World
Senators to Biden: Waive vaccine intellectual property rules
Ten liberal senators are urging President Joe Biden to back India and South Africa’s appeal to the World Trade Organization to temporarily relax intellectual property rules so coronavirus vaccines can be manufactured by nations that are struggling to inoculate their populations.
The lawmakers, in a letter delivered to the White House on Thursday evening, wrote that Biden should “prioritize people over pharmaceutical company profits” and support the temporary waiver of the rules. A waiver could pave the way for generic or other manufacturers to make more vaccines.
The letter was led by independent Sen. Bernie Sanders of Vermont, along with Democratic Sens. Elizabeth Warren of Massachusetts, Tammy Baldwin of Wisconsin and Sherrod Brown of Ohio. Democratic Sens. Richard Blumenthal of Connecticut, Chris Murphy of Connecticut, Edward Markey of Massachusetts, Jeff Merkley of Oregon, Chris Van Hollen of Maryland and Raphael Warnock of Georgia also signed the letter.
“Simply put, we must make vaccines, testing, and treatments accessible everywhere if we are going to crush the virus anywhere,” the lawmakers say in the letter, which was obtained by The Associated Press.
Also read: Covid-19 vaccines: Ex-leaders, Nobel laureates urge Biden to waive intellectual property rules
More than 100 nations support a temporary waiver, which could help vaccine manufacturing ramp up in poorer countries that are struggling to acquire vaccine supplies. The Biden administration has said it is studying the issue.
Opponents, including pharmaceutical companies, worry that it would set dangerous precedent in allowing scientists around the globe to copy American and European companies’ research — some of which was funded by the U.S. government — long before patents expire. The Trump administration had opposed calls for the waiver.
The White House did not respond to a request for comment on the lawmakers’ letter.
The lawmakers’ appeal to Biden came after a group of 170 former world leaders and Nobel laureates earlier this week sent a similar letter to Biden urging him to support a temporary waiver of the WTO’s intellectual property rules.
The coronavirus pandemic has killed nearly 3 million people worldwide, including more than 170,000 in India and more than 50,000 in South Africa, according to figures compiled by Johns Hopkins University.
Myanmar coup foes tout minority-backed shadow government
Opponents of Myanmar’s ruling junta went on the political offensive Friday, declaring they have formed an interim national unity government with members of Aung San Suu Kyi’s ousted cabinet and major ethnic minority groups.
The move comes on the eve of a diplomatic initiative to solve Myanmar’s crisis by the Association of Southeast Asian Nations, which is expected to hold a summit next week.
A violent crackdown by the junta has failed to stem opposition to the coup, and as the army has spread the fight to ethnic minorities in border areas, some ASEAN members believe the crisis threatens regional stability.
Opponents of the coup have been seeking an alliance with ethnic minority groups as a way of strengthening their resistance. The minorities for decades have kept up on-again, off-again armed struggles for greater autonomy in the borderlands.
While it was not clear if the minority political organizations had formally joined an alliance, the appointment of prominent personalities from their ranks showed a commitment to a joint struggle against the military, which is certain to boost morale to the anti-coup cause.
Also read: Stepping up Myanmar coup penalties, US suspends trade deal
Security forces have killed at least 726 protesters and bystanders since the Feb. 1 military takeover, according to the Assistance Association for Political Prisoners, which monitors casualties and arrests. The protests and the killings have been continuing on a daily basis.
The National Unity Government is nominally an upgrade from what had been called the Committee Representing Pyidaungsu Hluttaw, which was formed shortly after the coup by elected lawmakers who were barred by the army from taking their seats. The CRPH sought international recognition as Myanmar’s sole legitimate government body, but won only popular support from those opposed to military rule.
The junta declared the CRPH an illegal organization, and issued arrest warrants for its leading members.
A video posted Friday on social media showed veteran activist Min Ko Naing announcing the formation of the new body. He was a leader of the failed 1988 uprising against a previous military dictatorship and is one of the country’s most respected political figures aside from Suu Kyi. He went quickly underground after the coup and apparently has been active in political organizing against the junta since then.
“Please support the National Unity Government for the future of our citizens and our younger generation.” he said. “The people are the decision makers and the people will fight the final battle. Victory is coming, We must win our revolution.”
Also read: 93 killed in one of deadliest days since Myanmar coup
More details were provided in a statement on social media by Dr. Sasa, a physician and philanthropist who though in hiding has been the online public face of the CRPH..
“Today, at the end of Thingyan on the eve of Myanmar’s new year, we are proud to announce the formation of a new National Unity Government and the dawn of a new era for the people of Myanmar,” said Sasa. “For the first time in our history, Myanmar has a unity government that will reflect one of our nation’s greatest strengths - the diversity of our people.”
