Coronavirus patients most infectious when they first feel unwell: WHO

By Stephanie Nebehay

GENEVA (Reuters) – Studies show people with the coronavirus are most infectious just at the point when they first begin to feel unwell, World Health Organization (WHO) experts said on Tuesday.

This feature has made it so hard to control the spread of the virus that causes COVID-19 disease, but it can be done through rigorous testing and social distancing, they said.

“It appears from very limited information we have right now that people have more virus in their body at or around the time that they develop symptoms, so very early on,” Maria van Kerkhove, a WHO epidemiologist and technical lead on the pandemic, told a live session on social media.

Preliminary studies from Germany and the United States suggest that people with mild symptoms can be infectious for up to 8-9 days, and “it can be a lot longer for people who are more severely ill”, she said.

Earlier, some disease experts questioned her statement on Monday that transmission of COVID-19 by people with no symptoms is “very rare”, saying this guidance could pose problems for governments as they seek to lift lockdowns.

Van Kerkhove, citing disease-modeling studies, clarified on Tuesday that some people do not develop symptoms, but can still infect others.

“Some estimates of around 40 percent of transmission may be due to asymptomatic (cases), but those are from models. So I didn’t include that in my answer yesterday but wanted to make sure that I made that clear,” she said.

Dr. Mike Ryan, WHO’s top emergency expert, said that the novel coronavirus lodges in the upper respiratory tract, making it easier to transmit by droplets than related viruses such as SARS or MERS, which are in the lower tract.

“Now as we look at COVID-19, we have an infectious pathogen that is present in the upper airway for which the viral loads are peaking at the time you are just beginning to get sick,” he said.

“That means you could be in the restaurant feeling perfectly well and start to get a fever, you are feeling ok, you didn’t think to stay home, but that’s the moment at which your viral load could be actually quite high,” he said.

Ryan added: “And it’s because the disease can spread at that moment that the disease is so contagious, that’s why it spread around the world in such an uncontained way, is because it’s hard to stop this virus.”

But some countries have shown that transmission can be brought down to “an acceptable level or even to no level”, as New Zealand had recently demonstrated, he said.

(Additional reporting by Josephine Mason; Writing by Nick Macfie and Stephanie Nebehay; Editing by Kevin Liffey and Giles Elgood)

Bolsonaro threatens WHO exit as COVID-19 kills ‘a Brazilian per minute’

By Lisandra Paraguassu and Ricardo Brito

BRASILIA (Reuters) – President Jair Bolsonaro threatened on Friday to pull Brazil out of the World Health Organization after the U.N. agency warned Latin American governments about the risk of lifting lockdowns before slowing the spread of the novel coronavirus throughout the region.

A new Brazilian record for daily COVID-19 fatalities pushed the county’s death toll past that of Italy late on Thursday, but Bolsonaro continues to argue for quickly lifting state isolation orders, arguing that the economic costs outweigh public health risks.

Latin America’s most populous nations, Brazil and Mexico, are seeing the highest rates of new infections, though the pandemic is also gathering pace in countries such as Peru, Colombia, Chile and Bolivia.

Overall, more than 1.1 million Latin Americans have been infected. While most leaders have taken the pandemic more seriously than Bolsonaro, some politicians that backed strict lockdowns in March and April are pushing to open economies back up as hunger and poverty grow.

In an editorial running the length of newspaper Folha de S.Paulo’s front page, the Brazilian daily highlighted that just 100 days had passed since Bolsonaro described the virus now “killing a Brazilian per minute” as “a little flu.”

“While you were reading this, another Brazilian died from the coronavirus,” the newspaper said.

Brazil’s Health Ministry reported late on Thursday that confirmed cases in the country had climbed past 600,000 and 1,437 deaths had been registered within 24 hours, the third consecutive daily record.

Brazil reported another 1,005 deaths Friday night, while Mexico reported 625 additional deaths.

With more than 35,000 lives lost, the pandemic has killed more people in Brazil than anywhere outside of the United States and the United Kingdom.

Asked about efforts to loosen social distancing orders in Brazil despite rising daily death rates and diagnoses, World Health Organization (WHO) spokeswoman Margaret Harris said a key criteria for lifting lockdowns was slowing transmission.

