Second wave fears for Asia as countries exit lockdowns
Wuhan has reported its first cluster of coronavirus infections since a lockdown on the city, the epicentre of the outbreak in China, was lifted a month ago, stoking concerns of a larger resurgence.
The five new confirmed cases, all from the same residential compound, come amid efforts to ease restrictions across China as businesses restart and individuals get back to work.
"We must resolutely contain the risk of a rebound," the health authority in Wuhan, a city with a population of about 11 million, said in a statement on Monday, local time.
New confirmed cases reported in China since April have been low compared with the thousands every day in February, thanks to a nationwide regime of screening, testing and quarantine.
The small Wuhan cluster is the first to emerge since the end of the strict lockdown on April 8. One of the five cases reported on Monday was the wife of an 89-year-old man who became the first confirmed case in the city in well over a month on Sunday.
And neighbouring South Korea announced its highest number of infections for more than a month driven by a cluster in a Seoul night-life district.
With governments across the world trying to avoid a second wave, Asian nations that were among the first engulfed by the virus but have since brought it to heel are being keenly watched.
Much of China has begun to get back to a form of normality, and on Monday Shanghai Disneyland threw open its gates following a three-month shutdown.
"We are very much looking forward to the first day of reopening," said one eager visitor named Kitty.
"We have stayed at home for around two months and got bored enough."
But enthusiasm in China was tempered by news on Sunday that one person had tested positive for the virus in Wuhan. There were five more cases on Monday.
Local health officials said the new infections were all from the same residential compound and were mostly older people.
South Korean officials ordered nightclubs and bars closed after a new cluster of at least 86 cases linked to an entertainment district in the capital - many in gay clubs.
Officials scrambled to trace thousands of people who visited the area, but efforts were hampered with many believed to be reluctant to come forward because of the stigma surrounding homosexuality.
"If you hesitate a single day, our daily clock may stop for a month. Please contact the nearest clinic or health centre right now," urged Prime Minister Chung Sye-kyun.
The new cluster prompted officials to push back the reopening of schools this week.
South Korea was once home to Asia's worst outbreak outside China but has been held up as a global example for its early aggressive testing and tracing.
EUROPE SEES SOME LIGHT
Swathes of Europe began the long process of reopening from coronavirus lockdowns as France and Spain embraced new freedoms and Britain plotted a path to normality.
The mixed fortunes illustrate the highwire act governments face across the globe as they try to resuscitate shattered economies while keeping in check a pandemic that has now killed more than 282,000 people and infected over 4.1 million.
With millions out of work and economies badly bruised, governments are desperate to hit the accelerator, but most are choosing a gradual approach as fears about a resurgence of the virus loom large.
In parts of Europe, officials have been emboldened by promising trends, with Spain's daily fatalities falling to 123 and Italy - once Europe's epicentre - reporting fewer than 1000 patients in intensive care, the lowest since March 10 before the peak of its outbreak.
France has seen its daily fatalities decline for several days, though reported an uptick on Monday with 263, as it began to dismantle a military field hospital set up to take intensive care patients when hospitals were being inundated.
The French were able to venture outdoors without filling in a permit for the first time in nearly eight weeks on Monday, and some shops reopened their doors.
The wide boulevards of the Champs-Elysees in Paris were once again back to life with cars and shoppers waiting patiently to make purchases, but things were not as before.
"It's a little unreal, everyone is wearing masks, it's really strange," said Irina, queuing outside a cosmetics store.
Many Spaniards revelled in being able to visit outdoor terraces and cafes again after months under one of the world's toughest lockdowns, although virus hot spots such as Madrid and Barcelona remain under wraps.
"I really missed this, now you value these little pleasures," said Jesus Vazquez, a 51-year-old builder, as he enjoyed a sandwich and beer in the sunshine outside a bar in the city of Tarragona.
Shopping strips were once again populated in Greece, while in other parts of Europe from the Netherlands to Switzerland and Croatia youngsters headed back to the classroom after weeks at home.