The CRPH announced that Suu Kyi retains her post as state counsellor and Win Myint as president, though both were arrested in the coup and remain in detention, with criminal charges against them that supporters call politically motivated.
Sasa said the interim’s government’s vice president — its acting president - is Duwa Lashi La, a political leader of the Kachin minority from the country’s north, while the prime minister is Mahn Win Khaing Than, from the Karen minority in eastern Myanmar, who had been speaker of the elected upper house of Parliament.
Sasa himself comes from the Chin minority, while Myanmar’s government and military have always been dominated by the Burman majority.
Also read: Myanmar coup leader: 'Join hands' with army for democracy
It is not the first time in recent decades that opponent to military rule in Myanmar have formed a shadow government. In 1990, they formed the National Coalition Government of the Union of Burma after a military regime refused to recognize the results of a general election won in a landslide by Suu Kyi’s party.
That shadow government maintained a presence in territory controlled by the Karen on Myanmar’s eastern frontier, but also operated as a lobbying group based in Maryland in the United States. It dissolved itself in September 2012 after Suu Kyi’s party took part in by-elections earlier that year, capturing 43 of the 44 seats it contested.
Day workers leaving India's Mumbai as virus dries up jobs
Migrant workers are piling into rail stations in India’s financial capital Mumbai to head back to their home villages now that virus-control measures have dried up work in the hard-hit region.
“What do I do now?” asked Ramzan Ali, who’d been earning up to 500 rupees ($7) per day as a laborer but has been out of work for two weeks.
He arrived at Kurla railroad station on Friday morning and joined a long line to buy a ticket to board a train for Balrampur, his village in northern Uttar Pradesh state. Ali, 47, hopes to find some work in the village to feed his wife and four children.
The government of Maharashtra state, home to Mumbai, imposed lockdown-like curbs on Wednesday for 15 days to check the spread of the virus. It closed most industries, businesses and public places and limited the movement of people, but didn’t stop bus, train and air services.
Also read: Mumbai imposes strict virus restrictions as infections surge
An exodus ensued, with panicked day laborers hauling backpacks onto overcrowded trains leaving Mumbai. The migration is raising fears of the virus spreading in rural areas.
Maharashtra has been the center of the nation’s recent record surge in new infections. On Friday, India recorded another high of 217,353 new cases in the past 24 hours, pushing its total since the pandemic began past 14.2 million. The Health Ministry also reported 1,185 fatalities in the past 24 hours, raising deaths to 174,308.
The rush among migrant workers was not as desperate as last year when Indian Railways suspended all passenger train services during a strict and sudden nationwide lockdown. That forced tens of thousands of impoverished workers to walk or ride trucks and buses in soaring heat as they tried to return home.
Also, northern states like Punjab, Haryana and New Delhi and western Rajasthan state haven’t seen large-scale movement of migrant workers yet because it’s the harvesting season. Big farms have hired workers to harvest wheat and other crops and prepare for sowing new crops.
Mohammad Aslam, 24, is a tailor in Mumbai but said he has been sitting idle for 18 days. He was in line to board a train with relatives and others heading to the town of Muzzaffaarpur in eastern Bihar state.
“My extended family has a farm there and I can earn some money by working there,” he said.
Shiva Sanjeev, 27, was desperate to get on to a train because his 70-year-old grandfather is seriously ill in Gorakhpur in Uttar Pradesh state.
“I am getting frantic calls from my parents and other family members to get back to my hometown,” he said.
8 dead in shooting at FedEx facility in Indianapolis
Eight people were shot and killed in a late-night shooting at a FedEx facility in Indianapolis, and the shooter killed himself, police said.
Multiple other people were injured Thursday night when gunfire erupted at the facility near the Indianapolis International Airport, police spokesperson Genae Cook said.
At least four were hospitalized, including one person with critical injuries. Another two people were treated and released at the scene, Cook said.
Also read: Child among 4 dead in shooting at California office building
The shooter wasn’t immediately identified, and investigators were in the process of conducting interviews and gathering information. Cook said it was too early to tell whether the shooter was an employee at the facility.
The shooting was the latest in a string of mass shootings across the U.S. in recent months. Eight people were fatally shot at massage businesses across metro Atlanta, and 10 died in gunfire at a supermarket in Boulder, Colorado last month.
This was at least the third mass shooting this year in Indianapolis. Five people, including a pregnant woman, were shot and killed in January, and a man was accused of killing three adults and a child before abducting his daughter during at argument at a home in March.
Police were called to reports of gunfire Thursday just after 11 p.m. and officers observed an active shooting scene, Cook said. The gunman later killed himself.
