Turkish soldiers killed in Syrian army shelling in Idlib - BBC News

Four Turkish soldiers have been killed and nine wounded in shelling by Syrian government forces in Syria's north-western Idlib province, Turkey said.

It said up to 35 Syrian troops had been killed in retaliatory fire. Syria's media said there were no casualties.

Hundreds of thousands of people have fled an offensive by Syrian troops and their Russian backers against the last opposition stronghold in Idlib.

Many have moved towards the border with Turkey, which supports the opposition.

Turkey and Russia - a key ally of Syrian President Bashar al-Assad - signed a de-escalation deal for Idlib in 2017, but it has been frequently violated.

What did Turkey say?

Speaking to reporters on Monday morning, Turkish President Recep Tayyip Erdogan said 46 Syrian "regime targets" had been hit by the Turkish military.

He said that "30-35 Syrians on the other side have been neutralised [killed].

"Those who question our determination will soon understand they made a mistake," Mr Erdogan said.

He warned Russia not to get involved in Ankara's dealing with Damascus over the shelling, telling Moscow "not to stand in our way".

Turkey has previously said its troops were in Idlib to prevent clashes there, and that their positions were being co-ordinated beforehand.

Mr Erdogan warned last week that Turkey would respond militarily if its soldiers in the region were threatened in any way.

How has Syria reacted?

Syria's Sana state news agency said that "no injuries or damage were reported" in the Turkish strikes.

It said Syrian government troops were continuing their offensive in Idlib, liberating several villages in the province.

Meanwhile, the Syrian Observatory for Human Rights, a UK-based monitoring group, reported that six Syrian soldiers were killed in the Turkish strikes.

What's the background to this?

In 2017, Turkey and Russia signed a "de-escalation" deal on Idlib, which came into force a year later.

The two sides agreed to jointly patrol the area to prevent clashes between the opposition and Syrian government troops.

Turkey, which has 12 military observation posts in the region, has accused Russia of violating the agreement, a claim Moscow denies.

There are 3.6 million Syrian refugees in Turkey, and the president has said it would not be able to handle a fresh influx of displaced people.

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2020-02-03 07:55:24Z
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Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say - The New York Times

The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe, according to many of the world’s leading infectious disease experts.

The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents — may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States.

Scientists do not yet know how lethal the new coronavirus is, however, so there is uncertainty about how much damage a pandemic might cause. But there is growing consensus that the pathogen is readily transmitted between humans.

The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease.

“But will it be catastrophic? I don’t know.”

In the last three weeks, the number of lab-confirmed cases has soared from about 50 in China to 14,000 in 23 countries; there have been over 300 deaths, all but one in China.

But various epidemiological models estimate that the real number of cases is 100,000 or even more. While that expansion is not as rapid as that of flu or measles, it is an enormous leap beyond what virologists saw when SARS and MERS emerged.

When SARS was vanquished in July 2003 after spreading for nine months, only 8,098 cases had been confirmed. MERS has been circulating since 2012, but there have been only about 2,500 known cases.

The biggest uncertainty now, experts said, is how many people around the world will die. SARS killed about 10 percent of those who got it, and MERS now kills about one of three.

The 1918 “Spanish flu” killed only about 2.5 percent of its victims — but because it infected so many people and medical care was much cruder then, 20 to 50 million died.

By contrast, the highly transmissible H1N1 “swine flu” pandemic of 2009 killed about 285,000, fewer than seasonal flu normally does, and had a relatively low fatality rate, estimated at .02 percent.

The mortality rate for known cases of the Wuhan coronavirus has been running about 2 percent, although that is likely to drop as more tests are done and more mild cases are found.

It is “increasingly unlikely that the virus can be contained,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a nonprofit devoted to fighting epidemics.

“It is therefore likely that it will spread, as flu and other organisms do, but we still don’t know how far, wide or deadly it will be.”

In the early days of the 2009 flu pandemic, “they were talking about Armageddon in Mexico,” Dr. Fauci said. (That virus first emerged in pig-farming areas in Mexico’s Veracruz State.) “But it turned out to not be that severe.”

An accurate estimate of the virus’s lethality will not be possible until certain kinds of studies can be done: blood tests to see how many people have antibodies, household studies to learn how often it infects family members, and genetic sequencing to determine whether some strains are more dangerous than others.

Closing borders to highly infectious pathogens never succeeds completely, experts said, because all frontiers are somewhat porous. Nonetheless, closings and rigorous screening may slow the spread, which will buy time for the development of drug treatments and vaccines.

