Category: World

Britain will extend its coronavirus lockdown for at least three more weeks as a relaxation of the measures would damage both public health and the economy, foreign minister Dominic Raab said on Thursday.

“Relaxing any of the measures currently in place would risk damage to both public health and the economy,” he told reporters.

“Based on this advice … the government has decided that the current measures must remain in place for at least the next three weeks.”

The move was widely expected. Raab, who is deputizing for a recuperating Boris Johnson, had already made clear before Thursday’s series of government meetings that there would be no immediate lifting of the social distancing measures announced on March 23.

Britons are required to stay at home unless they are shopping for basic necessities or meeting medical needs. Citizens are allowed to exercise in public once a day, and can travel to work if they are unable to work from home.

The United Kingdom has the fifth-highest official death toll from COVID-19 among Western countries, after the United States, Italy, Spain and France, although the figure only covers hospital fatalities and the real number is probably much higher.

The U.K.’s hospital death toll from COVID-19 rose by 861 to 13,729 as of 4 p.m. ET on April 15, the health ministry said on Thursday. Broader statistics that include deaths in care homes and in the community suggest the total toll is much larger.

“We think it is too early to make a change,” Health Secretary Matt Hancock said earlier in the day. “While we’ve seen a flattening of the number of cases, and thankfully a flattening of the number of deaths, that hasn’t started to come down yet.

“If we just released all the measures now, then this virus would run rampant once again and we can’t let that happen.”

Johnson is convalescing at the prime minister’s country residence from COVID-19 complications that saw him become the first world leader admitted to intensive care due to COVID-19 complications.

The most stringent restrictions in British peacetime history have effectively closed down much of the world economy, and the U.K. is heading toward its deepest depression in three centuries.

Chance for resurgence

As leaders around the world begin to contemplate ways to exit the shutdown, epidemiologists have cautioned that a second wave of the outbreak could endanger the weak and elderly.

Neil Ferguson, a professor of mathematical biology at Imperial College London who advises the government, said Britain would probably have to maintain some level of social distancing until a vaccine for the novel coronavirus is available.

“If we relax measures too much then we will see a resurgence in transmission,” he told BBC radio. “If we want to reopen schools, let people get back to work, then we need to keep the transmission down in another manner.”

Meanwhile, Prince William on Thursday opened an emergency COVID-19 hospital built in just eight days in the exhibition centre of Britain’s second city, Birmingham.

The hospital is the second of seven being constructed around England in response to the novel coronavirus outbreak. It has a 500-bed capacity, which can be increased to 1,500.

William, the Duke of Cambridge, opened the new NHS Nightingale Hospital at the National Exhibition Centre via video link.

8% of March deaths involved coronavirus

Deaths from the novel coronavirus in England and Wales in March were highest among the elderly, those with underlying health conditions and men, according to official data published on Thursday.

Office for National Statistics (ONS) analysis of all deaths registered so far in March found that eight per cent involved coronavirus, making it the third most frequent underlying cause of death after dementia/Alzheimer’s disease and coronary heart disease.

Of the 3,912 deaths involving the coronavirus during the month, it was determined to be the underlying cause of death in 86 per cent of cases.

Slightly more than 90 per cent of those who died had at least one pre-existing health condition, with coronary heart disease the most common. The death rate among males from the coronavirus was double that of females, the ONS said.

The data also showed the rate of death increasing significantly in each age group from 55 upwards in males and 65 upwards in females. One in five deaths were in the 80 to 84 years age group, and there no deaths among those aged under 14.

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Before Washington state lifts its stay-at-home order, public health workers in Seattle’s King County want to be ready to douse any new sparks of infection.

That task, they say, requires at least 20 more investigators to call people who test positive for the coronavirus, track down their contacts and get them into quarantine. Without the extra help, the workers insist, the state can’t possibly be ready to resume normal everyday activities.

“We are trying to build these teams and processes in the midst of a crisis,” county health spokesperson Sharon Bogan said.

The challenge extends well beyond Seattle. As federal officials weigh how and when to reopen the country, experts say the United States does not have enough public health workers to suppress another outbreak, especially those qualified to do contact tracing, the critically important effort to find people who may have been exposed to the virus.

The Johns Hopkins Bloomberg School of Public Health estimated it could require 100,000 people, while Dr. Tom Frieden, the former head of the U.S. Centers for Disease Control (CDC), believes the number could be as high as 300,000.

