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Don’t self-medicate! French warned of ‘serious’ side effects on unproven coronavirus drugs

France reported its highest single-day coronavirus death toll on Monday, as the number of intensive care cases rose by more than 10 percent to 5,107. France’s drug watchdog on Monday warned of the potentially “serious” side effects of treatments being tested against the novel coronavirus, as it urged people to not self-medicate. The warning comes after “around 30 different serious side effects” were reported by patients in recent weeks, the head of France’s ANSM medicine agency Dominique Martin told AFP.

The patients had been taking Plaquenil – the brand name of the anti-malarial hydroxychloroquine – as well as other medicines such as the antiretroviral Kaletra, he added.

The drugs can trigger undesirable side effects and should “in no case be used as self-medication,” ANSM warned.

Mr Martin added that health experts were scrambling to determine whether the drugs currently being used to treat the flu-like infection were linked to the side effects, with initial conclusions expected by the end of the week.

ANSM ramped up its surveillance two weeks ago of trials of the drugs against the virus, “in particular when they are used outside of clinical trials of chloroquine, hydroxychloroquine, azithromycin, lopinavir/ritonavir, tocilizumab and colchicine,” he said.  

Before adding: “It’s perfectly normal that treatments be tried, given the circumstances, but that doesn’t mean we shouldn’t observe surveillance … of these substances.”

The statement was issued after the deaths of three coronavirus patients, though it remains unclear whether they died in hospital or whether their deaths are linked to self-medication.

The use of hydroxychloroquine, and its related compound chloroquine, has sparked a heated debate in France since a study carried out on a small number of coronavirus patients in the southern city of Marseille yielded promising results.

The microbiologist behind the study, Dr Didier Raoult, head of the infectious diseases department at Marseille’s La Timone hospital, insists that chloroquine can “efficiently” combat the virus.

On March 16, he announced his teams had treated 25 patients with hydroxychloroquine.

After six days, he said, only one in four still had the virus in their body, whereas 90 percent of patients who had not taken the drug were still infected.

Over the weekend, he said his new study of 80 patients showed that four out of five of those treated with the drug had “favourable” outcomes.

His repeated calls to expand the treatment triggered a rush on French pharmacies, despite warnings by medical experts that further trials should be carried out first.

Critics of Dr Raoult, whose theory has been hailed as potentially “game-changing” by US President Donald Trump, stress the testing was not carried out in a controlled study and that the results were purely “observational”.

Chloroquine was first synthesised in the 1930s.

A version called hydroxychloroquine, in use since the 1950s, is considered to be less toxic.

However, both drugs can cause serious side effects, including vision loss, heart problems and even death.

The French government, however, officially approved prescriptions of chloroquine to treat certain coronavirus patients, in particular those with more severe forms of the disease.

France’s health chief Jérôme Salomon 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 authorisation to allow certain patients with coronavirus to benefit from this therapeutic route.”

France recorded its highest single-day coronavirus death toll on Monday, health officials said.

The number of coronavirus deaths since March 1 climbed by 16 percent to 3,024, while the number of intensive care cases rose by more than 10 percent to 5,107.

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Coronavirus: Thailand trials 15-minute COVID-19 test

A new 15-minute COVID-19 test has been launched in Thailand aimed at increasing the number of people being screened for the deadly virus and easing the burden on the health system.

Chulalongkorn University in Bangkok rolled out the rapid kit this week hoping it will help to quickly identify people with the illness.

Coronavirus cases rose sharply in Thailand in March, with panicked citizens flocking to under-pressure hospitals for coronavirus tests.

Currently doctors rely on polymerase chain reaction (PCR) tests from nasal and throat swabs to detect COVID-19.

The demand for the PCR test can mean kits are in short supply and results can take two to four days.

The new rapid strip tests detect antibodies (IgG & IgM) in the blood serum or plasma which could indicate that a patient either currently or previously had COVID-19.

It works with a drop of blood and gives a first positive or negative result in 10 to 15 minutes.

Although it does not replace the need for laboratory testing of COVID-19‎, there is hope that the test kit will help reduce the large number of patients who need to go to the hospital for examination.

“We don’t want to replace the PCR test but we want to add some screening tests to help the government to decrease the amount of workload who come to have the PCR test by using our rapid test,”Professor Narin Hiransuthikul, vice president of Chulalongkorn University told Sky News.

“If the rapid test is accurate enough we would like to expand this kind of test to all the provinces in Thailand.”

Patients who get positive results are sent for a follow-up PCR test, those who are negative are told to self-quarantine for 14 days.

In recent trials the test had a 5% margin of error, so negative patients are retested after a few days to confirm the reading.

