‘A recipe for disaster,’ U.S. health official says of Americans ignoring coronavirus advice

By Susan Heavey and Doina Chiacu

WASHINGTON Reuters) – A spike in U.S. coronavirus infections is fueled in large part by people ignoring public health guidelines to keep their distance and wear masks, the government’s top infectious disease official said.

A daily surge in confirmed cases has been most pronounced in southern and western states that did not follow health officials’ recommendations to wait for a steady decline in infections for two weeks before reopening their economies.

“That’s a recipe for disaster,” Anthony Fauci, who directs the National Institute of Allergy and Infectious Diseases, told CNN in an interview broadcast on Monday.

“Now we’re seeing the consequences of community spread, which is even more difficult to contain than spread in a well-known physical location like a prison or nursing home or meatpacking place,” Fauci told the cable channel in the interview, which was recorded on Friday.

More than 2.5 million people have tested positive for the coronavirus in the United States and more than 125,000 have died of COVID-19, the respiratory illness it causes, according to a Reuters tally. The U.S. tally is the highest in the world while the global death toll in the pandemic surpassed half a million people on Sunday.

California ordered some bars to close on Sunday, the first major rollback of efforts to reopen the economy in the most populous U.S. state, following Texas and Florida ordering the closure of all their bars on Friday. Arizona and Georgia are among 15 states that had record increases in cases last week.

U.S. Vice President Mike Pence on Sunday pressed Americans to adopt face masks during a trip to Texas and wore one himself, a sharp turnaround for the administration. Republican President Donald Trump has refused to cover his face in public.

Pence and other top health officials were expected to visit Arizona and Florida later this week.

In places where cases are soaring, U.S. health officials are also considering “completely blanketing these communities with tests,” Fauci said, to try to get a better sense of an outbreak.

They would either test groups, or “pools,” of people or have community groups do contact tracing in person rather than by phone. Contact tracing involves identifying people who are infected and monitoring people who may have been exposed and asking them to voluntarily go into quarantine.

Fauci said that he was optimistic that a vaccine could be available by year’s end but that it was unclear how effective it would prove to be, adding that no vaccine would be 100% effective and citing challenges to achieve so-called herd immunity.

The top Republican in the U.S. House of Representatives, Kevin McCarthy, on Monday stressed individual actions to stop the spread of the virus, deflecting criticism from Democrats and some health experts that Trump botched the prevention effort.

“You can’t say the federal government should do everything, and then say the federal government can’t tell the states what to do,” McCarthy told CNBC. “The governors have a big responsibility here but every American has a responsibility. They should wear a mask.”

(Reporting by Susan Heavey and Doina Chiacu in Washington; Writing by Grant McCool; Editing by Howard Goller)

Global coronavirus deaths top half a million

By Jane Wardell and Cate Cadell

SYDNEY/BEIJING (Reuters) – The death toll from COVID-19 surpassed half a million people on Sunday, according to a Reuters tally, a grim milestone for the global pandemic that seems to be resurgent in some countries even as other regions are still grappling with the first wave.

The respiratory illness caused by the new coronavirus has been particularly dangerous for the elderly, although other adults and children are also among the 501,000 fatalities and 10.1 million reported cases.

While the overall rate of death has flattened in recent weeks, health experts have expressed concerns about record numbers of new cases in countries like the United States, India and Brazil, as well as new outbreaks in parts of Asia.

More than 4,700 people are dying every 24 hours from COVID-19-linked illness, according to Reuters calculations based on an average from June 1 to 27.

That equates to 196 people per hour, or one person every 18 seconds.

About one-quarter of all the deaths so far have been in the United States, the Reuters data shows. The recent surge in cases has been most pronounced in a handful of Southern and Western states that reopened earlier and more aggressively. U.S. officials on Sunday reported around 44,700 new cases and 508 additional deaths.

Case numbers are also growing swiftly in Latin America, on Sunday surpassing those diagnosed in Europe, making the region the second most affected by the pandemic, after North America.

On the other side of the world, Australian officials were considering reimposing social distancing measures in some regions on Monday after reporting the biggest one-day rise in infections in more than two months.

The first recorded death from the new virus was on Jan. 9, a 61-year-old man from the Chinese city of Wuhan who was a regular shopper at a wet market that has been identified as the source of the outbreak.

In just five months, the COVID-19 death toll has overtaken the number of people who die annually from malaria, one of the most deadly infectious diseases.

The death rate averages out to 78,000 per month, compared with 64,000 AIDS-related deaths and 36,000 malaria deaths, according to 2018 figures from the World Health Organization.

CHANGING BURIAL RITES

The high number of deaths has led to changes to traditional and religious burial rites around the world, with morgues and funeral businesses overwhelmed and loved ones often barred from bidding farewell in person.

In Israel, the custom of washing the bodies of Muslim deceased is not permitted, and instead of being shrouded in cloth, they must be wrapped in a plastic body bag. The Jewish tradition of Shiva where people go to the home of mourning relatives for seven days has also been disrupted.

In Italy, Catholics have been buried without funerals or a blessing from a priest. In New York, city crematories were at one point working overtime, burning bodies into the night as officials scouted for temporary interment sites.

In Iraq, former militiamen have dropped their guns to instead dig graves for coronavirus victims at a specially created cemetery. They have learned how to conduct Christian, as well as Muslim, burials.

ELDERLY AT RISK

Public health experts are looking at how demographics affect the death rates in different regions. Some European countries with older populations have reported higher fatality rates, for instance.

An April report by the European Center for Disease Prevention and Control looked at more than 300,000 cases in 20 countries and found that about 46% of all fatalities were over the age of 80.

In Indonesia, hundreds of children are believed to have died, a development health officials have attributed to malnutrition, anemia and inadequate child health facilities.

Health experts caution that the official data likely does not tell the full story, with many believing that both cases and deaths have likely been under reported in some countries.

(Reporting by Jane Wardell in Sydney and Cate Cadell in Beijing; Editing by Tiffany Wu and Daniel Wallis)

Special Report: As world approaches 10 million coronavirus cases, doctors see hope in new treatments

By Nick Brown, Deena Beasley, Gabriela Mello and Alexander Cornwell

(Reuters) – Dr. Gopi Patel recalls how powerless she felt when New York’s Mount Sinai Hospital overflowed with COVID-19 patients in March.

Guidance on how to treat the disease was scant, and medical studies were being performed so hastily they couldn’t always be trusted.