Both estimates represent a daunting number given that the combined federal, state and local public health workforce has been shrinking and is now probably less than 280,000, according to some estimates.

The budget approved by Congress for the CDC has fallen by 10 per cent between 2010 and 2019 when adjusted for inflation, according to the nonprofit group Trust for America’s Health, and that has had a trickle-down effect at state and county levels.

The problem has inspired some novel ideas, including enlisting Peace Corps volunteers, furloughed social workers and public health students. San Francisco is training librarians, medical students and people who work for the city attorney’s office.

WATCH | Canada’s challenges with contact tracing:

While the exact number of workers needed is a subject of debate, a top federal health official this week acknowledged the mandate to find many more.

“Everybody agrees that our public health capacity at the local and state level is not ready to take this on at a very large scale without reinforcements,” said Dr. Anne Schuchat of the CDC, who oversees the agency’s coronavirus response work.

The extra workers would help conduct testing, isolate sick cases and trace everyone those sick people had contact with.

New funds approved for response efforts

It’s crucial that such a system be in place before government officials ease physical-distancing guidelines, reopen schools or lift stay-at-home orders, said Frieden.

“If we have explosive spread when we reopen, we’ll have to close again. That will be very damaging, not just economically but from a health standpoint,” he said.

The U.S. government has funnelled about $800 million US to states for coronavirus response work that can include contact tracing. And on top of hundreds of staff sent to states to help with coronavirus work, the CDC has already assembled “community protection teams” of six to 12 people each to do contact tracing and investigate tools that could help with it. Some have already been deployed to states where spread of the virus has been relatively low.

Tiny Rhode Island has nearly 100 people “focused on nothing but contact tracing,” reaching out to hundreds of contacts of infected people each day, Gov. Gina Raimondo told reporters. She has urged all state residents to take a minute each evening to write down who they physically encountered that day and where those encounters took place.

“If I’m going out to the store, I’ll put the date, what store I went to and then the time I was there,” said Drew Grande, 40, of Cranston, R.I. He started a contacts diary on a note-taking app on his phone after he heard the governor’s request.

Contact tracing has changed over the last few months in the U.S. When the first handful of infections were being identified, teams of 20 or more might be assigned to each confirmed case. Investigations would often start with a staffer or two doing an in-person interview at a hospital bedside. Disease trackers might spend hours asking a sick person and that person’s relatives who they had been in contact with since symptoms surfaced.

In-person interviews are often better, said Isaac Ghinai, a CDC disease tracker assigned to work with Chicago’s health department.

“There’s a value to looking someone in the eye. You can build a relationship face to face that you can’t always do by phone,” he said. Some people are comfortable sharing personal details over the phone but others “require more cajoling.”

With hundreds of new cases emerging each day in Chicago, that kind of attention to individual infections has largely stopped. Instead, the priority is large groups of people who are particularly vulnerable, like those at nursing homes or homeless shelters. Many new confirmed cases are not being investigated, and when they are, the interviews may be done by only two or three people, and over the phone, Ghinai said.

Lack of testing materials, too

Could there be a digital solution? Apple and Google are teaming up on a contact-tracing app, and other efforts use Bluetooth to gather data from phones that came close to an infected person. Seattle scientist Trevor Bedford has developed a digital interview that public health departments can use if they don’t have enough people trained in contact tracing.

Whatever the solution, it will take a while.

People have to be tested and diagnosed before contact tracing kicks into gear, and testing remains limited in many parts of the country. This week, the Association of American Medical Colleges sent a letter to the White House Coronavirus Task Force saying that testing materials and machines remain in short supply.

President Donald Trump has floated the idea of easing at least some restrictions as early as May 1.

Some observers believe restrictions could be eased first in places where the spread is low, if rigorous testing and contact tracing could prevent a sudden explosion in infections.

But Schuchat warned that “there is no way the entire country could relax mitigation on May 1 and the country not experience a major resurgence.”

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In the six days after top Chinese officials secretly determined they likely were facing a pandemic from a new coronavirus, the city of Wuhan at the epicentre of the disease hosted a mass banquet for tens of thousands of people, and millions began travelling through the city for Lunar New Year celebrations.

President Xi Jinping warned the public on the seventh day, Jan. 20. But by that time, more than 3,000 people had been infected during almost a week of public silence, according to internal documents obtained by The Associated Press and expert estimates based on retrospective infection data.