Some 50 patients can be seen each day at the facility in Bangkok where chairs are meticulously separated to enforce social distancing.

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Satellite data lays scale of methane leaks bare, exposing climate risks

PARIS (AFP) – Methane, a powerful greenhouse gas, is leaking from industry sites at rates equivalent to the annual carbon emissions of France and Germany combined, a new analysis using satellite data showed on Tuesday (March 31).

Using imaging data gathered by the European Space Agency’s Sentinel-5P monitoring mission, the study shows more than 100 “high-volume emission events” worldwide from gas storage and transmission facilities.

These events alone emitted around 20 million tonnes of methane – the short-term equivalent to releasing 1.8 billion tonnes of carbon dioxide (CO2) pollution.

“The good news is most of these are man-made and can easily be addressed through action by individual companies, governments and regulators,” said Antoine Rostand, CEO of Kayrros, an asset observation platform that conducted the analysis.

While methane only stays in the atmosphere a fraction of the time that CO2 does, over a period of decades it is dozens of times more potent as a greenhouse gas.

Overall, greenhouse gas emissions from energy have risen globally nearly every year in the past decade, despite the 2015 Paris climate deal mandating their reduction.

The United Nations says that manmade emissions must decline 7.6 per cent annually by 2030 to limit global warming to 1.5 deg C above pre-industrial levels – the more ambitious cap laid out in the Paris deal.

Claus Zehner, Sentinel-5P mission manager at ESA, said satellite monitoring of methane leaks could help industry “support the reduction of global emissions and slow down climate change”.

The Kayrros analysis has not been reviewed by scientists but has been shared with the European Commission.

Commenting on the project, Gunnar Luderer and Nico Bauer, climate economists at the Potsdam Institute for Climate Impact Research, said that it might over-estimate the warming impact of methane leaks.

“Still, however, the annual leakage of 20 Mt of methane from 100 point sources mostly in the energy industry is an astonishing loss that is worth further validation,” they told Agence France-Presse.

They said that the leaks alone were worth nearly two thirds of all natural gas use in France every year, with an industry impact of roughly four billion euros (S$6.3 billion).

“Economists would expect that such leakage would be avoided for pure cost reasons,” said Luderer and Bauer.

“In any case, regulatory intervention could lead to lower emissions with economic benefit.”

READ MORE STORIES ON CLIMATE CHANGE

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Coronavirus: How to keep your husband happy in lockdown posters condemned

The Malaysian government’s department for women has apologised after it released series of online posters telling women how to keep their men happy during its COVID-19 lockdown.

Titled ‘Household Happiness’ the tips posted on Facebook and Instagram included giggling coyly instead of nagging, not allowing your appearance to slip and making sure the home is clean.

One suggested women avoid being sarcastic if their partner was not helping with the housework.

The online posters, with the hashtag #WanitaCegahCOVID19 (Women Prevent COVID-19), were condemned by women’s rights groups who said the campaign could worsen gender stereotypes and possibly encourage domestic violence.

The Women’s Centre for Change (WCC) said the Facebook and Instagram posts reinforced negative gender stereotypes of both women and men.

“It implies that women are ultimately responsible for getting domestic chores done when the duty should be a shared one,” it said in a statement.

“It makes women the ones who need to persuade their partners to chip in, and worse, asks that women downplay a rightful request by using infantile language and mannerisms – so as not to offend the apparent sensitivities of men.

“The implicit message is that men are allowed to slack off on domestic work and it’s women who must follow up with them – but they should only do so nicely.

“In short, it sends the message that women are subordinate in the home and are not allowed to function as equals to men.”

In a statement the Women, Family and Community Development Ministry said the aim had been to share methods and practices to sustain positive relationship within a family while women are working from home.

Director-general Datuk Saidatu Akhma Hassan said: “We are sorry if some of tips shared were inappropriate and touched on the sensitivities of some parties, and we will be more careful in the future.”

Three of the four posters have now been removed from social media.

Malaysia has shut schools and non-essential shops and imposed tight restrictions on travel and movement in a bid to reduce the impact of COVID-19.

Local media reports suggest a government helpline to aid domestic abuse victims and vulnerable children has had double its usual number of calls since the start of the lockdown.

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Germany reports 5,453 additional coronavirus cases, 149 more deaths

BERLIN (Reuters) – The number of confirmed coronavirus cases in Germany has risen to 67,366 and 732 people have died of the disease, statistics from the Robert Koch Institute (RKI) for infectious diseases showed on Wednesday.

Cases rose by 5,453 compared with the previous day while the death toll climbed by 149, the tally bit.ly/3aKER5W showed.