“The epidemic, the outbreak, in Latin America is deeply, deeply concerning,” she told a news conference in Geneva. Among six key criteria for easing quarantines, she said, “one of them is ideally having your transmission declining.”

In comments to journalists later Friday, Bolsonaro said Brazil will consider leaving the WHO unless it ceases to be a “partisan political organization.”

President Donald Trump, an ideological ally of Bolsonaro, said last month that the United States would end its own relationship with the WHO, accusing it of becoming a puppet of China, where the coronavirus first emerged.

Bolsonaro’s dismissal of the coronavirus risks to public health and efforts to lift state quarantines have drawn criticism from across the political spectrum in Brazil, where some accuse him of using the crisis to undermine democratic institutions.

But many of those critics are divided about the safety and effectiveness of anti-government demonstrations in the middle of a pandemic, especially after one small protest was met with an overwhelming show of police force last weekend.

Alfonso Vallejos Parás, an epidemiologist and professor of public health at the National Autonomous University of Mexico, said infections are high in Latin America as the virus was slow to gain a foothold in the region.

“It is hard to estimate when the pace of infection will come down,” he said.

(Reporting by Lisandra Paraguassu and Ricardo Brito; Additional reporting by Gabriela Mello in Sao Paulo, Gram Slattery and Pedro Fonseca in Rio de Janeiro and Adriana Barrera in Mexico City; Editing by Brad Haynes, Rosalba O’Brien and Leslie Adler)

‘It’s not over’: COVID-19 cases rise in some nations easing lockdowns: WHO

WHO
GENEVA (Reuters) – Some countries have seen “upticks” in COVID-19 cases as lockdowns ease, and populations must protect themselves from the coronavirus while authorities continue testing, the World Health Organization (WHO) said on Friday.

The epicenter of the pandemic is currently in countries of Central, South and North America, particularly the United States, WHO spokeswoman Margaret Harris said.

“On upticks (in cases), yes we have seen in countries around the world – I’m not talking specifically about Europe – when the lockdowns ease, when the social distancing measures ease, people sometimes interpret this as ‘OK, it’s over’,” Harris told a U.N. briefing in Geneva.

“It’s not over. It’s not over until there is no virus anywhere in the world,” she said.

Harris, referring to U.S. demonstrations since the killing of George Floyd 10 days ago, she said that protesters must take precautions. “We have certainly seen a lot of passion this week, we’ve seen people who have felt the need to be out and to express their feelings,” she added. “”We ask them to remember still protect yourself and others.”

To avoid infection, the WHO advised people to maintain a distance of at least 1 metre (3 feet), frequently wash hands and avoid touching their mouth, nose and eyes, Harris said.

(Reporting by Stephanie Nebehay; Editing by Kevin Liffey and Pravin Char)

Does drug touted by Trump work on COVID-19? After data debacle, we still don’t know

By Kate Kelland and Alistair Smout

LONDON (Reuters) – Scientists are resuming COVID-19 trials of the now world-famous drug hydroxychloroquine, as confusion continues to reign about the anti-malarial hailed by U.S. President Donald Trump as a potential “game-changer” in fighting the pandemic.

The renewed research push follows widespread criticism of the quality of data in a study published by The Lancet, an influential medical journal, which found high risks associated with the treatment.

The World Health Organization, which had last week paused trials when The Lancet study showed the drug was tied to an increased risk of death in hospitalized patients, said on Wednesday it was ready to resume trials.

The WHO’s change of mind is “a wise decision”, according to Martin Landray, co-lead scientist on the Recovery trial, the world’s largest research project into existing drugs that might be repurposed to treat COVID-19 patients.

“What all this episode really reflects is that without randomized trials, there is huge uncertainty,” said Landray, a professor of medicine and epidemiology at Oxford University.

Randomized studies are the gold standard in research, randomly assigning a treatment to one group of people and a dummy to another group so that the two can be compared. The Lancet study was a “retrospective observational” study, using a data set from an analytics firm, to see what effects the drug had had on some COVID-19 patients, compared to those who did not get it.

The WHO’s about-face came after nearly 150 doctors signed a letter to the Lancet outlining concerns about the study’s conclusions. The journal itself published an expression of concern about the research this week, saying “serious scientific questions have been brought to our attention”.

