“Those who make peaceful revolution impossible will make violent revolution inevitable.” – President John F. Kennedy (1962)
This week may be one of the worst weeks for Nigerian judiciary and they might have made the much vaunted Sowore’s revolution inevitable. The first salvo was the list of judges released by the National Judicial Council replete with the names of their sons and daughters as well as hangers on. Second is the farcical decision in EFCC vs Kalu where the Supreme Court “suo motu” created a new section to the constitution of Nigeria by vacating a conviction duly given under an extant law. The strange rationale by the Supreme Court is that the presiding judge, now elevated to the Court of Appeal should not have pronounced the sentence. The Court conveniently ignored the fact that the accused counsel had invited the judge to come back and continue the hearing by a formal letter!
Gone are the days when Nigerian judiciary is famously celebrated as the last bastion of defense for the common man. The days of Kayode Esho, Chukwudifu Oputa, Muhammed Uwais is long gone. Our judiciary is no more like Caesar’s wife, above board. The problem however is not necessarily down to the hydra headed monster of corruption alone but a more sinister evil called, nepotism. It is my humble opinion that an opaque process for selection of judges led us to where we found ourselves this week. And the problem did not start with the current chief justice. The dysfunction and bastardization have been long in coming, and as we will find out in this piece, the cancer has eaten deep into the fabric of this nation. The revolution is inevitable.
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What precipitate this write up is a social media post by a good friend of mine and I obtained his permission to repost his comment with my personal edits: “It took Orji Kalu only 4 months including Covid lockdown challenge to move from the High Court to Supreme Court to get his so called sound judgment from Supreme Court while it took ten years to get his case completed at the High Court level. Ten good years! And we are told justice in Nigeria is not cash and carry? The Supreme Court is preparing the ground for a revolution and very soon something extraordinary will take place. The same Supreme Court that will give 2021 and 2022 court date for poor defendants, sat and summarily decide a case within 4 months while cases of those facing a life sentence languish in the labyrinth of jungle justice!”
My first response to the post, is to retort that the problem did not start with judiciary, but they seem to have led the “nunc dimitis” for the internment of democracy in Nigeria. The judiciary may have pushed us to the praecipe but they were not the only one. We all recalled the impunity days of PDP rule and how they ride roughshod on people’s right, celebrating acquisition of jets obtained from corrupt practices while hordes of masses suffer the indignity of scrapping for foods from the gutter. Towards the end of that era, we all thought, if we can just get a man of integrity into Aso Rock, someone who will brook no atom of corruption, we will change the country. The election of 2015 seems to have lulled Nigerians into thinking that all we need is someone or a duo with integrity, so we elect Buhari and Osinbajo, a puritan and a pastor and went home satiated. What we were not prepared for or more appositely choose to ignore is the fact that the vehicle that brought them into governance is none other than the decrepit system that PDP used to feather their nest. In the first 4 years, we were told that the problem is with the National Assembly where the legistlooters shifted their control of the vortex of power in Abuja, opposing every anti-corruption moves of the executives. Then come the last election where the ruling party now controls the executive and legislative arm, but corruption runs through the gamut of the judiciary and Aso Rock looks the other way while nepotism festers in its rank.
It is as if the cancer has completely swallowed up the entire fabric of the nation. Cases involving the poor dragged on for years while those who can afford senior advocate can get quick justice. Many warned that this will sound the death knell of democracy in Nigeria. Every attempt to even build on free and fair election has been truncated by the judiciary. What with the recent confounding judgment from Imo and Bayelsa. Our two gargantuan political parties now owned our judiciary lock, stock and barrel. They sit in smoke filled rooms to determine who will be governors, legislators and judges, and those who will play ball are readily appointed as pawns in the chest board of the Nigerian ruling class, wives, nephews, cousins, sons and daughters are made judges and senior advocates overnight without recourse to any modicum of meritocracy. A friend of mine recently quipped that the problem of nepotism is not just that it defeats meritocracy and breeds mediocrity but that it infects the entire body politics and renders it comatose. Corruption can be traced, and ill-gotten wealth recovered but nepotism is more sinister. Those who obtain position of power and authority through nepotism hold fealty only to their masters who appointed them. Such appointee will readily twist the constitution, made up section that does not exist all at the behest of their “godfather”. It is insidious and evil.
I graduated from Nigerian Law School 30 years ago, after an excellent stint at Great Ife. My class at Ife, drawn from the north, east, west middle belt and south-south has in its rank some of the best legal minds any country will be proud of. We graduated with high hopes to take on the world and change the land. Few of us found ourselves abroad on scholarship where we flourish and excel. Those in legal practice in Nigeria, either at the federal or state ministry of justice or private practice are the ones my heart bleeds for, especially those without access to members of the National Judicial Council. I have had the privilege to advance my career abroad as an attorney and public defender. I frequently sit on panels that recommend colleagues for appointment as judges in a fair, open and transparent process; something my colleagues in Nigeria could only dream of.
