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Coronavirus: Wealthy nations compete for remdesivir supplies

Zolgensma, a gene therapy medicine for treating spinal muscular atrophy in children under the age of two, is now available in Germany. However, a single treatment of the drug, which is produced by Swiss pharmaceuticals company Novartis, comes at the steep price of €1.9 million ($2.1 million).

The manufacturer argues that this is a reasonable price considering that without it, it costs between €2.5 and 4 million to treat the degenerative disease over a lifetime.

Gilead Sciences, which has developed remdesivir, takes a similar line of argument, saying that the drug, which is viewed as a promising tool in the fight against COVID-19, could save costs in the long run.

In an open letter earlier this week, Daniel O’Day, chairman and CEO of Gilead Sciences, wrote: “Taking the example of the United States, earlier hospital discharge would result in hospital savings of approximately $12,000 per patient. Even just considering these immediate savings to the healthcare system alone, we can see the potential value that remdesivir provides.”

“We have decided to price remdesivir well below this value,” he continued. “To ensure broad and equitable access at a time of urgent global need, we have set a price for governments of developed countries of $390 per vial. Based on current treatment patterns, the vast majority of patients are expected to receive a 5-day treatment course using 6 vials of remdesivir, which equates to $2,340 per patient.”

Read more: Remdesivir is no miracle cure

A single treatment of Zolgensma, produced by Swiss pharmaceuticals firm Novartis, costs €1.9 million

What is fair drug pricing?

The editor of the German specialist magazine Arznei-Telegramm, Wolfgang Becker-Brüser, is not convinced. He told DW that the costs of treating COVID-19 without remdesivir had been calculated at random.

“There is an attempt to give the impression that the price is fair,” he said. “However, if there wasn’t a pandemic and so much public attention they might have set the price much higher.”

The Association of Research-Based Pharmaceutical Companies (vfa) refused to comment. “The vfa does not comment on the pricing schemes of individual companies,” it said in a statement to DW.

But in the past, the vfa has called on the pharmaceuticals sector to show responsibility with regard to consumers and demanded that affordable medicine and vaccines be made available.

An analysis by British researchers cited in the Germany weekly Der Spiegel came to the conclusion that it probably cost about €8 to produce one dose of remdesivir.

However, it is normal for the sale price to be much higher than the production price, considering companies invest huge sums into development.

Read more: How lab animals have fared in the coronavirus crisis

Gilead Sciences claims that it invested about $1 billion into remdesivir. This is actually at the lower end of the vfa’s scale for developing a new drug. The association told DW that companies tended to invest $1 to 1.6 billion in a new product.

For Wolfgang Becker-Brüser, this is “fantasy.”

“If the development costs are calculated to be so high then it is easy to demand higher prices,” he told DW.

For Alexander Nuyken, a pharmaceuticals expert at the consulting firm EY, there is a reason that development costs are so high: they encompass the risk of failure. “It has to be possible to add a premium for the risks incurred from the development of a drug to its approval,” he said.

Becker-Brüser said that in general drugs were becoming more expensive. “The number of prescriptions for new patented drugs is the same but their price is going up,” he said. This was already the case before the COVID-19 pandemic, as indicated by a report by the German health insurance company AOK from last year, according to which insurance companies are paying an increasingly high proportion of their medicine budget on particularly expensive drugs. Drugs as pricey as Zolgensma are only the tip of the iceberg.

Read more: Is the US-China rivalry tangling a coronavirus vaccine with geopolitics?

With regard to remdesivir, however, there had been some expectation that the cost per course of treatment would actually be higher. The Institute for Clinical and Economic Review, a US-based nonprofit organization that analyzes drug prices, had suggested that a reasonable price would be $2,800, while others had recommended $4,000.

But considering that remdesivir is practically a waste product, which Gilead Sciences originally developed to treat Ebola, without major success, Becker-Brüser presumes that the company opted for a compromise in view of the public pressure.

It could turn out to be a win-win situation for the company. Its share price rose when the price of remdesivir was announced earlier this week and orders have gone through the roof.

After being ineffective against Ebola, Gilead Sciences drug remdesivir is getting a second chance against COVID-19

Global competition

According to media reports, the US has already secured the entire stock of projected production for July and 90% for August.

