The New York Times
Brazil authorizes using hydroxychloroquine for Covid-19 patients amid a debate over its efficacy and dangers.
Brazil’s government on Wednesday encouraged doctors in the public health care system to treat coronavirus patients with hydroxychloroquine — a move the country’s two recently departed health ministers refused to sign off on because the drug can cause dangerous side effects.
In written guidance, the ministry encouraged medical professionals to administer the anti-malaria drug to treat patients with Covid-19 regardless of the severity of their symptoms. The guidance was issued five days after health minister Nelson Teich resigned, having lasted less than a month on the job.
Mr. Teich’s predecessor, Luiz Henrique Mandetta, was fired in April after clashing with President Jair Bolsonaro over the president’s disdain for social distancing measures and his enthusiastic endorsement of hydroxychloroquine.
Over the weekend, Mr. Mandetta warned that several Covid-19 patients who took hydroxychloroquine developed dangerous heart conditions. In the United States, the Food and Drug Administration issued a warning in April limiting the use of the drug to hospitalized patients in clinical trials who can be closely monitored for heart irregularities.
Mr. Bolsonaro and President Trump’s promotion of hydroxychloroquine has confounded medical experts who noted that the drug has shown no real benefit for hospitalized coronavirus patients. The controversy intensified Monday when Mr. Trump said that he had begun taking the drug daily as a preventive measure, a move several doctors called irresponsible, citing the potential side effects.
Mr. Bolsonaro has yet to appoint a new health minister. The ministry is being run by General Eduardo Pazuello, an active duty Army commander with no medical experience. Gen. Pazuello has appointed several military officials to senior roles at the ministry to replace health experts who have left in recent days.
President Xi Jinping of China has seized on the pandemic as an opportunity in disguise — a chance to redeem the party after early mistakes let infections slip out of control, and to rally national pride in the face of international ire over those mistakes.
Now, Mr. Xi needs to turn his exhortations of resolute unity into action — a theme likely to underpin the National People’s Congress, the annual legislative meeting that opens on Friday after a monthslong delay.
He must do all this while the country faces a diplomatic and economic climate as daunting as any since the Tiananmen Square crackdown in 1989.
“If you position yourself as a great helmsman uniquely capable of leading your country, that has a lot of domestic political risk if you fail to handle the job appropriately,” said Carl Minzner, a professor of Chinese law and politics at Fordham University.
So far, Mr. Xi has largely succeeded in rewriting the narrative in China. The disarray in other countries, especially the United States, has given him a reprieve from domestic political pressure by allowing officials to highlight China’s lower death toll, despite questions about the accuracy of the numbers.
The Trump administration’s withholding of funds from the World Health Organization also handed Mr. Xi a chance to appear munificent when he pledged $2 billion in assistance.
It is a dramatic turnaround from only months ago, when Mr. Xi faced a shaken and skeptical public.
Coronavirus infections have dropped sharply in Paris following a strict two-month lockdown and a growing contact tracing effort, health officials say, and they have remained in check since the city began a halting return to life nearly two weeks ago.
The decline has been sharpest in what were the city’s viral hot spots, in the less affluent northern neighborhoods.
“The drop is pretty spectacular,” said Renaud Piarroux, head of parasitology at one of the main Paris hospitals and organizer of the city’s mobile contact tracing teams.
But if the initial signs are hopeful, the reopening of Paris has been muted, in keeping with the national mood: fearful of what lies ahead, and angry at the government over its handling of the outbreak.
On the streets of Paris, shops have reopened, though many still lack customers. The police no longer check self-signed permits to leave home, yet streets in normally crowded neighborhoods like the Marais remain quiet. Table service at cafes and restaurants remains forbidden, a source of despair for chefs and cafe owners.
“People are being very timid,” said Philippe Bonaventure, a leather-work artisan hanging out in the normally buoyant food-shopping neighborhood around the Place d’Aligre. Shoppers crept about as if they didn’t quite believe their new freedom.
“Personally, I find this situation absolutely sketchy,” said Mr. Bonaventure. “Sad. Desperate,” he added, explaining that he remained “pessimistic” about the future.
“Half my existence is in the cafes,” he said. And the cafes remained closed.
As the pandemic continues to decimate global air travel, airlines are going to extraordinary lengths to reassure nervous travelers that everything is being done to make flying as safe as it can be.
On a Qatar Airways flight, that means passengers will be greeted by a cabin crew not only wearing safety goggles, masks and gloves, but also donning full protective suits over their uniforms, the airline said this week.
