Spain opens 200 criminal probes into care home pandemic failings

MADRID (Reuters) – Spain’s public prosecutor is investigating more than 200 cases of potential criminal mishandling of the coronavirus pandemic at nursing homes, where the virus spread almost unchecked during the devastating first wave.

Nearly 43,000 care home residents died of COVID-19 or suspected infection during the March-May first wave of contagion, according to official data.

At the time, staff reported shortages of basic protective equipment and army units deployed on disinfection missions discovered unattended bodies at several facilities.

The prosecutor’s office said nearly half of its investigations related to homicide through a neglect of duty of care, while it was looking into 21 cases of deficiencies in medical treatment.

With Spain reporting record infection numbers on an almost daily basis, it warned that risks still remained across the care home network, despite improvements made in recent months.

“The increase in general contagion is still a risk for residential environments,” it said in a statement on Thursday, adding that it would continue to closely monitor the situation.

Pre-existing weaknesses, including governance, funding, working conditions, a lack of coordination with primary health care, and a lack of isolation spaces, are still widespread, the report said.

Prosecutors shelved other cases, most of the time after charges were rolled into other cases or passed to courts, rather than because investigators found no evidence of wrongdoing.

Spain has about 5,500 nursing homes, housing some 400,000 people, according to the European Ageing Network, which represents both individual carers and businesses.

The heads of both Spain’s main care home associations said they needed more information on the investigations before commenting. In the past, the associations have blamed the government for failing to provide adequate supplies and the health service for refusing to admit residents with a positive diagnosis to hospitals.

(Reporting by Nathan Allen, Belén Carreño, Emma Pinedoñ; Editing by Ingrid Melander and Andrew Cawthorne)

Spain’s COVID-19 incidence hits new high as third wave of infection rages

MADRID (Reuters) – Spain’s incidence of the coronavirus as measured over the past 14 days reached a new high of 714 cases per 100,000 people on Tuesday after 689 cases the previous day, Health Ministry data showed, as a rampant third wave of infection grips the country.

The ministry reported 34,291 new infections, retreating from Friday’s record rise of more than 40,000, and bringing the cumulative tally to 2,370,742.

Spain’s overall death toll from the virus rose by 404 to 54,173, the data showed. Although daily increases in the death toll have been on the rise, it is still far below the nearly 900 deaths registered per day in late March and early April.

(Reporting by Nathan Allen, editing by Andrei Khalip)

Europe COVID death toll tops 300,000 as winter looms and infections surge

By Shaina Ahluwalia, Anurag Maan and Roshan Abraham

(Reuters) – More than 300,000 people have died of COVID-19 across Europe, according to a Reuters tally on Tuesday, and authorities fear that fatalities and infections will continue to rise as the region heads into winter despite hopes for a new vaccine.

With just 10% of the world’s population, Europe accounts for almost a quarter of the 1.2 million deaths globally, and even its well-equipped hospitals are feeling the strain.

After achieving a measure of control over the pandemic with broad lockdowns earlier this year, case numbers have surged since the summer and governments have ordered a second series of restrictions to limit social contacts.

In all, Europe has reported some 12.8 million cases and about 300,114 deaths. Over the past week, it has seen 280,000 cases a day, up 10% from the week earlier, representing just over half of all new infections reported globally.

Hopes have been raised by Pfizer Inc’s announcement of a potentially effective new vaccine, but it is not expected to be generally available before 2021 and health systems will have to cope with the winter months unaided.

Britain, which has imposed a fresh lockdown in England, has the highest death toll in Europe at around 49,000, and health experts have warned that with a current average of more than 20,000 cases daily, the country will exceed its “worst case” scenario of 80,000 deaths.

France, Spain, Italy and Russia have also reported hundreds of deaths a day and together, the five countries account for almost three quarters of the total fatalities.

Already facing the prospect of a wave of job losses and business failures, governments across the region have been forced to order control measures including local curfews, closing non-essential shops and restricting movement.

France, the worst-affected country in the EU, has registered more than 48,700 infections per day over the past week and the Paris region’s health authority said last week that 92% of its ICU capacity was occupied.

Facing similar pressures, Belgian and Dutch hospitals have been forced to send some severely ill patients to Germany.

In Italy, which became a global symbol of the crisis when army trucks were used to transport the dead during the early months of the pandemic, daily average new cases are at a peak at more than 32,500. Deaths have been rising by more than 320 per day over the past three weeks.