That delay from Jan. 14 to Jan. 20 was neither the first mistake made by Chinese officials at all levels in confronting the outbreak, nor the longest lag, as governments around the world have dragged their feet for weeks and even months in addressing the virus.

“This is tremendous,” said Zuo-Feng Zhang, an epidemiologist at the University of California, Los Angeles. “If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient. We might have avoided the collapse of Wuhan’s medical system.”

The Chinese government has repeatedly denied suppressing information in the early days, saying it immediately reported the outbreak to the World Health Organization.

“Those accusing China of lacking transparency and openness are unfair,” foreign ministry spokesperson Zhao Lijian said Wednesday when asked about the AP story.

China in mid-April has reported a total of 3,342 deaths from the virus among 82,341 cases, though it has faced questions about how it counts and reports cases. Around 3,000 people remain hospitalized with COVID-19, or are under isolation and monitoring for showing signs of the illness or testing positive but not displaying symptoms.

Other experts noted that the Chinese government may have waited on warning the public to stave off hysteria, and that it did act quickly in private during that time.

But what is clear, experts say, is that China’s rigid controls on information, bureaucratic hurdles and a reluctance to send bad news up the chain of command muffled early warnings. The punishment of eight doctors for “rumour-mongering,” broadcast on national television on Jan. 2, sent a chill through the city’s hospitals.

Here is a look at how the crisis played out in China from the internal documents:

Jan. 13: Thailand case raises concerns in China

For almost two weeks, China’s Center for Disease Control did not register any cases from local officials, internal bulletins obtained by the AP confirm. Yet during that Jan. 5-17 period, hundreds of patients were appearing in hospitals not just in the city of Wuhan but across the country.

Doctors and nurses in Wuhan told Chinese media there were plenty of signs that the coronavirus could be transmitted between people as early as late December. Patients who had never been to the suspected source of the virus, the Huanan Seafood Market, were infected. Medical workers started falling ill.

But officials obstructed medical staff who tried to report such cases. They set tight criteria for confirming cases, where patients not only had to test positive, but samples had to be sent to Beijing and sequenced. They required staff to report to supervisors before sending information higher, Chinese media reports show. And they punished doctors for warning about the disease.

An expert team dispatched from the central health agency on Jan. 8 failed to unearth any clear signs of human-to-human transmission in Wuhan. Yet during their stay, more than half a dozen doctors and nurses had already fallen ill with the virus, a retrospective China CDC study published in the New England Journal of Medicine would later show.

The teams looked for patients with severe pneumonia, missing those with milder symptoms. They also narrowed the search to those who had visited the seafood market — which was in retrospect a mistake, said Benjamin Cowling, an epidemiologist at the University of Hong Kong who flew to Beijing to review the cases in late January.

The muffling of warnings left top leaders in the dark. It took the first confirmed case outside China, in Thailand on Jan. 13, to jolt leaders in Beijing into recognizing the possible pandemic before them.

An internal memo cites China’s top health official, Ma Xiaowei, as saying the situation had “changed significantly” because of the possible spread of the virus abroad.

Jan. 15: Warning to regions, with a caveat

The memo, on a secret Jan. 14 teleconference held by Ma, shows that Chinese officials were deeply alarmed and had come to a much grimmer assessment than they were letting on in public.

For weeks, officials had stuck to the line that there was “no clear evidence of human-to-human transmission,” calling the disease “preventable and controllable.”

But during the teleconference, Ma said that “clustered cases suggest human-to-human transmission is possible.”

“The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event,” the memo cites Ma as saying.

WATCH | WHO says it didn’t know about human-to-human risk on Jan. 5:

After the teleconference, officials adjusted their language slightly, but continued to downplay the threat.

“We have reached the latest understanding that the risk of sustained human-to-human transmission is low,” Li Qun, the head of China CDC’s emergency centre, told Chinese state television on Jan. 15.

In response to the teleconference, the CDC in Beijing initiated the highest-level emergency response internally, level one, on Jan. 15.

It assigned top CDC leaders to 14 working groups tasked with getting funds, training health workers, collecting data, doing field investigations and supervising laboratories, an internal CDC notice shows. The National Health Commission also distributed a 63-page set of instructions to provincial health officials, obtained by the AP.

The instructions ordered health officials nationwide to identify suspected cases, hospitals to open fever clinics, and doctors and nurses to don protective gear. They were marked “internal” — “not to be spread on the internet” and “not to be publicly disclosed.”

No public warning for Lunar New Year

Before the teleconference, health authorities had focused narrowly on Wuhan.

