COVID-19 International Developments: Daily Scan, April 4, 2020
Prerna Gandhi, Associate Fellow, VIF
Medical
Coronavirus: What are the symptoms of Covid-19?

While many people who become infected experience only mild symptoms, there are emergency warning signs to look out for, according to the US Centres for Disease Control and Prevention (CDC). These include persistent pain or pressure in the chest, mental confusion or low responsiveness to stimuli, as well as bluish tinge to the lips or face. Some patients may also experience shortness of breath, sore throat and general aches and pains. There is growing evidence that a loss of taste or smell could also be a symptom of the disease. The WHO said very few people reported diarrhoea, nausea or a runny nose. Symptoms may appear two to 14 days after exposure to the novel coronavirus, according to the US CDC. If you have a fever, difficulty breathing or other severe or concerning symptoms, wear a surgical mask, seek medical attention promptly and reveal your recent travel history. Limited studies suggest the viral loads in the respiratory samples of asymptomatic patients – a key metric of an infected person's transmission capability – do not demonstrate distinct differences from those of confirmed cases.

AI model to identify coronavirus patients at greatest risk of becoming seriously ill differs from statistics

An AI algorithm built by New York University researchers found that age, gender, lung image patterns and temperature are not the most useful risk indicators. Although statistics had shown men older than 60 with pre-existing medical conditions tend to be at higher risk, acute respiratory distress and deaths have been seen in all age and gender groups, including people who appear to be young and healthy. Some patients develop the life-threatening acute respiratory distress syndrome (ARDS) within a matter of hours or days while others show only mild symptoms until they recover. In partnership with Chinese doctors, the new AI models used data from two hospitals in Wenzhou city, which showed that the three main risk factors were increases in the liver enzyme alanine aminotransferase; myalgias, a type of muscle pain; and rising haemoglobin levels. The models they built were proven to have 70 to 80 per cent accuracy in predicting severe cases

German vaccine makers urge regulators to ease rules for virus

German biotech groups leading the race to develop a coronavirus vaccine have warned that governments will have to ease clinical trial regulations for hundreds of millions of doses to be available by the end of the year. BioNTech and CureVac, based just 200km apart in south-west Germany, are carrying out trials of a potential vaccine on mice and are set to start trials on humans within weeks. But their progress will depend on regulators such as the European Medicines Agency and the US Food and Drug Administration agreeing to certify a vaccine that had been fast-tracked through the three phases of a clinical trial. The need for funding to enable large-scale production is another potential obstacle. Both companies are likely to have to raise more cash soon from governments or investors that are showing huge interest in them.

CDC recommends Americans wear face masks voluntarily in public but some officials say they felt 'pressured' to draft new guidelines

The US Centres for Disease Control and Prevention is recommending people wear face coverings in public. President Donald Trump announced the new guidelines on April 3, saying it's a voluntary measure and people should not wear surgical or medical masks. "It's really going to be a voluntary thing," he said. "I'm not choosing to do it." "The CDC would not have gone this direction if not for the White House," a senior official told CNN. "We would have tried more to understand about asymptomatic transmission. We would have done more studies if we had more time." US Surgeon General Jerome Adams told reporters that officials were not recommending the use of masks to the public because their potential to slow down the spread of the virus was unclear. Adams says that now face coverings should be worn especially when distancing protocols can be difficult to maintain.

21 of 40 critical coronavirus patients in Japan recovered on ECMO life support

Extracorporeal membrane oxygenation (ECMO), a form of life support treatment that takes on the role of the heart and lungs, has helped 21 of 40 novel coronavirus patients in a critical condition in Japan to recover, according to a report heard by economic revitalization minister Yasutoshi Nishimura during a meeting on April 2. At present, Japan has about 400 ECMO machines at medical institutions designated to handle infectious diseases across the country for the most critical patients, and some 13,000 ventilators to assist people with breathing. But concerns remain that a wider spread of infections will lead to a lack of provisions for people in need.

Japan offers Avigan for free to countries fighting coronavirus

The flu drug Avigan will be made available at no cost to countries that ask for it to treat the novel coronavirus; the Japanese government announced on April 3. Chief Cabinet Secretary Yoshihide Suga told a news conference that about 30 countries have sought Avigan through diplomatic channels. "We are making arrangements to provide it for free," he said. Doing so will help expand clinical research into the drug, Suga said. At 2,617 cases as of April 3, Japan has relatively few of the more than 1 million infections worldwide, making broad clinical trials difficult.