When I look at the state of Nigerian legal practice my heart bleeds. The career growth of colleagues in the legal profession in Nigeria is stunted not for lack of excellence but influence in the right place. Influence peddling is an art form in Nigeria and politicians used to have the exclusive preserve of selling it to the highest bidder, but our Judicial Council seems to have mastered the art. The problem will not be this pronounced if the sons and daughters they are foisting on Nigerian judiciary are steeped in the Nigerian experience or have a modicum of merit. As many of my colleagues are apt to complain, majority of the recent appointees hardly spend few years in Nigeria. They all went to schools abroad. Totally devoid of the Nigerian experience, and constantly removed from the everyday life Nigerians suffers under. Majority of them lives in the gilded mansions of their forbears in Abuja and other state capitals, where they are rarely touched by the “better angels of our nature” to use the phrase coined by Abraham Lincoln. It is therefore no surprise that they care only for what their “godfather” demand.
Let me however warns that the biggest mistake we could make is to think that the rot is only in the heart of our judiciary. Think again. Nepotism is next door, next street, next town and everywhere in Nigeria. It rampages through the land, be it North, East or West. Just look at our churches and mosques, who do you see minister or lead the prayers when the founder/visioner is not around? You guess right, if you say their sons and daughters. Gone are the days when Pa Fadayomi push to have a meritorious doctor of aerodynamics succeed him. Gone are the days when the leader of the faithful in Nigeria is selected by their aptitude in the knowledge of the Quaran. Nowadays, the exit of the leader is the beginning of the reign of the progeny. It has infected our colleges and universities, scholarship and opportunities that used to be available on merit are now exclusive preserve of the vice chancelor’s children and family members. Woe betide the school senate members that dare ask questions. Advertisement for jobs that has already been reserved for the children of the privileged are means to extort money in the form of application fees a la Abba Moro immigration recruitment scheme. A recent recruitment without advertisement at our apex bank reported by Sahara Reporters shows that successful applicants names were picked out of the rolodex of the governor. Commercial Banks staff are not an exemption, they are either recruited based on sex appeal or influential ministers/senators’ “recommendation” which doesn’t come easy for the educated but less privileged applicants.
A friend concluded an animated discussion on social media on this issue with a distinctively Nigerian resignation: “It is clear that those who do not want things to work properly in Nigeria are more powerful than those who are working towards finding solutions to our problems.” Again, my response is what do we have to lose if we embrace Omoyele Sowore’s revolution, even with its youthful disdain for experience? Especially when our current experienced leadership seems to treat the Nigerian masses with contempt. Look at it this way: They do not need our votes to win election, as they could procure midnight judgment in Abuja a la Bayelsa and Imo. They do not need to legislate to fill any lacunae in our constitutional experience as the Supreme Court proved in Kalu’s case. In fact, as long as oil flows and they have the means to fill their Cayman Island bank accounts, we may as well not exist. Greed and avarice have become the directive principle of Nigerian ruling class. To rescue ourselves from their vice grip, we need revolution now!
Governor Dapo Abiodun of Ogun State has extended the lockdown in the state by another week.
The governor announced this on Friday while briefing journalists in the state.
The governor frowned at the flouting of social and safety guideline to ensure the eradication of the virus in the state.
He noted that the lockdown extension was a precautionary method, adding that residents must wear face masks.
He said, “Reports reaching us have shown that many of our people are showing utter disregard for the precautionary guidelines, international best practices and safety measures rolled out, especially, during the window of relaxation of the lockdown.
“We have heard and seen the havoc that COVID-19 continues to wreck in other lands. Let us learn from these experiences.
“Now, to preserve the lives of our people, we are persuaded to extend the currently modified lockdown, which has been slightly eased, for another one week alongside the current guidelines.
“Wearing a face mask is mandatory. It is important to note that we have provided, and continue to provide, facemasks to public servants, groups and association.”
Abiodun said the test had intensified its contact tracing and would continue to test and treat people suspected or infected with the virus.
He added, “As of today, we have screened over 10,000 people and tested over 700. In addition to that, we have intensified our contact tracing capacity and have traced over 551 contacts of the COVID-19 positive patients.
“We are doing this to detect and treat people who are already infected rather than leaving them undetected which will be more detrimental because this will increase community transmission.”
Falsified and contaminated Defibrotide identified in WHO regions of Western Pacific, Europe and Eastern Mediterranean
This alert relates to falsified DEFIBROTIDE 200MG VIALS OF 2.5ML (80MG/ML) CONCENTRATE FOR SOLUTION FOR INFUSION identified in Australia, Latvia and Saudi Arabia. This product is sold under the brand name Defitelio.
Following enquiries with stakeholders, on 8 April 2020, WHO was informed that falsified DEFIBROTIDE 200MG vials had also been supplied to Saudi Arabia, displaying batch number 0286 and 0126 (see Table 1 below for full details).
Following enquiries with stakeholders, on 9 April 2020, WHO was informed that falsified DEFIBROTIDE 200MG vials, displaying batch number 0126, had also been identified in Australia and Latvia.
DEFIBROTIDE is used to treat hepatic veno-occlusive disease, in which the blood vessels in the liver become damaged and obstructed by blood clots. This can be caused by treatments prior to a stem cell transplantation.
Laboratory analyses, conducted by national medicines regulatory authorities and the manufacturer of the genuine product, established that these falsified products do not contain any of the expected active ingredient. The solution in the vials is also contaminated with mould (Cladosporium sp. and Aspergillus niger).
Information available to WHO indicates that both batches of falsified DEFIBROTIDE 200MG vials were present within the regulated supply chain in Latvia as early as January 2020 and were also handled by medicine wholesalers in the United Kingdom in February 2020. It is important to note that widespread vigilance is required from all countries, regardless of where the product was originally identified.