Some scientists said the episode had set back efforts to determine whether hydroxychloroquine was an effective or risky treatment for COVID-19, as some other trials around the world had also halted following the WHO’s initial decision to pause.

“It’s really impacted quite negatively the sort of studies that would be able to say if there is a benefit or harm,” Will Schilling told Reuters. He is co-lead on the UK COPCOV study which was paused last week, just days after its launch.

“At the moment, we don’t really know. That’s why these studies are needed, and now they’ve been slightly waylaid by all of this.”

Scientists acknowledge, though, that studies are being conducted at break-neck speed while garnering unprecedented levels of attention that could give findings unwarranted weight.

THE PRESIDENT’S TAKING IT

The drug has hit global headlines in large part because of its promotion by Trump, who said in March it could be a game-changer and last month revealed he was taking it himself, even after his own Food and Drug Administration (FDA) had advised that its efficacy and safety were unproven.

In the absence of clear scientific evidence, some authorities and consumers are buying up stocks of the drug in case it turns out to be effective. Britain, for example, is spending millions of pounds bulk-buying tablets.

Hydroxychloroquine has been shown in laboratory experiments earlier this year to be able to block the SARS-CoV-2 virus that causes COVID-19, but this effect has not been replicated in rigorous trials in people.

A separate study by University of Minnesota scientists of the potential preventative effect of hydroxychloroquine against the new coronavirus found it did not protect patients who had been given it prior to being exposed to COVID-19.

Here again, though, the waters have been muddied. The New England Journal of Medicine, which published the research on Wednesday, noted in an editorial, however, that there were limits to the scope of the study.

The University of Minnesota study also was limited in the scenario it tested, said Richard Chaisson, a Johns Hopkins researcher who is running a separate trial of the drug to determine whether it is effective in treating patients with moderate to severe versions of COVID-19.

There is still a need for robust studies looking at whether it might work in low doses before or after exposure, as well as against mild cases, moderate cases, hospitalized patients and seriously ill ones, he added.

WHO’S KNOCK-ON EFFECTS

The WHO decision to halt its trials last week had knock-on effects across the drug industry and medical profession.

French drugmaker Sanofi temporarily stopped enrolling recruits to its own study and pulled supplies of the drug for treatment. The UK COPCOV trial, aimed at establishing if hydroxychloroquine can prevent healthcare workers from contracting COVID-19, hit pause just a week after its launch.

Those studies are yet to resume.

Several European countries also have stopped using the drug for treating some COVID-19 patients.

Some trials have, however, continued despite the WHO’s move.

Novartis has not changed course with its study and the UK Recovery trial paused only briefly before moving ahead after safety checks. It is still enrolling patients and has signed up 4,500 recruits so far – 1,500 patients who are on the drug and around 3,000 who aren’t.

In short, the jury’s still out on hydroxychloroquine for COVID-19, according to Landray at Recovery.

“People can quote data, people can quote experts, but there is continuing huge uncertainty,” he said.

(Additional reporting by Michael Erman in New York; Writing by Josephine Mason and Peter Henderson; Editing by Pravin Char)

Explainer: Are asymptomatic COVID-19 patients safe or silent carriers?

By Cate Cadell and Roxanne Liu

BEIJING (Reuters) – China said 300 symptomless carriers of the novel coronavirus in Wuhan, the epicenter of the pandemic, had not been found to be infectious, in a bid to reassure people as countries ease restrictions. But some experts say asymptomatic infections are common, presenting a huge challenge in the control of the disease.

WHAT IS ASYMPTOMATIC AND PRE-SYMPTOMATIC?

The World Health Organization (WHO) defines https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf asymptomatic cases as those who don’t show symptoms but have been confirmed infected through a lab test. WHO notes there are few reports of truly asymptomatic cases.

The incubation period, or the time a person takes to show symptoms after getting infected, is the pre-symptomatic phase, the WHO says. Carriers can infect others during this period.

Health experts are not yet sure whether asymptomatic or pre-symptomatic cases are infectious. Some say data so far suggests those cases are probably equally likely to be able to spread infection.

The WHO agrees that pre-symptomatic carriers are infectious, and adds that there is also a possibility – although little evidence so far – that people who are asymptomatic may also transmit the virus. The WHO had said in early April that there had been no documented asymptomatic transmissions.