Coronavirus: why the Nordics are our best bet for comparing strategies

From a scientific perspective, and in the absence of better models, the Nordic countries of Sweden, Denmark, and Norway may, serendipitously, represent a powerful intervention trial. While Denmark and Norway closed their borders, restaurants and ski slopes and told all students to stay home this month, Sweden shut only its high schools and colleges, kept its preschools, grade schools, pubs, restaurants and borders open — and put no limits on the slopes. Yet, the country’s leader and health officials have stressed hand washing, social distancing and protecting people over the age of 70 by limiting contact with them. As of March 28, the coronavirus transmission rate numbers for Sweden and Norway are estimated to be 2.47 and 0.97 respectively, with Denmark’s around one. One Swedish academic has predicted that up to half the Swedish population will be infected by the end of April. Although it is probably too soon to see a clear effect of interventions on mortality rates, by April 1, COVID-19 deaths in Sweden accounted for 24 per million citizens, whereas in Norway it was only eight deaths per million. Swedish hospitals have doubled their intensive care capacity within ten days, Eriksson told a press conference on March 30. The next step is to triple capacity.

Economic
Don't Expect a Crisis to Be Good for Gold

Central banks have a shrinking appetite for the metal. If they turn net sellers, the recent rally could come to a halt. In the short term, gold is only valuable in a crisis to the extent that you’re prepared to sell it. Any countries facing shortages of foreign currency to manage their balances of payments should be liquidating metal at the moment, rather than adding to their holdings. Further, in a world that still runs on the dollar, the prime attraction of gold is the ease with which it can be exchanged for greenbacks. So long as the yield on Treasuries doesn’t drop to zero, they’ll represent a more attractive way of raising cash dollars for as long as those swap lines are open (which the Federal Reserve has already announced). Rolling three-month additions to official sector gold holdings (those held by central banks and international institutions such as the International Monetary Fund) in January amounted to just 67 metric tons, the slowest pace since August 2018. The official sector owns about a fifth of the gold that was ever mined, and was the biggest buyer last year after jewellery consumers.

China-led AIIB to set up $5 billion fund to tackle virus epidemic

The China-led Asian Infrastructure Investment Bank said on April 3 that it will set up a fund worth $5 billion to help its member countries tackle the economic turmoil triggered by the coronavirus pandemic. The Bank said it plans to take steps such as investing in infrastructure related to public health and lending money to manufacturers in its 102-member nations for the next one and a half years, adding it may expand the fund if the situation further worsens. Proposed by China in 2013, the AIIB was launched in December 2015. Japan and the United States are the only Group of Seven industrial powers that have not joined the bank.

Short-time work: A vital tool in Germany's economic armoury against coronavirus

Kurzarbeit or short term work is a familiar term to those aware of previous Germany battles to keep the economy ticking over in a time of global crisis. According to Anke Hassel, a professor of public policy at the Hertie School in Berlin, the policy "is one of the reasons why Germany recovered so quickly after the 2008-9 financial crises". The scheme enables companies drastically affected in a downturn to either send their workers home or significantly reduce their hours without having to lay them off. Workers will still receive a significant chunk of their wages, with the state stepping in to cover much of the shortfall. If a company avails of the scheme, workers are laid off temporarily but will still be paid. Their employers receive Kurzarbeitergeld or "short-term work money" from the Federal Employment Agency (BA), which is also responsible for paying unemployment benefits. The government will pay 60% of the salary workers received before the crisis, or 67% if they have children. If and when the crisis abates, workers can then return to their full employment status without having had to be let go.

BRICS New Development Bank issues bond for financing COVID-19 fight

BRICS New Development Bank (NDB) issued a 3-year RMB Coronavirus Combating Bond on April 2 to raise 5 billion Yuan (706 million U.S. dollars), the Bank said in a statement released the next day. The bond, issued in the China Interbank Bond Market, marked the first RMB-denominated Coronavirus Combating Bond issued by multilateral development bank in China, the statement said. Due to an extraordinary demand from investors, the final order book was in excess of 15 billion Yuan, more than three times oversubscribed, the statement said. The bond issue was aimed at supporting the Chinese government in the financing of public health expenditure in the provinces of Hubei, Guangdong, and Henan, which were hard-hit by COVID-19. "NDB is fully committed to supporting our member countries during this period of crisis to fight the spread of COVID-19 and stand ready to provide the necessary financing to this objective," said Leslie Maasdorp, NDB Vice President and CFO. Headquartered in Shanghai, the NDB was established by Brazil, Russia, India, China, and South Africa. The bank formally opened in July 2015.