“We’re still trying to ascertain the exact reason and cause for this incident,” Cook said.
FedEx released a statement saying it is cooperating with authorities and working to get more information.
“We are aware of the tragic shooting at our FedEx Ground facility near the Indianapolis airport. Safety is our top priority, and our thoughts are with all those who are affected,” the statement said.
Also read: Defying lethal shootings, Myanmar protesters back on streets
Family members gathered at a local hotel to await word on loved ones. Some said employees aren’t allowed to have their phones with them while working shifts at the facility, making it difficult to contact them, WTHR-TV reported.
Live video from news outlets at the scene showed crime scene tape in the parking lot outside the facility.
A witness who said he works at the facility told WISH-TV that he saw a man with a gun after hearing several gunshots.
“I saw a man with a submachine gun of some sort, an automatic rifle, and he was firing in the open,” Jeremiah Miller said.
Another man told WTTV that his niece was sitting in the driver’s seat of her car when the gunfire erupted, and she was wounded.
“She got shot on her left arm,” said Parminder Singh. “She’s fine, she’s in the hospital now.”
He said his niece did not know the shooter.
China ramps up vaccination drive with free eggs, other goods
China’s success at controlling the coronavirus outbreak has resulted in a population that has seemed almost reluctant to get vaccinated. So it is accelerating its inoculation campaign by offering incentives — free eggs, store coupons and discounts on groceries and merchandise — to those getting a shot.
After a slow start, China is now giving millions of shots a day. On March 26 alone, it administered 6.1 million shots. A top government doctor, Zhong Nanshan, has announced a June goal of vaccinating 560 million of the country’s 1.4 billion people.
The challenge lies partly in the sheer scale of the effort and the need to convince a population that currently feels safe from infections.
When patients first showed up at hospitals in Wuhan in late 2019 with fevers, coughs and breathing difficulties, the government locked down the city and others in Hubei province for more than two months starting in January 2020. Wuhan later became known as the epicenter of the outbreak.
Also read: Covid-19 vaccines: Ex-leaders, Nobel laureates urge Biden to waive intellectual property rules
Since then, China has controlled the virus through stringent border controls and quick lockdowns whenever new outbreaks crop up. People can dine out in restaurants and the risk of infection is low, so many don’t seem to be in a hurry to get the vaccine.
“I think everyone has a sense of security and comfort, and there’s no big rush to get vaccinated unless you are asked to do so,” said Helen Chen, a health care specialist at a market research firm in Shanghai.
But China also wants to open up as the world seeks to return to pre-pandemic normalcy and Beijing readies to welcome tens of thousands of visitors as host of the Winter Olympics in February 2022. While successful with swift lockdowns and a robust contact tracing system via smartphones, the government is also weighing those measures in balance with an eventual return to normalcy.
For now, in major cities like Shanghai and Beijing, the government has relied mostly on sustained messaging and freebies to convince people to get vaccinated.
Shopping malls have offered points at stores or coupons. A temple in Beijing offered free entry to anyone showing proof of vaccination. Shanghai is using buses in its campaign to set up mobile vaccination points.
And then there are the free eggs.
“Good news. Starting from today, residents 60 years old and above who have gotten their first shot are eligible for five ‘jin’ (2.5 kilograms or 5 1/2 pounds) of eggs. First come, first serve,” said a poster by a city-run health center in Beijing.
Also read: Denmark stops AstraZeneca COVID-19 vaccine rollout
Wang Feng was too young for the eggs from the clinic, but the 25-year-old chef said he got the vaccine anyway because he could not go to work without it.
“I thought if it worked, then might as well,” he added.
Some people have expressed doubts about how good the existing vaccines are, Chinese or not, given how quickly they were developed.
“I don’t think such an effective vaccine can be made so quickly,” said Amy Lu, who works in a university in Shanghai.
The five vaccines currently being used in China have an efficacy range of 50.7% to 79.3%, based on what the companies have said. That doesn’t mean they have no value — most experts say that anything above 50% is useful getting the pandemic under control, along with preventing hospitalizations and deaths.
“Even if everyone gets two doses, you may not be able to achieve herd immunity.” said Wang Chenguang, a former professor at Peking Union Medical College and an immunology expert. Herd immunity occurs when enough of the population has immunity, either from vaccinations or past infection, to stop the uncontrolled spread of an infectious disease.
China may need to vaccinate at least 1 billion people to achieve that, said Wang Huaqing, a top immunology official with China’s Center for Disease Control, in an interview with state media this week. As of early April, roughly 34 million people had received two shots and about 65 million got one dose.
