Friday, March 20, 2020

Chinese Study: Hot and Humid Weather to Reduce Spread of Coronavirus

An increase of just one degree Celsius and 1% relative humidity increase substantially lower the (Covid-19) virus’s transmission, says a study published on March 10, 2020 by Chinese researchers. In an earlier 2009 study published in the Proceedings of the National Academy of Sciences, researchers had found that high absolute humidity can help kill flu virus particles in a given environment.

A team of Chinese researchers unveiled the results of their study last week that looked at how temperature and humidity may affect the transmission of COVID-19, the illness caused by the new coronavirus. It showed that coronavirus transmission rates decline with increased temperatures and humidity. This may explain why there appear to be few reports of local COVID-19 transmissions in places like Pakistan. Most of the known coronavirus cases in Pakistan appear to be those of the people who have come into the country from cold, dry places like northern Iran where the pandemic is raging. The rate of local transmission in Pakistan is not zero but relatively low.

At the same time, small-scale clinical studies in China and France are indicating that chloroquine (Resochin) and its variant hydroxychloroquine (HCQ) are effective in treating coronavirus patients.  Both of these drugs are manufactured in Pakistan. These developments are showing light at the end of the tunnel.
COVID-16 Transmission Rates Vs Temperature and Humidity

New Chinese Study: 

The research team included Jingyuan Wang, Kai Feng, Weifeng Lv of Beihang University, and Ke Tang from Tsinghua University. They studied 100 different Chinese cities that each reported more than 40 cases of COVID-19 from Jan. 21 to 23, 2020.

“In the early dates of the outbreaks, countries with relatively lower air temperature and lower humidity (e.g. Korea, Japan and Iran) saw severe outbreaks than warmer and more humid countries (e.g. Singapore, Malaysia and Thailand) do," the researchers wrote.

Here's an excerpt from the abstract published by the team:

"After estimating the serial interval of COVID-19 from 105 pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework for 100 Chinese cities, high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities. One degree Celsius increase in temperature and one percent increase in relative humidity lower R by 0.0383 and 0.0224, respectively. This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19."

Some experts are pointing to the increased amount of UV rays from the sun the Northern Hemisphere will be subject to this time of year as a factor that could slow the virus, according to a story in AccuWeather.

Infections Rate Drop With Higher Temp and Humidity. Source: JP Morgan


Possible Treatments For COVID-19 Patients:

Recently, Chinese research (reported in Clinical Trials Arena) reported that “data from the drug’s [chloroquine] studies showed ‘certain curative effect’ with ‘fairly good efficacy’ … patients treated with chloroquine demonstrated a better drop in fever, improvement of lung CT images, and required a shorter time to recover compared to parallel groups. The percentage of patients with negative viral nucleic acid tests was also higher with the anti-malarial drug… Chloroquine has so far shown no obvious serious adverse reactions in more than 100 participants in the trials… Chloroquine was selected after several screening rounds of thousands of existing drugs. Chloroquine is undergoing further trials in more than ten hospitals in Beijing, Guangdong province and Hunnan province.”

Resochin (chloroquine) made by Bayer Pakistan

A small French study found only 25% of COVID19 patients who took it for 6 days still had the virus while 90% of those who had not taken it still had Covid-19.


HCQ (Hydroxychloroquine) Manufactured by Getz Pakistan

Anti-Malarial and Antibiotic Combo:

A new French study by Philippe Gautret et al recently published in the International Journal of Antimicrobial Agents has found early evidence that the combination of hydroxychloroquine (HCQ), a popular anti-malaria drug known under the trade name Plaqenuil, and antibiotic azithromycin (aka Zithromax or Azithrocin) could be effective in treating the COVID-19 coronavirus and reducing the duration of the virus in patients.

French Study Results


Economic Impact of Coronavirus Pandemic:

Service sector accounts for  50% of the world GDP and 54% of Pakistan's GDP.  Social distancing will significantly impact the services, particularly retail, restaurants, travel, transport and education sectors. Imran Khan has expressed fear that the pandemic will devastate the economies of developing countries.

“My worry is poverty and hunger," Khan said. "The world community has to think of some sort of a debt write-off for countries like us, which are very vulnerable, at least that will help us in coping with (the coronavirus).”

Summary:

Recent Chinese research is showing that hot and humid weather will significantly slow down transmission of coronavirus or COVID-19.  An increase of just one degree Celsius and 1% relative humidity increase substantially lower the (Covid-19) virus’s transmission, says a study published on March 10, 2020 by Chinese researchers. At the same time, small-scale clinical studies in China and France are indicating that chloroquine and its variant hudroxychloroquine are effective in treating coronavirus patients. Both of these developments are showing light at the end of the tunnel.