Other important unknowns include who is most at risk, whether coughing or contaminated surfaces are more likely to transmit the virus, how fast the virus can mutate and whether it will fade out when the weather warms.

Coronavirus Map: Tracking the Spread of the Outbreak

The virus has sickened more than 14,600 people in China and 23 other countries.

The effects of a pandemic would probably be harsher in some countries than in others. While the United States and other wealthy countries may be able to detect and quarantine the first carriers, countries with fragile health care systems will not. The virus has already reached Cambodia, India, Malaysia, Nepal, the Philippines and rural Russia.

“This looks far more like H1N1’s spread than SARS, and I am increasingly alarmed,” said Dr. Peter Piot, director of the London School of Hygiene and Tropical Medicine. “Even 1 percent mortality would mean 10,000 deaths in each million people.”

Other experts were more cautious.

Dr. Michael Ryan, head of emergency responses for the World Health Organization, said in an interview with STAT News on Saturday that there was “evidence to suggest this virus can still be contained” and that the world needed to “keep trying.”

Dr. W. Ian Lipkin, a virus-hunter at the Columbia University Mailman School of Public Health who is in China advising its Center for Disease Control and Prevention, said that although the virus is clearly being transmitted through casual contact, labs are still behind in processing samples.

But life in China has radically changed in the last two weeks. Streets are deserted, public events are canceled, and citizens are wearing masks and washing their hands, Dr. Lipkin said. All of that may have slowed down what lab testing indicated was exponential growth in the infection.

It’s unclear exactly how accurate tests done in overwhelmed Chinese laboratories are. On the one hand, Chinese state media have reported test kit shortages and processing bottlenecks, which could produce an undercount.

But Dr. Lipkin said he knew of one lab running 5,000 samples a day, which might produce some false-positive results, inflating the count. “You can’t possibly do quality control at that rate,” he said.

Anecdotal reports from China, and one published study from Germany, indicate that some people infected with the Wuhan coronavirus can pass it on before they show symptoms. That may make border-screening much harder, scientists said.

Epidemiological modeling released Friday by the European Center for Disease Prevention and Control estimated that 75 percent of infected people reaching Europe from China would still be in the incubation periods upon arrival, and therefore not detected by airport screening, which looks for fevers, coughs and breathing difficulties.

But if thermal cameras miss victims who are beyond incubation and actively infecting others, the real number of missed carriers may be higher than 75 percent.

Still, asymptomatic carriers “are not normally major drivers of epidemics,” Dr. Fauci said. Most people get ill from someone they know to be sick — a family member, a co-worker or a patient, for example.

The virus’s most vulnerable target is Africa, many experts said. More than 1 million expatriate Chinese work there, mostly on mining, drilling or engineering projects. Also, many Africans work and study in China and other countries where the virus has been found.

If anyone on the continent has the virus now, “I’m not sure the diagnostic systems are in place to detect it,” said Dr. Daniel Bausch, head of scientific programs for the American Society of Tropical Medicine and Hygiene, who is consulting with the W.H.O. on the outbreak.

South Africa and Senegal could probably diagnose it, he said. Nigeria and some other countries have asked the W.H.O. for the genetic materials and training they need to perform diagnostic tests, but that will take time.

At least four African countries have suspect cases quarantined, according to an article published Friday in The South China Morning Post. They have sent samples to France, Germany, India and South Africa for testing.

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At the moment, it seems unlikely that the virus will spread widely in countries with vigorous, alert public health systems, said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University Medical Center.

“Every doctor in the U.S. has this top of mind,” he said. “Any patient with fever or respiratory problems will get two questions. ‘Have you been to China? Have you had contact with anyone who has?’ If the answer is yes, they’ll be put in isolation right away.”

Assuming the virus spreads globally, tourism to and trade with countries besides China may be affected — and the urgency to find ways to halt the virus and prevent deaths will grow.

It is possible that the Wuhan coronavirus will fade out as weather warms. Many viruses, like flu, measles and norovirus, thrive in cold, dry air. The SARS outbreak began in winter, and MERS transmission also peaks then, though that may be related to transmission in newborn camels.

Four mild coronaviruses cause about a quarter of the nation’s common colds, which also peak in winter.

But even if an outbreak fades in June, there could be a second wave in the fall, as has occurred in every major flu pandemic, including those that began in 1918 and 2009.

By that time, some remedies might be on hand, although they will need rigorous testing and perhaps political pressure to make them available and affordable.

In China, several antiviral drugs are being prescribed. A common combination is pills containing lopinavir and ritonavir with infusions of interferon, a signaling protein that wakes up the immune system.