“You felt very helpless,” said Patel, an infectious disease doctor at the hospital. “I’m standing in front of a patient, watching them struggle to breathe. What can I give them?”

While there is still no simple answer to that question, a lot has changed in the six months since an entirely new coronavirus began sweeping the globe.

Doctors say they’ve learned enough about the highly contagious virus to solve some key problems for many patients. The changes could be translating into more saved lives, although there is little conclusive data.

Nearly 30 doctors around the world, from New Orleans to London to Dubai, told Reuters they feel more prepared should cases surge again in the fall.

“​We are well-positioned for a second wave,” Patel said. “We know so much more.”

Doctors like Patel now have:

*A clearer grasp of the disease’s side effects, like blood clotting and kidney failure

*A better understanding of how to help patients struggling to breathe

*More information on which drugs work for which kinds of patients.

They also have acquired new tools to aid in the battle, including:

*Widespread testing

*Promising new treatments like convalescent plasma, antiviral drugs and steroids

*An evolving spate of medical research and anecdotal evidence, which doctors share across institutions, and sometimes across oceans.

Despite a steady rise in COVID-19 cases, driven to some extent by wider testing, the daily death toll from the disease is falling in some countries, including the United States. Doctors say they are more confident in caring for patients than they were in the chaotic first weeks of the pandemic, when they operated on nothing but blind instinct.

In June, an average of 4,599 people a day died from COVID-19 worldwide, down from 6,375 a day in April, according to Reuters data.

New York’s Northwell Health reported a fatality rate of 21% for COVID-19 patients admitted to its hospitals in March. That rate is now closer to 10%, due to a combination of earlier treatment and improved patient management, Dr. Thomas McGinn, director of Northwell’s Feinstein Institutes for Medical Research, told Reuters.

“I think everybody is seeing that,” he said. “I think people are coming in sooner, there is better use of blood thinners, and a lot of small things are adding up.”

Even nuts-and-bolts issues, like how to re-organize hospital space to handle a surge of COVID-19 patients and secure personal protective equipment (PPE) for medical workers, are not the time-consuming, mad scrambles they were before.

“The hysteria of who’d take care of (hospital staff) is not there anymore,” said Dr. Andra Blomkalns, head of emergency medicine at Stanford Health Care, a California hospital affiliated with Stanford University. “We have an entire team whose only job is getting PPE.”

To be sure, the world is far from safe from a virus that continues to rage. It is expected to reach two grim milestones in the next several days: 10 million confirmed global infections and 500,000 deaths. As of Thursday evening, more than 9.5 million people had tested positive for the coronavirus, and more than 483,000 had died, according to Reuters data. The United States remains the epicenter of the pandemic, and cases are rising at an alarming pace in states like Arizona, Florida and Texas.

There is still no surefire treatment for COVID-19, the disease caused by the new virus, which often starts as a respiratory illness but can spread to attack organs including the heart, liver, kidneys or central nervous system. Scientists are at least months away from a working vaccine.

And while medical knowledge has improved, doctors continue to emphasize that the best way for people to survive is to avoid infection in the first place through good hygiene, face coverings and limited group interaction.

Dr. Ramanathan Venkiteswaran, medical director of Aster Hospitals in the United Arab Emirates, said COVID-19 will likely result in permanent changes in medicine and for the general public on “basic things like social distancing, wearing of masks and hand washing.”

LEARNING ON THE FLY

In the medical field, change can be slow, with years-long studies often needed before recommendations are altered. But protocols for COVID-19 have evolved at lightning speed.

In Brazil, São Paulo-based Hospital Israelita Albert Einstein, one of the country’s leading private hospital networks, has updated its internal guidelines for treating coronavirus patients some 50 times since the outbreak began earlier this year, according to Dr. Moacyr Silva Junior, an infectious disease specialist at the center. Those guidelines govern questions such as which patients are eligible for which drugs, how to handle patients with breathing problems, and the use of PPE like masks, gowns and gloves.

“In only three months, a resounding amount of scientific work on COVID-19 has been published,” he said.

At Stanford Health Care, treatment guidelines changed almost daily in the early weeks of the pandemic, Blomkalns said. She described a patchwork approach that began by following guidelines established by the U.S. Centers for Disease Control and Prevention, then modifying them to reflect a shortage of resources, and finally adding new measures not addressed by the CDC, such as how to handle pregnant healthcare workers.

The new coronavirus has been particularly vexing for doctors because of the many and often unpredictable ways it can manifest. Most people infected experience only mild flu-like symptoms, but some can develop severe pneumonia, stroke and neurological disease. Doctors say the biggest advance so far has been understanding how the disease can put patients at much higher risk for blood clots. Most recently, doctors have discovered that blood type might influence how the body reacts to the virus.

“We developed specific protocols, such as when to start blood thinners, that are different from what would be done for typical ICU patients,” said Dr. Jeremy Falk, pulmonary critical care specialist at Cedars-Sinai Medical Center in Los Angeles.

Around 15% of COVID-19 patients are at risk of becoming sick enough to require hospitalization. Scientists have estimated that the fatality rate could be as high as 5%, but most put the number well below 1%. People with the highest risk of severe disease include older adults and those with underlying health conditions like heart disease, diabetes and obesity.

While rates of COVID-19 infection have recently been rising in many parts of the United States, the total number of U.S. patients hospitalized with COVID-19 has been steadily falling since a peak in late April, according to the CDC.

Many hospitals report success with guidelines for “proning” patients – positioning them on their stomachs to relieve pressure on the lungs, and hopefully stave off the need for mechanical ventilation, which many doctors said has done more harm than good.

“At first, we had no idea how to treat severely ill patients when we (ventilate),” said Dr. Satoru Hashimoto, who directs the intensive care division at Kyoto Prefectural University of Medicine in Japan. “We treated them in the fashion we treated influenza,” only to see those patients suffer serious kidney, digestive and other problems, he said.

Hospitals say increased coronavirus testing – and faster turnaround times to get results – are also making a difference.

“What has really helped us triage patients is the availability of rapid testing that came on about six weeks ago,” said Falk of Cedars-Sinai. “Initially, we had to wait two, three or even four days to get a test back. That really clogged up the COVID areas of the hospital.”

Faster, wider testing also helps conserve PPE by identifying the negative patients around whom doctors don’t have to wear as much gear, said Dr. Saj Patel, who treats non-critical patients at the University of California San Francisco Medical Center. “You can imagine how much PPE we burned through” waiting for test results, he said.