The Doha-based airline, which flew to 150 international destinations before the pandemic, said the measures would be in place for “a number of weeks.” The airlines will also soon require passengers to wear face coverings. Social areas on planes will be closed. Large bottles of hand sanitizer will be available in the galleys.
Around the world, airlines are scrambling to keep planes from becoming coronavirus hot beds and demonstrate to customers that they are taking safety seriously.
Philippines Airlines and AirAsia also plan to use new uniforms that incorporate personal protective equipment. Other airlines have ramped up cleaning, kept middle seats on planes empty and retooled boarding procedures. Some flight hubs, like Hong Kong International Airport, are using temperature checks and antimicrobial booths to disinfect people’s clothes and skin before boarding.
On Wednesday, United Airlines said it was partnering with Clorox and the Cleveland Clinic to bolster its disinfection practices and hold the airline’s policies to high safety standards.
Cyclone Amphan slammed into India’s coast on Wednesday, knocking down huge trees, bringing ropes of rain and sending millions of poor villagers rushing into evacuation shelters.
The emergency response was complicated by the coronavirus. India and Bangladesh are still under lockdown, and many people living in swampy coastal areas of both nations were fearful of packing into crowded shelters where the chances of infection could be much higher.
The storm made landfall around 4 p.m. near Digha, a town on India’s eastern coast. Meteorologists said this week that Amphan, which has been fueled by the warm waters of the Bay of Bengal, could be one of the most powerful cyclones in decades.
Indian television channels showed images of frothy waves cresting sea walls and trees snapping into pieces. The winds blew apart some buildings, and Indian news media reported that at least one child was killed after a mud wall collapsed on him.
More than three million people in India and Bangladesh were evacuated to emergency cyclone shelters. Still, some of the shelters are only half full, because of concerns about social distancing during the coronavirus pandemic.
The people in the storm’s path include about one million Rohingya Muslims who live in refugee camps along the Bangladeshi coastline. The recent confirmation of the first cases of Covid-19 in the camps has added another layer of anxiety and danger to relief efforts.
In a medical research project nearly unrivaled in its ambition and scope, volunteers worldwide are rolling up their sleeves to receive experimental vaccines against the coronavirus — only months after the virus was identified.
Companies like Inovio and Pfizer have begun early tests in people to determine whether their vaccine candidates are safe. Researchers at the University of Oxford in England say they could have a vaccine ready for emergency use as soon as September.
In labs around the world, there is now cautious optimism that a coronavirus vaccine, and perhaps more than one, will be ready sometime next year.
An effective vaccine will be crucial to ending the pandemic, which has sickened at least 4.8 million worldwide and killed at least 323,000. And just creating it won’t be enough: manufacturers will need to dramatically scale up production and distribution.
“What people don’t realize is that normally vaccine development takes many years, sometimes decades,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in Boston who led the monkey trials. “And so trying to compress the whole vaccine process into 12 to 18 months is really unheard of.”
“If that happens, it will be the fastest vaccine development program ever in history.”
In other science news:
Health experts are warning that stagnant plumbing systems in emptied office buildings could pose a threat when employees return. Bacteria — including the type that causes the respiratory condition Legionnaires’ disease — can build up if not properly addressed.
Amnesty International on Wednesday slammed Singapore’s decision to sentence a man to death using a Zoom video call after the country went into lockdown because of the coronavirus outbreak, denouncing the court’s action as “cruel and inhumane.”
A spokesperson for Singapore’s Supreme Court confirmed to Amnesty that a Malaysian national received the sentence this month after his conviction on drug-trafficking charges. Reuters reported that the man, Punithan Genasan, 37, was told on Friday that he would be hanged for masterminding a 2011 heroin transaction, court documents showed.
Mr. Genasan’s lawyer, Peter Fernando, told Reuters that he did not object to the judgment being delivered on Zoom. But rights groups criticized the proceedings.
“Whether via Zoom or in person, a death sentence is always cruel and inhumane,” Amnesty International’s death penalty adviser, Chiara Sangiorgio, said in a statement. “This case is another reminder that Singapore continues to defy international law and standards by imposing the death penalty for drug trafficking, and as a mandatory punishment.”
The Singapore decision was the second known case of capital punishment being handed down by video link, according to the criminal justice watchdog group Fair Trials. The group reported that a man in Nigeria was found guilty of murder and sentenced to death earlier this month. It noted there were “grave concerns” about the fairness of such proceedings.