Germany, too, has apparently secured supplies. Health Minister Jens Spahn has been applying pressure. He said that he expected “Germany and Europe to have access to supplies to such a drug.” The British government has also said that it has enough reserves.

So far, remdesivir has not been fully approved in any country and there has not been enough research into how effective it really is against the novel coronavirus. But apart from Dexamethason, it is the drug that seems to have the most potential for treating patients with SARS-CoV-2 and limiting the disease’s course.

Read more: Is dexamethasone the game changer in COVID-19 treatment?

Alexander Nuyken said that it was not surprising that the world’s wealthy nations were all eager to get hold of supplies. “That’s why it is particularly important that we find common solutions in international alliances.”

There are already several international forums in which this is being attempted and a European vaccine alliance has been formed with the WHO.

However, the problem, as with the global fight against the climate emergency, is that if the US does not play by the same rules, the attempts of other states will be curbed.

Those who benefit, said Becker-Brüser, are the pharmaceuticals giants, “which are in a position to aim higher.”

It will soon become clear how high Gilead Sciences is prepared to go. Right now, the European Union is negotiating with the US company and trying to ensure that all 27 states have supplies in the coming months.

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India’s HIV and TB patients suffer consequences of coronavirus pandemic

When the coronavirus pandemic hit India, many were worried that the country’s overworked public healthcare system would not be able to cope with the added burden of the outbreak. The crisis has brought to light the flaws and discrepancies of India’s health outreach programs.

National outreach programs for infectious diseases such as tuberculosis (TB) and HIV have become severely underfunded and put on the back burner due to a shift of focus to limiting COVID-19 infections. But health professionals warn that such a move could have detrimental effects on India’s population in the future.

Read more: India could have ‘several coronavirus peaks’

TB far deadlier

COVID-19 has so far claimed more than 17,000 lives in India. Yet tuberculosis remains a far more fatal disease for the South Asian country. The highly infectious disease claimed over 79,000 lives in 2019 alone, according to the latest annual TB report.

A recent joint study by the London School of Hygiene & Tropical Medicine and Lancaster University projected that the pandemic could add at least 110,000 more fatalities in countries including India, China and South Africa. The researchers also noted that the crisis could result in overall decreased clinic attendance as well as delayed diagnosis and treatment.

However, India’s minister for health and family welfare, Harsh Vardhan, commended the country’s progress for handling its TB crisis. “The government is committed to achieving the Sustainable Development Goals of eliminating TB in the country by 2025, five years ahead of the global target,” he announced.

Read more: Coronavirus triggers mental health crisis in India

But Saurabh Rane, an advocate for Survivors Against TB – a community-based initiative led by TB survivors – said since the outbreak of COVID-19, “it has been an absolute nightmare for [TB] patients.”

Rane, who is a TB survivor himself, said that while most patients reach out to understand how to deal with the stress and anxiety caused by the pandemic, “they don’t know if they can get the tests done in time, get time from their doctors for consultations or even procure their next batch of medications.”

Rane believes one of the greatest failures of India’s healthcare system has been the lack of communication and outreach from the New Delhi government. “If the system has not faced this before, the patient hasn’t either. Communication opens a channel to understand their problems and that is when you can find solutions for them. Increase bandwidth on the helpline, provide them chat options, figure out doorstep drug delivery mechanisms, create spaces for testing, and troubleshoot problems as they occur,” he said, adding: “The public health system has to fight an old pandemic in the middle of a new one.”

Read more: Has India’s Hindu nationalist government mismanaged the country’s response to the coronavirus?

Getting hold of HIV medication amid lockdown

India is home to the world’s third largest population of HIV+ patients. The Indian government provides lifelong ART (anti retro-viral) medication to all registered patients.

But when the nationwide lockdown was in place, many HIV sufferers couldn’t visit the hospital or clinic facilities to obtain the necessary medication due to the shutdown of public transport.

“Adherence is key to taking ART and for a total suppression of the HIV virus. It is non-negotiable, simply because we can’t negotiate with our virus. If we miss say 2-3 doses in a month or if we do not adhere at least 97% of the time, the virus can bounce back and we are likely to develop resistance,” said Loon Gangte, co-ordinator of the Delhi Network of Positive People – an initiative aimed to improve the lives of people living with HIV.

Even as restrictions are gradually lifted, those living with HIV still face fear and distress on a regular basis. Gangte says the situation is worse for low-income HIV patients as well as ostracized members of society such as sex workers and transgenders.