In the Czech Republic some teens revelled in being able to go to the cinema again - a novel outing after months of lockdown.
"We wanted to see what it's like just to go and see a film with my friends again," 16-year-old Tomas Fohler told AFP from behind a mask, now compulsory in the country.
Germany too has set in motion the reopening of shops, eateries, schools and gyms, but Chancellor Angela Merkel refreshed warnings to stay safe after official data showed the infection rate picking up speed again.
"It is necessary that we can have confidence that people are actually sticking to the basic guidelines, so keeping distance, covering mouth and nose, being considerate of each other," she said Monday.
In Britain, meanwhile, the government unveiled a "cautious road map" setting out new freedoms which included outdoor exercise and allowing construction, manufacturing and other manual workers back on the job.
Almost seven weeks after a nationwide stay-at-home order was put in place, more than 31,800 people have died in Britain - a figure second only to the United States.
Russia took a similarly cautious approach and said some work could resume this week, even as daily cases hit over 11,000, a record high in the country, and deaths topped 2,000.
BRAZIL BURIALS MOUNT
As Europe and Asia started to embrace a post-pandemic new normal, other parts of the world feared the worst could be yet to come.
Latin America and the Caribbean marked a grim milestone this weekend, passing 20,000 deaths out of more than 373,000 cases.
Brazil has been the worst hit, with 11,000 deaths.
Gravediggers in the country have watched in horror as the bodies pile up. "When I first saw how fast the number of burials was going up, I got scared," said Xavier, 52, who works at the public cemetery in Manaus, the capital of Amazonas state in northwestern Brazil.
Before the pandemic, the city of 2.1 million people registered 30 deaths per day on average. Now, the number has risen to about 100.
"I've gotten used to it. I just hope it will be over soon."
NYC COULD REOPEN IN JUNE
It comes as the reopening of hard-hit New York City could start in June as long as coronavirus-related hospitalisation and other statistics continue to trend downward, Mayor Bill de Blasio said on Monday (local time).
"June is when we're going to potentially be able to make some real changes if we continue our progress," Mr de Blasio said.
"This conversation, end of May, beginning of June is when we're going to be able to start filling in the blanks."
Mr de Blasio noted that the city will continue to monitor its daily coronavirus indicators such as the number of hospitalisation, those admitted to intensive care units and the percentage of people tested who are positive for COVID-19 in order to decide when to reopen non-essential businesses.
"We have our daily indicators. The state has their indicators," Mr de Blasio said. "We're all working together … they're all valuable measures."
"By both sets of measures, we're clearly not ready yet."
Governor Andrew Cuomo has extended New York's "Pause" order to June 7.
However, any of the state's regions will still be able to phase in re-openings sooner if they meet a series of seven benchmarks.
WHO URGES 'EXTREME VIGILANCE' AS COUNTRIES EXIT LOCKDOWN
Meanwhile, the World Health Organisation on Monday (local time) hailed dwindling COVID-19 infection rates and deaths in some countries, but called on nations to show "extreme vigilance" as they begin loosening their restrictions.
Swathes of Europe began the long process of reopening from coronavirus lockdowns on Monday, with officials in countries like France and Spain emboldened by declining death rates.
"The good news is that there has been a great deal of success in slowing the virus and ultimately saving lives," WHO director-general Tedros Adhanom Ghebreyesus told a virtual briefing.
WHO emergencies chief Michael Ryan meanwhile hailed the gradual lifting of the lockdowns as a sign of "hope".
But he cautioned that "extreme vigilance is required." More than 280,000 people have died out of the more than four million known COVID-19 infections worldwide.
And while the drastic measures implemented by many countries have allowed them to get a tentative handle on the virus, there are widespread fears that there could be fresh waves of intense transmission.
Ryan urged countries to boost their public health responses, ensuring they can identify fresh cases, and trace and isolate all contacts, which he said could help "avoid a major second wave".
But he warned that while "many countries have made very systematic investments in building up their public health capacities during the lockdowns, others have not."