Hospitals around the world acted early to restructure operations, including floor layouts, to isolate coronavirus patients and reduce exposure to others. It wasn’t always smooth, but doctors say they’re figuring out how to do it more efficiently.

“Our hospital infrastructure, and the way that we … manage people coming through the door is a lot slicker than it was earlier in the epidemic,” said Dr. Tom Wingfield, a clinical lecturer at the Liverpool School of Tropical Medicine in Liverpool, England.

USING WHAT’S AT HAND

But even if hydroxychloroquine looks unlikely as an effective COVID-19 treatment, hospitals continue to try new medications – both by repurposing older drugs and exploring novel therapies. Patients are being enrolled in hundreds of coronavirus clinical trials launched in the past three months.

Many hospitals said they are seeing success with the use of plasma donated by survivors of COVID-19 to treat newly infected patients.

People who survive an infectious disease like COVID-19 are generally left with blood containing antibodies, which are proteins made by the body’s immune system to fight off a virus. The blood component that carries the antibodies, known as convalescent plasma, can be collected and given to new patients.

Early results from a study at New York’s Mount Sinai Hospital found that patients with severe COVID-19 who were given convalescent plasma were more likely to stabilize or need less oxygen support than other similar hospital patients. But results from other studies have been mixed, and doctors still await findings from a rigorously-designed trial. And availability of plasma varies between regions.

At Henry Ford Hospital in Detroit, Michigan, “anecdotally everyone can provide stories” of the benefits of plasma, said Dr. John Deledda, the hospital’s chief medical officer.

But in rural New Mexico, hospitals that care for largely underserved populations struggle to find it. “There’s a limited number of blood centers” that can provide plasma, said Valory Wangler, chief medical officer at Rehoboth McKinley Christian Health Care Services, in Gallup, New Mexico. Until trial data is more conclusive, plasma is “not something we’re pursuing actively,” she said.

Dr Abdullatif al-Khal, head of infectious diseases at Qatar’s Hamad Medical Corporation and a co-chair of the country’s pandemic preparedness team, said he saw patients improve after he started using donated plasma early in the course of COVID-19 before the patients deteriorated.

Qatar is also assessing a steroid known as dexamethasone to treat COVID-19. But Khal says he wants to wait for publication of clinical data behind a recent UK study suggesting that the steroid reduced death rates by around a third among the most severely ill COVID-19 patients.

In patients with severe COVID-19, the immune system can overreact, triggering a potentially harmful cascade. Steroids are an older class of drugs that suppress that inflammatory response. But they can also make it easier for other viral or bacterial infections to take hold – making doctors leery of their use in a hospital setting or in patients with early-stage COVID-19.

Some countries, including Bahrain and the United Arab Emirates, reported using HIV drugs lopinavir and ritonavir with some success. Clinical trials, though, have suggested little benefit, and they aren’t widely used in the United States.

MIDNIGHT DELIVERY

Many of the doctors who spoke with Reuters were bullish on the use of remdesivir, the only drug so far shown to be effective against the coronavirus in a rigorous clinical trial. The antiviral developed by California-based Gilead Sciences Inc <GILD.O> was shown to reduce the length of hospital stays for COVID-19 patients by about a third, but hasn’t been proven to boost survival.

Remdesivir is designed to disable the mechanism by which certain viruses, including the new coronavirus, make copies of themselves and potentially overwhelm their host’s immune system.

It is available under emergency approvals in several countries, including the United States. But Gilead’s donated supplies are limited, and distribution and availability are uneven.

Dr. Andrew Staricco, chief medical officer at McLaren Health Care, which operates 11 hospitals across Michigan, recalls the urgency to obtain remdesivir early on. He got an email from Michigan’s health department on May 9, a week after the U.S. Food & Drug Administration authorized the drug for use in treating COVID-19. The health department said it had received a small batch from the federal government, and planned to dole it out to local hospitals based on need. Staricco wrote back, saying he had 15 to 18 critically ill patients, but was given enough to treat just four.

The drug was so precious, he said, that state police troopers were responsible for transporting it to the hospital – which they did, dropping it off around 1 a.m. the next morning.

Health officials originally directed remdesivir for use on the most critically ill patients. But doctors later found they got the best results administering it earlier.

“We started finding that, actually, the sooner you get treated with it, the better,” Staricco said. “We’ve revisited our criteria for giving it to patients three different times.”

Data on the drug, he said, is still scarce. But his anecdotal observations on the benefits of early treatment were echoed by several U.S. doctors.

‘COPY-CATTING’

Gilead on Monday said it aims to manufacture another 2 million courses of remdesivir this year, but did not comment on how it plans to distribute, or sell, those supplies for use by hospitals. The company has licensed the antiviral to several generic drugmakers, who will be allowed to sell the medication in over 100 low-income nations.

Although much about the coronavirus remains unknown, a key reason hospitals say they now are more prepared owes to teamwork.

Many doctors described a kind of unofficial network of information sharing.

In hard-hit Italy, Dr. Lorenzo Dagna of the IRCCS San Raffaele Scientific Institute in Milan, organized conference calls with institutions in the United States and elsewhere to share experiences and anecdotes treating COVID-19 patients.

McLaren’s Staricco said the Michigan hospital chain adopted its policy on use of blood thinners by looking at peers at Detroit Medical Center and Vanderbilt University Medical Center.

As more institutions put their guidelines online, he said, there was “lots of copy-catting going on.”

(Reporting by Nick Brown in New York, Deena Beasley in Los Angeles, Gabriela Mello in São Paulo and Alexander Cornwell in Dubai.; Additional reporting By Alistair Smout in London, Matthias Blamont in Paris, Emilio Parodi in Milan, Lisa Barrington in Dubai, Rocky Swift in Tokyo and Sangmi Cha in Seoul.; Editing by Michele Gershberg and Marla Dickerson)

 

Black Americans disproportionately die in police Taser confrontations

By Linda So

WASHINGTON (Reuters) – As police confront protesters across the United States, they’re turning to rubber bullets, pepper spray, tear gas and other weapons meant to minimize fatalities.

But some are using a weapon that has potential to kill: the Taser. When those encounters have turned fatal, black people make up a disproportionate share of those who die, according to a Reuters analysis.

Reuters documented 1,081 cases through the end of 2018 in which people died after being shocked by police with a Taser, the vast majority of them after 2000. At least 32% of those who died were black, and at least 29% were white. African-Americans make up 14% of the U.S. population, and non-Hispanic whites 60%.