They searched for visitors to a market that dealt in live game, believing the virus was largely transmitted from animals to humans. But rattled by the case in Thailand, Chinese leaders launched a nationwide hunt to find cases, the documents show.

The memo warned the risk of transmission was higher with many people travelling for the upcoming Lunar New Year holiday. “All localities must prepare for and respond to a pandemic,” it said.

Officials in Hubei province, where Wuhan is located, were instructed to begin temperature checks at transportation hubs and cut down on large public gatherings.

The public was not warned, even as the new measures began to turn up hundreds of cases across the country and thousands of people dined at a mass Lunar New Year banquet in Wuhan.

In the memo, Ma demanded officials unite around Xi. It made clear that social stability was a key priority during the long lead-up to China’s two biggest political meetings of the year in March.

“Emphasize politics, emphasize discipline, emphasize science,” the memo cites Ma as saying.

Jan. 20: Xi goes public

On Jan. 20, President Xi issued his first public comments on the virus, saying the outbreak “must be taken seriously” and every possible measure pursued.

A leading Chinese epidemiologist, Zhong Nanshan, announced for the first time, on national television, that the virus was transmissible from person to person. If the public had been warned a week earlier to take actions such as physical distancing, mask wearing and restricting travel, cases could have been cut by up to two-thirds, one paper later found.

WATCH | Tips on wearing a mask:

Wuhan’s case count had climbed exponentially by the time of Xi’s comments — four on Jan. 17, then 17 the next day and 136 the day after. Across the country, dozens of cases began to surface, in some cases among patients who were infected earlier but had not yet been tested. In Zhejiang, for example, a man hospitalized on Jan. 4 was only isolated on Jan. 17 and confirmed positive on Jan. 21. Shenzhen, where Yuen had earlier found six people who tested positive, finally recorded its first confirmed case on Jan. 19.

The Wuhan Union Hospital, one of the city’s best, held an emergency meeting on Jan. 18, instructing staff to adopt stringent isolation — still before Xi’s public warning.

An earlier warning could have saved lives, said Zhang, the doctor in Los Angeles.

However, other health experts said the government took decisive action in private given the information available to them.

“They may not have said the right thing, but they were doing the right thing,” said Ray Yip, the retired founding head of the U.S. Centers for Disease Control’s office in China. “On the 20th, they sounded the alarm for the whole country, which is not an unreasonable delay.”

If health officials raise the alarm prematurely, it can damage their credibility — “like crying wolf” —and cripple their ability to mobilize the public, said Cowling, the epidemiologist in Hong Kong.

Rewriting history, and a blame game

By late January, boiling public anger over China’s initial handling of the outbreak put the leadership on the defensive. Health experts accused Wuhan’s leaders of a coverup, and Beijing fired local officials.

National leaders began to publicize directives they had earlier made in secret in apparent attempts to demonstrate they had acted decisively from the beginning. On Feb. 17, Xi revealed he had led the response as early as Jan. 7, two weeks before his first public comment on the virus. Days later, the National Health Commission published a notice revealing its confidential teleconference, dated to Jan. 14.

The public notice omitted sections of the internal memo showing how alarmed officials had been at the time. It added lines suggesting that commission leaders were responding proactively to what then seemed a minor outbreak.

In the weeks after the severity of the epidemic became clear, some experts accused Wuhan officials of intentionally hiding cases.

“I always suspected it was human-to-human transmissible,” said Wang Guangfa, the leader of the second expert team, in a Mar. 15 post on Weibo, the Chinese social media platform. He fell ill with the virus soon after returning to Beijing on Jan. 16.

Wuhan’s then-mayor, Zhou Xianwang, blamed national regulations for the secrecy.

“As a local government official, I could disclose information only after being authorized,” Zhou told state media in late January. “A lot of people didn’t understand this.”

It wasn’t just Wuhan. In Shenzhen, hundreds of miles away in southern China, a team led by microbiologist Yuen Kwok-yung used its own test kits to confirm that six members of a family of seven had the virus on Jan. 12. In an interview with Caixin, a respected Chinese finance magazine, Yuen said he informed CDC branches “of all levels,” including Beijing. But internal CDC numbers did not reflect Yuen’s report, the bulletins show.

Some world leaders turned blind eye to outbreak

The delay may support accusations by U.S. President Donald Trump that the Chinese government’s secrecy held back the world’s response to the virus.