Gao Fu, the head of the CDC, said last weekend that China is considering various strategies such as mixing different vaccines to try to increase effectiveness. Outside experts say China could eventually deploy other, more effective vaccines, such as the Pfizer or Moderna shots.
“The best thing to do is to actually allow the use of other better vaccines and make them to be available to the Chinese people, but that’s probably very challenging politically,” said Jin Dong-yan, an expert on vaccines at the University of Hong Kong’s medical school.
Chinese drugmaker Fosun Pharmaceutical Group has partnered with Germany’s BioNTech to sell the Pfizer vaccine in China. However, it has only been approved in Hong Kong and Macao, special territories in China with their own regulatory agencies. A clinical trial for mainland approval is underway.
Vaccination is supposed to be voluntary, but overzealous efforts by some local governments and companies prompted health officials to issue a warning this week against forced vaccinations.
Also read: South Asian Govts must ensure equitable access to COVID-19 vaccines: AI
A hospital in Danzhou on the southern island province of Hainan issued an apology after it issued a notice to staff saying, “Those who are not vaccinated could be fired.”
In Zhejiang province, an April 2 announcement said all government departments, Communist Party cadres and people working in universities would be required to take the lead in getting shots.
The national government also required vaccination for all residents in Ruili, a border town with Myanmar, because of a recent outbreak.
Getting vaccinated can also mean being able to avoid some of the more onerous obstacles that some local institutions have set up in the name of pandemic control.
Beijing student Bright Li said he got vaccinated so he would no longer need approval to leave campus. Although barely enforced, Li became concerned after the university put up posters publicly denouncing a student who left campus without permission last winter after that student had gone to an area with a confirmed COVID-19 case.
The vaccine drive has run into scattered shortages and delays.
In Haikou, the capital of Hainan, health authorities issued a temporary stay on providing a second shot to those not involved with two major upcoming events, “owing to relative tightness” in the vaccine supply. Shortages were also reported in two southern cities, Foshan in Guangdong Province and the port of Xiamen in Fujian province.
China’s vaccine makers have expanded production capacity massively, and health officials say they are confident demand can be met by the end of the year.
Alert over shortage of new drugs for ‘world’s most dangerous bacteria’
A lack of new treatments for common infections has left people dangerously exposed to the “world’s most dangerous bacteria”, the UN health agency said on Thursday. The alert from the World Health Organization (WHO) is delivered in a report showing that none of the 43 antibiotics in development today sufficiently addresses the growing threat posed by 13 priority drug-resistant bacteria.
“The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fuelling the impact of antimicrobial resistance and threatens our ability to successfully treat bacterial infections,” said Dr. Hanan Balkhy, WHO Assistant Director General on antimicrobial resistance.
Also read:How do we know the COVID-19 vaccines are safe?
Those most at risk are young children and those living in poverty, but antibiotic-resistant infections can affect anyone, said WHO partner AMR, reports UN News.
Youngsters at risk
According to WHO, three in 10 newborns who develop blood infections die, because the antibiotics that are used to treat sepsis are no longer effective.
Bacterial pneumonia – another preventable illness which has developed resistance to available drugs – is also a major cause of childhood mortality among under-fives.
WHO’s annual Antibacterial Pipeline Report, notes that almost all antibiotics available today are variations of those discovered by the 1980s.
We rely hugely on them in all areas of our lives, from having a tooth out at the dentist, to organ transplants and cancer chemotherapy.
Unproductive pipeline
But after reviewing antibiotics that are in the clinical stages of testing, as well as those in development, the report highlighted a “near static pipeline” of production, which WHO’s Haileyesus Getahun likened to the “Achilles heel” of global health security.
Also read:WHO health alert brings COVID-19 facts to billions via WhatsApp
“Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in research and development of new and effective antibiotics,” said Mr. Getahun, WHO Director of Antimicrobial Resistance Global Coordination.
“We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the antimicrobial threat.”
Only a few drugs have been given early-stage approval by regulators in recent years “and most of these agents…offer limited clinical benefit over existing treatments, WHO said, with the warning that the “rapid emergence of drug-resistance to these new agents” was a certainty.
Fractional gains
This was despite the fact that “some promising products” were in different stages of development, as only a fraction of these will make it to market in a sector hampered by the small return on investment from successful antibiotic products, which has limited the interest of most large pharmaceutical companies.
“Overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance,” the UN agency concluded.
Driving research
To promote investment in antibiotics development, WHO and partner Drugs for Neglected Diseases initiative (DNDi) have set up the Global Antibiotic R&D Partnership (GARDP) to develop innovative treatments.
The UN health agency has also been working closely with other non-profit funding partners such as the CARB-X to accelerate antibacterial research.