Table 1: falsified defibrotide subject of WHO Alert n°5/2020, identified in Australia, Latvia and Saudi Arabia
The two products listed in Table 1 are confirmed falsified, on the basis that there is deliberate misrepresentation of their identity, composition and source.
The genuine manufacturer of Defibrotide, GENTIUM S.R.L has also confirmed to WHO that:
They did not manufacture the above products.
Authentic DEFIBROTIDE 200MG VIALS with batch number 0286 were supplied to Argentina, Hong Kong, Malaysia, Singapore and Turkey.
Authentic DEFIBROTIDE 200MG VIALS with batch number 0126 were supplied to Australia, Jordan, Kuwait, Lebanon, New Zealand, Qatar, Singapore, Turkey and the United Arab Emirates.
For guidance and photographs, please refer to page 2 of this Alert n°5/2020.
Photos of Falsified DEFIBROTIDE Batch number: 0286, with expiry date: 09/2021
Sample from Latvia Sample from Latvia
Photos of Falsified DEFIBROTIDE Batch number: 0126, with expiry date: 08/2021
Sample from Australia Sample from Australia
WHO requests increased vigilance within the supply chains of countries likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centres, wholesalers, distributors, pharmacies and any other suppliers of medical products.
If you are in possession of the above products, please do not use them. If you have used these falsified products, or if you suffer an adverse reaction/event having used these products, you are advised to seek immediate medical advice from a qualified healthcare professional, and to report the incident to the National Regulatory Authorities/National Pharmacovigilance Centre.
All medical products must be obtained from licensed, authorized and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.
National regulatory/health authorities are advised to immediately notify WHO if these falsified products are identified in their country(ies). If you have any information concerning the manufacture, distribution, or supply of these products, please contact rapidalert@who.int.
WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show, highlighting the need to improve awareness and scale up services to prevent and treat herpes.
About 13% of the world’s population aged 15 to 49 years were living with herpes simplex virus type 2 (HSV-2) infection in 2016, the latest year for which data is available. HSV-2 is almost exclusively sexually transmitted, causing genital herpes. Infection can lead to recurring, often painful, genital sores in up to a third of people infected.
Herpes simplex virus type 1 (HSV-1) is mainly transmitted by oral to oral contact to cause oral herpes infection – sometimes leading to painful sores in or around the mouth (“cold sores”). However, HSV-1 can also be transmitted to the genital area through oral sex, causing genital herpes.
Around 67% of the world’s population aged 0 to 49 had HSV-1 infection in 2016 – an estimated 3.7 billion people. Most of these infections were oral; however, between 122 million to 192 million people were estimated to have genital HSV-1
infection.
Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive
health” says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at the World Health Organization (WHO).
Herpes and HIV
People with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. Thus, HSV-2 likely plays a substantial role in the spread of HIV globally. Women are more susceptible to both HSV-2 and HIV. Women living in
the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection.
No cure: vaccine needed
There is no cure for herpes. Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.
Better awareness, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. In addition, development of better treatment and prevention interventions is needed, particularly
HSV vaccines.
“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.
Authored by staff at the University of Bristol, the WHO, and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization, this new study estimates the global infection prevalence and incidence of HSV-1 and HSV-2
in 2016.
Read More
https://www.who.int/news-room/detail/01-05-2020-billions-worldwide-living-with-herpes
New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.
The
results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world.
Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization.
Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world.
What is maternal sepsis and how does it lead to maternal death?
Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.
The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.
Few
previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.
A better understanding of maternal infection
GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.
The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.
GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
which are not usually recorded as maternal sepsis, including post-abortion and indirect infections.
The result is a more complete understanding of the frequency and impact of maternal infections in health facilities.
GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk.
Putting global numbers on maternal infection and sepsis
Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management.
Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.
Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
haemorrhage.
This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.
Preventing, identifying and treating maternal infection and sepsis
Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.
GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively.
For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.
GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.
This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
providers to manage the frequency and outcome of maternal infections.
An opportunity to implement evidence-based practice
GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives.
WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
on 5 May which celebrates the central role played by nurses and midwives in clean health care.
Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.
Heads of state and global health leaders today made an unprecedented commitment to work together to accelerate the development and production of new vaccines, tests and treatments for COVID-19 and assure equitable access worldwide.
The COVID-19 pandemic has already affected more than 2.4 million people, killing over 160,000. It is taking a huge toll on families, societies, health systems and economies around the world, and for as long as this virus threatens any country, the entire world is at risk.
There is an urgent need, therefore, while following existing measures to keep people physically distanced and to test and track all contacts of people who test positive, for innovative COVID-19 vaccines, diagnostics and treatments.
“We will only halt COVID-19 through solidarity,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries, health partners, manufacturers, and the private sector must act together and ensure that the fruits of science and research can benefit everybody.”
Work has already started. Since January, WHO has been working with researchers from hundreds of institutions to develop and test vaccines, standardize assays and standardize regulatory approaches on innovative trial designs and define criteria to prioritize vaccine candidates. The Organization has prequalified diagnostics that are being used all over the world, and more are in the pipeline. And it is coordinating a global trial to assess the safety and efficacy of four therapeutics against COVID-19.