While the new vaccine being developed by Pfizer and German partner BioNTech will take time to arrive, authorities are hoping that once winter is passed, it will stem further outbreaks next year.

Citi Private Bank analysts described the news as “the first major advance toward a Post-COVID world economy”.

“More than any fiscal spending package or central bank lending program, a healthcare solution to COVID has the greatest potential to restore economic activity to its full potential…” it said in a note.

European Commission President Ursula von der Leyen on Monday said the European Union would soon sign a contract for 300 million doses of the vaccine, just hours after the drugmaker announced promising late-stage trials.

Yet health experts cautioned that the vaccine, should it be approved, was no silver bullet – not least because the genetic material it’s made from needs to be stored at temperatures of minus 70 degrees Celsius (-94 F) or below.

Such requirements pose a challenge for countries in Asia, as well as Africa and Latin America, where intense heat is often compounded by poor infrastructure.

(Reporting by Anurag Maan, Shaina Ahluwalia, Chaithra J and Roshan Abraham in Bengaluru, Sujata Rao-Coverley in London; editing by Jane Wardell, James Mackenzie, Nick Macfie and Mike Collett-White)

No clear link between school opening and COVID surge, study finds

By Kate Kelland

LONDON (Reuters) – Widespread reopening of schools after lockdowns and vacations is generally not linked to rising COVID-19 rates, a study of 191 countries has found, but lockdown closures will leave a 2020 “pandemic learning debt” of 300 billion missed school days.

The analysis, by the Zurich-based independent educational foundation Insights for Education, said 84% of those 300 billion days would be lost by children in poorer countries, and warned that 711 million pupils were still out of school.

“It’s been assumed that opening schools will drive infections, and that closing schools will reduce transmission, but the reality is much more complex,” said IfE’s founder and chief executive Randa Grob-Zakhary.

The vast majority – 92% – of countries that are through their first wave of COVID-19 infections have started to reopen school systems, even as some are seeing a second surge.

IfE found that 52 countries that sent students back to school in August and September – including France and Spain – saw infection rates rise during the vacation compared to when they were closed.

In Britain and Hungary, however, infection levels dropped after initial school closures, remained low during the holidays, and began rising after reopening.

Full analysis of these 52 countries found no firm correlation between school status and infections – pointing to a need to consider other factors, IfE said.

“The key now is to learn from those countries that are reopening effectively against a backdrop of rising infections,” Grob-Zakhary said.

The report said 44 countries have kept schools closed.

It found countries are developing strategies for schools during the pandemic – including some, such as Italy, France, which order temporary school closures on a case-by-case basis.

Other measures include policies on masks, class rotations and combining remote with in-school lessons.

“This first real global test highlights what school life looks like in a COVID-world,” said Grob-Zakhary. “Understanding how countries undergoing a massive second wave are dealing with this new reality in the classroom is essential to guide future reopening decisions and to help schools remain open.”

(Reporting by Kate Kelland; Editing by Giles Elgood)

Spain sentences Salvadoran ex-officer to 133 years in jail over priests’ massacre

MADRID (Reuters) – Spain’s High Court sentenced a former army colonel from El Salvador on Friday to 133 years in prison for the murder of five Spanish Jesuit priests in 1989 during the Central American country’s civil war.

Inocente Orlando Montano Morales, 77, was also found responsible by the judges for the murders of the priests’ housekeeper and her 15-year-old daughter, as well as a local Jesuit priest. The court could not convict him of these crimes because his extradition to Spain did not cover these cases.

The massacre was one of the most notorious acts of a decade-long civil war during which 75,000 people were killed and 8,000 went missing.

The judges said they found Montano Morales guilty of five counts of “murder of terrorist nature,” adding that the killings were committed by the state apparatus, making them what “is commonly known as terrorism implemented by the state”.

They added that the total maximum prison term is 30 years.

Montano Morales has been in custody since 2011 when he was arrested in the United States on immigration fraud charges. He was deported to Spain in 2017.

The Spanish government has indicted 20 former Salvadoran army officers for the killings of the priests, their housekeeper and her daughter. One of the priests, Father Ignacio Ellacuria, was a prominent critic of the U.S.-backed right-wing government.

The massacre occurred on Nov. 16, 1989, when a group of soldiers from the U.S.-trained Atlacatl Battalion entered the campus of the Central American University where Ellacuria was rector.

Ellacuria had advocated a negotiated settlement to the military-led junta government’s war against the left-wing Farabundo Marti National Liberation Front (FMLN). International revulsion at the murders of the priests helped to push through such a solution, with the war ending in 1992.