Despite the easing of lockdown measures, experts warn that Indians suffering from highly infectious diseases other than the coronavirus remain in a vulnerable position.

“People should not be deprived of treatment as they too have their right to health. We urge the government not to abandon initiatives on HIV/AIDS, TB, and drug addiction,” said Abu Mere, president of NNagaDao, a local non-governmental organization.

Read more: India: Being blind during the coronavirus pandemic

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May 8, 1945: Total Defeat or Day of Liberation?

On May 8, 1945 the guns finally fell silent. World War II, started by Adolf Hitler’s Nazi Third Reich in 1939, was over. The unconditional surrender of Germany’s armed forces, the Wehrmacht, brought to an end the suffering of millions — initially, however, only in Europe because Nazi Germany’s ally, Japan, continued fighting and would only concede defeat in August when the Americans had dropped atomic bombs on the cities of Hiroshima and Nagasaki.

For the international anti-Hitler coalition — led by the Soviet Union, the United States, Great Britain and France — May 8 was, despite all the suffering that had gone before, a day to celebrate. That joy was not shared by most Germans. Their country had been destroyed and then divided into four zones of occupation by the victorious powers. Defeat had been complete and overwhelming. It triggered emotions of guilt and shame. The Third Reich had set the terrible conflict in motion with its invasion of Poland. Unprecedented crimes against humanity followed, above all the systematic extermination of six million Jews.

In the post-war years, any sense of outrage over these crimes was still not enough for most Germans to consider May 8 as a day of liberation — in contrast to the European countries that German forces had occupied during the six years of war. Now the tables had been turned: Germany defeated and occupied. An ideological war between the communist Soviet Union and an alliance of democracies in the West began to take hold, signaling the division of Germany and the division of Europe.

Theodor Heuss: ‘We knew of these things’

On May 8, 1949, exactly four years after the end of World War II, representatives of the country’s political parties gathered in the city of Bonn to enact a new constitution (Basic Law) for the emerging Federal Republic of Germany (FRG, West Germany). The Free Democrat Theodor Heuss (FDP) was in a reflective mood as he looked back on the end of the war: “The fundamental fact is that for each of us May 8, 1945 remains the most tragic and questionable paradox of history. Why? Because we were, at one and the same time, redeemed and annihilated.”

In September 1949, Heuss was elected as Germany’s first federal president. Three years later, his visit to the former Bergen-Belsen Concentration Camp was seen as a watershed moment. “The Germans must never forget what was done by people of their nation during these shameful years,” said West Germany’s head of state as he contemplated Germany’s biggest crime — the Holocaust. And, Heuss added, “We knew of these things.”

A monument to the Red Army: “The Liberator”

While senior West German politicians struggled to come up with the right gestures, and the right words, to describe the crimes committed in Germany’s name, the German Democratic Republic (GDR, East Germany) — founded on October 7, 1949 — had adopted the occupying Soviet Union’s state cult of anti-fascism. The most visible manifestation of this development was the gigantic War Memorial and Military Cemetery at Treptower Park for more than 5,000 war dead, inaugurated on the fourth anniversary of the end of the conflict.

At the heart of the complex is a soldier cradling a small child in his arm while at the same time crushing a Nazi swastika under the heel of his boot. With this monument, towering 30 meters into the sky above, East Germany’s leaders took a firm grip on the imagery that would be employed to commemorate the end of the war. “The Liberator,” as the gigantic figure was called, embodied the Soviet Union’s triumph over Nazi Germany. Its political system, based on violence and oppression, would be imposed on the whole of the Eastern Bloc by Soviet dictator Joseph Stalin. 

The Soviet War Memorial in Berlin was built to commemorate the 80,000 Soviet soldiers who died in WWII.

Walter Ulbricht attacks West Germany’s accession to NATO

East Germany styled itself as a bulwark against fascism and imperialism. The country’s enemies were to be found west of the Elbe River and west of the Atlantic: in West Germany and the USA. There was no forum for a critical appraisal of Germany’s responsibility for the horrors committed during the Nazi era. Walter Ulbricht set the tone by, at the behest of the Soviets, imposing the Zwangsvereinigung – the forced merger of the Communist Party (KPD) and the Social Democratic Party (SPD) in East Germany to form the ruling Socialist Unity Party (SED).