The challenge is to speed up and harmonize processes to ensure that once products are deemed safe and effective, they can be brought to the billions of people in the world who need them. Past experience, in the early days of HIV treatment, for example, and in the deployment of vaccines against the H1N1 outbreak in 2009, shows that even when tools are available, they have not been equally available to all.
So today leaders came together at a virtual event, co-hosted by the World Health Organization, the President of France, the President of the European Commission, and the Bill & Melinda Gates Foundation. The event was joined by the UN Secretary General, the AU Commission Chairperson, the G20 President, heads of state of France, South Africa, Germany, Vietnam, Costa Rica, Italy, Rwanda, Norway, Spain, Malaysia and the UK (represented by the First Secretary of State).
Health leaders from the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI-the Vaccine Alliance, the Global Fund, UNITAID, the Wellcome Trust, the International Red Cross and Red Crescent Movement (IFRC), the International Federation of Pharmaceutical Manufacturers (IFPMA), the Developing Countries Vaccine Manufacturers’ Network (DCVMN), and the International Generic and Biosimilar Medicines Association (IGBA) committed to come together, guided by a common vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, to launch this groundbreaking collaboration. They are joined by two Special Envoys: Ngozi Okonjo-Iweala, Gavi Board Chair and Sir Andrew Witty, former CEO of GlaxoSmithKline.
They pledged to work towards equitable global access based on an unprecedented level of partnership. They agreed to create a strong unified voice, to build on past experience and to be accountable to the world, to communities and to one another.
“Our shared commitment is to ensure all people have access to all the tools to prevent, detect, treat and defeat COVID-19,” said Dr Tedros. “No country and no organization can do this alone. The Access to COVID-19 Tools Accelerator brings together the combined power of several organizations to work with speed and scale.”
Health leaders called on the global community and political leaders to support this landmark collaboration and for donors to provide the necessary resources to accelerate achievement of its objectives, capitalizing on the opportunity provided by a forthcoming pledging initiative that starts on 4 May 2020. This initiative, spearheaded by the European Union, aims to mobilize the significant resources needed to accelerate the work towards protecting the world from COVID-19.
Read More
https://www.who.int/news-room/detail/24-04-2020-global-leaders-unite-to-ensure-everyone-everywhere-can-access-new-vaccines-tests-and-treatments-for-covid-19
NEW YORK: One medical worker called it “insane”, another said it induces paranoia – the speed with which patients are dying from the novel coronavirus is shocking even veteran doctors and nurses as they scramble to determine how to stop such sudden deterioration.
Patients “look fine, feel fine, then you turn around and they’re unresponsive”, said Diana Torres, a nurse at Mount Sinai Hospital in New York, the epicentre of the pandemic in the US where the virus has infected nearly 430,000 people and caused more than 14,700 deaths.
“I’m paranoid, scared to walk out of their rooms.”
It isn’t just the elderly or patients with underlying health conditions, who can be fine one minute, and at death’s door the next.
It can happen for the young and healthy, too, health professionals told Reuters.
A young woman died unexpectedly while nurse Laurie Douglas was on duty at Our Lady of the Lake Hospital in Baton Rouge, Louisiana.
After 34 years on the job, Douglas said she normally has “an intuition of who is going to fade and who may improve”.
“But these people are throwing that out the window.
“Last week, she was planning her wedding.
“This week, her family is planning her funeral,“ she said, referring to the deceased patient.
Patients might enter the hospital with strong oxygen levels and be engaged in happy conversation, said a resident emergency doctor at New York-Presbyterian Hospital, only to be “gasping for breath” and intubated a few hours later.
“The scary thing is there are no rules to it,“ the resident said on condition of anonymity.
These scenes are playing out everywhere as Covid-19 has infected more than 1.4 million worldwide and killed more than 85,000 as of Wednesday.
The quick turns for the worse are likely products of an “overly exuberant” reaction by the immune system as it fights the virus, said Dr Otto Yang, an infectious disease specialist at the UCLA Medical Centre in Los Angeles.
Called a cytokine storm, it occurs when the body overproduces immune cells and their activating compounds – cytokines – causing dangerously high blood pressure, lung damage and organ failure.
Emily Muzyka, 25, a nurse in the New York suburbs, said she reached her breaking point last week, when a relatively healthy 44-year-old woman needed sudden intubation.
“I had a meltdown that night,“ she said.
“I cried to my boyfriend.”
Intubation refers to inserting a tube into the mouth and through the airway of a Covid-19 patient struggling to breathe, so they can be hooked to a mechanical ventilator.
Journalist Anick Jesdanun, who was in good health and had run 83 marathons, died last week from Covid-19, according to a post on Facebook by his cousin Prinda Mulpramook.
Jesdanun, who was 51, at first didn’t need hospitalisation, according to the post.
He had begun to recover and showed clear lungs and strong vital signs during a doctor’s visit in late March. But “a sudden setback” sent him to the emergency room on April 1, and “13 hours later we lost him”, Mulpramook wrote.
A nurse at Mount Sinai’s intensive care unit recalled watching patients’ kidneys quickly shut down, adding that many require intravenous drips of the blood thinner Heparin.
“It’s insane how sick they get, how quickly.
“We’re really trying hard to figure out how to treat them.”
Some of those hospitals are experimenting with unproven drugs in hopes of helping patients, including the anti-malaria medication hydroxychloroquine.