(Reporting by Nathan Allen and Andrei Khalip; Editing by Ingrid Melander and Frances Kerry)

Swiss add Paris, Vienna to list of areas for coronavirus quarantine

ZURICH (Reuters) – Switzerland has added the regions around Paris and Vienna to its list of areas with high COVID-19 infection rates requiring incoming travelers to enter quarantine for 10 days.

The government said it was adopting a regional approach for neighboring countries for the measures which will come into force on Sept. 14. As part of this, it named Ile de France and the Vienna region as areas with a raised risk of infection.

The government also put the Czech Republic and all of Spain on its list of entire countries with a quarantine requirement, which already includes the United States,  India and Brazil.

“It is not a good idea to go to high-risk areas,” Health Minister Alain Berset told a media conference, advising Swiss travelers to steer clear of places on the list.

Switzerland, which has had quarantine restrictions since July 6, said it was responding to a spike in infection numbers in the country.

Switzerland reported 528 new cases of the coronavirus on Friday, the highest daily rise in infections since early April.

As part of its new approach, the government said only regions of neighboring countries where the infection rate is above its limit of 60 cases per 100,000 people will be added to the list, rather then the entire country.

Border regions may be exempted from the list to take into account the close interaction with neighboring regions, it said.

Thousands of workers cross Switzerland’s borders with France, Germany and Italy daily to work in Geneva, Basel and the southern canton of Ticino.

(Reporting by John Revill; Editing by Michael Shields)

Steroids cut death rates among critically ill COVID-19 patients, major study finds

By Kate Kelland

LONDON (Reuters) – Treating critically ill COVID-19 patients with corticosteroid drugs reduces the risk of death by 20%, an analysis of seven international trials found on Wednesday, prompting the World Health Organisation to update its advice on treatment.

The analysis – which pooled data from separate trials of low dose hydrocortisone, dexamethasone and methylprednisolone – found that steroids improve survival rates of COVID-19 patients sick enough to be in intensive care in hospital.

“This is equivalent to around 68% of (the sickest COVID-19) patients surviving after treatment with corticosteroids, compared to around 60% surviving in the absence of corticosteroids,” the researchers said in a statement.

The WHO’s clinical care lead, Janet Diaz, said the agency had updated its advice to include a “strong recommendation” for use of steroids in patients with severe and critical COVID-19.

“The evidence shows that if you give corticosteroids …(there are) 87 fewer deaths per 1,000 patients,” she told a WHO social media live event. “Those are lives … saved.”

“Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by COVID-19,” Jonathan Sterne, a professor of medical statistics and epidemiology at Britain’s Bristol University who worked on the analysis, told the briefing.

He said the trials – conducted by researchers in Britain, Brazil, Canada, China, France, Spain, and the United States – gave a consistent message throughout, showing the drugs were beneficial in the sickest patients regardless of age or sex or how long patients had been ill.

The findings, published in the Journal of the American Medical Association, reinforce results that were hailed as a major breakthrough and announced in June, when dexamethasone became the first drug shown to be able to reduce death rates among severely sick COVID-19 patients.

Dexamethasone has been in widespread use in intensive care wards treating COVID-19 patients in some countries since then.

Martin Landray, a professor of medicine and epidemiology at the University of Oxford who worked on the dexamethasone trial that was a key part of the pooled analysis published on Wednesday, said the results mean doctors in hospitals across the world can safely switch to using the drugs to save lives.

CLEAR BENEFITS

“These results are clear, and instantly usable in clinical practice,” he told reporters. “Among critically ill patients with COVID-19, low-dose corticosteroids … significantly reduce the risk of death.”

Researchers said the benefit was shown regardless of whether patients were on ventilation at the time they started treatment. They said the WHO would update its guidelines immediately to reflect the fresh results.

Until the June findings on dexamethasone, no effective treatment had been shown to reduce death rates in patients with COVID-19, the respiratory disease caused by the new coronavirus.

More than 25 million people have been infected with COVID-19 and 856,876​ have died, according to a Reuters tally.

Gilead Sciences Inc’s remdesivir was authorized by United States regulators in May for use in patients with severe COVID-19 after trial data showed the antiviral drug helped shorten hospital recovery time.

Anthony Gordon, an Imperial College London professor who also worked on the analysis, said its results were good news for patients who become critically ill with COVID-19, but would not be enough to end outbreaks or ease infection control measures.

“Impressive as these results are, this is not a cure. We now have something that will help, but it is not a cure, so it’s vital that we keep up all the prevention strategies.”