To explore the Reuters database of deaths involving police and Tasers, click here:

“These racial disparities in Taser deaths are horrifying but unsurprising,” said Carl Takei, a senior staff attorney at the American Civil Liberties Union. “Police violence is a leading cause of death for black people in America, in large part because over-policing of black and brown communities results in unnecessary police contacts and unnecessary use of force.”

In 13% of the deaths identified in police reports, autopsies or other records as involving people of Hispanic ethnicity, Reuters was unable to document race. The race of the person who died was also unknown in the remaining 26% of the cases.

The deaths illustrate a challenge for U.S. law enforcement at a time when protests over police killings have thrown a spotlight on their tactics. Tasers, which deliver a pulsed electrical current meant to give police several seconds to restrain a subject, have been nearly universally embraced since the early 2000s as a less lethal alternative to firearms. About 94% of America’s roughly 18,000 police agencies now issue Tasers.

Tasers drew fresh attention over the weekend after the Friday night death of Rayshard Brooks. A police officer shot the 27-year-old with his handgun after Brooks ran away with an officer’s Taser and pointed it at police following a scuffle, the Georgia Bureau of Investigation said. A lawyer for the Brooks family, L. Chris Stewart, said Brooks’ wielding of the Taser didn’t justify his shooting, noting that police routinely argue in court that the devices are non-lethal weapons.

In a series of reports in 2017, however, Reuters identified more than a thousand cases since 2000 in which people died after being shocked by police with the weapons, typically in combination with other forms of force.

Most independent researchers who have studied Tasers say deaths are rare when they are used properly. But the Reuters investigation found that many police officers are not trained properly on the risks, and the weapons are often misused. Tasers fire a pair of barbed darts that deliver a paralyzing electrical charge or can be pressed directly against the body – the “drive stun” mode – causing intense pain.

Some recent examples of Taser misuse highlight the risks and confusion surrounding the weapon.

On May 30, during nationwide protests over the death of George Floyd in Minneapolis, two college students, Taniyah Pilgrim, 20, and Messiah Young, 22, had gone out to get food and were stuck in traffic due to the demonstrations in Atlanta.

In a confrontation with police caught on bodycam video, one officer repeatedly struck the driver’s side window with a baton as a second officer stunned Pilgrim with a Taser. A third officer used a Taser on Young, as the police dragged the black students out of the car.

Video footage of the officers shocking them drew criticism around the country. Atlanta Police Chief Erika Shields apologized at a news conference the next day. “How we behaved as an agency, as individuals was unacceptable,” she said. Young was treated in the hospital and required stitches. Shields resigned on Saturday after the Brooks killing.

After the May 30 incident, one officer wrote in a police report that he used his Taser because he was unsure whether the students were armed. The Taser’s manufacturer, Axon Enterprise Inc, warns in guidelines distributed to police departments that the weapon should not be used on people who are driving or restrained. And law enforcement experts say Tasers generally shouldn’t be used on anyone who is already immobilized, such as in a car.

Six police officers involved in the incident — five of them black, one white — were charged for using excessive force. Four have been fired. Two have sued the mayor and police chief seeking their jobs back. An attorney representing the two officers says he believes the firings were politically motivated.

“The question police should be asking is not: ‘Can I use the Taser?’ but ‘Should I?’” said Michael Leonesio, a retired police officer who ran the Oakland Police Department’s Taser program and has served as an expert witness in wrongful death lawsuits against Axon. “This is a dangerous weapon,” Leonesio said. “The more it’s used, the more people are going to die.”

Axon says its weapons are not risk-free but are safer than batons, fists, tackles and impact munitions. “Any loss of life is a tragedy regardless of the circumstance, which is why we remain committed to developing technology and training to protect both officers and the community,” the company said in an email to Reuters.

“TASE HIS ASS”

On a hot July day in 2017, Eurie Martin, 58, wanted a drink of water. After walking more than 12 miles to visit relatives for his birthday, he stopped to ask a homeowner for water in Deepstep, a town of about 130 people in central Georgia. The homeowner refused and called police to check out Martin, “a black man,” according to the district attorney.

Martin was walking on the side of the road when a Washington County Sheriff’s deputy arrived and tried to speak with him. Martin, who suffered from schizophrenia, ignored him and kept walking. The deputy called for backup.

The officers said Martin got “defensive” and “clinched his fists,” ignoring commands to place his hands behind his back, the district attorney said. One deputy told another to “Tase his ass,” according to the officers’ dashboard camera video.

When the deputy fired the Taser, Martin fell to the ground, removed the Taser prong from his arm, and walked away. A third deputy arrived and fired his stun gun at Martin’s back, causing him to fall.

The deputies surrounded Martin as he lay face down, applying the weight of their bodies and deployed their Tasers 15 times. Martin could be heard crying out in pain saying, “they killing me.” He died of cardiac arrhythmia during police restraint, according to an autopsy.

“He was a victim of walking while black,” said Mawuli Davis, an attorney representing Martin’s family. The deputies, who were fired after they were indicted, said they followed their training on use of the stun gun.

Last November, a judge granted the three deputies – all white – immunity from prosecution just weeks before they were to go trial on murder charges in Martin’s death.

In its guidelines distributed to police departments, Axon warns against using multiple Tasers at the same time. Law enforcement experts say repeated applications and continuous use of stun guns can increase the risk of death and should be avoided.

The sheriff’s office declined to respond to multiple requests for comment.

The judge ruled the deputies acted in self-defense and that their use of the Taser was “justified” and “reasonable under the circumstances.” Citing Georgia’s Stand Your Ground Law, the judge wrote all people have the right to use reasonable force to protect themselves against “death or great bodily injury.”

The district attorney appealed the ruling, and the case is scheduled to be heard before the state Supreme Court in August. If the high court overturns the lower court’s ruling, the murder charges against the deputies will be reinstated.

Martin died “for daring to ask for a drink of water in the Georgia sun,” said his sister Helen Gilbert. “Every person of common sense knows he did nothing to deserve his death. I will not rest until this long walk to justice is complete.”

SCRUTINY

Deaths involving Tasers typically draw little public scrutiny – no government agency tracks how often they’re used or how many of those deployments prove fatal. Coroners and medical examiners use varying standards to assess a Taser’s role in a death. And there are no uniform national standards governing police use of Tasers.

Late in 2009, as evidence of cardiac risks from Tasers mounted, the manufacturer made a crucial change: It warned police to avoid firing its stun gun’s electrified darts at a person’s chest.