“We’re essentially throwing the kitchen sink at these patients,“ a doctor said.
Read More
https://www.thesundaily.my/home/speed-of-covid-19-deaths-shock-doctors-and-nurses-AF2241516
There is no better warning about the growing confusion that seems to be gradually beclouding the federal government’s response to the coronavirus challenge than the belief it betrayed last week that, perhaps, all it needs to calm the fears and apprehensions of Nigerians about its ability to halt the spread of the virus is to reel out a catalogue of activities President Buhari was said to have undertaken so far concerning the pestilence, whether the people felt their impact or not.
Now, if your family is starving badly, do you solve the rumbling signs of biting hunger in their stomach with some wild tales of the efforts deployed by you so far to feed them, or just keep quiet, give them food, and they will see and feel for themselves that you have played your role responsively and effectively? Or if you must talk, tell them something you have done whose benefits they can readily verify and identify with.
Indeed, some Nigerians are beginning to achieve the conviction that there must be something about being in government in this country that seems to diminish the reasoning ability of people once they get in there and deprives them of the capacity to realize when they have stopped making sense or even become downright annoying. This is very pathetic.
And so, last week, presidential spokesperson, Mr. Femi Adesina, issued a document entitled: “COVID-19: What President Buhari Has Done And Is Doing.” And, I suppose that with the release of that handout, the virus immediately received a deadly blow and vanished from the country! Aren’t we so blessed? Why then are Nigerians not on the streets celebrating the unprecedented feat?
A prominent item on Mr. Adesina’s list is the president’s March 29 broadcast. And what exactly did the broadcast achieve? The two things I can readily remember now is that Gen Buhari had announced the continuation of the school feeding programme for pupils who are all at home now due to the closure of schools as part of the efforts to contain the spread of the coronavirus. Probably, nobody remembered to inform him and his speech writers that school children were on compulsory holidays, or are they going to send the food to them in their homes? Or, perhaps, somebody is trying to find a justification for the billions of naira we will be informed later was spent on the exercise?
Also, the president proclaimed the lockdown of Lagos and Ogun states and the Federal Capital Territory (FCT). And when he was through, he returned to his hideout – where only a few privileged eyes and ears see and hear from him, and then come out to tell us what they think he has said or done.
Now, what exactly was the lockdown meant to achieve? Okay, as social interactions are reduced, the chances of spreading the virus decrease. Yes, but what else? Has anyone seen any evidence that there were any plans to use the stay-at-home period to access the people and step up medical tests to determine how many people have become infected with the virus and how they could be attended to?
The government that was boasting that it was “adequately prepared” to tackle the virus was later to prove when the virus eventually arrived that it was only making empty claims as usual. A country of 200 million people has yet to demonstrate any capacity to test even a reasonable fraction of one percent of her population. And somebody is publishing a document to tell us what the president was supposed to have done or is doing. As if such boring tales will remove the cloud of gloom hovering over Nigeria?
Again, in a country where electric power is just an unaffordable luxury for many, how can a leader just lock down some states and return to his hideout to continue his “vacation” that was rudely interrupted by the loud, persistent and widespread demands that he should address his country even though some other presidents were doing daily briefings and leading the war against the virus from the front? As the markets closed and movements became restricted, how are those who could afford to buy and stock food items at home preserve them without electric power?
What of the greater population which depend on daily earnings for their survival? What is the government’s plan for them? Okay, we are hearing of palliatives that have been extended to this category of people and the billions of naira that have already been transferred to their accounts? Now, who has encountered the happy recipients of the twenty thousand naira (N20, 000) said to have been given to each of them? Are there really existing data showing the social and economic status of every Nigerian which is in the possession of the authorities? So, all the “poor and vulnerable” Nigerians now have bank accounts whose details are known to the government? So, why then are too many Nigerians very suspicious of these claims as shown in their social media comments? And why is such a rare display of kindness by this government not being celebrated? Or have the funds (if indeed any were shared) ended up in the hands of the same people who have more than enough to need them while those who are genuinely deprived remain terribly famished?
Already, the biting hunger out there is forcing a growing number of people to defy the no-movement decree and soon, the whole effort might be defeated, and the country will return to square one. Information Minister, Mr. Lai Mohammed, is threatening that the lockdown may be extended if Nigerians fail to behave themselves. But what he should rather have done is to hasten to school himself to realize that there is always a price to pay when leaders leave the country they claim to be governing in great disarray only to suddenly wake up when there is an emergency to grope for fix-quick solutions.
A few days after the president’s broadcast (that is, Tuesday, March 31), Daily Independent carried a front page lead story about 26 Americans who came into the country through the Murtala Mohammed International Airport and headed to Calabar without being screened. Now, who cleared their trip to the country and why were there no health officials available to screen them and ensure they were quarantined for 14 days before being allowed to fly to Calabar? Is it because they are Americans or clients of the Nigerian National Petroleum Corporation (NNPC) or both? Does that automatically exempt any of them from being a carrier of the virus which is presently ravaging their own country? What kind of government claims to be fighting a virus with one hand and using the other hand to be undermining the efforts being deployed to contain it?