Under his leadership, May 8 became the “Day of Liberation,” an annual ritual that East Germany instrumentalized for propaganda purposes right through to the dying days of communism, with a focus on current events or goals. Walter Ulbricht, for instance, used the 10th anniversary of the end of the war to rail against West Germany’s accession to NATO. At a mass rally in East Berlin, attended by some 200,000 people, he accused the West of blocking German reunification while East Germany, “a peace-loving and democratic state,” battled to bring the divided country together.

Konrad Adenauer speaks of “cleansing and transformation”

At the same time, West German Chancellor Konrad Adenauer (CDU) spoke of Germany’s NATO membership — that he himself had forced through — as an expression of trust in the fledgling democracy. In Paris, ten years after the end of the war, the Christian Democrat politician argued that the German people had paid with “boundless suffering” for the atrocities carried out in their name by a fanaticized leadership: “In this suffering a cleansing and transformation came to pass.”

To mark the 20th anniversary of the end of the war, Adenauer‘s successor Ludwig Erhard (CDU) became the first high-ranking politician in the West to use the word “liberation.” However, he used it to refer to curbs on freedom in communist states. If the defeat of Hitler’s Germany had banished all injustice and tyranny from the world, then humanity would have reason enough, he said, “to celebrate 8th May as a memorial to freedom.”

Konrad Hermann Josef Adenauer was the first post-war Chancellor of Germany from 1949 to 1963.

Willy Brandt praises women, refugees and displaced people

It was to be another five years before the political elite in West Germany really began to re-think their position on the end of the war. In 1970, under the first social democrat chancellor, Willy Brandt, the Moscow and Warsaw Treaties were signed. It was reconciliation with one-time enemies in war, the Soviet Union and Poland, and milestones in what became known as the policy of détente. It would lead, one year later, to the social democrat being awarded the Nobel Peace Prize.

In his speech marking the 8th of May Willy Brandt did not actually use the word “liberation”but was at pains to recognize and commemorate the role of women, refugees and displaced people in the rebuilding of Germany. He was especially effusive in his praise for “our fellow Germans in the GDR.” They had, as he put it, in the face of great adversity not of their own choosing, “achieved successes that they can be proud of and which we must fully respect.”

Helmut Kohl talks twice of a “Day of Liberation”

Under Willy Brandt’s former foreign minister Walter Scheel (FDP), who served as federal president from 1974, there was a decisive change in West Germany’s approach to the meaning of May 8, 1945: “We were liberated from a terrible yoke. From war, murder, subjugation and barbarity,” he said on the 30th anniversary of the end of the war: “But we have not forgotten that this liberation came from outside. That we, the Germans, were not capable of shaking off this yoke ourselves.” The head of state pointed out that it was not in 1945 that Germany had lost its honor, but far earlier: in 1933, with Hitler’s seizure of power.

Another federal president came to a remarkably similar conclusion in 1985: the Christian Democrat Richard von Weizsäcker. His address four decades after the end of the war is generally seen as the greatest and most important on this theme. Intriguingly, he was far from being the first person to speak explicitly of a “Day of Liberation.” Chancellor Helmut Kohl (CDU) used the same language in that same year — twice. Initially in February in his “Report on the State of the Nation in a Divided Germany” and then on April 21 in the presence of US President Ronald Reagan on the 40th anniversary of the liberation of the Bergen-Belsen Concentration Camp.

U.S. President Ronald Reagan and then West German Chancellor Helmut Kohl on their visit to the military cemetery in Bitburg, western Germany in 1985.

Richard von Weizsäcker: “Look truth straight in the eye”

What makes von Weizsäcker’s speech so special it that when he refers to May 8, 1945 as a “Day of Liberation” nobody is excluded: “It liberated us all from the inhuman system of violence and persecution that the Nazis established.” In East Germany, meanwhile, leader Erich Honecker insisted on highlighting the things that divided East and West. He said the liberation from Hitler and his fascist system gave the German people the opportunity to build their lives on a wholly new foundation, and “We used this opportunity.”