WHAT ELSE DOES CHINA SAY?

China has reported around 83,000 cases of COVID-19, the disease caused by the new coronavirus. It does not include asymptomatic cases in that total official count, but began reporting them separately on a daily basis on March 31.

That has raised concerns about Beijing’s commitment to transparency, and some experts say it could also paint a misleading picture of how the virus spreads.

“If you watch (such asymptomatic cases) really closely, you would see something … that probably fits with a more realistic mild disease than a complete asymptomatic,” Ian Mackay, a virologist at the University of Queensland said.

“But the term is around now and it’s going to stick. It’s a nice piece of theatre, but I don’t think it’s going to give useful information.”

Asymptomatic cases under medical observation in China dropped to 357 as of Tuesday from 1,541 as of March 30.

Wuhan has tested almost its entire population of 11 million and found no new COVID-19 cases.

Wuhan’s low rate of symptomless carriers is in line with China’s previous reporting, said Zhong Nanshan, the government’s senior medical adviser, adding that the result showed that the country didn’t cover up the epidemic as some U.S. politicians claimed.

HOW ABOUT REST OF ASIA?

Some countries in Asia include asymptomatic carriers in their total confirmed cases.

In Vietnam, which has just over 300 COVID-19 cases, almost 37% were symptomless, according to health ministry data.

Researchers concluded that asymptomatic infection was common and found two asymptomatic patients had infected at least four other people.

South Korea, which had early success in taming the outbreak through aggressive testing, said 20%-30% were asymptomatic. A senior health official said the virus could be widely transmitted during the incubation period, but asymptomatic patients were less likely to transmit it.

Singapore, which has the highest number of cases in Southeast Asia, does not give data on asymptomatic cases but has said an overwhelming majority of positive cases in its crowded migrant workers’ dormitories show mild or no symptoms.

The Philippines said about 13% of its nearly 19,000 cases were asymptomatic. In India, some 28% of 40,184 people who tested positive between Jan. 22 and April 30 were asymptomatic, according to a study.

(Reporting by Cate Cadell and Roxanne Liu in Beijing; Additional reporting by Kate Kelland in London, John Mair in Sydney, James Pearson in Hanoi, John Geddie in Singapore, Neil Jerome Morales in Manila, Sangmi Cha in Seoul, Rocky Swift in Tokyo and Miyoung Kim in Singapore; Writing by Sayantani Ghosh in Singapore; Editing by Kim Coghill)

U.N. warns of global mental health crisis due to COVID-19 pandemic

By Kate Kelland

LONDON (Reuters) – A mental illness crisis is looming as millions of people worldwide are surrounded by death and disease and forced into isolation, poverty and anxiety by the pandemic of COVID-19, United Nations health experts said on Thursday.

“The isolation, the fear, the uncertainty, the economic turmoil – they all-cause or could cause psychological distress,” said Devora Kestel, director of the World Health Organization’s (WHO) mental health department.

Presenting a U.N. report and policy guidance on COVID-19 and mental health, Kestel said an upsurge in the number and severity of mental illnesses is likely, and governments should put the issue “front and centre” of their responses.

“The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently,” she told reporters at a briefing.

The report highlighted several regions and sections of societies as vulnerable to mental distress – including children and young people isolated from friends and school, healthcare workers who are seeing thousands of patients infected with and dying from the new coronavirus.

Emerging studies and surveys are already showing COVID-19’s impact on mental health globally. Psychologists say children are anxious and increases in cases of depression and anxiety have been recorded in several countries.

Domestic violence is rising, and health workers are reporting an increased need for psychological support.

Reuters last week reported from interviews with doctors and nurses in the United States who said either they or their colleagues had experienced a combination of panic, anxiety, grief, numbness, irritability, insomnia and nightmares.

Outside of the health sector, the WHO report said many people are distressed by the immediate health impacts and the consequences of physical isolation, while many others are afraid of infection, dying, and losing family members.

Millions of people are facing economic turmoil, having lost or being at risk of losing their income and livelihoods, it added. And frequent misinformation and rumors about the pandemic and deep uncertainty about how long it will last are making people feel anxious and hopeless about the future.

It outlined action points for policy-makers to aim “to reduce immense suffering among hundreds of millions of people and mitigate long-term social and economic costs to society”.