Another important new WHO-partnered initiative is the AMR Action Fund, that was set up by pharmaceutical companies, philanthropists and the European Investment Bank; its aim is to strengthen and accelerate antibiotic development through pooled funding.
Hong Kong democracy leaders given jail terms amid crackdown
A Hong Kong court on Friday sent five leading pro-democracy advocates, including media tycoon Jimmy Lai, to up to 18 months in prison for organizing a march during the 2019 anti-government protests that triggered an overwhelming crackdown from Beijing.
A total of nine advocates were given jail terms, but four of them, including 82-year-old lawyer and former lawmaker Martin Lee, had their sentences suspended after their age and accomplishments were taken into consideration.
They were found guilty earlier this month of organizing and participating in a massive protest in August 2019, where an estimated 1.7 million people marched in opposition to a bill that would have allowed suspects to be extradited to mainland China. The march was not authorized by the police.
Also read: Hong Kong court puts off release of pro-democracy activists
Their convictions and sentencing are another blow to the city’s flagging democracy movement, which is facing an unprecedented crackdown by Beijing and Hong Kong authorities.
The court suspended the 11-month prison sentence of Lee, an 82-year-old lawyer and former lawmaker known for his advocacy for human rights and democracy, for two years because of his age.
Lai, the founder of Hong Kong’s Apple Daily tabloid, was sentenced to 12 months in prison. He was already held on other charges, including collusion with foreign forces to intervene in the city’s affairs — a new crime under a sweeping national security law that Beijing imposed on the city in 2020.
Lee Cheuk-yan, a pro-democracy activist and former lawmaker who helped organize annual candlelight vigils in Hong Kong on the anniversary of the bloody crackdown on pro-democracy protests in Beijing’s Tiananmen Square in 1989, was sentenced to 12 months in prison.
Lawyers Albert Ho and Margaret Ng both had their 12-month jail sentences suspended for two years. Former lawmaker Leung Kwok-hung was sentenced to 18 months, while another former legislator, Cyd Ho, was given a jail sentence of eight months.
Two other former lawmakers, Au Nok-hin and Leung Yiu-chung, who previously pleaded guilty, were also given jail sentences. Au got 10 months while Leung’s eight-month jail term was suspended for one year.
“I’m ready to face the penalty and sentencing and I’m proud that I can walk with the people of Hong Kong for this democracy,” Lee Cheuk-yan said ahead of the court session, as supporters held up signs condemning political persecution. “We will walk together even in darkness, we will walk with hope in our hearts.”
Also read: Thousands flee Hong Kong for UK, fearing China crackdown
Hong Kong had enjoyed a vibrant political culture and freedoms not seen elsewhere in China during the decades it was a British colony.
Beijing had pledged to allow the city to retain civil liberties for 50 years after it reverted to Chinese rule in 1997, but recently has ushered in a series of measures, including the national security legislation and electoral reforms that many fear are a step closer to making Hong Kong no different from mainland cities.
Under the new rules, Hong Kong residents can be held liable for any speech or action deemed secessionist, subversive, terrorist or perceived as colluding with hostile foreign political groups or individuals. Electoral changes mean just 20 out of 90 Legislative Council members will be directly elected and Beijing will retain even tighter control over the body that picks Hong Kong’s future chief executives.
Hong Kong’s last British governor, Chris Patten, said that the Chinese Communist Party’s “comprehensive assault” on freedoms of Hong Kong and its rule of law remains relentless.
“This week, we have witnessed some of the most distinguished of the city’s peaceful and moderate champions of liberty and democracy placed in Beijing’s vengeful sights,” he said in a statement. “The CCP simply does not understand that you cannot bludgeon and incarcerate people into loving a totalitarian and corrupt regime.”
Why are so many babies dying of Covid-19 in Brazil?
More than a year into the pandemic, deaths in Brazil are now at their peak. But despite the overwhelming evidence that Covid-19 rarely kills young children, in Brazil 1,300 babies have died from the virus. One doctor refused to test Jessika Ricarte's one-year-old son for Covid, saying his symptoms did not fit the profile of the virus. Two months later he died of complications from the disease, reports BBC.
After two years of trying, and failed fertility treatments, teacher Jessika Ricarte had all but given up on having a family. Then she fell pregnant with Lucas.
"His name comes from luminous. And he was a light in our life. He showed that happiness was much more than we imagined," she says.
She first suspected something was wrong when Lucas, always a good eater, lost his appetite.
At first Jessika wondered if he was teething. Lucas's godmother, a nurse, suggested that he might just have a sore throat. But after he developed a fever, then fatigue and slightly laboured breathing, Jessika took him to hospital, and asked for him to be tested for Covid.
