coming days. “There is no zero risk in any environment,” he stressed. If someone falls ill, the ability to track anyone who has been on the plane is essential. “We need to make the air travel experience as safe as possible.”
#UN; #WHO; ImpactOfCodiOnWomen&Youth; #LiftingLockdowns
Geneva, Jun 12 (Canadian-Media): As the COVID-19 pandemic continues to escalate, the World Health Organization (WHO) is concerned about its impact on women, children and young people, UN reports said.
Doctor taking temperature to a family of returnees quarantined in temporary shelter in Venezuela. Image credit: OCHA/Gema Cortes
"The indirect effects of COVID-19 on these groups may be greater than the number of deaths due to the virus itself”, agency chief Tedros Adhanom Ghebreyesus said on Friday.
The pandemic has overwhelmed health systems in many parts of the world, which means women may be at greater risk of dying from complications related to pregnancy and childbirth.
Early evidence also suggests that people in their teens and 20s are at increased risk of depression and anxiety, online harassment, physical and sexual violence and unintended pregnancies.
Breastfeeding still best
In response, WHO has published guidelines for health facilities on maintaining essential services during the pandemic, including for newborn care.
Experts have also investigated the risk of COVID-19 being transmitted to babies during breastfeeding.
“Based on the available evidence, WHO’s advice is that the benefits of breastfeeding outweigh any potential risks of transmission of COVID-19”, said Tedros.
“Mothers with suspected or confirmed COVID-19 should be encouraged to initiate and continue breastfeeding and not be separated from their infants, unless the mother is too unwell.”
So far, experts have not been able to detect live virus in breastmilk, though fragments have been identified in several cases, according to Dr. Anshu Banerjee, Director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health and Ageing.
“So, the risk of transmission from mother, to child therefore, so far, has not been established”, he said.
COVID-19 and children: many unknowns
Health experts are working to get a clearer picture of how COVID-19 affects children and adolescents.
Much remains to be known about the disease’s impacts on this population, according to Dr. Maria van Kerkhove, an epidemiologist and WHO’s technical lead on the pandemic.
“We have a number of unknowns that we’re really trying to better understand”, she said, responding to a journalist’s question.
“How often are they infected? Do they play a role in transmission and if so, how much are they playing in that role? What roles do schools potentially have?”
Dr. Michael Ryan, WHO head of emergencies, added that several studies are underway, including into why some children end up with severe outcomes and needing to be hospitalized from the disease.
Meanwhile, countries coming out of lockdowns to contain COVID-19 spread must strike a “careful balance” between public safety and the need to avert further damage to their economies.
Dr. Ryan said WHO is concerned that some nations, which have passed the peak of the pandemic, are now seeing an uptick in cases.
“There is a careful balance to be struck between keeping everyone at home and continuing to completely suppress transmission of COVID-19, and the untoward effects of that on the economy and the society. And that is not an easy balance”, he said.
Dr. Ryan reiterated WHO advice on the need for strong national public health surveillance to determine where the virus is increasing so that authorities can take action.
#UN; #COVIDRelatedTravelRestrictions; #seafarers;#KeyWorkers; #Covid19Pandemic; #ILO
Geneva, Jun 12 (Canadian-Media): Due to COVID-related travel restrictions, hundreds of thousands of the world’s two million seafarers have been “stranded at sea for months”, said the UN chief on Friday, calling for them to be categorized as “key workers”, during the pandemic, UN reports said.
COVID-related travel restrictions is worsening the plight of seafarers by the day.
Image credit: International Maritime Organization
Unable to disembark, the statement released on behalf of António Guterres through his Spokesperson, said that the maximum sea time stipulated in international conventions, was being ignored, “with some seafarers marooned at sea for 15 months”.
“The Secretary-General is concerned about the growing humanitarian and safety crisis facing seafarers around the world”, said the statement.
The ongoing crisis is having a direct impact on the shipping industry, which transports more than 80 per cent of traded goods – including vital medical supplies, food and other basic necessities - critical for the COVID-19 response and recovery.
“The world could not function without the efforts of seafarers, yet their contributions go largely unheralded” said Mr. Guterres. “They deserve far greater support at any time, but especially now”.