Related Links:

18 comments:

Faisal F. said...

Many you-tubers, bloggers and seasonal Corona Virus experts have dismissed this as a myth but the research seems to make some sense to me.

If we take a closer look at the number of cases by country it clearly indicates that the countries with warmest weather at this time of the year,for example sub-saharan North African countries like Algeria, Tunisia, Morocco and Libya have seen the least spread.

Australia is closer to China than Europe or USA but still it has far less number of corona cases than those countries.

It’s not to say that higher temperature will absolutely kill the virus but it may slow down the spread of it.

Imran Q. said...

It’s almost end of summer in Australia and similarly hot weather is starting out in ME, both locations cations haven’t reported reduced number of cases.

Riaz Haq said...

I agree with Faisal's interpretation of the Chinese study data: "It’s not to say that higher temperature will absolutely kill the virus but it may slow down the spread of it".

We also need to distinguish between coronavirus infections of travelers coming from cold dry regions and the cases of local transmissions.

Anwar S. said...

Informative!

As many of us probable remember or share same experience as I did: Every year before the Malaria season hit Pakistan, my Father use to force/encouraged us to take RASOCHIN to avoid becoming a victim of Malaria.
'Rasochin to rescue' Here we go!!!

Riaz Haq said...

Viruses, in general, do not like sunny, warm and humid air. The number of new cases in Wuhan and Hubei Province in China have dropped dramatically in recent days. That information comes from not only the Chinese government, but also from non-government sources. It’s interesting to note that the weather has turned partly to mostly sunny, dry and relatively warm over much of China. (map above from WWLP)

https://www.woodtv.com/bills-blog-2/the-weather-in-wuhan-china-and-bergamo-italy/


Average high temperatures in Wuhan in mid-March are in the upper 50s. Over the last five days, the high temperatures have been 73, 66, 75 and 74. Back in January, high temperatures in Wuhan were in the 40s. They also had 4.29″ of rain in January and 4.21″ of rain in February.


The center of the coronavirus in Italy is Bergamo, in the Lombardy area northeast of Milan in Northern Italy. There were almost 500 deaths in Italy just today (Wed.). That’s more than the entire population of Pewamo, Mecosta, Bloomingdale or New Era in West Michigan. The median age of those who have died in Bergamo is near 80 years old. The obituary page in the local paper is usually 1 1/2 pages. Wednesday, it was 10 pages. Six Catholic priests have died in Bergamo in just the last week. There are some amazing success stories. A 95-year-old woman in Bergamo has recovered, as has an 81-year-old woman with diabetes and a recent broken hip.

Bergamo has had a cool month. For March 1-18, the temperature in Bergamo was 2.9 degrees cooler than average. The first six days of March brought 3.38″ of rain to Bergamo. However, from March 7 – 18, they have had only 0.72″ of rain.

We anticipated that as we move deeper into spring, temperatures warm and we get a little more sunshine, that the improving weather will be at least a minor positive factor in fighting this disease.

“We need to be sure the whole world is prepared. There’s more than one country involved—and our response is only as strong as our weakest link,” warns Lee. China’s live-bird markets might seem exotic from a Western perspective.

But right now, one of those stalls could be brewing an even more deadly version of H7N9, one that could pass quickly through crowds of people in London and New York. As Lee says, “Viruses don’t need visas or passports. They just travel.”

Ahmad F. said...

There are no shortages of the year-round flu in tropical countries where both temp and humidity are high.

Riaz Haq said...

Ahmad: "There are no shortages of the year-round flu in tropical countries where both temp and humidity are high."

The data shows the infection rates are low in high temp and humidity but never go to zero.

Riaz Haq said...

#WHO #Philippines warns #coronavirus #Covid_19 can survive both hot, humid climates » Manila Bulletin News

https://news.mb.com.ph/2020/02/08/who-ph-2019-ncov-can-survive-both-hot-humid-climates/

The World Health Organization (WHO) Philippines warned on Saturday, Feb. 8, that the 2019 novel coronavirus (2019-nCoV) can survive in both hot and humid climates.

This was one of the rumors and myths the WHO Philippines debunked in its latest Twitter posts.

“2019-nCoV has spread to countries with both hot and humid climates, as well as cold and dry,” WHO Philippines said.

Doc Mo said...