In the United States, the combination is sold as Kaletra by AbbVie for H.I.V. therapy, and it is relatively expensive. In India, a dozen generic makers produce the drugs at rock-bottom prices for use against H.I.V. in Africa, and their products are W.H.O.-approved.

Another option may be an experimental drug, remdesivir, on which the patent is held by Gilead. The drug has not yet been approved for use against any disease. Nonetheless, there is some evidence that it works against coronaviruses, and Gilead has donated doses to China.

Several American companies are working on a vaccine, using various combinations of their own funds, taxpayer money and foundation grants.

Although modern gene-chemistry techniques have made it possible to build vaccine candidates within just days, medical ethics require that they then be carefully tested on animals and small numbers of healthy humans for safety and effectiveness.

That aspect of the process cannot be sped up, because dangerous side effects may take time to appear and because human immune systems need time to produce the antibodies that show whether a vaccine is working.

Whether or not what is being tried in China will be acceptable elsewhere will depend on how rigorously Chinese doctors run their clinical trials.

“In God we trust,” Dr. Schaffner said. “All others must provide data.”

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2020-02-02 19:35:00Z
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Streatham: Man shot dead by police after stabbings in London - BBC News

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A man has been shot dead by officers in a "terrorist-related" incident in south London, the Met Police have said.

It is believed two people have been injured in stabbings on Streatham High Road.

Gun shots were heard just after 14:00 GMT on Sunday. Police later said the scene had been "fully contained".

Prime Minister Boris Johnson tweeted that his thoughts were with the injured and others affected. He thanked emergency services for their response.

London Ambulance Service said it was treating a number of people at the scene.

The Metropolitan Police said it was awaiting updates on the condition of those injured.

• Live updates on Streatham incident

Gulled Bulhan, a 19-year-old student from Streatham, saw the shooting take place in front of a Boots pharmacy.

"I was crossing the road when I saw a man with a machete and silver canisters on his chest being chased by what I assume was an undercover police officer," he told the PA news agency.

"The man was then shot. I think I heard three gun shots."

Mr Bulhan said he then ran into the library and saw ambulances and armed officers arrive.

Mayor of London Sadiq Khan thanked emergency services for their "swift and courageous response", saying: "They truly are the best of us."

"Terrorists seek to divide us and to destroy our way of life - here in London we will never let them succeed."

Streatham's Labour MP Bell Ribeiro-Addy said her thoughts were with those injured, their families and those who witnessed the attack.

BBC journalist Steffan Powell, in Streatham, said the incident happened at the bottom of his road.

"There were armed police everywhere, they have been telling residents to stay inside," he told BBC News.

He said a helicopter was up and police officers were patrolling the streets.

He said pedestrians still on the street were being allowed to head away from the scene.

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2020-02-02 16:02:46Z
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Confirmed case of coronavirus in Boston, possible case in New York - ABC News

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2020-02-02 15:11:45Z
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Streatham: Man shot dead by police after stabbings in London - BBC News

A man has been shot dead by officers in a "terrorist-related" incident in south London, the Met Police have said.

It is believed a number of people have been stabbed in the incident at Streatham High Road, police said.

Witnesses on social media have said they heard three gun shots fired just after 14:00 GMT on Sunday and people were being treated by doctors.

London Ambulance Service said it had a number of resources attending the incident.

One person tweeted: "Something major happening in Streatham High Road. Armed police and roads closed off".

BBC journalist Steffan Powell, in Streatham, said the incident happened at the bottom of his road.

"There were armed police everywhere, they have been telling residents to stay inside," he told BBC News.

He saw a helicopter and police officers patrolling the streets.

He said pedestrians still on the street were being allowed to head away from the scene.

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2020-02-02 15:24:26Z
52780588293840

First person outside of mainland China dies of Wuhan coronavirus - CNN

Philippines health officials announced Sunday that a 44-year-old Chinese man had died the day before from coronavirus after flying into the country from Wuhan, the Chinese city of 11 million at the center of the outbreak.

There are more than 14,300 confirmed cases around the world, and 305 people have died. All but one of the deaths have been in mainland China.

Within China, almost 60 million people remain on effective lockdown as the country battles to contain the virus amid reports its health system is on its knees, running out of beds and supplies.

International response

There are now more than 160 confirmed cases in 26 countries or territories outside of mainland China. And as the virus continues to spread around the world, governments are stepping up their responses.

The United States, Australia and New Zealand have all announced that they will not allow foreign nationals who have traveled from or transited through China to enter. All three countries will continue to allow citizens who have visited China to enter, although they will need to be quarantined.