Schools and universities around the world are struggling with how best to reopen. As students in some parts of Asia return to class, many of their peers in North America and Europe remain months away from being educated together.
Even in South Korea, where most universities opened this month, not all education officials were rushing to reopen secondary schools. Prime Minister Chung Sye-kyun has said the reopening of schools is one of the last tests of the country’s ability to sustain a new kind of daily life under Covid-19.
In the city of Incheon, west of Seoul, for example, students from 66 high schools were turned away and told to go home on Wednesday after two seniors tested positive for the virus. They were believed to have contracted it at a karaoke parlor that had been visited by a recent patient linked to an outbreak in Itaewon, a popular nightlife district in Seoul.
But on the same day at Shinhyeon High School in Seoul, hundreds of seniors were among the nearly half-million high school students who returned to their classrooms nationwide after a monthslong absence.
Teachers at Shinhyeon greeted students by spraying their hands with sanitizer.
“I am a bit scared because we have to return to school while the epidemic with no vaccine is still out there,” Lee Na-yeon, a Shinhyeon student, told the all-news cable channel YTN. “But it feels good to see the teachers and friends again after so long.”
Vivian Wang is a China correspondent whose reporting explores how China’s global rise is reshaping the lives of its people. She lives in Hong Kong, where she also covers the territory’s evolving relationship with the mainland.
Two blocks from my apartment on the western edge of Hong Kong Island, a Starbucks has been transformed into what looks like a construction zone, or maybe a strange art installation.
An armchair near the window was cordoned off for a time with masking tape, and more strips stretched over and around other chairs nearby, taut like tightropes over their neighboring tabletops. Rectangles of white cardboard are clipped to the sides of tables, which now look more like office cubicles than places to gather with friends.
But if the customers are fazed by the oddness of their surroundings, they don’t show it.
On a recent Tuesday night, a young couple huddled at one of the tape-free tables, laughing at something on the girl’s phone. A man hunched over his laptop, seemingly oblivious to the silos shielding him from his fellow patrons.
Hong Kong was one of the first places outside mainland China to be hit by the coronavirus, and the landscape of the city changed immediately.
There were temperature checks at every public building, and signs in elevators telling you how often the buttons were sanitized. A pharmacy chain handed out fistfuls of stickers with every purchase, featuring the chain’s mascot — a winking orange cat — and a reminder: “Wash your hands! Rub your hands! 20 seconds, Thx.”
Everywhere, there were reminders that these were not normal times.
Four months later, those signs are still around. But the city is humming back to life.
Hotels in Greece, where tourism accounts for at least 25 percent of gross domestic product, are scheduled to open by June 15, and some international flights are to restart on July 1. Anyone arriving from abroad is currently required to go through a two-week quarantine upon arrival even if a diagnostic test is negative, a measure that has been extended until May 31.
Speaking to the BBC on Monday, the Greek tourism minister, Harry Theoharis, suggested that if arriving tourists were at some point not subject to the two-week quarantine, Greece would “welcome reciprocity.”
He added that if the country did not impose quarantine on British tourists, Greece would like its citizens to also be exempt from the quarantine that Britain is set to impose on arriving passengers starting early next month. Grant Shapps, the British transport minister, said this week that the government was considering the creation of “air bridges” between Britain and low-risk countries.
Spain, which is also financially dependent on tourism, is expected to open its borders to tourists in late June, while Portugal plans to reopen its beaches on June 6, though social distancing measures will be in place.
Italy is to start welcoming tourists on June 3, and no one will have to self-isolate upon arriving in the country. The British government has urged Britons against all but essential travel to Italy, which, with 32,169 coronavirus-related deaths, has been one of the hardest hit places in Europe.
The campaign to replace Burundi’s long-reigning president has been marred by arrests and alleged killings of political opponents. But during a time of a pandemic, it has also featured rallies in packed stadiums.
Burundi’s citizens will on Wednesday elect a successor to President Pierre Nkurunziza, a former rebel leader who has ruled the country with impunity for the last 15 years, evading international efforts to call him to account for human rights abuses.
More than five million people were expected to vote at about 1,500 polling stations, and experts said that it could be the first competitive election since a civil war that began in 1993 and ended in 2005.
But the risk of contracting the coronavirus adds a critical dimension. From the outbreak’s onset, the authorities cited divine protection for keeping the country open and for holding large rallies.
And even after reporting 42 positive cases and one death, officials have continued to insist that the virus would not affect the country as severely as it has others worldwide.