> What's the opinion of doctors on these questions:
>
> 1. Is social distancing worth the economic cost?
Whatever we can do to prevent spread is worth the economic cost. Remember the Spanish flu death toll was 50-100 million people and the population then was much less. Moreover, keep in mind that treating a COVID-19 patient is also very costly, so the old adage: ‘prevention is better than cure’.
I think we should also be testing more people. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants. The United States has so far carried out 74 tests per 1 million inhabitants according to data from the U.S. Centers for Disease Control and Prevention. In addition, United States has been plagued by much fewer and faulty testing kits. While incidence of COVID-19 increases in Europe and USA, the incidence has dropped by about 90% in South Korea. They have achieved it without taking extreme measures of locking down whole cities.
>
> 2. How long should it last?
It is anyone’s guess. It depends on the measures we take. My guesstimate is at least several months
>
> 3. Should there be a national quarantine?
I don’t think there is a need right now. We should learn from South Korea: Transparency, exercise precaution, ample availability of PPE and testing, early detection and isolation on case by case basis.
>
> 4. Is there a need to flatten the curve?
Yes. For all the reasons stated above
>
> 5. Will the virus die when hot weather arrives?
No. However, it’s survival time on surfaces decreases. Moreover, the distance traveled by droplets from coughing and sneezing decreases from 6 feet to about 2 feet.
>
> 6. Will it infect 55% of the population in California?
> Quite possible. Depends on how we deal with it. Please remember 20% of infected people have no symptoms and are carriers. Moreover, the # of present cases is under reported due to poor testing.
> 7. What percent will end up in the hospital?
> I am not sure of the hospitalization rate but about 2.5 -3% cases in United States are seriously ill. Please also keep in mind that although the chance of dying from the disease is much higher in people over 65, 40% of cases hospitalized in United States is between ages 20-55.
> 8. What percent will not make it?
> About 4% Worldwide while 1.3% in United States so far. The lower % in United States is probably due to superior medical care.
> 9.Is the malaria drug plus Z-pack combo an effective treatment or simply a placebo?
> It is early to say but seems to hold promise. It may very well be effective.
> 10. When a vaccine for this virus be discovered before this year comes to a close?
Likely. There is lot of progress being made on this front

Riaz Haq said...

"Many people blame the coronavirus epidemic on globalization, and say that the only way to prevent more such outbreaks is to de-globalize," writes Yuval Noah Harari, the author of Sapiens. "Just the opposite. The real antidote to epidemic is not segregation, but rather cooperation"


https://time.com/5803225/yuval-noah-harari-coronavirus-humanity-leadership/


Epidemics killed millions of people long before the current age of globalization. In the 14th century there were no airplanes and cruise ships, and yet the Black Death spread from East Asia to Western Europe in little more than a decade. It killed between 75 million and 200 million people – more than a quarter of the population of Eurasia. In England, four out of ten people died. The city of Florence lost 50,000 of its 100,000 inhabitants.
In March 1520, a single smallpox carrier – Francisco de EguĂ­a – landed in Mexico. At the time, Central America had no trains, buses or even donkeys. Yet by December a smallpox epidemic devastated the whole of Central America, killing according to some estimates up to a third of its population.

In 1918 a particularly virulent strain of flu managed to spread within a few months to the remotest corners of the world. It infected half a billion people – more than a quarter of the human species. It is estimated that the flu killed 5% of the population of India. On the island of Tahiti 14% died. On Samoa 20%. Altogether the pandemic killed tens of millions of people – and perhaps as high as 100 million – in less than a year. More than the First World War killed in four years of brutal fighting.



In the century that passed since 1918, humankind became ever more vulnerable to epidemics, due to a combination of growing populations and better transport. A modern metropolis such as Tokyo or Mexico City offers pathogens far richer hunting grounds than medieval Florence, and the global transport network is today far faster than in 1918. A virus can make its way from Paris to Tokyo and Mexico City in less than 24 hours. We should therefore have expected to live in an infectious hell, with one deadly plague after another.
However, both the incidence and impact of epidemics have actually gone down dramatically. Despite horrendous outbreaks such as AIDS and Ebola, in the twenty-first century epidemics kill a far smaller proportion of humans than in any previous time since the Stone Age. This is because the best defense humans have against pathogens is not isolation – it is information. Humanity has been winning the war against epidemics because in the arms race between pathogens and doctors, pathogens rely on blind mutations while doctors rely on the scientific analysis of information.

Riaz Haq said...