- No 'herd immunity' -
"If disease persists in countries at a low level without the capacity to investigate clusters, identify clusters, there is always the risk that the disease will take off again," he said.
Without naming names, Ryan decried that some countries were choosing to "drive through this blind" by not dramatically ramping up their capacity to test and trace cases while they have the chance.
The WHO warned against the notion in some countries that even if they do not take the measures needed to halt the spread of the virus, their populations will quickly build so-called "herd immunity".
"Early serological studies reflect that a relatively low percentage of the population has antibodies to COVID-19," Tedros said, pointing out that this means "most of the population is still susceptible to the virus".
More than 90 so-called serological studies, which reveal the presence of antibodies in the blood to determine whether a person has had a past infection, were being conducted in several countries.
The WHO's COVID-19 technical lead Maria Van Kerkhove said that while the UN agency has not yet been able to critically evaluate the studies, initial data released showed that between one and 10 percent of people had antibodies.
"There seems to be a consistent pattern so far that a low proportion of people have these antibodies," she said.
Ryan agreed, saying the early results belied the widely-held assumption that most cases of the virus were mild and going undetected.
Preliminary results were "showing the opposite... that the proportion of people with significant clinical illness is actually a higher proportion" than previously thought, he said, stressing that "this is a serious disease".
"This idea that maybe countries that have lax measures... will all of a sudden magically reach some herd immunity, and so what if we lose a few old people along the way... is a really dangerous, dangerous calculation," he said.
WHY MORE MEN ARE DYING FROM COVID-19
Meanwhile, men are more likely to die from COVID-19 than women and researchers in Europe think they know why.
Men have higher amounts of an enzyme called angiotensin-converting enzyme (ACE2) in their blood than women, heart researchers in the Netherlands, Norway and Cyrus have found.
ACE2 is a receptor on the outside of cells that the COVID-19 virus uses to infect healthy cells.
It is widely distributed in tissues throughout the body including the lungs, veins, heart, kidney, and is found in particularly high levels in the testes.
In Australia, 56 per cent of the deaths from COVID-19 have been among males and men are slightly more likely to contract the virus (50.6 per cent of cases).
Overseas the gender divide has been much greater with 70 per cent of COVID-19 deaths in Italy occurring among males, while in New York men were almost twice as likely as women to die from the virus.
In China, men made up 64 per cent of the country's deaths, while in Germany, they accounted for 62 per cent. The World Health Organisation said globally 60 per cent of deaths have occurred in men while only 47 per cent of virus cases occurred in men.
In the new study, published in the European Heart Journal researchers measured ACE2 concentrations in blood samples taken from two groups of over 3500 heart failure patients from 11 European countries.
The study had started before the coronavirus pandemic and did not include patients with COVID-19.
"When we found that one of the strongest biomarkers, ACE2, was much higher in men than in women, I realised that this had the potential to explain why men were more likely to die from COVID-19 than women," said Iziah Sama, a doctor at UMC Groningen who co-led the study.
The study found that widely used blood pressure medications called ACE inhibitors did not lead to higher ACE2 concentrations.
This is important because earlier on in the pandemic there had been some concern these drugs might make COVID-19 worse.
This study concludes they do not increase the COVID-19 risk for people taking them and heart specialists have been urging their patients to continue taking the medications.
It comes as Chinese researchers found traces of COVID-19 in semen but they don't know yet whether the virus can be sexually transmitted.
Researchers at the Shangqiu Municipal Hospital tested the semen of 38 COVID-19 patients and found 15.8 per cent of the virus in their semen.
More than one in four patients at the acute stage of the infection had the virus detected in their semen and 8.7 per cent of those who were recovering from the virus also had the virus present in semen, the study published in the Journal of the American Medical Association found.
"Therefore, to avoid contact with the patient's saliva and blood may not be enough, since the survival of SARS-CoV-2 in a recovering patient's semen maintains the likelihood to infect others," the authors conclude.
However, they say the detection of the virus in the semen does not mean the disease can be sexually transmitted, further research is needed to determine that.
Originally published as Second wave fears for Asia as countries exit lockdowns