These included redressing historic under-investment in psychological services, providing “emergency mental health” via remote therapies such as tele-counseling for frontline health workers, and working proactively with people known to have depression and anxiety, and with those at high risk of domestic violence and acute impoverishment.

(Reporting by Kate Kelland, Editing by William Maclean)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

Trade deal in doubt?

U.S. President Donald Trump said he opposed renegotiating the “Phase 1” trade deal on Monday after Chinese-run state newspaper The Global Times reported some government advisers in Beijing were urging fresh talks.

Rising U.S.-China tensions over the coronavirus outbreak have cast the trade deal between the two countries, and proposed talks on a Phase 2 deal, into doubt.

The Global Times said that malicious attacks by the United States have ignited a “tsunami of anger” among Chinese trade insiders after China made compromises in the Phase 1 pact.

Dangerous calculation

WHO officials urged “extreme vigilance” on Monday as countries began to exit from lockdowns, stressing that early studies point to lower-than-expected antibody levels against the COVID-19 disease within the general population, meaning that most people remain susceptible.

Dr Mike Ryan, head of the WHO’s emergencies program warned countries that have “lax measures” in place to be wary of counting on herd immunity to halt the spread of COVID-19, saying: “This is a really dangerous, dangerous calculation.”

Economic boost

Once Australia removes most social distancing restrictions by July, its GDP will rise by $6.5 bln each month, Treasurer Josh Frydenberg was expected to tell lawmakers on Tuesday in a speech updating them on his budget planning.

Britain’s finance minister Rishi Sunak is similarly due to answer questions about the economic response to COVID-19 in parliament on Tuesday afternoon.

There, the focus is how Britain plans to continue the Coronavirus Job Retention Scheme, which is paying employers 80% of the wages of more than 6 million workers who are on temporary leave from businesses affected by the coronavirus. The scheme is due to run until the end of June.

Prime Minister Boris Johnson said on Monday that coronavirus infections had peaked, and that people who could not work from home should return to their workplaces if possible.

Testing 11 million in 10 days

The Chinese city of Wuhan, the epicenter of China’s coronavirus outbreak, plans to conduct nucleic acid testing over a period of 10 days, an internal document seen by Reuters showed and two sources familiar with the situation said, with every district told to submit a detailed testing plan by Tuesday.

The city of 11 million people reported its first cluster of new infections over the weekend after a months-long lockdown was lifted on April 8.

These plans come as the global alarm was sounded on Monday over a potential second wave of coronavirus infections after Germany reported that the reproduction rate of the pathogen had risen above 1.

Canceled Cannes

“It breaks my heart,” said Joseph Morpelli, leading member of the so-called ‘stepladder gang’ of ardent autograph-hunters and amateur paparazzi, as he stood across the street from the venue of the canceled Cannes Festival on Monday.

Usually, a hive of activity, the location where Morpelli and his fellow diehard fans could get a glimpse of celebrities walking down the red carpet is now deserted, as the film festival which was meant to start on Tuesday has been called off.

It was only the third time in its history that the festival has failed to take place. The two previous occasions were the outbreak of World War Two and 1968, when France was roiled by violent protests.

(Compiled by Karishma Singh)

WHO chief says pandemic ‘far from over’, worried about children

GENEVA (Reuters) – The coronavirus pandemic is “far from over” and is still disrupting normal health services, especially life-saving immunisation for children in the poorest countries, the head of the World Health Organization (WHO) said on Monday.

The U.N. agency is concerned about rising numbers of cases and deaths in Africa, Eastern Europe, Latin America and some Asian countries, even as the numbers flatten or decline in some wealthier nations.

“We have a long road ahead of us and a lot of work to do,” WHO Director-General Tedros Adhanom Ghebreyesus told a virtual news conference in Geneva, adding that a second wave of infections could be prevented with the right actions.

The novel coronavirus, which emerged late last year in the central Chinese city of Wuhan, has alrady infected 2.97 million and claimed 205,948 lives, according to the latest Reuters tally.

Tedros expressed concern that the health of children was being threatened by the impact of the coronavirus emergency on vaccination programmes for other diseases.

“Children may be at relatively low risk from severe disease and death from COVID-19 – the respiratory illness caused by the novel coronavirus – but can be at high risk from other diseases that can be prevented with vaccines,” said Tedros.