But on March 3 in Tacoma, Washington, that warning wasn’t heeded.

Newly released video and audio recordings show Tacoma police officers using a Taser and beating a black man as he shouted, “I can’t breathe” — similar to George Floyd’s desperate cry when a white police officer in Minneapolis pressed a knee into his neck on May 25.

Police said they found Manuel Ellis, 33, trying to open doors of unoccupied cars and that he attacked a police vehicle and two officers. An attorney for his family said he was walking home from a convenience store when the confrontation with police took place.

Police handcuffed Ellis and bound his legs with a canvas strap after firing a Taser into his chest, according to an autopsy report. He lost consciousness, and efforts to resuscitate him were unsuccessful. The medical examiner ruled his death a homicide. An autopsy listed his cause of death as respiratory arrest due to hypoxia as a result of physical restraint.

His death sparked protests in Tacoma on June 5 after video of the incident surfaced. The governor called for a new investigation, and the city’s mayor demanded the four officers involved be fired and prosecuted. Two officers are white, one is black and the other is Asian. They have been placed on administrative leave, but have not been charged.

One of the officers, Christopher Burbank, declined to comment. Attempts by Reuters to reach the other three were unsuccessful. The Tacoma Police Department said it was cooperating with county and state investigators.

(Additional reporting by Grant Smith. Editing by Jason Szep)

Family of Rayshard Brooks demands justice after Atlanta police fatally shoot him in the back

(Reuters) – The family of Rayshard Brooks, a black man whose death reignited protests in Atlanta over the weekend, on Monday said they were “heartbroken” and “tired” of the racial injustice that they said led to Brooks’ death at the hands of Atlanta police.

An autopsy conducted on Sunday showed that Brooks, 27, died from blood loss and organ injuries caused by two gunshot wounds to his back, the Fulton County Medical Examiner’s office said in a statement, ruling his death a homicide.

“We’re tired and we are frustrated. Most importantly we’re heartbroken, so we need justice for Rayshard Brooks,” his cousin, Tiara Brooks, said at a news conference.

“The trust that we have in the police force is broken. The only way to heal some of these wounds is through a conviction and a drastic change in the police department,” she added.

Brooks’ fatal encounter with the police came after police responded to a call that he had fallen asleep in his car in a Wendy’s restaurant drive-through lane.

Caught on video, the encounter seemed friendly at first but when an officer moved to arrest him, Brooks struggled with him and another officer at the scene before breaking away across the parking lot with what appears to be a police Taser in his hand.

A video from the restaurant’s cameras shows Brooks turning as he runs and possibly aiming the Taser at the pursuing officers, both white, before one of them fires his gun and Brooks falls.

Prosecutors will decide by midweek whether to bring charges, Fulton County District Attorney Paul Howard said on Sunday.

Several members of Rayshard Brooks’ family attended the news conference in tears, and spoke of him as a warm family man who loved to take his daughter skating. One man left the room during the briefing in hysterics, shouting, “Somebody took my cousin!”

Atlanta’s police chief, Erika Shields, resigned over the shooting. The officer suspected of killing Brooks was fired, and the other officer involved in the incident was put on administrative leave.

Brooks’ death reignited protests in Atlanta after days of worldwide demonstrations against racism and police brutality prompted by the death of George Floyd, an African American, when a Minneapolis policeman knelt on his neck for nearly nine minutes on May 25.

Brooks’ widow, Tomika Miller, implored the public to protest peacefully in her husband’s name.

“We want to keep his name positive,” she said.

(Reporting by Susan Heavey, Gabriella Borter and Nathan Layne; Editing by Steve Orlofsky and Jonathan Oatis)

Minneapolis police chief breaks off talks with officer union

By Nathan Layne

(Reuters) – The Minneapolis Police Department will withdraw from contract talks with the officer union as it seeks to end relationships that have “eroded trust” in the community and overhaul the force following George Floyd’s death, its chief said on Wednesday.

Chief Medaria Arradondo, at a media briefing, also said he would implement a new early-warning system to identify police officer misconduct, allowing supervisors to intervene more quickly to get problematic officers off the street.

The decision to cut off negotiations with the Police Officers Federation of Minneapolis comes a few days after a majority of the city council pledged to dismantle the police force, raising pressure on the chief to take action.

“What our city needs now more than ever is a pathway and a plan that provides hope, reassurance and actual measures of reform,” Arradondo said. “This work must be transformational but I must do it right.”

He said he would bring in advisers to conduct a review of how the contract could be restructured for “greater community transparency and more flexibility for true reform,” adding that the main focus was not on wages and benefits.

“This is further examining those significant matters that touch on such things as critical-incident protocol, our use of force, the significant role that supervisors play in this department and also the discipline process.”

The May 25 death of Floyd, an unarmed black man who died after a white Minneapolis police officer knelt on his neck for nearly 9 minutes, sparked two weeks of nationwide protests putting a spotlight on minorities killed by police.

Derek Chauvin, the former officer who knelt on Floyd’s neck, has been charged with second-degree murder. Three other officers at the scene, including two rookies, were also charged with aiding and abetting in his death.

(Reporting by Nathan Layne in Wilton, Conn.; Editing by Bernadette Baum and Matthew Lewis)

U.S. Department of Justice says probe into George Floyd’s death ‘top priority’

(Reuters) – The U.S. Department of Justice said on Thursday it had made its investigation into police involvement in the death of George Floyd a “top priority,” after a second day of protests in Minneapolis over the unarmed black man’s death.

Experienced prosecutors and investigators from the Federal Bureau of Investigation had been assigned as part of a “robust” probe into whether the police officers involved had violated federal laws, the department said in a statement.

The statement followed a second day of protests in Minneapolis triggered by rage over the death of Floyd, a black man who was seen in a widely circulated video gasping for breath as a white officer knelt on his neck.

Floyd, 46, died on Monday. The investigation will be carried out by the U.S. Attorney’s Office for the District of Minnesota, the Justice Department’s civil rights division and the FBI’s Minneapolis Field Office.

The widely circulated video of Floyd’s fatal encounter on Monday night with the police, taken by a bystander, showed him lying face down and handcuffed, groaning for help and repeatedly saying, “please, I can’t breathe,” before becoming motionless.

The second day of demonstrations, accompanied by looting and vandalism, began on Wednesday hours after Minneapolis Mayor Jacob Frey urged prosecutors to file criminal charges against the white policeman shown pinning Floyd to the street.