Okay, the Minister of Health, Dr. Osagie Ehanire, has just announced that an 18-man Chinese team of medical “experts” will soon arrive the country to “assist” Nigeria in the fight against the coronavirus. Now, is it the federal government that asked China for help or was it China that volunteered their assistance? Indeed many Nigerians are vehemently opposed to this gesture at this time. Our own local medical experts have not shown any signs of being overburdened by the work, so what difference are these 18 Chinese doctors and nurses going to make? Will they, like the 26 privileged Americans, also be given express entry into the country or will they be isolated for 14 days as should be the case, before they would be allowed to start rendering their “assistance”?
Do we really need this Chinese gift now or is it that the government lacks the liver to politely decline their offer of help, despite the widespread apprehension among the citizenry about their involvement (since many Nigerians, habour strong fears that the gesture might turn out a Greek gift)? Even the umbrella body of Nigerian doctors, the Nigerian Medical Association (NMA), has come out to strongly oppose the coming of the Chinese medical team. Is it that our government is too intimidated to say NO to China’s offer probably because it has yoked itself so much with crushing debts due to its excessive borrowings from them – debts, whose positive effects on Nigerian lives many are yet to see?
I raise these points because, although, Nigeria has recorded one of the lowest deaths from coronavirus, it was the stubborn refusal of the government to close our borders when it became very necessary and urgent (and despite calls from well-meaning Nigerians) that led to the explosion in the number of confirmed cases that the country has recorded today. In saner climes, the government should have profusely apologized for that terrible miscalculation that is costing the nation so much now.
But it now has another opportunity now to gratify the yearning of Nigerians and reject the Chinese offer even if it is well-meaning and the fears about it are misplaced.
Now, what lessons is the government taking away from the scourge of coronavirus? Will they see the need to equip our hospitals this time and upgrade at least few of them to world standard now that they have realized the folly of always waiting to use public funds to send themselves and their families abroad to treat even minor ailments? For the first time in Nigeria, the naïve and largely misguided Nigerian leaders have found out that it is not always safe to seek solutions for health challenges outside the country and that there is afterall no place like home. This is hoping that the lesson will endure and be redemptive.
*Ugochukwu Ejinkeonye, is a Nigerian journalist and writer. (scruples2006@yahoo.com)
Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.
Transcript:
Speaker key:
TJ Tarik Jasarevic
TAG Dr Tedros Adhanom Ghebreyesus
LG Lady Gaga
HE Hugh Evans
MR Dr Michael Ryan JA Jamie
MK Dr Maria Van Kerkhove KA Kai
KT Kate
IN Innocent
YA Yang
00:00:19
TJ Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking raise hand if you are
on Zoom. Today we have a special guest but I will let Dr Tedros do his opening remarks and introduce them. Before I give the floor to Dr Tedros, just to remind you, we will also be sending you some news from other
WHO offices around the world with the audio file from this press briefing a little bit later. I give the floor immediately to Dr Tedros.
00:01:07
TAG Good morning, good afternoon and good evening. The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes people in the entertainment
industry.
Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.
WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.
Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the One World Together At Home virtual global special on Saturday 18th April. It’s now my great pleasure to invite
Lady Gaga and Hugh Evans to say more about this very special event, One World.
00:03:10
LG Thank you very much, Dr Tedros. Good morning, good afternoon and good evening to everyone who’s listening and watching. I would like to thank the World Health Organization and the
United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization for asking me to collaborate
with you on this special.
We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This global pandemic is a catastrophe. I’m so thankful to them and I’m also
praying for those who are sick. It’s been a pleasure to partner with Global Citizen and we’ve been working all together behind the scenes to raise money for the World Health Organization.
I would also like to send my prayers as well to people that are losing their jobs and are having a hard time feeding themselves and their children. We are raising money for the World Health
Organization’s COVID-19 Solidarity Response Fund and seven days ago we held a call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
list as there have been many corporations and philanthropists that have been very, very generous during this time.
00:04:38
Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like to reiterate our deep gratitude to the medical community. My heart is very, very aching and warm for those
who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families or their patients. What you’re doing is putting yourselves in harm’s way to help the world
and we all salute you and you are a triumph truly.
I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible] essential PPE, supplies and testing kits around the world and will help improve lab capacity
to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.
I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities and initiatives so that the front-line health workers in most immediate need have the resources they need
to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.
We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.
00:06:47
I would like to, on behalf of the World Health Organization and Global Citizen, thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do air live on April 18th put your wallets away, put your credit cards away, anything
away that you need to and just sit back and enjoy the show that you all very much deserve.
I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.
HE Good morning, good afternoon, good evening and thank you, Dr Tedros and thank you, Lady Gaga. Your Excellencies, ladies and gentlemen; Lady Gaga, Dr Tedros,
you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
of bravery demonstrated by the front-line community health workers around the world and I hope that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
the backbone of our communities.
Global health is at the very core of the global citizen mission and we must ensure that the world’s poorest and most marginalised people have access to resources to cope with and tackle this health crisis. Through One
World: Together At Home on April 18th we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
workers.
00:09:09
In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.
In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli, Billie Eilish, Billy Joe Armstrong of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington, Lang Lang, Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.
We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional international broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.
00:11:43
The digital broadcast will celebrate and support brave community health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge
and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.
Thank you all.
TJ Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.
TAG Once again I would like to thank Lady Gaga and Hugh Evans for their partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise resources to fight the pandemic so I thank her for her incredible passion and commitment and leadership and
also to my friend, Hugh Evans, for connecting all the dots and for his leadership.