#US #FDA testing coronavirus treatments, including anti-malaria chloroquine (Resochin), hydroxychloroquine (HCQ), remdesivir & injecting plasma from recovered #COVID19 patients to jump start sick patients' immune response. #coronavirus https://tcrn.ch/3bg5ShP via @techcrunch

U.S. Food and Drug Administration Commissioner Stephen Hahn addressed the ongoing work of the agency in terms of its work on potential treatments and vaccines for the COVID-19 coronavirus currently spreading globally. Despite a claim early in Thursday’s White House briefing on the pandemic by President Donald Trump that one proposed treatment, anti-malarial chloroquine, had already been approved by the FDA for COVID-19 treatment, Hahn said that in fact the agency is currently looking at widespread clinical trials of the drug, but it is not yet approved for that use.

“In the short term, we’re looking at drugs that are already approved for other indications,” Dr. Hahn said. “Many Americans have read studies and heard media reports about this drug chloroquine, which is an anti-malarial drug. It’s already approved, as the president said, for the treatment of malaria [Trump had not said this, but had instead said it was now approved for COVID-19] as well as an arthritis condition. That’s a drug that the president has directed us to take a closer look at, as to whether an expanded use approach to that could be done to actually see if that benefits patients. And again, we want to do that in the setting of a clinical trial, a large pragmatic clinical trial to actually gather that information and answer the question that needs to be answered.”

Another potential treatment which has shown signs of possible positive effect, remdesivir, was also cited by Trump as being very “near” approval for use by the FDA. Hahn clarified that in fact, while remdesivir is currently undergoing clinical trials, it’s following the normal FDA process for approval for clinical medical therapeutic use in the U.S. He declined to comment on ongoing commercial arrangements with remdesivir maker Gilead when asked when we might expect the drug to be available commercially.

Hahn also highlighted another experimental treatment possibility that the FDA is investigating: Using plasma derived from blood taken from coronavirus patients who have recovered, and injecting that into other patients in an attempt to potentially jump start their own immune response.

“There’s a cross-agency effort about something called convalescent plasma,” he said. “This is a pretty exciting area. And again, this is something that we have given assistance to other countries with as this crisis has developed, so FDA has been working for some time on this. If you’ve been exposed to coronavirus and you’re better, you don’t have the virus in your blood. We could collect the blood now, this is a possible treatment. This is not a proven treatment, I just want to emphasize that, [but we would] collect the blood, concentrate that and have the ability, once it’s pathogen-free, that is virus-free, be able to give that to other patients and the immunoglobulins, the immune response could potentially provide a benefit to patients.”

Riaz Haq said...

Pakistan’s top hematologist and transplant surgeon says that the blood of recovered patients of COVID-19 – the mysterious respiratory illness caused by the novel coronavirus – could be used to slow the spread of the deadly contagion which has killed nearly 10,000 people and sickened tens of thousands others worldwide.

“The body of a COVID-19 patient creates antibodies to fight off the virus. These antibodies in the blood of a recovered patient could be used to boost the immunity of the newly infected people,” Dr Tahir Shamsi, the head of National Institute of Blood Diseases, told The Express Tribune in an interview.

In medical lexicon, this technique is called “passive immunisation” which was introduced in 1890, he added. This technique is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases.


https://tribune.com.pk/story/2179772/1-passive-immunisation-can-save-covid-19-patients-pakistans-top-hematologist/?amp=1

Riaz Haq said...

An official handout released on the instruction of the minister of defense production said that the country’s ordinance factories had “attained the capability to produce 25,000 Face Masks and 10,000 liters of Hand Sanitizers on a daily basis.”
The official statement described its new production potential as “a landmark achievement and a proud moment for the entire nation.”
“Special cloth has been used in production of Face Masks, that makes it re-usable after wash,” the statement said, adding that in view of the current situation, wherein the country was fighting novel coronavirus, Pakistan’s defense related production capability “had been diverted toward mass production of Face Masks and Hand Sanitizers.”
“The laudable efforts by Pakistan Ordnance Factories will indeed complement the ongoing national drive to fight COVID-19,” it continued while promising “further breakthrough” in “the near future.”
Pakistan’s security forces have already been playing their role in preventing the spread of the dreaded virus in the country by activating the network of their hospitals across the country to deal with the problem.

https://www.arabnews.pk/node/1647331/pakistan

Riaz Haq said...