The victim’s brother Philonise Floyd told CNN on Thursday that he was “tired of seeing black men die” and understood people’s anger but urged protesters to be peaceful.

“To the police, I want them to get everything right, start doing your job the right way because I haven’t been seeing it,” Floyd said.

“I want justice, I just want justice,” he added, struggling to fight back tears.

(Reporting by Nathan Layne in Wilton, Connecticut and Maria Caspani in New York; Editing by Gareth Jones and Bernadette Baum)

Four Minneapolis policemen fired after death of unarmed black man

By Eric Miller

MINNEAPOLIS (Reuters) – Four Minneapolis police officers were fired on Tuesday over the death of an unarmed black man seen in a video lying face down in the street, gasping for air and groaning, “I can’t breathe,” while a white officer knelt on his neck for several minutes.

Hours after the officers’ dismissals were announced, thousands of protesters filled the streets around the scene of Monday evening’s deadly incident in a boisterous but peaceful rally. Many in the crowd wore facial coverings to protect against spread of the coronavirus.

But the gathering took an unruly turn around dusk as police in riot gear fired tear gas and non-lethal bean-bag rounds into the crowds while protesters hurled water bottles and other projectiles, the Minneapolis Star-Tribune reported.

Local news footage showed some demonstrators vandalizing the outside of a police precinct station and a squad car. The unrest appeared to have dissipated after dark as rain fell.

The day began with Minneapolis police chief Medaria Arradondo telling reporters that the Federal Bureau of Investigation had opened an inquiry at his request into the fatal arrest caught on video the night before.

Mayor Jacob Frey said at the same news briefing that regardless of the investigation’s outcome, it was clear the death of the man in custody, later identified as George Floyd, was unjustified, and that race was a factor.

“Being black in America should not be a death sentence,” the mayor said. “For five minutes we watched as a white police officer pressed his knee into the neck of a black man. For five minutes. When you hear someone calling for help, you are supposed to help.”

The mayor later announced the termination of four officers on Twitter, saying, “This is the right call.”

‘I CAN’T BREATHE’

The case was eerily reminiscent of the 2014 killing of Eric Garner, an unarmed black man in New York City, who died after being put in a police chokehold and telling the officers, “I can’t breathe.”

The officers involved in Monday’s encounter were responding to a report of a forgery in progress, and found a man fitting the suspect’s description, Floyd, aged in his 40s, in a car, according to a police department account.

After Floyd got out of the car, the department said, there was a physical altercation between the officers and Floyd. Floyd was handcuffed, and he appeared to be in medical distress, according to police.

Cell phone footage taken by an onlooker does not show what precipitated the confrontation. It opens with Floyd lying beside the rear wheel of a vehicle, with a white officer pinning him to the street by pressing a knee into Floyd’s neck.

Floyd can be heard repeatedly moaning and gasping while he pleads, “Please, I can’t breathe, please, man,” as bystanders gather around, growing increasingly agitated and shouting at police to let him up. After several minutes, Floyd gradually grows quiet and ceases to move.

An ambulance took the suspect to the hospital, where he died a short time later, police said. No weapons were involved, and no officers were hurt in the incident, according to police.

In the case of Garner, he was placed in a banned chokehold by a white police officer trying to arrest him for illegally selling loose cigarettes on the street.

Garner’s dying words, “I can’t breathe,” became a rallying cry for the Black Lives Matter movement calling attention to a wave of African-Americans and other minorities who died at the hands of police using unjustified lethal force.

Attorney Benjamin Crump, retained by Floyd’s family, said in a statement that officers’ “abusive, excessive and inhumane use of force cost the life of a man who was being detained by the police for questioning about a non-violent charge.”

(Reporting by Eric Miller in Minneapolis; Writing and additional reporting by Steve Gorman in Los Angeles; Additional reporting by Brendan O’Brien in Chicago; Editing by Bill Tarrant, Leslie Adler and Gerry Doyle)

Grief in a pandemic: Holding a dying mother’s hand with a latex glove

By Deborah Bloom and Nathan Layne

KIRKLAND, Wash. (Reuters) – Doug Briggs put on a surgical gown, blue gloves and a powered respirator with a hood. He headed into the hospital room to see his mother – to tell her goodbye.

Briggs took his phone, sealed in a Ziplock bag, into the hospital room and cued up his mother’s favorite songs. He put it next to her ear and noticed her wiggle, ever so slightly, to the music.

“She knew I was there,” Briggs recalled, smiling.

Between songs by Barbara Streisand and the Beatles, Briggs conference-called his aunts to let them speak to their sister one last time. “I love you, and I’m sorry I’m not there with you. I hope the medicine they’re giving you is making you more comfortable,” said Meri Dreyfuss, one of her sisters.

Somewhere between “Stand by Me” and “Here, There, and Everywhere,” Barbara Dreyfuss passed away – her hand in her son’s, clad in latex. It would be two days before doctors confirmed that she had succumbed to COVID-19, the disease caused by the coronavirus.

Doug Briggs is pictured outside of the Life Care Center of Kirkland, where his mother, Barbara Dreyfus, was a resident, contracted coronavirus disease (COVID-19), and later died in a hospital, in Kirkland, Washington, U.S., March 16, 2020. REUTERS/David Ryder

Dreyfuss, 75, was the eighth U.S. patient to die in a pandemic that has now killed more than 1,200 nationally and nearly 25,000 worldwide. She was among three dozen deaths linked to the Life Care nursing home in Kirkland, Washington, the site of one of the first and deadliest U.S. outbreaks. (For interactive graphics tracking coronavirus in the United States and worldwide, click https://tmsnrt.rs/2Uj9ry0 and https://tmsnrt.rs/3akNaFr )

Dreyfuss’s final hours illustrate the heartrending choices now facing families who are forced to strike a balance between staying safe and comforting their sick or dying loved ones. Some have been cut off from all contact with parents or spouses who die in isolation, while others have strained to provide comfort or to say their final goodbyes through windows or over the phone.

Just three days before his mother died, Briggs had been making weekend plans with her. Now, in his grief, he found himself glued to news reports and frustrated by the mixed messages and slow response from local, state and federal officials.

“You find out all these things, of what they knew when,” Briggs said.

Officials from Life Care Centers of America have said the facility responded the best it could to one of the worst crises ever to hit an eldercare facility, with many staffers stretched to the brink as others were sidelined with symptoms of the virus. As the first U.S. site hit with a major outbreak, the center had few protocols for a response and little help from the outside amid national shortages of test kits and other supplies.