Some governments have also raised their travel advisory warnings. The US, for instance, has labeled China a "do not travel" destination -- the highest possible warning.

A number of countries have evacuated their citizens from Wuhan. The US evacuated 195 Americans, who are under a 14-day quarantine on an air force base in California.

US Defense Secretary Mark Esper has also approved a request to provide military housing for up to 1,000 people who may need to be quarantined after arriving in the US from overseas travel, the Pentagon said in a statement.

Fears over the pandemic have rattled global stock markets and forced both US and global carriers to amend flight schedules as demand for China travel declines.

Major airlines -- including British Airways and Australia's Qantas -- have announced they will no longer fly to mainland China. Delta said it will suspend flights between the US and China starting on Sunday until at least April 30, according to a press release.

Chinese response

In mainland China, tens of millions of people remain under effective quarantine after the government imposed travel restrictions on a number of cities in Hubei province. Wuhan -- where the outbreak was first reported -- is the capital of Hubei province.

Although the outbreak has spread to every province and region of China, the outbreak remains worst in Hubei, where more than 7,100 have been diagnosed with coronavirus and 249 people have died.

A total of 57 million people across 15 cities in Hubei are on some form of lockdown. Huanggang -- a city of 7.5 million in Hubei province -- is only allowing one representative from each household to leave their home every other day to go out for grocery shopping in order to minimize the flow of people in the city.

The unprecedented decision to shut down entire cities comes as the country faces a shortage of medical supplies. Chinese Premier Li Keqiang has even asked the European Union to help China procure medical supplies, according to a Chinese government statement.

Patients and medical staff have also told CNN of delays in testing for the virus, raising concerns that the outbreak in China may be worse than is reported.

CNN's Yong Xiong and Steven Jiang in Beijing; and Carly Walsh in Hong Kong contributed reporting.

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2020-02-02 13:20:00Z
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First person outside of mainland China dies of Wuhan coronavirus - CNN

Philippines health officials announced Sunday that a 44-year-old Chinese man had died the day before from coronavirus after flying into the country from Wuhan, the Chinese city of 11 million at the center of the outbreak.

There are more than 14,300 confirmed cases around the world, and 305 people have died. All but one of the deaths have been in mainland China.

Within China, almost 60 million people remain on effective lockdown as the country battles to contain the virus amid reports its health system is on its knees, running out of beds and supplies.

International response

There are now more than 160 confirmed cases in 26 countries or territories outside of mainland China. And as the virus continues to spread around the world, governments are stepping up their responses.

The United States, Australia and New Zealand have all announced that they will not allow foreign nationals who have traveled from or transited through China to enter. All three countries will continue to allow citizens who have visited China to enter, although they will need to be quarantined.

Some governments have also raised their travel advisory warnings. The US, for instance, has labeled China a "do not travel" destination -- the highest possible warning.

A number of countries have evacuated their citizens from Wuhan. The US evacuated 195 Americans, who are under a 14-day quarantine on an air force base in California.

US Defense Secretary Mark Esper has also approved a request to provide military housing for up to 1,000 people who may need to be quarantined after arriving in the US from overseas travel, the Pentagon said in a statement.

Fears over the pandemic have rattled global stock markets and forced both US and global carriers to amend flight schedules as demand for China travel declines.

Major airlines -- including British Airways and Australia's Qantas -- have announced they will no longer fly to mainland China. Delta said it will suspend flights between the US and China starting on Sunday until at least April 30, according to a press release.

Chinese response

In mainland China, tens of millions of people remain under effective quarantine after the government imposed travel restrictions on a number of cities in Hubei province. Wuhan -- where the outbreak was first reported -- is the capital of Hubei province.

Although the outbreak has spread to every province and region of China, the outbreak remains worst in Hubei, where more than 7,100 have been diagnosed with coronavirus and 249 people have died.

A total of 57 million people across 15 cities in Hubei are on some form of lockdown. Huanggang -- a city of 7.5 million in Hubei province -- is only allowing one representative from each household to leave their home every other day to go out for grocery shopping in order to minimize the flow of people in the city.

The unprecedented decision to shut down entire cities comes as the country faces a shortage of medical supplies. Chinese Premier Li Keqiang has even asked the European Union to help China procure medical supplies, according to a Chinese government statement.

Patients and medical staff have also told CNN of delays in testing for the virus, raising concerns that the outbreak in China may be worse than is reported.

CNN's Yong Xiong and Steven Jiang in Beijing; and Carly Walsh in Hong Kong contributed reporting.

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2020-02-02 10:25:00Z
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