Taiwan, which sits just 100 miles off China’s coast and has a population of more than 23 million, has recorded only 440 coronavirus cases and seven deaths. Its first case was reported on Jan. 21, the same day as the first American case.
In a statement, the U.S. secretary of state, Mike Pompeo, praised Ms. Tsai for her leadership, including Taiwan’s response to the virus.
“Her courage and vision in leading Taiwan’s vibrant democracy is an inspiration to the region and the world,” he said, adding that the outbreak had “provided an opportunity for the international community to see why Taiwan’s pandemic-response model is worthy of emulation.”
“Taiwan separatist forces and their actions are contrary to national justice and will surely be nailed to the column of shame in history,” the Chinese Defense Ministry said in a statement. The ministry warned that China would take “all necessary measures” to safeguard its sovereignty.
During her speech, Ms. Tsai praised the Taiwanese people and health officials, many of whom were in attendance, for successfully facing the pandemic. “In recent months, Taiwan’s name has appeared in headlines around the world, thanks to our successful containment of the coronavirus outbreak,” she said.
Across Indonesia, malls and shopping streets are packed with people seemingly oblivious to the idea of social distancing.
Keeping with tradition, they have been shopping for new clothes to look their best on Indonesia’s most important holiday, Eid al-Fitr, which falls on Sunday. Many are wearing face masks, but others are not.
In Jakarta, the capital, crowds of shoppers swarmed the streets this week around the huge Tanah Abang market. The venue itself was closed to prevent the spread of the virus, and a banner read: “Stay home, Corona is destroyed. Leave home, Corona reigns.” But vendors had filled streets around it with stalls selling head scarves, long, flowing skirts and men’s shirts and trousers.
In the neighboring city of Bogor, where shopping streets were also crowded, officials complained that some shoppers were using government coronavirus aid to buy new holiday clothes, local news outlets reported.
President Joko Widodo, who reluctantly imposed nationwide restrictions, including barring people from returning to their home villages for the holiday, has more recently called for learning to coexist with the virus.
But in Jakarta, which has a third of the nation’s cases, the governor, Anies Baswedan, extended pandemic restrictions from Friday until June 4. He urged the public to stay home and avoid large gatherings, calling the next two weeks “a defining moment.”
President Trump said on Wednesday that he may try to convene world leaders at Camp David for the annual Group of 7 meeting, as a further sign of “normalization” as the United States and many other countries begin to reopen.
“Now that our Country is ‘Transitioning back to Greatness’, I am considering rescheduling the G-7, on the same or similar date, in Washington, D.C., at the legendary Camp David,” Mr. Trump wrote in a Twitter post. “The other members are also beginning their COMEBACK. It would be a great sign to all – normalization!”
Mr. Trump agreed to hold the summit at his presidential retreat in Maryland after initially saying the gathering would happen at the Trump National Doral resort near Miami. Critics said it was inappropriate for him to host a diplomatic event at one of his properties.
It was unclear whether Mr. Trump has discussed the idea with other G7 leaders and how willing they would be to travel abroad with the large staff and security entourages they require.
The French government said that President Emmanuel Macron was “prepared to go to Camp David, health conditions permitting,” given the importance of the group in the pandemic response.
Prime Minister Justin Trudeau of Canada told reporters on Wednesday that the decision would rest with health experts.
“We’ll certainly take a look at what the U.S. is proposing as host of the G7 to see what kind of measures will be in place to keep people safe,” he said.
After the virus struck, the G7 agreed to hold the gathering by video for the first time. It is scheduled for June 10-12. The group is made up of the United States, Germany, Japan, France, Britain, Canada, and Italy.
Reporting was contributed by Aurelien Breeden, Adam Nossiter, Ian Austen, Ernesto Londoño, Carl Zimmer, Knvul Sheikh, Noah Weiland, Michael Crowley, Mihir Zaveri, Karen Zraick, Ben Dooley, Jennifer Jett, Hannah Beech, Iliana Magra, Jack Ewing, Abdi Latif Dahir, Raphael Minder, Megan Specia, Yonette Joseph, Tariro Mzezewa, Mark Landler, Richard C. Paddock, Dera Menra Sijabat, Lou Stoppard, Choe Sang-Hun, Mike Ives, Nicholas Bogel-Burroughs, Richard Pérez-Peña, Donald G. McNeil Jr., Sarah Mervosh, Mike Baker, Steven Erlanger, Chris Horton, Vivian Wang, Stephen Castle, Sameer Yasir and Jeffrey Gettleman. Claire Fu contributed research.