(Reporting by Kate Kelland; Editing by Mark Heinrich and Catherine Evans)

J&J to start mid-stage coronavirus vaccine trials in three European countries

By Nathan Allen

MADRID (Reuters) – Johnson & Johnson’s Janssen unit will begin mid-stage trials for its coronavirus vaccine in Spain, the Netherlands and Germany next week, Spain’s health minister said on Friday, as the U.S. drugmaker expands testing for its experimental shot.

The Phase II trial will last two months and include 550 participants across the three countries, including 190 people in Spain, Salvador Illa told a news conference in Madrid.

“It’s a vote of confidence in our health system,” Illa said, adding it was the first human trial for a coronavirus vaccine to be approved in Spain.

The study will focus on healthy people between the ages of 18 and 55 as well as people over 65.

Johnson & Johnson said the study will evaluate the safety and the ability to induce an immune response from single dose and two-dose regimens of the vaccine candidate, the company said in a statement.

Spain, which has western Europe’s highest tally of coronavirus cases, is also working with AstraZeneca via the European Union’s vaccine procurement program to secure sufficient doses.

J&J’s website says if the latest trials are successful, it will begin final Phase III studies, in which even more volunteers will receive the experimental vaccine.

More than 150 potential vaccines are being developed and tested globally to combat the COVID-19 pandemic, with 30 in human trials.

There is so far no approved vaccine, except one authorized in Russia before large-scale trials.

J&J is carrying out tests in the United States and Belgium, and this week added Chile, Argentina and Peru to the list of Latin American nations where it plans to conduct Phase III trials on 60,000 volunteers, in a study that will also cover Brazil, Colombia and Mexico.

The company’s potential vaccine uses “viral vectors” to generate immune responses, similar to the approach taken by the University of Oxford and AstraZeneca in their experimental vaccine, as well as China’s CanSino.

(Reporting by Nathan Allen and Jose Elías Rodríguez; editing by Mark Potter and Jason Neely)

Proportion of youth with COVID-19 triples in five months: WHO

By Ankur Banerjee and Stephanie Nebehay

(Reuters) – Young people who are hitting nightclubs and beaches are leading a rise in fresh coronavirus cases across the world, with the proportion of those aged 15 to 24 who are infected rising three-fold in about five months, the World Health Organization said.

An analysis by the WHO of 6 million infections between Feb. 24 and July 12 found that the share of people aged 15-24 years rose to 15% from 4.5%.

Apart from the United States which leads a global tally with 4.8 million total cases, European countries including Spain, Germany and France, and Asian countries such as Japan, have said that many of the newly infected are young people.

“Younger people tend to be less vigilant about masking and social distancing,” Neysa Ernst, nurse manager at Johns Hopkins Hospital’s biocontainment unit in Baltimore, Maryland told Reuters in an email.

“Travel increases your chances of getting and spreading COVID-19,” she said, adding young people are more likely to go to work in the community, to a beach or the pub, or to buy groceries.

The surge in new cases, a so-called second wave of infections, has prompted some countries to impose new curbs on travel even as companies race to find a vaccine for the fast-spreading virus that has claimed more than 680,000 lives and upended economies.

Even countries such as Vietnam, widely praised for its mitigation efforts since the coronavirus appeared in late January, are battling new clusters of infection.

Among those aged 5-14 years, about 4.6% were infected, up from 0.8%, between Feb. 24 and July 12, the WHO said, at a time when testing has risen and public health experts are concerned that reopening of schools may lead to a surge in cases.

Anthony Fauci, the leading U.S. expert on infectious diseases, urged young people last month to continue to socially distance, wear masks and avoid crowds, and cautioned that asymptomatic people could spread the virus, too.

Indeed, health experts in several countries have urged similar measures as they report that infected youth show few symptoms.

“We’ve said this before and we’ll say it again: young people are not invincible,” WHO Director General Tedros Adhanom Ghebreyesus told a news briefing in Geneva last week.

“Young people can be infected; young people can die; and young people can transmit the virus to others.”

Last month, Tokyo officials said they would conduct coronavirus testing in the city’s nightlife districts, and instructed nightclubs to provide customers with enough space with good ventilation and to ask them to avoid speaking loudly.

In France last month, authorities shut down a bar where people breached hygiene rules and caused an outbreak.