European officials worry coronavirus-weakened companies could be acquisition targets by China

"We will avoid a sell-out of German economic and industrial concerns," German Minister for Economic Affairs and Energy Peter Altmaier said last week as he announced plans for a fund to take stakes in or buy out local companies needing a lifeline. Cabinet colleague Andreas Scheuer had warned a day earlier of a possible "economic attack" by predatory foreign buyers. Their administration also launched a separate initiative to provide guaranteed liquidity to troubled companies. While introducing support funds for local companies, Spain, Italy and Australia have also been moving to tighten controls on foreign takeovers. "We are going to block foreign companies from taking control of strategic Spanish companies by taking advantage of the share price collapse," Spanish Prime Minister Pedro Sanchez said on March 17. Sanchez and other government officials have made no explicit mention of Chinese investors. But the record of Chinese companies, especially state-owned ones, buying up dozens of high-profile assets in countries hit by the European debt crisis, especially Greece and Portugal, weighs on policymakers across the continent.

Japanese Automobile Industry hopes to weather storm with strong balance sheets

Toyota Motor suspended production at five plants across Japan on April 3, joining the ranks of automakers throughout the world that have been forced to do the same as the coronavirus pandemic stifles sales. Honda and Nissan Motor have also signalled plans to halt production in Japan, with Suzuki halting all of its plants and Mitsubishi Motors already partially suspending the assembly of light vehicles. Toyota has requested a 1 trillion yen ($9.2 billion) emergency credit line from Sumitomo Mitsui Banking Corporation and MUFG Bank to help it weather the pandemic. This follows Moody's downgrade last week of its credit ratings for Toyota, Honda and Nissan, saying the sector was expected to remain vulnerable to the coronavirus outbreak given its sensitivity to consumer demand and sentiment. But with more than 6 trillion Yen in cash and short-term investments, as well as 23 trillion yen in retained earnings, analysts say Toyota's balance sheet looks stable for now. Japan's nine major carmakers have enough cash on hand to cover around two months of revenue on average, said Tokai Tokyo Research Institute's Sugiura, with Toyota able to cover 2.4 months, thanks to strong retained earnings which account for 43.4% of their total assets.

Strategic
US bought ventilators from Russian company under sanctions

Russia’s delivery of medical supplies on a giant AN-124 cargo plane included ventilators made by Kret, a subsidiary of Rostec, the Kremlin’s defence conglomerate, which is on a US Treasury blacklist. The US Treasury’s Office of Foreign Asset Control mentioned that “the humanitarian deliveries received from the Russian government appear non-sanctionable under Russia/Ukraine related sanctions authorities administered by Ofac”. “To the extent that such sanctions apply, Treasury has authority to license US persons to engage in transactions that are consistent with US foreign policy and national security interests,” Ofac said. “I'm not concerned about Russian propaganda,” Trump said. “He offered a lot of high quality stuff that I accepted. That may save a lot of lives. I'll take it every day.” The US sanctions normally prohibit all American people and companies from dealing with entities on its Specially Designated Nationals list. Kret was added to the SDN list in 2014 for its manufacture of “electronic warfare and intelligence equipment” as well as several important military systems and components.

Southeast Asia at risk of missing coronavirus cases amid dengue outbreak: experts

The concurrent outbreaks of dengue and Covid-19 in Southeast Asia will pose new challenges for authorities and health care workers, with experts warning that new coronavirus infections could slip through the cracks. Responding to a query, the World Health Organisation emphasised that dengue and Covid-19 were “two completely different viruses”, pointing out that the former is a flavivirus while the latter is a coronavirus.“While the initial symptoms of both diseases can be similar, we can differentiate between the two as the disease progresses,” it said. “The decision to order [a test for either disease] is made by the clinician and is based on the clinical presentation and other information including the epidemiological link and other exposure.” There are some 390 million dengue infections around the world each year, according to an estimate cited by the WHO. With strict lockdowns in place, spraying anti-mosquito aerosols has also been halted.

U.N. Agencies Struggle to Carry On Remotely

The U.N. Security Council lost more than a week tackling a host of technical difficulties and political disputes—Russia initially insisted all council decisions be taken at U.N. headquarters—before it settled on a strategy for approving U.N. mandates. The U.N. Human Rights Council—which shuttered its operations indefinitely on March 12—is still struggling to conduct its business, according to the minutes of an internal meeting by the U.N. Human Rights Council bureau, which includes representatives of key regional groups and a senior official with the U.N. Office at Geneva (UNOG), which manages operations in the United Nations’ Swiss headquarters. IT technicians at the U.N. are testing various online options to determine whether they can securely encrypt sensitive diplomatic discussions and guard against hacks and other threats to U.N. cyber security. The U.N. is also striving to facilitate formal meetings of the rights council, complete with live, virtual interpretation of discussion in the six official languages—Arabic, Chinese, English, French, Russian, and Spanish. Informal meetings, without simultaneous interpretation, will not come online before the end of next week.