"The doctor put on the oximeter. Lucas's levels were 86%. Now I know that is not normal," says Jessika.
But he was not feverish, so the doctor said: "My dear, don't worry. There's no need for a Covid test. It's probably just a minor sore throat."
He told Jessika that Covid-19 was rare in children, gave her some antibiotics and sent her home. Despite her misgivings, there was no option to have Lucas tested privately at the time.
Jessika says that some of his symptoms dissipated at the end of his 10-day antibiotics course, but the tiredness remained - as did her concerns about coronavirus.
"I sent several videos to his godmother, my parents, my mother-in-law, and everyone said that I was exaggerating, that I should stop watching the news, that it was making me paranoid. But I knew that my son was not himself, that he was not breathing normally."
This was May 2020, and the coronavirus epidemic was growing. Two people had already died in her town, Tamboril in Ceará, north-east Brazil. "Everyone knows each other here. The town was in shock."
Jessika's husband Israel was worried that another hospital visit would increase the risk that she and Lucas would become infected with the virus.
But the weeks went by, and Lucas became sleepier and sleepier. Finally on 3 June, Lucas vomited over and over again after eating lunch, and Jessika knew she had to act.
They returned to their local hospital, where the doctor tested Lucas for Covid, to rule it out.
Lucas's godmother, who worked there, broke the news to the couple that his test result was positive.
"At the time, the hospital did not even have a resuscitator," says Jessika.
Lucas was transferred to a paediatric intensive care unit in Sobral, over two hours away, where he was diagnosed with a condition called multi-system inflammatory syndrome (MIS).
This is an extreme immune response to the virus, which can cause inflammation of vital organs.
Experts say the syndrome, which affects children up to six weeks after they are infected with coronavirus, is rare, but leading epidemiologist Dr Fatima Marinho from the University of São Paolo, says that, during the pandemic, she is seeing more cases of MIS than ever before. Although it doesn't account for all deaths.
When Lucas was intubated, Jessika wasn't allowed to stay in the same room. She rang her sister-in-law to try and distract herself.
"We could still hear the sound of the machine, the beep, until the machine stopped and there was that constant beep. And we know that happens when the person dies. After a few minutes, the machine started working again and I started to cry."
The doctor told her Lucas had suffered a cardiac arrest but they had managed to revive him.
Dr Manuela Monte, the paediatric doctor who treated Lucas for over a month in the ICU in Sobral, said she was surprised that Lucas's condition was so serious, because he did not have any risk factors.
Most children affected by Covid have comorbidities - existing conditions such as diabetes or cardiovascular disease - or are overweight, according to Lohanna Tavares, a paediatric infectologist at Albert Sabin Children's Hospital in Fortaleza, the state capital.
But that wasn't the case with Lucas.
During the 33 days Lucas was in the ICU, Jessika was only allowed to see him three times. Lucas needed immunoglobulin - a very expensive medication - to deflate his heart, but luckily an adult patient who had bought his own had donated one leftover ampoule to the hospital. Lucas was so ill that he went on to receive a second dose of immunoglobulin. He developed a rash on his body and was running a persistent fever. He needed support to breathe.
Then Lucas began to improve and the doctors decided to take out his oxygen tube. They video-called Jessika and Israel so that he wouldn't feel alone as he regained consciousness.
"When he heard our voices he started to cry," says Jessika.
It was the last time they were to see their boy react. During the next video call "he had a paralysed look". The hospital requested a CT scan and discovered Lucas had had a stroke.
Still, the couple were told Lucas would make a good recovery with the right care and would soon be moved out of ICU and into a general ward.
When Jessika and Israel went to visit him, the doctor was just as hopeful as they were, she says.
"That night, I put my cell phone on silent. I dreamed Lucas came up to me and kissed my nose. And the dream was a great feeling of love, gratitude and I woke up very happy. Then I saw my cell phone and saw the 10 calls that the doctor had made."
The doctor told Jessika that Lucas's heart rate and oxygen levels had dropped suddenly, and he had died early that morning.
She feels sure that if Lucas had been given a Covid test when she had requested it back in early May he would have survived.
"It is important that doctors, even if they believe it is not Covid, do the test to eliminate the possibility," she says.
"A baby does not say what he is feeling, so we depend on tests."
Jessika believes that the delay in proper treatment made his condition more serious. "Lucas had several inflammations, 70% of the lung was compromised, the heart increased by 40%. It was a situation that could have been avoided."
Dr Monte, who treated Lucas, agrees. She says that although MIS cannot be prevented, treatment is much more successful if the condition is diagnosed and treated early.