‘NOT FEELING TOO GOOD’

A flower child of the 1960’s, Dreyfuss lived a life characterized by art and activism. After marrying her high school sweetheart and giving birth to their son, she pursued a degree in women’s studies at Cal State Long Beach, where she marched for women’s equality and abortion rights.

Furious over President Gerald Ford’s pardoning of former president Richard Nixon in 1974, Dreyfuss took to her typewriter and penned an angry letter to Ford. “Today is my son’s 9th birthday,” she wrote of a young Briggs. “I do not feel like celebrating.”

By the time she arrived at the Life Care Center in May 2019, years of health issues had dimmed some of that spark, her son said. Fibromyalgia and plantar fasciitis restricted her to a walker or a wheelchair, and chronic obstructive pulmonary disease required her to have a constant flow of oxygen.

When her son visited on Feb. 25, he brought a grocery bag of her favorites, including diet A&W root beer. She awoke from a nap and smiled at him, but hinted at her discomfort.

“Hi Doug,” she said. “I’m not feeling too good.”

Still, Dreyfuss talked about an upcoming visit with her sisters – the movies she wanted to see, the restaurants she wanted to try. The mother and son then had only a vague awareness of the deadly virus then ravaging China.

In hindsight, Briggs realized he had witnessed the first signs of her distress. His mother was using more oxygen than usual, her breathing was more strained.

At the time, staff at the nursing home believed they were handling a flu outbreak and were unaware the coronavirus had started to take hold, a spokesman has said.

‘A TINY FOOTNOTE’

Two days later, Briggs dropped by to see his mom. She felt congested, and staff were going to X-ray her lungs for fluid. Briggs, 54, still saw no red flags, and continued to discuss weekend plans with his mother.

“I hope we can finally watch that new Mr. Rogers movie,” she told him, referring to the film, A Beautiful Day in the Neighborhood.

Briggs hugged his mom before she was wheeled to the imaging room and drove for a quick meal. Soon after, he received a call from the nursing home. His mother was experiencing respiratory failure. She was on her way to the hospital. Doug rushed to nearby EvergreenHealth Medical Center. By then, she was unresponsive.

At the time, there were 59 U.S. cases of coronavirus, a number that has since soared to more than 85,000.

After hearing of her sister’s sudden hospitalization, Meri Dreyfuss remembered an earlier voicemail from Barbara: her distant voice, groaning for 30 seconds. When she had first heard it, she assumed Dreyfuss had called by accident, but now she realized her sister was in pain. “It haunts me that I didn’t pick up the phone,” she said.

Briggs spent close to 10 hours the next day in his mom’s hospital room. He wore a medical mask and anxiously watched her vital signs – especially the line tracking her oxygen saturation.

On his way out the door, a doctor took him aside to say they were testing her for the coronavirus. He remembered the difficulty reconciling the outbreak taking place on television – far away, in China – with what was happening in his mother’s hospital room.

In the Bay Area, Meri and Hillary Dreyfuss were packing their suitcases on Feb. 28 when Briggs telephoned. After the call, they decided that visiting their sister would pose too much danger of infection.

“I realized there was no way we were going to get on a plane at that point, because we couldn’t see her,” said the middle sister, Hillary. “And now, it seemed that we shouldn’t be seeing Doug, either.”

They canceled their flights. On Saturday, Feb. 29, Briggs learned his mother’s condition was deteriorating. Tough decisions loomed. Briggs and his aunts decided to prioritize making her comfortable over keeping her alive. Doctors gave her morphine to relax the heaviness in her lungs.

She died the next day.

Having emerged from a two-week quarantine, Briggs will soon retrieve his mother’s cremated remains. The family has been struggling with how to memorialize her life in such chaotic times.

“All the things that one would want to happen in the normal mourning process have been subsumed by this larger crisis,” said Hillary Dreyfuss. “It’s almost as though her death has become a tiny footnote in what’s going on.”

(Reporting by Deborah Bloom and Nathan Layne; Editing by Paul Thomasch and Brian Thevenot)

‘There are no funerals:’ Death in quarantine leaves nowhere to grieve

By Angelo Amante, Parisa Hafezi and Hayoung Choi

(Reuters) – Struck down by coronavirus at the age of 83, the long life of Alfredo Visioli ended with a short ceremony at a graveyard near Cremona, his hometown in northern Italy.

“They buried him like that, without a funeral, without his loved ones, with just a blessing from the priest,” said his granddaughter Marta Manfredi who couldn’t attend. Like most of the old man’s family – like most of Italy – she was confined to her home.

“When all this is over,” she vows, “we will give him a real funeral.”

Everywhere the coronavirus has struck, regardless of culture or religion, ancient rituals to honor the dead and comfort the bereaved have been cut short or abandoned for fear of spreading it further.

The virus, which has killed nearly 9,000 people worldwide, is reshaping many aspects of death, from the practicalities of handling infected bodies to meeting the spiritual and emotional needs of those left behind.

In Ireland, the health authority is advising mortuary workers to put face masks on dead bodies to reduce even the minor risk of infection. In Italy, a funeral company is using video links to allow quarantined families to watch a priest bless the deceased. And in South Korea, fear of the virus has caused such a drop in the number of mourners that funeral caterers are struggling for business.

There is little time for ceremony in hard-hit cities such as Bergamo, northeast of Milan, where the mortuaries are full and the crematorium is working around the clock, said Giacomo Angeloni, a local official in charge of cemeteries.

Bergamo, home to about 120,000 people, has been dealing with 5-6 times the number of dead it would in normal times, he said.

Italy has now reported nearly 3,000 deaths from COVID-19, the disease caused by the coronavirus – the highest outside China where the virus first emerged. The Italian army sent 50 troops and 15 trucks to Bergamo on Wednesday to take bodies to less overwhelmed provinces.

A ban on gatherings has shattered the vital rituals that help us grieve, said Andy Langford, the chief operating officer of Cruse Bereavement Care, a British charity providing free care and counseling to those in grief.

“Funerals allow a community to come together, express emotion, talk about that person and formally say goodbye,” he said.

“When you feel you have no control over how you can grieve, and over how you can experience those last moments with someone, that can complicate how you grieve and make you feel worse,” he said.

EXTRA STAFF

In Iran as in northern Italy, hospital and funeral workers are overwhelmed with bodies, as the virus has torn across the country, killing 1,284 people and infecting thousands, according to state TV.