However, even the public announcement on Jan. 20 left the U.S. nearly two months to prepare for the pandemic. Given the Trump administration’s often bellicose and skeptical stance toward China in the previous three years, it’s not clear earlier knowledge would have changed its approach.

After Jan. 20, Trump ignored the warnings of his own staff and dismissed the disease as nothing to worry about, while the government failed to bolster medical supplies and deployed flawed testing kits.

Trump defenders have pointed to his impeachment trial in the Senate as diverting his attention, but he was acquitted in early February, holding six more campaign-style rallies and dismissing the possibility the virus would spread extensively in the U.S.

Leaders across the world turned a blind eye to the outbreak, with British Prime Minister Boris Johnson calling for a strategy of “herd immunity” — before falling ill himself.

Brazilian President Jair Bolsonaro sneered at what he called “a little cold.”

According to tracking by Johns Hopkins University in Maryland, there were over two million reported COVID-19 cases worldwide as of early in the day on April 16, with about 138,500 coronavirus-related deaths.

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First came the deadly pandemic, then the economic meltdown, and now a third international crisis looms. It’s geopolitical, involving escalating tensions between the world’s existing and emerging superpowers: the United States and China.

This week’s feud about the World Health Organization is just one flashpoint in a rivalry intensifying on multiple fronts.

It only seems likely to escalate in this U.S. election year, as President Donald Trump drops hints that bashing Beijing will be a central campaign theme. 

Polls suggest there’s deep anger in the United States against the Chinese government amid the COVID-19 pandemic, creating a potentially large audience for Trump’s message. 

Trump is ripping foreign institutions and his election rival as China-friendly. Trump’s son and his former campaign manager are promoting calls to slap China with financial penalties. 

A flood of bills introduced in the U.S. Congress would steer manufacturing of critical supplies away from China.

The countries are expelling each other’s media outlets.

Watch: Trump suspends WHO funding

The idea that Canada is immune to any fallout from their clashing is repudiated by recent history.

Canadians have already suffered human and economic costs for the country’s supporting role in a U.S.-China legal drama, and Ottawa is still under monumental pressure in its dilemma over allowing China’s Huawei into the 5G network.

Frightening lessons from history

Graham Allison is more worried than ever.

The founding dean of Harvard’s Kennedy School, he wrote a book three years ago about a terrifying pattern in world history: the likelihood of war when a new global power emerges to challenge the old order.

Allison examined the lessons of 16 such transformational moments in the last 500 years in Destined For War: Can America and China Escape Thucydides’ Trap. 

Twelve resulted in war.

His book argued that the U.S. and China were making the same mistakes that previously led to disaster, and it could get worse with nationalists leading both countries.

That was in 2017. Asked last week whether the countries are now closer to open hostility, Allison replied unequivocally: “You bet.” 

He said in his frequent visits to Beijing and Washington decision-makers regularly ask what Thucydides, the ancient Greek military historian mentioned in his book’s title, might say today. 

“My answer each time,” Allison said, “[is that] he’d say both parties [are] right on script, accelerating at a faster pace than he would have expected, towards what could be the grandest collision of all times.”

Watch: Anger in China after whistleblower doctor dies

Anger over the current pandemic stems from allegations that Beijing’s secretive behaviour made the initial outbreak worse.

The Associated Press reports that the Chinese government sat on evidence for a week about a possible pandemic, while punishing whistleblowers and reportedly restricting research in what international activists call China’s “Chornobyl moment.” 

Many ordinary Chinese people share in this anger, judging from memorials and demonstrations around the country. 

Under fire for his own inconsistent response to the crisis, Trump is seeking to tap some of that frustration. 

Peter Navarro, whose job in the White House now involves procuring medical gear, was, before joining Trump, a China hawk in books and film. 

He said the world’s mask shortage was made worse because the Chinese government bought hundreds of millions of them early, while the international community was “still sleeping” about the severity of COVID-19.

“That’s a significant discussion we need to have [with China], at least after this is all over,” Navarro told Fox News last week.

The Trump administration has a receptive audience for this message. 

A new Harris poll finds overwhelming consensus in the U.S. that China is responsible for COVID-19. Ninety per cent of Republicans, 75 per cent of independents, and 67 per cent of Democrats agreed with that statement.

Trump’s campaign is now repeatedly swinging at former U.S. vice-president Joe Biden as soft on China; they say Biden’s son is profiting from relations with Beijing.