In a bid to ensure that changeovers can safely take place, the Secretary-General called on all countries to “formally designate seafarers and other marine personnel as ‘key workers’”.
Repatriate marine workers
Meanwhile, taking full account of public health concerns, UN agencies – including the International Labour Organization (ILO) and the International Maritime Organization (IMO) – have been working with the International Chamber of Shipping and the International Transport Workers Federation, to develop protocols for crew changeovers.
“The Secretary-General calls on all governments to urgently implement these protocols, allowing stranded seafarers to repatriate and others to join ships”, the statement concluded.
Endangering maritime safety
Last month, ILO received claims that numerous seafarers in need of immediate medical care ashore, were not permitted to disembark at many ports around the world, while those waiting to return to sea, were losing their source of income.
And earlier this week, ILO Director-General Guy Ryder said that “forcing exhausted seafarers to continue working more than four months beyond the end of their contract is unacceptable”, as it “jeopardizes their health and endangers maritime safety”.
“We call on governments to work together to make these crew changes happen in safety", he upheld.
#Boston; #UnitedStates; #hydroxychloroquine, #Covid19Pandemic; #TheLancet; #Barcelona
Boston (United States), Jun 10 (Canadian-Media): Through the fog of alleged misconduct, hope, hype, and politicization that surrounds hydroxychloroquine, the malaria drug touted as a COVID-19 treatment, a scientific picture is now emerging, Eric Topol, said director of the Scripps Translational Science Institute, https://www.sciencemag.org/news said.
Image. Hydroxychloroquine. Image credit: Wikimedia commons
Praised by presidents as a potential miracle cure and dismissed by others as a deadly distraction, hydroxychloroquine was spared a seeming death blow last week. On 4 June, after critics challenged the data, The Lancet suddenly retracted a paper that had suggested the drug increased the death rate in COVID-19 patients, a finding that had stopped many clinical trials in their tracks. But now three large studies, two in people exposed to the virus and at risk of infection and the other in severely ill patients, show no benefit from the drug. Coming on top of earlier smaller trials with disappointing findings, the new results mean it’s time to move on, some scientists say, and end most of the trials still in progress.
“It just seems like we are ignoring signal after signal,” says Eric Topol, director of the Scripps Translational Science Institute. U.S. President Donald Trump’s promotion of it led to a scientific “obsession” with hydroxychloroquine despite thin evidence for its promise, he says. “We’d be better off shifting our attention to drugs that might actually work.” Peter Kremsner of the University of Tübingen agrees hydroxychloroquine “certainly isn’t a wonder drug.” The new results left him “wrestling” with the question of whether to proceed with two hydroxychloroquine trials, one in hospitals and the other in patients with milder illness at home.
Hydroxychloroquine and its sister drug chloroquine have been used against malaria and other diseases for decades. The first evidence that they might work against SARS-CoV-2 came from test tube data. Since then, hundreds of trials have been launched around the globe. Scientists are trying the drugs in low doses and high doses; alone or combined with the antibiotic azithromycin, the antiviral compound favipiravir, or other drugs; and in patients with mild or severe disease, health care workers, pregnant women, and people living with HIV.
On 5 June, researchers in the United Kingdom announced the results from the largest trial yet, Recovery, in a press release. In a group of 1542 hospitalized patients treated with hydroxychloroquine, 25.7% had died after 28 days, compared with 23.5% in a group of 3132 patients who had only received standard care. “These data convincingly rule out any meaningful mortality benefit,” wrote the investigators, who ended the study early and promised to publish the full results as soon as possible.
The results are persuading some doctors to stop using the drug for COVID-19. “The Recovery trial, in addition to the signals from other studies we have received so far, are enough to convince me to not offer hydroxychloroquine to hospitalized patients,” Nahid Bhadelia, a physician at Boston Medical Center, wrote in an email. Martin Landray of the University of Oxford, one of Recovery’s principal investigators, agrees: “If you, your spouse, your mother gets admitted to hospital and is offered hydroxychloroquine, don’t take it,” he says.