(Reporting by Ankur Banerjee and Vishwadha Chander in Bengaluru and Stephanie Ulmer-Nebehay in Geneva; Editing by Sayantani Ghosh and Bernadette Baum)

New travel curbs imposed as world tackles second COVID-19 wave

By Stephen Coates and Peter Graff

SYDNEY/LONDON (Reuters) – Nations in Asia imposed new restrictions on Monday and an abrupt British quarantine on travelers from Spain threw Europe’s summer reopening into disarray, as the world confronted the prospect of a second wave of COVID-19 infections.

In the United States, where infection rates have been climbing since mid-June, President Donald Trump’s national security adviser Robert O’Brien became the most senior White House official to test positive.

Surges were reported in a number of countries previously singled out as places where the virus was under control.

Australia recorded a record daily rise. Vietnam locked down the city of Danang, forcing tens of thousands of visitors to evacuate. Mainland China confirmed the most new locally transmitted cases since early March. Papua New Guinea shut its borders.

Hong Kong banned gatherings of more than two people, closed down restaurant dining and introduced mandatory face masks in public places, including outdoors.

Just weeks after European countries trumpeted the reopening of tourism, a surge in infections in Spain prompted Britain to order all travelers from there to quarantine for two weeks, torpedoing the travel plans of hundreds of thousands of people.

The World Health Organization said travel restrictions could not be the answer for the long term, and countries had to do more to halt the spread inside their borders by adopting proven strategies such as social distancing and the wearing of masks.

“It is going to be almost impossible for individual countries to keep their borders shut for the foreseeable future. Economies have to open up, people have to work, trade has to resume,” WHO emergencies program director Mike Ryan said.

“What is clear is pressure on the virus pushes the numbers down. Release that pressure and cases creep back up.”

NOT LIKE BEFORE

Officials in some of the European and Asian countries where the virus is again spreading say new outbreaks will not be as bad as the original waves that hit earlier this year, and can be contained with local measures rather than nationwide shutdowns.

But countries that have suffered extreme economic hardship from months of lockdowns are also determined not to let the virus get out of control again, even if that means reversing the path to reopening.

Europe has yet to lift bans on travelers from many countries, including the United States where the White House said national security adviser O’Brien presented no risk of infection for Trump or Vice President Mike Pence.

Britain’s announcement of the return of quarantine for Spain was likely to torpedo the revival of airlines and tourism businesses across the continent, which had thought they had survived their biggest crisis in living memory.

Britain accounts for more than 20% of foreign visitors to Spain, where tourism represents 12% of the economy.

Europe’s biggest airline, Ryanair, cut its annual passenger target by a quarter on Monday and warned a second wave of COVID-19 infections could lower that further.

A British junior health minister said more European countries could end up on the “red list” if infections surge.

“If we see the rates going up, we would have to take action because we cannot take the risk of coronavirus being spread again across the UK,” Helen Whately told Sky News when asked if Germany or France might be next after Spain.

In China, which managed to squelch local transmission through firm lockdowns after the virus first emerged in the central city of Wuhan late last year, a new surge has been driven by infections in the far western region of Xinjiang.

In the northeast, Liaoning province reported a fifth straight day of new infections and Jilin province reported two new cases, its first since late May.

Australian authorities who have imposed a six-week lockdown in parts of the southeastern state of Victoria said it could last longer after the country’s highest daily increase in infections.

“The tragedy of COVID-19 is that we know, with the number of new infections that we have seen today, that there will be many further deaths in the days ahead,” Australian Deputy Chief Medical Officer Michael Kidd told reporters.

In Japan, the government said it would urge business leaders to ramp up anti-virus measures such as staggered shifts, and aimed to see rates of telecommuting return to levels achieved during an earlier state of emergency.

“At one point, commuter numbers were down by 70 to 80%, but now it’s only about 30%,” Economy Minister Yasutoshi Nishimura said late on Sunday. “We really don’t want to backtrack on this, so we have to explore new ways of working and keep telecommuting high.”

Vietnam is evacuating 80,000 people, mostly local tourists, from Danang after three residents tested positive at the weekend. Until Saturday, the country had reported no community infections since April.

North Korean state media reported on the weekend that the border town of Kaesong was in lockdown after a person who defected to South Korea three years ago returned this month with symptoms of COVID-19. If confirmed, it would be the first case officially acknowledged by Pyongyang.

Papua New Guinea halted entry for travellers from Monday, except those arriving by air, as it tightens curbs against infections that have more than doubled over the past week.

(Reporting by Reuters bureaus; Writing by Stephen Coates and Peter Graff; Editing by Nick Macfie)