"The earlier he would have received specialised care, the better," she says. "He arrived at the hospital already critically ill. I believe he could have had a different outcome if we could have treated him earlier."
Jessika now wants to share Lucas's story to help others who may miss critical symptoms.
"Every child I know was saved by some warning and the mother says: 'I saw your posts, I took my son to the hospital and he is now at home.' It's as if it were a little bit of Lucas," she says.
"I have been doing for these people what I wish they had done for me. If I had had information, I would have been even more cautious."
There is a misconception that children are at zero risk for Covid, says Dr Fatima Marinho, who is also a senior adviser to the international health NGO Vital Strategies. Marinho's research has found that a shockingly high number of children and babies have been affected by the virus.
Between February 2020 and 15 March 2021, Covid-19 killed at least 852 of Brazil's children up to the age of nine, including 518 babies under one year old, according to figures from the Brazilian Ministry of Health. But Dr Marinho estimates that more than twice this number of children died of Covid. A serious problem of underreporting due to lack of Covid testing is bringing the numbers down, she says.
Dr Marinho calculated the excess of deaths by unspecified acute respiratory syndrome during the pandemic, and found that there were 10 times more deaths by unexplained respiratory syndrome than in previous years. By adding these numbers, she estimates that the virus in fact killed 2,060 children under nine years old, including 1,302 babies.
Why is this happening?
Experts say the sheer number of Covid cases in the country - the second-highest number in the world - have increased the likelihood that Brazil's babies and young children are affected.
"Of course, the more cases we have and, as a result, the more hospitalisations, the greater the number of deaths in all age groups, including children. But if the pandemic were controlled, this scenario could evidently be minimised," says Renato Kfouri, president of the Scientific Department of Immunisations of the Brazilian Society of Pediatrics.
Such a high infection rate has overwhelmed Brazil's entire health care system. Across the country, oxygen supplies are dwindling, there is a shortage of basic medicines and in many ICUs across the country there are simply no more beds.
Brazilian President Jair Bolsonaro continues to oppose lockdowns and the infection rate is being driven by a variant called P.1 which emerged in Manaus, in northern Brazil, last year, and is thought to be much more contagious. Twice the number of people died last month than in any other month of the pandemic, and the upward trend is continuing.
Another problem driving the high rates in children is a lack of testing.
Marinho says that for children often the Covid diagnosis comes too late, when they are already seriously ill. "We have a serious problem detecting cases. We don't have enough tests for the general population, even fewer for children. Because there is a delay in the diagnosis, there is a delay in care for the child," she says.
This is not just because there is little testing capacity, but also because it is easier to miss, or misdiagnose, the symptoms of children suffering from Covid-19, as the disease tends to present differently in younger people.
"A child has a lot more diarrhoea, a lot more abdominal pain, and chest pain, than the classic Covid picture. Because there is a delay in diagnosis, when the child arrives at the hospital they are in a serious condition and can end up complicating - and dying," she says.
But it's also about poverty and access to health care.
An observational study of 5,857 Covid-19 patients under the age of 20, carried out by Brazilian paediatricians led by Braian Sousa from the São Paolo school of medicine, identified both comorbidities and socioeconomic vulnerabilities as risk factors for the worst outcome of Covid-19 in children.
Marinho agrees this is an important factor. "Most vulnerable are black children, and those from very poor families, as they have the most difficulty accessing help. These are the children most at risk of death." She says this is because crowded housing conditions make it impossible to socially distance when infected, and because poorer communities do not have access to a local ICU.
These children are also at risk of malnutrition, which is "terrible for the immune response", Marinho says. When Covid payments stopped, millions were plunged back into poverty. "We went from 7 million to 21 million people below the poverty line in one year. So people are also going hungry. All of this is impacting mortality."
Sousa says his study identifies certain risk groups among children that should be prioritised for vaccination. Currently, there are no vaccines available for children under 16 years of age.
Visits by relatives to children in ICU have been restricted since the beginning of the pandemic, for fear of infection.
Dr Cinara Carneiro, an ICU doctor at Albert Sabin Children's Hospital, says this has been immensely challenging, not just because parents are a comfort to their children, but because they can also help in a clinical sense - they can tell when their child is in pain or in psychological distress and when they need soothing rather than medicating.
And she says the parents' absence intensifies their own trauma when they hear their child's condition has deteriorated and they haven't been there to witness it.
"It hurts to see a child dying without seeing their parents," says Dr Carneiro.
In an attempt to improve the communication between parents and their children, staff at Albert Sabin hospital clubbed together to buy phones and tablets to facilitate video calls.
Dr Carneiro says this has helped immensely. "We have made over 100 video calls between family members and patients. This contact has greatly reduced the stress."