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Paris Club creditors agree to cancel $1.4 billion of Somali debt

WASHINGTON/PARIS (Reuters) – The Paris Club of creditor nations agreed on Tuesday to restructure Somalia’s debt, including immediately canceling $1.4 billion owed by the impoverished Horn of Africa country.

Three decades of conflict have left Somalia all but cut off from the global financial system and relief from its debt is expected to open the way for new sources of financing for the country.

The decision, first reported by Reuters, cancels 67% of the debts owed to Paris Club creditors by Somalia. It came after more than nine hours of discussions by videoconference.

Somali Finance Minister Abdirahman Beileh called the decision a big step forward for his country, which is also grappling with the coronavirus outbreak and a recent desert locust swarm.

“We had very productive discussions with the Paris Club and we welcome their support in relieving Somalia of a substantial amount of its debt to them,” Beileh told Reuters.

He said the Somali government would hold separate bilateral discussions with the creditors to finalize the process. He said his government would continue the economic reforms it had undertaken over the past eight years to enable the debt relief.

An official with the International Monetary Fund said several creditors were expected to grant Somalia additional debt relief on a bilateral basis, and it could eventually see 100% debt cancellation deals with some countries after it completes additional steps under the Heavily Indebted Poor Countries (HIPC) Initiative in about three years.

The IMF and the World Bank said last week that Somalia had taken the necessary steps here to begin receiving debt relief.

Several of Somalia’s Paris Club creditors, including the United States, the UK and Norway, as well as the World Bank and the IMF, urged Paris Club members to provide “generous” debt relief to Somalia during the negotiations on Tuesday, said one source familiar with the discussions.

Somalia is the 37th country to qualify for debt relief under the HIPC process.

In time, debt relief will help Somalia reduce its external debt to $557 million in net present value terms from $5.2 billion at the end of 2018, the IMF and the World Bank said.

The IMF last week also approved a new three-year $395 million financing arrangement for Somalia under its Extended Credit Facility (ECF) and Extended Fund Facility (EFF).

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Italy shows signs that coronavirus pandemic is slowing down with hopeful new figures

In Italy, Europe’s hardest-hit nation, with more recorded deaths than any other nation, there are signs that coronavirus might be loosening its grip. Now, many are asking whether COVID-19 has finally peaked.

The peak of a pandemic in a country is when the number of new infections in a single day reaches its highest point.

Cases now registered in Italy will reflect exposure to the virus around two weeks ago, according to health chiefs.

The increase in new confirmed cases in Italy is at its lowest since the outbreak began – four percent.

This is promising, as it is half as much as four days ago, and a further four times less than two weeks ago.

And, the number of those who have recovered from the virus has reached its highest ever level.

On Monday, this figure stood at 1,590.

In Lombardy – regarded as the worst hit region, in the north of the country – the amount of people testing positive for the virus has dropped sharply.

It fell from 25,392 on Sunday to 25,006 on Monday, according to Johns Hopkins University.

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Despite a move in the right direction, the positive cases rebounded on Tuesday by around 120 people.

Experts were also quick to point out that these figures are only the number of confirmed cases, rather than the real amount of people infected.

The true amount will never be known, with many carrying the virus unknowingly to themselves or the authorities.

The decline in the rise of new infections could also be in part down to the reduced number of tests being administered in the past few days.

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[ANALYSIS] 

The number of people who died from the virus after testing positive in Italy on Sunday was the lowest daily rise in deaths since Wednesday last week.

Yet, coronavirus proved its uncanny ability to thwart our control, with it bouncing back on Monday and Tuesday, rising by 812, according to the the Civil Protection Agency said, reversing two days of decline.

Last week, the head of Italy’s national health institute said the country had not yet reached its peak.

But, Silvio Brusaferro said there were “signs of a slowdown” in the number of people becoming infected.

This led many to suggest the peak might be closer than what was previously thought.

Meanwhile, Mike Ryan, head of health emergencies at the World Health Organisation (WHO), said there was “hope” that Italy is soon approaching its peak.

This was, he said, as lockdown measures began to prove their worth.

He warned that it was difficult to known when the peak has been reached, however, using Wuhan as an example of how the peak went up and down before it was actually reached.

Mr Ryan also emphasised the importance of not just trying to get past the peak, but testing and isolating cases.

He said: “The question is how do you go down, and going down isn’t just about a lockdown and let go.

“To get down from the numbers, not just stabilise, requires a redoubling of public health efforts to push down.”

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Grounded cabin crew get hospital training as Sweden battles coronavirus

STOCKHOLM (Reuters) – Furloughed crew from crisis-hit Scandinavian airline SAS are taking a three-day course in basic hospital duties to help plug gaps in a Swedish healthcare system strained by thousands of coronavirus cases.