China’s rising unemployment statistics pose grave challenge to Xi

According to a count by Sarah Tong and Yao Li at the National University of Singapore’s East Asian Institute, since January 24 China’s various ministries have issued more than 20 policy directives, almost all of them directed at helping companies stabilise their operations and avoid lay-offs. Despite this focus, the government’s official unemployment rate came in at a record high 6.2 per cent in February. A continued rise in unemployment into double-digit territory over the coming months, chief economist at Enodo Economics in London predicts, would represent a grave social and political challenge for Xi’s administration. If the world’s second-largest economy is not performing markedly better by the end of June, China’s powerful president could face unprecedented economic and political challenges, ranging from double-digit unemployment to the country’s first official recession since 1976.

Japan has 26 coronavirus clusters in 14 prefectures, double mid-March total: govt report

Japanese authorities have recorded 26 coronavirus infection clusters in 14 prefectures including Tokyo, according to data current to March 31 that was released by the Ministry of Health, Labour and Welfare on April 2. The numbers represent a significant rise on those in a previous report released in mid-March, when eight prefectures including the capital were recorded as having 13 infection clusters. The government calculates an infection cluster as one in which five or more people are found to have contracted the novel coronavirus in a single location. The areas with the most clusters confirmed so far are Hyogo Prefecture in western Japan, and Tokyo, which each have four. Tokyo's infection clusters have taken place in medical facilities and restaurant businesses, whereas Hyogo Prefecture's are concentrated in medical establishments, welfare facilities and other locations.

Singapore to impose partial lockdown for a month

Singapore on April 3 tightened its measures to curb the coronavirus spread that effectively amounts to a month long partial lockdown, with people told to stay at home and most workplaces ordered to close, after an alarming increase in unlinked local cases. "We will close most workplaces except for essential services and key economic sectors," Prime Minister Lee Hsien Loong said on national television, adding that all schools and universities will switch to home-based learning. The number of people infected with the virus has increased by 65 to 1,114, out of them five have died. Nine of the new cases are imported and 56 are local cases without recent travel history abroad.

Coronavirus could trigger biggest fall in carbon emissions since World War II

Carbon dioxide emissions could fall by the largest amount since World War II this year as the coronavirus outbreak brings economies to a virtual standstill, according to the chair of a network of scientists providing benchmark emissions data. Professor Rob Jackson, who chairs the Global Carbon Project, which produces widely-watched annual emissions estimates, said carbon output could fall by more than 5 per cent year-on-year - the first dip since a 1.4 per cent reduction after the 2008 financial crisis."I wouldn't be shocked to see a 5 per cent or more drop in carbon dioxide emissions this year, something not seen since the end of World War II," Prof Jackson, an expert of Earth system science at Stanford University in California, told Reuters in an email. "Neither the fall of the Soviet Union nor the various oil or savings and loan crises of the past 50 years are likely to have affected emissions the way this crisis is," he said.

As Africa locks down, some deliveries of aid are threatened

African nations have closed airports and locked down some of the continent's largest cities out of caution, but that compounds the serious problem of shortages of health and other items. The continent now has more than 7,000 confirmed virus cases on top of sprawling crises related to hunger, locusts, conflict and more. "If the chaos caused by this pandemic is allowed to curtail humanitarian assistance, the results will be catastrophic," the medical charity Doctors without Borders warned in a statement on April 3. Aid organizations are now in the extraordinary situation of negotiating for humanitarian corridors in peaceful regions after at least 32 countries closed their borders, according to Africa Centers for Disease Control and Prevention data. Some nations have made exceptions for cargo, humanitarian aid or emergency flights. But at least 21 low-income and middle-income countries, most of them in Africa, are already seeing shortages of vaccines because of border closures or flight disruptions, GAVI, the Vaccine Alliance, said in a statement on April 3. In Kenya, travel restrictions have delayed the delivery of pesticides needed to fight the most devastating locust outbreak some East African countries have seen in 70 years, an official with the U.N. Food and Agriculture Organization told The Associated Press.

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Image Source: https://www.bbc.com/news/health-51214864

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