Scientists stress the risk of death in this age group is still "very low" - the current figures suggest only 0.58% of Brazil's 345,287 Covid deaths to date have been of 0-9 year olds - but that is more than 2,000 children.
"The numbers are really scary," says Dr Carneiro.
When to seek help
While coronavirus is infectious to children, it is rarely serious. If your child is unwell it is likely to be a non-coronavirus illness, rather than coronavirus itself.
The Royal College of Paediatrics and Child Health advises parents seek urgent help if their child is:
Becoming pale, mottled and feeling abnormally cold to the touch
Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
Has severe difficulty in breathing, becoming agitated or unresponsive
Is going blue round the lips
Has a fit/seizure
Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
Develops a rash that does not disappear with pressure (the 'Glass test')
Has testicular pain, especially in teenage boys
Citigroup to exit retail banking in India
American multinational investment bank Citigroup announced on Thursday that it will exit retail operations in India and 12 other countries, and instead focus on wealth management and institutional businesses.
New York-headquartered Citigroup's subsidiary Citibank is India's largest foreign bank. Citibank India's core services include investment and retail banking, capital markets, risk management and credit cards.
In a statement, Citigroup Chief Executive Jane Fraser said, "Citigroup will depart China, India and 11 other retail markets, where we don't have the scale we need to compete."
Apart from India and China, Citigroup will pull out from Australia, Bahrain, Indonesia, South Korea, Malaysia, the Philippines, Poland, Russia, Taiwan, Thailand and Vietnam.
"As a result of the ongoing refresh of our strategy, we have decided that we are going to double down on wealth," Fraser said.
"We will operate our consumer banking franchise in Asia and EMEA solely from four wealth centres -- Singapore, Hong Kong, the UAE and London. This positions us to capture the strong growth and attractive returns the wealth management business offers through these important hubs.
"We believe our capital, investment dollars, and other resources are better deployed against higher returning opportunities in wealth management and our institutional businesses in Asia," she added.
Citigroup recently reported its first-quarter income of USD 19.3 billion and profits of $7.9 billion.
Alert over shortage of new drugs for ‘world’s most dangerous bacteria’
A lack of new treatments for common infections has left people dangerously exposed to the “world’s most dangerous bacteria”, the UN health agency said on Thursday.
The alert from the World Health Organization (WHO) is delivered in a report showing that none of the 43 antibiotics in development today sufficiently addresses the growing threat posed by 13 priority drug-resistant bacteria.
“The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fuelling the impact of antimicrobial resistance and threatens our ability to successfully treat bacterial infections,” said Dr. Hanan Balkhy, WHO Assistant Director General on antimicrobial resistance.
Those most at risk are young children and those living in poverty, but antibiotic-resistant infections can affect anyone, said WHO partner AMR.
Youngsters at risk
According to WHO, three in 10 newborns who develop blood infections die, because the antibiotics that are used to treat sepsis are no longer effective.
Bacterial pneumonia – another preventable illness which has developed resistance to available drugs – is also a major cause of childhood mortality among under-fives.
WHO’s annual Antibacterial Pipeline Report, notes that almost all antibiotics available today are variations of those discovered by the 1980s.
We rely hugely on them in all areas of our lives, from having a tooth out at the dentist, to organ transplants and cancer chemotherapy.
Unproductive pipeline
But after reviewing antibiotics that are in the clinical stages of testing, as well as those in development, the report highlighted a “near static pipeline” of production, which WHO’s Haileyesus Getahun likened to the “Achilles heel” of global health security.
“Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in research and development of new and effective antibiotics,” said Mr. Getahun, WHO Director of Antimicrobial Resistance Global Coordination.
“We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the antimicrobial threat.”
Only a few drugs have been given early-stage approval by regulators in recent years “and most of these agents…offer limited clinical benefit over existing treatments, WHO said, with the warning that the “rapid emergence of drug-resistance to these new agents” was a certainty.
Fractional gains
This was despite the fact that “some promising products” were in different stages of development, as only a fraction of these will make it to market in a sector hampered by the small return on investment from successful antibiotic products, which has limited the interest of most large pharmaceutical companies.
“Overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance,” the UN agency concluded.
Driving research
To promote investment in antibiotics development, WHO and partner Drugs for Neglected Diseases initiative (DNDi) have set up the Global Antibiotic R&D Partnership (GARDP) to develop innovative treatments.
The UN health agency has also been working closely with other non-profit funding partners such as the CARB-X to accelerate antibacterial research.
Another important new WHO-partnered initiative is the AMR Action Fund, that was set up by pharmaceutical companies, philanthropists and the European Investment Bank; its aim is to strengthen and accelerate antibiotic development through pooled funding.