The two German states did not manage to arrive at a similar evaluation of the end of the war until after the fall of the Berlin Wall on November 9, 1989. For just a couple of months, East Germany was governed by the country’s only freely-elected prime minister: Lothar de Maizière (CDU). On the 45th anniversary of the end of the war in 1990, he told a gathering of the World Jewish Congress in Berlin that May 8 “will cast long shadows on the post-war history of the Germans” while at the same time demonstrating their “inability to mourn.” He said the Germans must learn, “to live with this history honestly and sincerely, to be open to its admonishments and memories.” De Maizière’s words are reminiscent of von Weizsäcker’s in his famous 1985 address: “Today, on May 8, let us as best we can, look truth straight in the eye.”

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As coronavirus lockdown eases, Italians fear bleak future

It is a sunny morning in Rome, with blue skies and warm spring temperatures in the Italian capital. Yet, the city’s venerable sculptures and monuments seem lonely; its empty squares and streets are like an eerie film set. The throngs of tourists are gone, in their place, police officers stand at every corner asking pedestrians why they are out and about.

Italians had eagerly awaited Prime Minister Giuseppe Conte’s press conference last Sunday, hoping he would finally announce the country’s ongoing lockdown would end on May 4. But Conte disappointed them, saying instead that restrictions would be lifted in increments.

Read moreCoronavirus: Lifting lockdowns, European countries go their own way

‘We’ll be starving soon’

“I don’t see black for the future, but I’m not looking at things through rose-colored glasses either. Gray is probably the color I would use to describe the situation,” says Claudio, a Roman taxi driver. Claudio says he waits hours every day for a fare, and he has no idea how he will manage to pay his taxes next month.

“The virus has lost its punch here, still it won’t take much and we’ll be starving soon. I’m really scared. Because if you have debts or get behind on your mortgage, you can’t get new loans from the bank,” bemoans Claudio.

Roman taxi driver Claudio says he sees the future as ‘gray’

Italy has survived the first months of the coronavirus crisis and strict social distancing rules appear to have had a positive effect. Now, the Italian government has announced the beginning of a second phase in the fight, one that will put economics ahead of social life. The government is keen to get the Italian economy running again, and its new plan will see most production start back up on May 4. Restaurants will once again be able to receive food deliveries, and cafes and hair salons will also be allowed to open on that date.

Read moreCoronavirus: Doctors in Italy cry foul over protection

‘The next phase will be more difficult’

Prime Minister Conte thanked Italians for the patience they have shown. He said he was proud of how far Italians have already come in this extraordinary fight, calling it a great success. Still, he added, “The next phase will be more difficult.”

Taxi driver Claudio is frustrated, saying, “Many Italians had to take on debt because of the crisis.” The Italian government has offered a monthly compensation of €600 ($659) to self-employed citizens as well as those with full-time jobs, but Claudio remains skeptical: “Most Italians are still waiting on last month’s payment. If that money doesn’t come, how can they pay next month’s taxes?”

Conte told Italians: ‘The next phase will be more difficult’

Claudio says other countries have done far more to help their citizens financially, “The only thing we’re getting is permission to leave our houses,” he adds sarcastically.

That opinion is shared by Simona, who runs a cafe in the heart of Rome. “Even if that money was paid out for weeks it still wouldn’t be enough.” He says the plan is useless: “Many families are still waiting for the €600 they have been promised. How are they supposed to feed their children? We expected financial help from the government. Italy is literally starving.”

Read moreCoronavirus crisis: Children suffer most from being locked down

Travel restrictions to remain in place

Travel restrictions will remain in place even in phase two of the government plan. From May 4 onward, citizens will only be allowed to leave their houses to shop for groceries and medicine, to go to work or the doctor, and to visit relatives and partners. Citizens will only be allowed to travel outside their home region if they can prove that it is absolutely necessary.

Irene Farinelli, a 70-year-old retiree, is strictly opposed to the idea of regional isolation. She says, “My children and grandchildren live in a different region. I haven’t been able to see them for two months. Many people are worried that we will be locked up at home for a long time. We have to get out of this situation as soon as possible.”

Irene Farinelli says she hasn’t seen her children or grandchildren in two months

Yet, even though many Italians want to see travel restrictions lifted, epidemiologists and virologists are calling for the government to keep them in place for as long as possible. Andrea Cristanti from the University of Padua is one of the country’s most respected virologists. He argues the small steps the government has taken to loosen restrictions already go too far. Speaking with the newspaper La Repubblica, Cristanti said: “When the country was put under lockdown on March 11, we had 1,800 new infections each day. That is the same number we registered yesterday.”