But some scientists say they want to see the full data before making up their minds. About one in four patients died in both arms of the study, Kremsner notes—a very high rate, suggesting they were gravely ill when treatment started. Nicholas White of Mahidol University in Bangkok, who also studies hydroxychloroquine, agrees the full data need evaluation. “But overall, it’s very unlikely, in my view right now sitting here, that anything’s going to change,” he says.
Another hope for hydroxychloroquine, that it might prevent people exposed to the virus from getting sick, also faded last week when David Boulware of the University of Minnesota, Twin Cities, and colleagues published the results of the largest study to date of this strategy, called postexposure prophylaxis (PEP). The researchers sent either hydroxychloroquine or a placebo by mail to 821 people who had been in close contact with a COVID-19 patient for more than 10 minutes without proper protection. They reported in The New England Journal of Medicine that 12% of the people who took the drug went on to develop COVID-19 symptoms, versus 14% in a placebo group, a difference that was not statistically significant.
A second large PEP trial has come up empty as well, its leader tells Science. Carried out in Barcelona, Spain, that study randomized more than 2300 people exposed to the virus to either hydroxychloroquine or the usual care. There was no significant difference between the number of people in each group who developed COVID-19, says Oriol Mitjà of the Germans Trias i Pujol University Hospital. Mitjà says he has submitted the results for publication.
If you, your spouse, your mother gets admitted to hospital and is offered hydroxychloroquine, don’t take it.
Martin Landray, University of Oxford
The data are important because they come from large randomized trials. So far, most data came from small trials or case series. A meta-analysis of 24 such studies published in the Annals of Internal Medicine concluded there was “insufficient and often conflicting evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19.”
The new findings raise questions about whether to stop other trials. Most are much smaller than Recovery, and thus less powerful; their outcomes are unlikely to change many minds. And continuing the trials may prevent researchers from testing drugs with a better chance of working and robs patients of the chance to try those. Landray says the World Health Organization (WHO) is now likely to end the hydroxychloroquine arm of its large COVID-19 treatment trial, named Solidarity. “I think the decision is pretty obvious,” he says. WHO says it is considering the issue.
There is one exception. Many researchers agree that a good case can be made for continuing to test whether hydroxychloroquine can prevent infection if given to people just in case they get exposed to the virus, for instance on the job at a hospital—a strategy called pre-exposure prophylaxis (PrEP). “You have a much better chance of preventing something with a weak drug than you have of curing a fully established infection,” says White, who runs one of the largest PrEP trials. He notes that doxycycline, an antibiotic, has long been used in malaria prophylaxis. “We would never treat anybody with it, it’s too weak. But it’s a very good prophylactic.”
Landray, however, is on the fence about continuing prophylaxis trials: “I suspect it’s one of these decisions where there isn’t a right or wrong.” It’s an important question, Bhadelia says, because an effective PrEP drug could have a major impact on the pandemic. Hydroxychloroquine, a cheap and widely available drug, is one of the few compounds that could fit the bill.
But the Lancet paper, despite its retraction, will make it more difficult to continue current trials, White laments. Published on 22 May, the study claimed, supposedly based on data from 96,000 patients around the world, that hydroxychloroquine and chloroquine, whether given alone or in combination with another drug, caused a steep increase in deaths. That led many regulatory agencies to ask scientists to halt their trials and make sure they were not harming their patients. Recovery and Solidarity were temporarily halted but resumed after a safety committee took a look at the data.
Many other trials are still on pause. U.K. regulators, for instance, have asked for a raft of additional safeguards, says Joseph Cheriyan, a clinical pharmacologist at Cambridge University Hospital and principal investigator of a PrEP trial in health care workers. That study already excluded patients who take any one of several dozens of drugs, but Cheriyan says regulators have asked for more changes, which will set the trial back weeks. And despite the Lancet retraction, the alarming headlines about the drug’s risks have made it much more difficult to convince people to participate in a trial, White says. “I just think these trials have been really badly damaged and some of them may never restart.”
The problem for scientists is that there’s such a rush to find treatments for the rapidly spreading virus, Mitjà says: “The pressure is immense.” Yet that shouldn’t stop researchers from properly analyzing data and making carefully considered decisions, White says. “We don’t always have to act today,” he says. “Let’s not panic.”