Biden’s campaign spokesperson pushed back by pointing to a glaring inconsistency in Trump’s message: the president personally praised China’s handling of the virus. 

It’s one of many twists and turns in Trump’s own erratic messaging during this crisis.

International institutions are already being pulled into the feud. 

The World Health Organization is just the latest. The U.S. has suspended WHO funding in the midst of the pandemic because it wants a review into whether it was too willing to cover for Beijing.

Three categories of potential consequences

A former Canadian official who used to brief politicians about emerging threats on behalf of Canada’s intelligence agency lists international institutions as one of three areas likely to be impacted by China-U.S. hostility.

“There are no answers yet to any of these things. I don’t have a crystal ball,” said Stephanie Carvin, formerly of CSIS and now a professor at Carleton University’s Norman Paterson School of International Affairs.

“But these are the things I’ll be looking at.”

Her list includes: 

• International institutions. U.S.-China tensions aren’t just threatening the WHO. They’re also part of a broader dispute that has paralyzed the World Trade Organization’s top enforcement body. The countries are also fighting over voting rights at the International Monetary Fund, which could soon play a critical role in stabilizing faltering economies. Carvin expects an “acceleration” of existing tension at international bodies.

• Trade. At least nine bills currently in the U.S. Congress would seek to study or reverse U.S. reliance on China for medical supplies. Canada and the U.S. are already studying ways to repatriate some production of vital minerals used in manufacturing. That’s atop multiple other signs of cooling in business relations.

• Economic actions. Carvin said the Chinese government will continue using economic pressure to achieve political aims, rewarding friendlier countries and punishing foes.

The Chinese government is working to build goodwill, doling out masks to other countries, including Canada, as the rest of the world scrambles for supplies.  

And they’ve pointed out that the U.S. was hardly kept in the dark about the virus: it was notified in January, and even closed its Wuhan consulate on January 26.

They also accuse the U.S. of hypocrisy regarding free speech. 

A Chinese foreign ministry spokeswoman raised the firing of U.S. Navy Capt. Brett Crozier after he sounded the alarm about a COVID-19 outbreak on his ship.

“By American values, he should be hailed as a hero instead of being punished, right?” said Chinese spokeswoman Hua Chunying.

“The comments by these few U.S. politicians are just shameless and morally repulsive.”

Watch: WHO defends its record on COVID-19

In the U.S., meanwhile, there’s now lots of talk about making China pay for the coronavirus — literally.

It includes a class-action suit in Florida, and reports that the U.S. government is considering legal action over alleged hoarding of medical gear. 

One Canadian company that produces masks in China told CBC News that the Chinese government forbade exports. 

One Washington-based trade analyst said the U.S. has a big decision to make, if it truly intends to decouple trade from China.

The decision in question: whether to rejoin other allies in the Asia-Pacific trade deal, said Eric Miller.

It could be another election issue — Trump withdrew from the TPP and Biden has talked about possibly rejoining.

One thing Miller is adamant about: U.S.-China relations will change.

“This marks the real breaking point that puts the U.S. and China on a definitive cold-war path. It had been coming for a while,” he said. 

“There is a profound sense of anger in the United States … [A feeling that] China has to pay.”

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Quite uncharacteristically, the Russian state TV host did not bury the bad news as he led off the show.

“We’re now following the same model as Italy,” Yevgeny Popov said in a stunning about-face from just two weeks ago, when the host of the popular Russian talk show 60 Minutes said the government was getting the coronavirus outbreak under control.

Now, Russia’s most widely watched Kremlin-funded news programs are telling people they should prepare for thousands of deaths.

Along with that shift in messaging has also come a change in behaviour from President Vladimir Putin.

Shifting messages

Putin had been keeping an unusually low profile as the virus spread, preferring to make good news pronouncements such as paid holidays for workers and help for businesses, while leaving unpopular decisions such as enforcing quarantines to lower-level officials.

But this week, a concerned-looking Putin has made daily addresses, emphasizing that the situation has become dire and Russians should prepare themselves for plenty more bad news.

“Truly extraordinary measures are required to stop the spread of the infection,” he said in an address Tuesday from a conference room at his estate outside Moscow, where he’s been holed up for the past two weeks after meeting doctors who later tested positive for COVID-19, the illness caused by the coronavirus.

Officially, Russia has registered more than 25,000 cases of the coronavirus and 198 deaths, but many doctors and local officials believe those numbers don’t reflect the true extent of the outbreak.

Putin, who after 20 years in power rarely reverses course on any significant policy matter, has suddenly backtracked on several.    