Read moreWorld’s top coronavirus experts face fame, scorn amid pandemic

No school until September

Daniele, a young father, complains that schools are being ignored even though factories will be allowed to open: “Who is supposed to look after the children if we can’t take them to their grandparents’? We’re being abandoned.”

Romans are skeptical, crushed under the burden of coronavirus restrictions and the financial damage they have brought with them. Even more disheartening to citizens is the fact that they do not believe phase two of this fight will bring much relief.

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Coronavirus antibody tests and immunity certificates pose ethical and scientific problems

Countries around the world are clamoring for an exit strategy as economies lag and unemployment skyrockets amid their COVID-19 lockdowns. Indeed, Austria has already begun to relax some restrictions, and German Chancellor Angela Merkel is expected to announce on Wednesday that some shops and schools may reopen under strict conditions.

Even in hard-hit Spain and Italy, where infection and death rates are only slowly declining, governments are planning how quickly they can relieve their millions of citizens bearing the financial and psychological burdens of over a month of social distancing.

One mechanism for a return to normality that has been floated in Italy, Germany, and the US, is to issue so-called “immunity certificates” to individuals who have recovered from the novel coronavirus, using antibody tests that have only been in development in Italy and China for a matter of weeks. This would allow “healthy” people to return to work and move about freely.

The idea has been particularly popular in Italy, where it has already been put into use in some areas in the north. The village of Vo’, in the Veneto region, has served as inspiration for some; testing of every single townsperson kept the pandemic completely under control. The president of the devastated region, Luca Zaia, is a major proponent of a certificate scheme, as is the leader of another virus epicenter: New York State Governor Andrew Cuomo.

‘A sign of an insecure society’

However, these plans are both scientifically and ethically controversial, and experts have warned that immunity certificates could be a sign of leaders ready to jump the gun on ending lockdowns.

Dr. Martin Schnell, a professor of social philosophy and ethics in healthcare at Germany’s University of Witten/Herdecke, cautioned that such proposals were “a sign of an insecure society.”

Schnell said that the impulse behind the idea was understandable: “Imagine you are sitting in traffic, you will feel very differently if you know that it will end in 20 minutes versus when you know nothing … we want to know what we are doing something for, and when it will end. Right now we don’t know either.”

He was further skeptical of the feasibility of using immunity certificates in smaller towns, where everyone knows one another. The risk of creating resentment by essentially splitting society into two groups, where one is allowed to go about their normal lives and the other is not, would be extremely “detrimental to the community solidarity,” that is holding society together at the moment.

“On the other hand, you can’t make unequal things equal,” and immunity certificates could, in theory, be a “just” way of moving forward.

But Schnell highlighted one large caveat: The plan “can only be considered ethical if you keep all the other social distancing measures in place, such as standing 1.5 meters apart or wearing masks, to protect both the healthy and the vulnerable.” This could be extremely difficult to do in certain scenarios, such as in public transport many people use to get to work.

In Barcelona, Red Cross workers hand out masks to public transport users. Social distancing can be hard in enclosed spaces, like subway cars.

Reopening too quickly?

Schnell called into question the wisdom of plans of countries like Austria and Germany to reopen so quickly. While there is a need to know when the traffic jam will end, it would be more responsible to provide a normative plan based on certain milestones, he explained. One example is waiting until the R0 infection rate drops below 1, meaning each individual infects fewer than one other individual. Such a plan contrasts with the calls for a calendar date based on a rash desire to restart distressed economies.

If governments roll back restrictions, added Schnell, only to have to re-implement them again in a few weeks or a month due to a second outbreak, this could risk “a crisis of democracy.”

“Political leaders need to offer a plausible scenario for a loosening of restrictions,” rather than a timely one, “or risk losing all their credibility,” Schnell said.

Indeed, China has just recorded its biggest increase in new infections in six weeks. Despite having initially quelled the first major wave of the pandemic, citizens returning from abroad have brought cases back with them.

This points to the potentially premature nature of many proposals on how to reopen society, including antibody tests and immunity certificates.

Read more: What is life like in post-lockdown Wuhan?