Some 13 million people have been affected worldwide by delays in regular immunisations against diseases including polio, measles, cholera, yellow fever and meningitis, he said.

Shortages of vaccines against other diseases are being reported in 21 countries as a result of border restrictions and disruptions to travel caused by the coronavirus pandemic, Tedros said, citing the GAVI global vaccine alliance.

“The number of malaria cases in sub-Saharan Africa could double,” he said, referring to the potential impact of COVID-19 on regular malaria services. “That doesn’t have to happen, we are working with countries to support them.”

WHO’s top emergencies expert Dr. Mike Ryan, asked about some U.S. states lifting restrictions despite a lack of contact-tracing and the government’s handling of the crisis, said the United States seemed to have a “very clearly laid-out”, science-based federal plan for fighting its coronavirus epidemic.

“The federal government and the system of governors are working together to move America and its people through this very difficult situation,” Ryan said.

But the federal system linking 50 states made the situation “complex”, he added.

Ryan also repeated an earlier WHO warning against easing restrictions too soon.

(Reporting by Stephanie Nebehay and Emma Farge in Geneva and Michael Shields in Zurich; editing by Gareth Jones)

Global coronavirus cases pass three million as lockdowns begin to ease

By Cate Cadell

BEIJING (Reuters) – Global confirmed coronavirus cases surpassed 3 million on Monday, as the United States neared 1 million cases, according to a Reuters tally.

It comes as many countries are taking steps to ease lockdown measures that have brought the world to a standstill over the past eight weeks. he first 41 cases were confirmed in Wuhan, China, on Jan. 10. The 3 million confirmed infections in less than four months are comparable in number with the roughly 3-5 million cases of severe illness caused by seasonal influenza around the world each year, according to the World Health Organisation.

An average of 82,000 cases have been reported per day in the past week. Over a quarter of all cases are in the United States, and over 43% have been recorded in Europe.

The death toll from the virus stood at more than 205,000 as of Monday, and almost one in seven reported cases of the disease has been fatal.

The true mortality rate is likely to be substantially lower as the tally of infections does not include many mild or asymptomatic and unconfirmed cases.

Some severely affected countries in Europe, including Italy, France and Spain, have recorded a drop in daily case numbers over recent weeks, but still recorded 2,000-5,000 new infections per day in the past week.

Total cases rose 2.5% on Sunday, the lowest daily rate in almost two months, and down from a peak in late March when the total was rising by more than 10% a day.

The United States has reported an average of more than 30,000 new cases a day in the past week, and now represents around a third of all new cases.

TENTATIVE REOPENING

Italy said it will permit some factories to reopen on May 4 as part of a staggered reopening, while Spain relaxed lockdown rules on Sunday, allowing children outside under supervision.

Several U.S. states have reopened businesses amid predictions that the jobless rate could hit 16% for April.

In Asia, which accounts for just under 7% of all cases, some countries are struggling to keep new infections in check. They include Japan and Singapore, which saw cases rise in April despite earlier successful efforts to slow the spread.

Others in the region have managed to rein in outbreaks, including South Korea, which has reported around 10 cases a day in the past week, down from a peak of over 1,000 in February.

In China, where the virus first emerged, officials reported just three new infections for Sunday and said all patients in Wuhan, the original epicentre, had now been discharged.

Case numbers continue to rise faster than the global average in Latin America and Africa. Total cases in Mexico grew 7-10% a day in the past week, reaching 13,800, while cases in Brazil surpassed 60,000 on Sunday.

Over 40% of Africa’s 32,600 cases are in the north, where Morocco, Egypt and Algeria are reporting serious outbreaks.

(Reporting by Cate Cadell; editing by Nick Macfie and Kevin Liffey)

Trump’s halt to WHO funding prompts condemnation as coronavirus cases near 2 million

By Jeff Mason and Paulina Duran

WASHINGTON/SYDNEY (Reuters) – U.S. President Donald Trump’s move to halt funding to the World Health Organization over its handling of the coronavirus pandemic prompted condemnation on Wednesday from world leaders as recorded global infections approached the 2 million mark.

Trump, who has reacted angrily to accusations his administration’s response to the worst epidemic in a century was haphazard and too slow, had become increasingly hostile towards the U.N. agency before announcing the halt on Tuesday.