A nationwide referendum that could allow him to serve up to two more six-year terms as president was postponed, and he stepped back from an oil price war with Saudi Arabia that he’d initiated and agreed to limit Russian oil output in a deal aimed at propping up the crashing ruble.

Party postponed

But the biggest reversal came on Wednesday with a decision to postpone the May 9 Victory Day parade marking the 75th anniversary of the end of the war in Europe — a hugely symbolic event, arguably more important to many Russians than even the Olympics.

Heaped in national pride and symbolism, the annual event is always a display of military might, but doubly so this year, as it was designed to be a personal celebration of Putin’s long reign at the top of Russia’s political hierarchy. The Kremlin had repeatedly denied it would ever consider moving the celebration.

But with the strain on Russia’s underfunded health-care system now showing up everywhere, the plan to assemble tens of thousands of soldiers and spectators for the spectacle in Moscow’s Red Square now appears to be too great a risk for the country’s leadership.

Video posted Wednesday by the independent Echo Moscow radio station showed patients in a St. Petersburg hospital, reportedly with pneumonia, lying in the corridors on bare mattresses.

“There’s no oxygen [for patients],” the medic who shot the video said in a comment that accompanied it.

In the city of Ufa, 1,500 kilometres east of Moscow, as many as 1,100 patients and staff at Kuvatov Clinical Hospital have been under quarantine for the past 10 days after COVID-19 rampaged through the facility.

In an interview with CBC News on Monday, Dr. Rimma Kamalova, who heads the hospital’s rheumatology department and is quarantined in the facility, said when the outbreak started, regional health authorities refused to test patients for coronavirus. 

“According to our policies  … we could not do testing on coronavirus,” she said.

“We had orders, at that time, not to give this diagnosis and take the relevant [mitigation] measures.” 

She spoke with CBC News while awaiting the results of her own COVID-19 test, noting that she was already exhibiting high fever and other symptoms. Every single other doctor on her ward is also sick, she said.

“We were extremely worried about this. [The patients] would come into the hospital, be admitted and then treated, then discharged and they would go back to their towns, and cities and regions.”

Doctors defiant

Once the extent of the outbreak became apparent, she says, the same health authorities that ordered them not to test for coronavirus accused them of letting it get out of control.

By April 6, the situation had become too extreme to ignore and the entire hospital was put into quarantine, with no one, including staff, allowed in or out.

In the northern region of Komi, the Moscow Times reports that six hospitals are under a similar quarantine.

In Moscow, 13 million residents live mostly in highrises closely packed together. The city has two-thirds of the active cases in the country.

Hospital admissions are spiking, according to the city’s mayor, and widely circulated social media videos this week have shown long lines of ambulances waiting to drop off patients. Some drivers complained they had been in line for as long as 15 hours.

Increasingly, doctors are coming forward and risking their positions and reputations to speak out about the deteriorating situation.

Faulty tests

In a series of interviews, several doctors told CBC News that Russian health authorities squandered early opportunities to contain the virus, in part because testing was faulty.

“The sensitivity of the tests is about 65-70 per cent,” said Dr. Pavel Brand, who works at a private clinic in Moscow.

“So we sometimes don’t know if the person died from COVID or from something else. And so we put them in another part of statistics, and that’s why the statistics are low.”

Russia has developed its own COVID-19 tests that the government claims have been administered to more than a million people, but there have been repeated criticisms about large numbers of false-negatives. 

There were also long delays with verifying positive results, as only one facility in Siberia was equipped to do it. 

Infection specialist Alexei Yakovlev at the Medsi hospital in Moscow said most early cases of COVID-19 were treated as pneumonia by health authorities, and only now has Russia’s government agreed to combine the tally of both.

“The numbers of patients with severe pneumonia are going up, and my feeling is that we have not reached the peak yet,” he told CBC News.

He said in the days ahead he expects a dramatic spike in both deaths and active cases, once the combined figures for COVID-19 and pneumonia are released.

Businesses crushed

The Kremlin also appears to be growing increasingly concerned about the economic fallout from the shutdown of Moscow and other Russian cities.

Anastasia Tatulova, who owns Anderson Cafe catering services in Moscow, said the government put businesses like hers in an impossible position when it ordered employees to stay home from work for the month of April, yet still expected her to pay dozens of workers.

“We have no safety net,” she said. “These decrees come out and, well, it seems they don’t even understand the basics of how a business is set up in Russia.”