Antibodies: Too many unknowns

Additionally, although successful antibody tests have been developed in Italy, Germany, and China, the consensus in the scientific community is that as of yet, there are still many unknowns as to how the body recovers from a COVID-19 infection. There have been reports in China, Japan, and Italy of patients who had overcome the virus and then become re-infected.

Furthermore, studies in China and Italy have shown that different patients exhibit different levels of antibodies to fight the virus, with some having none at all, and that many people may take far longer to recuperate than the conventional two weeks.

Experts have also told trade publication The Scientist that there are major problems with a great deal of the heaps of COVID-19 related studies now pouring into medical journals for pre-publication, and only so many virologists are available to conduct peer reviews. With so much demand to make breakthroughs, papers are being reported as medical fact when they have not even been peer reviewed or selected for publication yet.

Among the many things scientists are not yet sure of is how long immunity lasts and whether some recovered individuals have a high enough level of antibodies to fight this coronavirus a second time, making antibody tests and immunity certificates implausible as exit strategies.

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COVID-19: Sex workers suffer during social distancing in India

Neha [the name has been changed to protect her identity], a 23-year-old sex worker, works in Delhi while the rest of her family lives in India’s northern Haryana state. She is the sole earner in the family and pays for the education of her younger brother and sister, as well as medical bills for her ailing mother.

The nationwide lockdown implemented by the Indian government to contain the spread of COVID-19 has left Neha and many other sex workers jobless.

“If the situation persists, there will be only one option left for me: suicide,” Neha told DW during a phone interview.

Read more: Coronavirus lockdown: Delhi struggles to feed migrants left behind

Neha’s family doesn’t know anything about her occupation. They think she works as a salesperson at a small company in Delhi. The landlord has waived April’s rent, but she will have to pay interest on next month’s rent. “How am I going to do that? I am totally clueless,” she said.

Thousands of sex workers across India are facing a similar ordeal. According to local organizations, almost 5,000 girls work as prostitutes in Delhi’s G B Road area. Many of them live in rented rooms in different parts of the city and around 1,500 live in G B Road’s red-light district.

There has been a complete ban on their activities for weeks as a result of the coronavirus lockdown.

Read more: Domestic violence rises amid coronavirus lockdowns in Asia

Fund raising for sex workers

Some non-governmental organizations are working to help sex workers in these difficult times.

“We are raising funds for the sex workers. Many people have come forward to help us. We have provided for around 800 sex workers to date, but it will only be sufficient for a few days,” Anurag Garg of the Kat Katha non-profit organization told DW.

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Amit Kumar, director of the All India Network of Sex Workers, told DW that many sex workers have returned to their villages due to the current situation. Those who are still in Delhi are facing a dire outlook, he added.

“Many of them have nothing to eat,” Kumar said. “The government has made some arrangements for migrant laborers, but nothing has been done [exclusively] to help sex workers.”

In a letter to the government, the Women’s Commission of Delhi has urged authorities to help the sex workers.

Read more: Coronavirus in India: Bihar’s healthcare system faces risk of collapse

Huge impact on informal sectors

Some 1.3 billion people in India have been under a 21-day lockdown from March 25 in response to the coronavirus outbreak. There are restrictions on people leaving their homes, with only essential services being allowed to function.

The authorities have hinted they will extend the lockdown until the end of the month. It is unclear how this will impact the livelihood of daily wage laborers and those working in the country’s informal sectors.

Read more: Under coronavirus lockdown, Delhi slum residents struggle to get water

Sex workers face massive discrimination in the South Asian country, and their work is not recognized as legal. Even after the end of lockdown, social distancing will have a negative impact on their livelihood.

Mahasweta Mukherjee, director of the non-governmental organization Durbar, said that sex workers won’t be able to restart their work even after the government ends the lockdown.

“They will have to wait for at least a month to be sure that the pandemic is not spreading. The virus is more likely to transmit in brothels,” Mukherje said, adding that the government must announce an economic package for sex workers so that they can survive through the crisis.

Read more: Coronavirus: Indian mosque event becomes infection hotspot

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How the internet is making stay-at-home difficult for Africans

Across the African continent, most governments have implemented a lockdown on their citizens to mitigate and ultimately halt the spread of COVID-19. So far, South Africa has been the worst hit country by the virus with about 1,749 cases as of Tuesday (07.04.2020).  Read more: French doctor apologizes for ‘Africa’ coronavirus test …

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