We all look forward to joining you for the One World: Together At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
We understand that some countries have recommended or are considering the use of both medical and non-medical masks in the general population to prevent the spread of COVID-19.
00:14:21
First and foremost medical masks must be prioritised for health workers on the front lines of the response. We know medical masks can help to protect health workers but they’re in short supply globally. We’re concerned that the mass
use of medical masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.
In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for health workers. In the community we recommend the use of medical masks by people who are sick and those who
are caring for a sick person at home.
WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.
If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in this area. We encourage countries that are considering the use
of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.
00:17:13
Keep your distance, clean your hands, cough or sneeze into your elbow and avoid touching your face. Less than 100 days since WHO was notified about the new coronavirus research has accelerated at incredible speed. The viral genome
was mapped in early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
20 institutions and companies are racing to develop a vaccine.
WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries and people. I want to thank the Medicines Patent Pool and Unitaid for the initiative they announced last
Friday to include medicines and diagnostics for COVID-19 in their licensing pool.
I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.
00:19:09
Poorer countries and fragile economies stand to face the biggest shock from this pandemic and leaving anyone unprotected will only prolong the health crisis and harm economies more. I call
on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.
Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over as early
as this Sunday. We’re not there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.
This would not have been possible without the incredible health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
workers in DRC faced the double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.
Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.
00:22:00
One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.
TJ Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will now open the floor. I will go to one question
that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in cases caused through religious gatherings in India, in fact almost a third of new cases
were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
followers?
MR First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s really unacceptable. We ask everyone and every community to see our health workers
as our heroes and to support them in every way we can.
With regard to gatherings of any type, be they religious or be they for other purposes, there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
are now postponed or cancelled. We’ve been working very, very closely with religious and faith-based organisations all over the world including groups from the Islamic tradition, Christian
traditions and others and continue to work through faith-based organisations to communicate using our Epiwin platform.
00:24:21
We’re also continuing to develop guidance specifically for the holy month of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
the risks associated with such holy events.
But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be treated with sensitivity, as the health workers who treat them so it’s very important that we’re not profiling COVID-19
along racial, along religious, along ethnic lines. This is not helpful.
TJ Thank you very much. This was a question from Ankit Kumar from India Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?
JA Hi, yes. Can you hear me? TJ Yes. Please go ahead.
JA Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned
with that, if you could give us a little bit more about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
to three times more infectious than influenza so what do you have to say about that? Thanks.
00:26:13
MK I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted are of significant interest to all of us. What we are doing is working
with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand when most transmission is happening, when any transmission is happening.
What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals and these are people that can be very early on in symptoms, even when they start
to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.
We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic phase. There have been some studies that have come out and we learned about this when we were on mission
in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.
However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through droplets, you still have to have these infectious particles that come out
of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.
00:27:42
We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.
Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.
So what we can say is that most people are transmitting this virus while they are symptomatic.
JA Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.
The thing we need to address in all of this is very often the idea of severity versus infection and there is a huge association between the dose of exposure and the severity of infection. We see this in many other
infectious diseases so we also probably need to look at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.
00:29:26
So it’s not just a matter of looking at how many people in the community are infected but are there specific elements of exposure that cause individuals to have a higher dose of exposure or a specific route of exposure
that causes more severe infection? There is also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
heavily contaminated you can imagine the large dose.
In other circumstances individual particles or virus particles potentially floating through the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant in
terms of driving infection, is that significant, does that produce an infectious dose that can successfully infect another individual?
These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think we need more information on what is the infectious dose and particularly
the relationship between the dose of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.
TJ Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?
00:31:01
KA Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global push to try and find a pre-exposure prophylaxis or a post-exposure prophylaxis. I understand there’re
several trials going on, most of them with chloroquine or hydroxychloroquine. I was just wondering whether you can speak a little bit to what role this could potentially play.
Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?
MR Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.
Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying to bring together a larger set of collaborative studies that will give
us the answers we need.
In terms of post-exposure prophylaxis I don’t believe we have at the moment studies planned but Maria can speak to that but there is certainly evidence for the use of – not proven evidence of effectiveness but there are a number
of studies underway and trials underway that use hyperimmune globulin in the treatment of disease; in other words they use that purified plasma of recovered individuals to give an antibody boost to people who are
suffering the disease.
00:32:49
Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.
MK Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries. We have teams through our science division and through GOARN,
through the Global Outbreak Alert Network, who are pulling together available literature on a number of topics, one of which is looking at different types of therapeutics and drugs.
The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying to evaluate every piece of evidence that is published so that we can look at the way in
which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer towards an effective treatment for COVID-19.
TJ Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?
KT Yes, hi. Good evening or good morning. I’m from BFM Radio Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
what WHO’s guidance would be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing some of these lock- downs? Thank you very much.
00:34:29
MR Thank you. It is a difficulty for governments right now because the lock-downs in many situations are proving effective in dampening the flames of the epidemic in those countries but those
lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.
The transition strategy out of lock-down requires a calibrated, step-wise approach. It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
include closure of schools, closure of churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.
Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
the lock-down you have to have an alternative method to suppress the infection. The way to do that is active case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.
00:36:32
In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
The specific parameters you need to be looking at are on two sides.
One is, it would be very inadvisable to lock down [sic] if the number of cases coming through the hospital is already at a level where your occupancy of beds is nearly at 100%. You need to be in a position where
you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.