On Wednesday, Putin responded by offering small businesses up to $160 Cdn a month per employee, as long as the company retains most of its workers.

To put that in perspective, Russia’s statistics agency says average monthly wages range between $850 and $1,300 Cdn, depending on the exchange rate.

Prominent economist Alexei Kudrin, the architect of many of Russia’s most successful financial reforms and now an auditor of government spending, told a Russian business publication that the economic implications of the outbreak are close to catastrophic. 

He predicts more than eight million Russians may be unemployed by the end of 2020 — a threefold increase from the start of the crisis.

Compared to Canada, which has a robust unemployment system and has introduced other benefits to help during the emergency, Russia’s social supports are relatively meagre.

The TASS Russian news agency reports that the amount available to a single person per month ranges from between $30 and $150 Cdn.

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Nations around the world reacted with alarm Wednesday after President Donald Trump announced a halt to the sizable funding the United States sends to the World Health Organization. Health experts warned the move could jeopardize global efforts to stop the COVID-19 pandemic. 

At a briefing in Washington, Trump said he was instructing his administration to halt funding for WHO pending a review of its role “in severely mismanaging and covering up the spread of the coronavirus.” The United States is WHO’s largest single donor, contributing between $400 million and $500 million US annually to the Geneva-based agency in recent years.

Trump has repeatedly labelled COVID-19 the “Chinese virus” and criticized the UN health agency for being too lenient on China, where the novel virus first emerged late last year.

Outside experts have questioned China’s reported infections and deaths from the virus, calling them way too low and unreliable. An investigation by The Associated Press has found that six days of delays between when Chinese officials knew about the virus and when they warned the public allowed the pandemic to bloom into a public health disaster.

International pushback

The European Union on Wednesday said Trump has “no reason” to freeze WHO funding at this critical stage and called for measures to promote unity instead of division. EU foreign policy chief Josep Borrell said the 27-nation bloc “deeply” regrets the suspension of funds and added that the UN health agency is “needed more than ever” to combat the pandemic.

Borrell said “only by joining forces can we overcome this crisis that knows no borders.”

The EU has increasingly been critical of the Trump administration over the past years.

The novel coronavirus is spread by microscopic droplets expelled into the air or left on surfaces when people sneeze or cough. Worldwide, the pandemic has infected nearly two million people and killed more than 127,000, according to a tally by Johns Hopkins University.

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

“That said, the WHO as an organization 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.”

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.”

Germany’s foreign minister, Heiko Maas, pushed back on Trump’s announcement. 

“Placing blame doesn’t help,” he wrote on Twitter. “The virus knows no borders. We must work closely against COVID-19. Strengthening the UN, in particular the underfunded WHO, is a better investment, for example, to develop and distribute tests and vaccines.”

Devi Sridhar, chair of global public health at the University of Edinburgh, called Trump’s decision “extremely problematic,” noting that the chronically underfunded WHO is leading efforts to help developing countries fight the spread of COVID-19.

“This is the agency that’s looking out for other countries and leading efforts to stop the pandemic,” Sridhar said. “This is exactly the time when they need more funding, not less.” 

Sridhar said Trump’s move was a short-sighted political decision that would likely have lasting consequences. 

WATCH | Trump suspends WHO funding, touts plan to restart economy:

“Trump is angry, but his anger is being directed in a way that is going to ultimately hurt U.S. interests,” she said. 

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

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

Critiques from home

In the United States, Trump’s decision has drawn criticism from American Medical Association President Dr. Patrice Harris, the U.S. health advocacy group Protect Our Care and Melinda Gates, co-chair of the Bill and Melinda Gates Organization, among others.

Dr. Harris called the move “a dangerous step in the wrong direction that will not make defeating COVID-19 easier.” Gates wrote on Twitter that removing funding to the WHO during a pandemic is “as dangerous as it sounds.”

Former national security advisor John Bolton took to Twitter to defend the decision, calling it the “correct response” in light of the organization’s failures.

The WHO did not respond to repeated requests from The Associated Press for comment, but Director-General Tedros Adhanom Ghebreyesus and other top WHO officials were expected to attend a news conference on the pandemic later Wednesday. 

Many analysts have praised the initial response to the pandemic by WHO, which is being challenged as national interests collide with the international cooperation that UN agencies rely on. 

But recently, many governments have split with WHO’s advice on issues of public health policy, notably on travel restrictions and whether the public should wear masks.

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