The authorities have hired new people to dig graves, said a manager at Tehran’s Behesht-e Zahra cemetery. “We work day and night,” he said. “I have never seen such a sad situation. There are no funerals.”

Most corpses arrive by truck and are buried without the ritual washing that Islam dictates, he said.

Some Iranians suspect that the official haste to bury them has more to do with obscuring the spiraling death toll than halting the spread of the virus.

Deaths from COVID-19 have been recorded as heart attacks or lung infections, a hospital worker in Kashan, a city about a three-hour drive from Tehran, told Reuters.

“The officials are lying about the death toll,” the worker said. “I have seen dozens of corpses in the past few days, but they have told us not to talk about it.” Two nurses at Iranian hospitals also told Reuters they thought the death toll was higher than the official tally.

Iranian authorities have rejected allegations of a cover-up, and President Hassan Rouhani, in a televised speech on Mar. 18, said his government had been “honest and straightforward with the nation.”

INFECTION RISK

In several countries, clusters of infection have followed funerals. In South Korea, where more than 90 people have died, the government has urged the families of COVID-19 victims to cremate their loved ones first, and hold the funeral later.

Korean funerals usually take place in hospitals, and involve three days of prayers and feasting. Most of the country’s early cases were linked to a church in Daegu city and a hospital in a nearby county. In February, several members of the Shincheonji Church of Jesus attended a funeral at the hospital for the brother of the church’s founder.

Since the outbreak, the number of mourners at funerals has plunged by 90%, regardless of whether the deceased had the virus, said Choi Min-ho, secretary general of the Korea Funeral Association.

“The culture of funerals has changed significantly,” he said. “A handful of mourners quickly offer condolences and leave the place without dining together out of infection worries.”

Condolence money, traditionally handed over in cash, is now sent via bank transfer, he added.

Authorities in Wuhan, the epicenter of China’s outbreak and location of the majority of its deaths, quickly identified the funeral business as a potential source of transmission.

The local civil affairs bureau in late January ordered all funerals for confirmed COVID-19 victims to be handled at a single funeral home in the city’s Hankou district. Mourning ceremonies, usually boisterous social events in China, were curtailed along with all other public gatherings.

Those restrictions are still in place, even though the number of new cases has dwindled in recent weeks. Bereaved families are not even allowed to see the bodies of their loved ones, a worker at the funeral home told Reuters.

In China, the ashes of the deceased tend to be kept in funeral homes until they are taken to a family plot on public holidays such as the Tomb Sweeping Festival in April. That’s also canceled this year.

“DEATH MANAGEMENT”

In Spain, too, a large cluster of cases has been traced to a funeral in the northern town of Vitoria in late February. At least 60 people who attended tested positive after the event, said local media reports.

With over 600 deaths, Spain is the second-worst hit country in Europe after Italy, and most people are now confined to their homes. Referring to these restrictions, Prime Minister Pedro Sanchez has called coronavirus a “cruel” disease that paralyses the human need to socialize.

In Ireland, up to 100 guests are still allowed at all funerals – for now. But most families are opting for small private ceremonies and encouraging others to express their condolences online through websites such as RIP.ie, where death notices and funeral invitations are usually posted.

Open casket funerals are out for any victim of coronavirus, and “the family should be advised not to kiss the deceased,” according to new guidelines from Ireland’s Health and Safety Executive to its funeral directors.

The risk of catching coronavirus from a dead body is slim, public health officials say, but some countries are recommending extra measures.

Israel has reported no coronavirus deaths, but its health ministry says the deceased should be double-wrapped in impermeable plastic. Ritual washing and rites will be performed in full protective gear and the corpse re-wrapped in plastic for burial. Normally Israel’s Jewish dead are laid to rest in a cloth smock and shroud.

Ireland’s guidelines advise workers in funeral parlors to put face masks on dead bodies before moving them, in case they “expel a very small amount of air and viral droplets from the lungs” and infect the living.

In Britain, where the pandemic is still gathering pace, there is widespread anxiety about the likely death toll.

Britain has been slower in implementing the strict measures seen elsewhere in Europe, and expert estimates of how many will die from COVID-19 have ranged wildly from the tens to the hundreds of thousands.

An emergency bill to tackle the virus, which has killed 104 people in Britain, includes a number of measures the government says will “streamline the death management process.” The measures include allowing funeral directors to register a death on behalf of a self-isolating family.

Deborah Smith, a spokesperson for the National Association of Funeral Directors, said the bill will help the profession “preserve the dignity of those who die and care for their bereaved families with compassion – even if they are not able to have the kind of funeral they would have wanted.”

Smith would not be drawn on the expected numbers, but said “funeral directors are preparing for a variety of scenarios.”

“NOT ALONE”

One scenario is already playing out in Wuhan.

Last month, a worker at the funeral home in Hankou district, identifying himself only as Huang, wrote an essay that was circulated on social media. He said funeral workers were as overwhelmed as the city’s medics but had received less recognition.

He said staff had worked without a break since the start of the epidemic. “Some of our employees don’t even drink water because they need to go to the toilet and it’s difficult to take off the protective clothing,” he wrote.

Half a world away, in the virus-stricken Italian town of Bergamo, funeral workers wage a near-identical struggle.

“It’s like being in a war with an invisible enemy,” said Roberta Caprini, a partner in Centro Funerario Bergamasco, a funeral service in Bergamo. “We’ve been working without interruption for two weeks and sleeping 3-4 hours a night when we manage it. Everyone in our area, us included, has lost someone or have someone sick in their home.”

Bergamo’s Church of All Saints has become a makeshift mortuary, its pews pushed aside to accommodate the dead. Caprini said she had counted at least 60 coffins when she visited on Tuesday.

She spoke of the “real torture” felt by families who watched sick relatives taken away to hospital and never saw them again. Her company has arranged video links to burials, to allow families to watch the priest bless the deceased.

Sometimes, she said, they drive the hearses past the bereaved family’s home, so mourners “can at least come down at the moment and offer a quick prayer.”

(This story has been refiled to fix the bylines)

(Reporting by Elisa Anzolin and Emilio Parodi in Milan; Angelo Amante in Rome; Parisa Hafezi in Dubai; David Stanway in Shanghai; Joan Faus in Barcelona; Hayoung Choi in Seoul, Padraic Halpin in Dublin; Emma Farge in Zurich; Kate Kelland in London and Dan Williams in Jerusalem; Writing and additional reporting by Andrew RC Marshall; Edited by Sara Ledwith and Jason Szep)