You need to look at things like the doubling rate; how many days does it take for the number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
somewhere like Korea two to 6% of the samples they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.
00:37:45
You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific measurements that they need to look at to chart the path out of lock-down.
That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down and then we will wait and we will look at the data and if that works we go to the next
stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.
We want to achieve it as quickly as possible and we want to avoid many countries going into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
they can avoid the worst of this and we need to support them to avoid them going into that situation.
The most damaging lock-downs are in many developing countries where people – as the DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
around lock-down and around disease control in vulnerable periurban populations living in poverty, in poor rural communities. We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
those situations.
00:39:41
TJ Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?
IN Thank you. Can you hear me?
TJ Not very well but we will try. Please go ahead.
IN Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?
Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.
Hello?
TJ Yes, we are just trying to make sure that we understood the question but we will try. MR I think this is Nigeria. Is it?
TJ Yes.
00:41:08
MR Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
and, I believe, spoke with the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.
We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries.
They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.
With the many vulnerable people including refugees and migrants who live in those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
Union countries.
00:42:46
MK I’ll answer the question around vaccines. What we can say is that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
in place in whichever populations are under study with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust scientific evidence
but we ensure that all of the studies that are done are done with appropriate and the highest level of ethical considerations.
One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.
Some only have imported cases and there is an opportunity here, this window of opportunity that the DG has spoken about exists in many countries still. There is an opportunity to prevent the worst from happening
in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.
We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
where we need to put a lot of emphasis and support so that we can prevent countries from reaching a point where they need to put in these very restrictive movement restrictions.
TAG Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
the situation will not deteriorate. It may.
00:45:06
So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.
The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.
The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
will actually help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.
From WHO’s side we have been supporting and we increased, improved the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but
we’re working on that too and we’re finding different ways of addressing the gap.
00:48:06
But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.
Then on the vaccines issue there was, I think, a comment last week from a couple of
scientists who said the testing ground for the new vaccines will be Africa. To be honest, I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.
Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s
in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.
The hangover from a colonial mentality has to stop — and WHO will not allow this to happen. It was a disgrace actually and appalling to hear during the 21st century from scientists that kind of remark and we condemn
this in the strongest terms possible but we assure you that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
beings because we’re all human beings.
00:50:37
Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
design mechanisms for equitable distribution of the vaccines.
While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
of access or challenges to access ahead of time.
That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.
There should not be a divide between the haves and the have-nots.
If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.
TJ Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?
00:52:58
YA Can I hear you?
TJ Yes, we can hear you. Please go ahead.
YA As World Health Day is approaching what do you have to say to the front-line medical workers in China and around the world in the global anti-virus efforts? This question is
for Dr Tedros. Thank you.
TJ If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.
YA Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China and around the world in the global anti-virus effort?
TAG I think I have said it earlier; as you know, this is the year of the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
Assembly in mid-May. Unfortunately we’re in this situation but we will be launching a report tomorrow which is the first of its kind. It’s a report on the state of nursing. We will launch it tomorrow during the World Health
Day.
00:55:01
But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.
If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
professionals are very important because they are safeguarding that very important aspect of life — that’s health.
So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while saving lives so my message first is to the public at large; that each and every individual
should recognise, whether it’s during normal times or pandemics like now, the role of health professionals and help them, protect them, really appreciate and respect what they are doing.
To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something special to the extent of losing your life
while helping others to live. We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.
00:58:11
But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through
a different prism and they will also see your role.
But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing and you have all our respect and appreciation and we believe in
you, that together we will finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.
TJ Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will conclude this press briefing with these important words from Dr Tedros. We will
have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.
TAG [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.
01:00:18
Read More
https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020
PUTRAJAYA: A vaccine for Covid-19 is predicted to be obtainable in the market in about a 12 months as checks and analysis on it’s nonetheless on the early section, in line with Health director-general Datuk Dr Noor Hisham Abdullah.
He stated the World Health Organisation (WHO) are nonetheless wanting into a few compounds and analysis to develop a vaccine for this illness.
“So it will take probably about a year or a year and a half before we can get the vaccine in the market.
“Research is ongoing and hopefully by doing the research, we can get the vaccine as soon as possible,“ he said at the daily Covid-19 media briefing, here today.
In another development, Dr Noor Hisham said the Health Ministry (MOH) had accepted several Covid-19 patients who have recovered as volunteers for research on blood plasma.
“Two or three patients who have recovered are coming forward to contribute to science and technology.
“They are donating their blood to help MOH carry out research and for science to look at the viscosity of antibodies (which will be used to treat Covid-19 patients),” he stated.
He added that MOH would earlier display blood donors (former sufferers) to make sure they’re freed from the virus and of different infections comparable to Hepatitis C and so forth.
MOH will even conduct Covid-19 take a look at on the blood donors to make sure they’re actually freed from the virus.
“After that, MOH will take blood from them and separate it into red blood cells and plasma. The plasma will later be sent to IMR (Institute for Medical Research) to study its antibody viscosity.
“The procedure will be repeated after two weeks. If the antibody viscosity is high, then MOH may use the plasma from the patient to treat other patients,” he added. – Bernama
Read More
https://www.thesundaily.my/local/covid-19-vaccine-in-about-a-year-health-dg-AA2211651
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