The airline, part owned by the governments of Sweden and Denmark, temporarily laid off 10,000 staff – 90% of its workforce – this month to cut costs and ride out a plunge in air travel due the pandemic and related border closures.

With Stockholm’s healthcare system in need of reinforcement as cases rise, Sophiahemmet University Hospital is teaching former cabin crew skills such as sterilizing equipment, making hospital beds and providing information to patients and their relatives.

The first students are due to complete the course on Thursday and the response has been overwhelming.

“We now have a long, long list of healthcare providers that are just waiting for them,” said Johanna Adami, principal at the University. Airlines in Australia, and the U.S. have also enquired about using the training methods for their staff.

She said municipalities, hospitals and nursing homes have all been queuing up to employ the re-trained staff, who will number around 300 in the coming weeks. Adami said airline staff were particularly suited to helping in the healthcare sector.

“They have basic healthcare education from their work. They are also very experienced to be flexible and think about security and also to handle complicated situations,” she said.

Sweden has around 4,500 confirmed cases of the virus and 180 deaths, with the capital especially hard hit. Healthcare officials in Stockholm have scrambled to set up a temporary hospital in a convention center and warned of a lack off staff and safety equipment to meet the crisis.

Malin Ohman, 25, a airline stewardess from northern Sweden was in the first class of students.

“In the a blink of an eye I decided – ‘yes of course, why wouldn’t I’,” she said of her decision to retrain. “I felt that we could just contribute with something,” she added.

The course is free of charge and the companies involved with the training are not seeking to make a profit. Funding, about 7 million Swedish crowns ($698,000) is provided by the Marianne and Marcus Wallenberg foundation.

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India’s race to build a $650 ventilator

In an 8,000 sq ft (743 sq m) facility in the western Indian city of Pune, a bunch of young engineers are racing against time to develop a low-cost ventilator that could save thousands of lives if the coronavirus pandemic overwhelms the country’s hospitals.

These engineers – from some of India’s top engineering schools – belong to a two-year-old start-up which makes water-less robots that clean solar plants.

Last year, Nocca Robotics had a modest turnover of 2.7 million rupees ($36,000; £29,000). The average age of the mechanical, electronic and aerospace engineers who work for the firm is 26.

India, by most estimates, only has 48,000 ventilators. Nobody quite knows how many of these breathing assistance machines are working. But it is a fair assumption that all those available are being used in intensive care units on existing patients with other diseases.

About one in six people with Covid-19 gets seriously ill, which can include breathing difficulties. The country faces seeing its hospitals hobbled as others around the world have been, with doctors forced to choose who they try to save.

At least two Indian companies make ventilators at present, mostly from imported components. They cost around 150,000 ($1,987; £1,612) rupees each. One of them, AgVa Healthcare, plans to make 20,000 in a month’s time. India has also ordered 10,000 from China, but that will meet just a fraction of the potential demand.

The invasive ventilator being developed by the engineers at Nocca Robotics will cost 50,000 rupees ($662). Within five days of beginning work, a group of seven engineers at the start-up have three prototypes of a portable machine ready.

They are being tested on artificial lungs, a prosthetic device that provides oxygen and removes carbon dioxide from the blood. By 7 April, they plan to be ready with machines that can be tested on patients after approvals.

“It is most certainly doable,” said Dr Deepak Padmanabhan, a cardiologist at Bangalore’s Jayadeva Institute of Cardiovascular Sciences and Research, and a key advisor on this project. “The simulations on artificial lungs have been done and seem to work well.”

Inspiring story

The race to develop this inexpensive, home-grown invasive breathing machine is an inspiring story of swift coordination and speedy action involving public and private institutions, something not common in India.

“The pandemic has brought us all together in ways I could never imagine,” says Amitabha Bandhopadhyay, a professor of biological sciences and bioengineering at Indian Institute of Technology (IIT), Kanpur, and a key mover of the project.

The young engineers mined open source medical supplies groups on the internet to find information on how to make the ventilators. After securing permissions, it took them exactly eight hours to produce the first prototype. Of particular use, say doctors, were some designs by engineers at MIT. With imports stalled, the engineers picked up pressure sensors – a key component of the machine that helps supply oxygen to lungs at a pressure that doesn’t cause injury – from those used in drones and available in the market.

Local authorities helped open firms that stock components – each machine needs 150 to 200 parts – and made sure that a bunch of engineers who had returned home to Nanded after the lockdown were still able to travel 400km (248 miles) back to Pune to work on the machine.