The WHO, which is based in Geneva, had promoted China’s “disinformation” about the virus that likely led to a wider outbreak than otherwise would have occurred, Trump said.

He said WHO had failed to investigate credible reports from sources in China’s Wuhan province, where the virus was first identified in December, that conflicted with Beijing’s accounts about the spread and “parroted and publicly endorsed” the idea that human to human transmission was not happening.

“The WHO failed in this basic duty and must be held accountable,” Trump told a White House news conference on Tuesday.

A U.S. official told Reuters that Trump made the move despite pushback within his administration, especially from top health advisers. There was no immediate reaction from the WHO, which has been appealing for more than $1 billion to fund operations against the pandemic.

The United States is the biggest overall donor to the WHO, contributing more than $400 million in 2019, roughly 15% of its budget.

Some 1.99 million people globally have been infected and nearly 128,000 have died since the disease emerged in China late last year, according to a Reuters tally.

U.N. Secretary-General Antonio Guterres said it was not the time to reduce resources for the WHO.

“Now is the time for unity and for the international community to work together in solidarity to stop this virus and its shattering consequences,” he said in a statement.

China, which has won WHO praise for its actions to curb the virus’s spread, urged the United States on Wednesday to fulfil its obligations to the WHO.

“This decision weakens the WHO’s capability and harms international cooperation,” Foreign Ministry spokesman Zhao Lijian said.

EU foreign policy chief Josep Borrell said on Twitter: “Deeply regret U.S. decision to suspend funding to WHO. There is no reason justifying this move at a moment when their efforts are needed more than ever.”

German Foreign Minister Heiko Maas said apportioning blame did not help. “The virus knows no borders,” he said in a tweet.

New Zealand Prime Minister Jacinda Ardern said the WHO was essential to tackling the pandemic.

“At a time like this when we need to be sharing information and we need to have advice we can rely on, the WHO has provided that,” she said. “We will continue to support it and continue to make our contributions.”

GRAPHIC: Tracking the novel coronavirus in the U.S. – https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html

‘BLAME CHINA, NOT WHO’

Australian Prime Minister Scott Morrison said he sympathised with Trump’s criticisms of the WHO, especially its “unfathomable” support of re-opening China’s “wet markets”, where freshly slaughtered, and live, animals are sold.

“But that said, the WHO also as an organisation does a lot of important work including here in our region in the Pacific and we work closely with them,” Morrison told an Australian radio station.

“We are not going to throw the baby out of with the bathwater here, but they are also not immune from criticism.”

John Sawers, the former head of Britain’s MI6 foreign intelligence service, said China concealed crucial information about the outbreak from the rest of the world and that it would be better to hold China responsible rather than the WHO.

Former Norwegian Prime Minister Gro Harlem Brundtland, who headed the WHO from 1998 to 2003, said an attack on the organization was “the last thing we need right now” since it had the power and ability to oversee the outbreak.

In its latest Strategy Update, the WHO said countries that ease restrictions should wait at least two weeks to evaluate the impact before easing again.

It said that the world stands at a “pivotal juncture”.

More than 2,200 people died in the United States on Tuesday, a record toll according to a Reuters tally, even as it debated how to reopen its economy.

New York City, hardest hit by the outbreak, revised its death toll sharply up to more than 10,000, to include victims presumed to have died of the lung disease but never tested.

U.S. health advocacy group Protect Our Care said Trump’s WHO funding withdrawal was “a transparent attempt … to distract from his history downplaying the severity of the coronavirus crisis and his administration’s failure to prepare our nation”.

Global stocks fell as oil prices dropped and warnings of the worst global recession since the 1930s underscored the economic damage done by the pandemic. The International Energy Agency forecast a 29 million barrel per day dive in April oil demand to levels not seen in 25 years.

Denmark became the latest country to ease its coronavirus lockdown on Wednesday, by reopening schools and day care centres. But concerns they might become breeding grounds for a second wave of cases convinced thousands of parents to keep their children at home.

(Open https://tmsnrt.rs/3aIRuz7 in a separate browser for an interactive graphic to track the global spread)

(Reporting from Reuters bureaux across the world; Writing by Lincoln Feast and Nick Macfie; Editing by Robert Birsel and Philippa Fletcher)