Some leading Indian industrialists, including a major medical device-making company, have offered their factories to manufacture the machines. The plan is to make 30,000 ventilators, at around 150-200 a day, by the middle of May.

Social media influencers joined the effort. Rahul Raj, a lithium battery-maker and an IIT alumnus, crowd-sourced a group called Caring Indians to “pool resources and experience” to cope with the pandemic. Within 24 hours, 1,000 people had signed up. “We tweeted to the local lawmaker and local police in Pune to help the developers, and made contacts with people who would be interested in the project,” Mr Raj said.

‘No-frills machine’

Expat Indian doctors and entrepreneurs who went to the same school – IIT is India’s leading engineering school and alumni include Google chief Sundar Pichai – held Zoom meetings with the young developers, advising them and asking questions about the machine’s development. The head of a US-based company gave them a 90-minute lecture on how to manage production. A former chief of an info-tech company told them how to source the components.

Lastly, a bunch of doctors vetted every development and asked hard questions. In the end, more than a dozen top professionals – pulmonologists, cardiologists, scientists, innovators, venture capitalists – have guided the young team.

Doctors say the goal is to develop a “no-frills” breathing machine tailored to Indian conditions.

Ventilators depend on pressurised oxygen supply from hospital plants. But in a country where piped oxygen is not available in many small towns and villages, developers are seeing whether they can also make the machine run on oxygen cylinders. “In a way we are trying to de-modernise the machine to what it was barely 20 years ago,” says Dr Padmanabhan.

“We are not experienced. But we are very good at making products easily. The robots that we make are much more complex to make. But this is a life-saving machine and carries risk, so we have to be very, very careful that we develop a perfect product which clears all approvals,” said Nikhil Kurele, the 26-year-old co-founder and chief executive officer of Nocca Robotics.

In just a week’s time, India will learn whether they pulled off the feat.

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Hamilton launches website to support small businesses impacted by COVID-19

The city of Hamilton has launched a website where residents who want to support local businesses can access them, all in one place.

HometownHub.ca is divided into three sections: food, products, and gift cards, with direct links to the websites of Hamilton’s small businesses.

Norm Schleehahn, the city’s director of economic development, said the site, created in partnership with Hamilton Rising and ShopEatPlay, is also helping to bring merchants online if they’re not already selling their products remotely.

“There is no cost for the merchant to participate,” said Schleehahn.

“If the merchant does not offer gift cards at this time, ShopEatPlay will get them up and running with a digital gift card offering at no cost to the business for three months.”

Schleehahn describes the site as a “parallel economy” for brick-and-mortar businesses that rely on walk-up traffic and don’t have that particular revenue source at this time.

The COVID-19 pandemic has forced hundreds of retailers across Hamilton to close their doors or reduce their operational capacity.

For businesses on Locke Street, which were slowly beginning to recover after months of construction closed the street to traffic, it’s been a major blow.

“Locke Street is just devastated,” said Steven McDuffee, who has been running Pure Home Couture Apothecary on Locke alongside his wife Abby since 2002.

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The road underwent major reconstruction between March and September of 2019, during which it was closed to vehicle traffic. The street re-opened toward the end of September but was still impacted by construction until November.

During that time, McDuffee estimates that about 15 businesses shut their doors permanently and the ones that remained open lost up to 50 per cent of their business.

Pure Home was forced to let its staff go and the store is now being run solely in its online form by Steven, Abby and their son.

One of the products that they’ve started selling online is a homemade sanitizer that started when Abby was making some just for use at home.

“Because our daughter has cerebral palsy and she’s severely challenged … we have to be super careful on this, bringing anything home. So she was making some hand sanitizer because we have all of the ingredients. For our perfumes, diffusers, room sprays, and things that we normally make. And then she thought, why don’t I put a label on this and sell it?”

The hand sanitizer has been one of their most popular items since transitioning to the online-only store, but McDuffee said they now have another challenge: the supply chain.

“Things that you need are not readily available. There’s high demand for hand sanitizer ingredients, bottles and things of that nature. Everybody wants it, so it’s hard to get.”

Other suppliers have shut down and aren’t producing the ingredients they need. As a result, McDuffee said they’re only selling what they have in stock.

“It’s hard to make any promises to anybody because you can only work with what’s in your factory. And beyond that, it’s just kind of roll the dice and see what today brings.”

With the launch of the city’s HometownHub site, McDuffee said he hopes it encourages people to support their local businesses while staying at home.

“To go on Amazon and pull products out of the U.S. right now for whatever reason, if they can be replaced by a Canadian-made product or a locally-made product, I would hope that that’s something that people will gravitate to. Because we all need to help each other right now.”

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