The newly- formed Corona Experts Advisory Group (CEAG) in its first meeting on Tuesday has warned the public against the unsupervised usage of Chloroquine and Hydroxichloro-quine, saying the drug could cause serious side effects/untoward reactions.”

https://www.dawn.com/news/1543479

The CEAG in its first meeting on Tuesday deliberated the opinion of using Chloroquine and Hydroxichloroquine for prophylaxis of COVID-19 based on current available evidence,” reads a meeting document.

An official said the CEAG issued the warning after numerous complaints that a majority of the people was using the drug for the prevention of the coornavirus disease and self-medication in this regard was going unchecked.

He added the CEAG also showed its utter displeasure on the unchecked usage of social media where self-proclaimed doctors suggest the self-medication. This may cause a new ‘ health disaster’ if not stopped immediately, the meeting said.

“The committee is of the opinion that there is insufficient scientific evidences to advise Chloroquine and Hydroxichloroquine for prophylaxis (prevention) of the COVID-19”, reads the document.

The CEAG also issued guidelines for the protection of the frontline health professionals attending coronavirus patients at the public hospitals across the Punjab province.

It issued three levels of the prevention - general pre-examination triage/OPDs, triage centres for corona general wards and isolation wards/ICUs, and HDUs to be adopted by health professionals during treatment of the patients.

The CEAG has declared mandatory use of surgical masks for the entire staff working at all healthcare facilities of Punjab.

It has directed the staff working at OPDs of infectious diseases and OPDs of respitary care, endoscopic examination rooms must upgrade their surgical masks to medical protective masks (N 95).

The CEAG has declared mandatory usage of the protective face screen based on level III protection while collecting respiratory specimens from suspected and confirmed patients.

It declared that the surgical masks are disposable and may be used for six hours provided it does not get wet.

“The life of N95 mask is eight days (eight hours duty per 24 hours with two hours break) provided if they do not get soiled and are used by the same user”, read the new guidelines.

They CEAG issued guidelines to disinfect the operation threathres, sample collection rooms and other areas where the suspected and confirmed patients are attended or kept.

The body has strictly directed the health professionals and heads of the teaching and other institutions to follow these guidelines strictly in letter and spirit to prevent them from the coronavirus.

Riaz Haq said...

Pakistan Reaches 1,000 Cases Faster Than Italy (4:32 p.m. HK)

https://business.financialpost.com/pmn/business-pmn/u-s-agrees-to-stimulus-deal-death-toll-at-18900-virus-update

The South Asian nation reached more than 1,000 cases in 29 days, two days before Italy, according to data compiled by Bloomberg. People who visited neighboring Iran for a pilgrimage make up most of Pakistan’s cases. Iran outpaced both nations to reach the 1,000 mark in 13 days.

Rush for Trump-Backed Drug Sparks India Export Ban (4:30 p.m. HK)

India banned exports of a malaria drug backed by U.S. President Donald Trump amid a run on supplies globally, even as scientists continue to search for conclusive evidence of the medicine’s effectiveness against the novel coronavirus. Exports of hydroxychloroquine will be limited to fulfilling fully paid existing contracts, while certain shipments on humanitarian grounds may also be allowed.

Separately, a small study found Hydroxychloroquine to be no more effective than conventional care. The report published by the Journal of Zhejiang University in China showed that patients who got the medicine didn’t fight off the new coronavirus more often than those who did not get the medicine.

Riaz Haq said...

Johns Hopkins University, sent this excellent summary to avoid contagion , sharing it with you because it is very clear:


* The virus is not a living organism, but a protein molecule (DNA) covered by a protective layer of lipid (fat), which, when absorbed by the cells of the ocular, nasal or buccal mucosa, changes their genetic code. (mutation) and convert them into aggressor and multiplier cells.

* Since the virus is not a living organism but a protein molecule, it is not killed, but decays on its own. The disintegration time depends on the temperature, humidity and type of material where it lies.

* The virus is very fragile; the only thing that protects it is a thin outer layer of fat. That is why any soap or detergent is the best remedy, because the foam CUTS the FAT (that is why you have to rub so much: for 20 seconds or more, to make a lot of foam). By dissolving the fat layer, the protein molecule disperses and breaks down on its own.

* HEAT melts fat; this is why it is so good to use water above 25 degrees Celsius for washing hands, clothes and everything. In addition, hot water makes more foam and that makes it even more useful.

* Alcohol or any mixture with alcohol over 65% DISSOLVES ANY FAT, especially the external lipid layer of the virus.

* Any mix with 1 part bleach and 5 parts water directly dissolves the protein, breaks it down from the inside.

* Oxygenated water helps long after soap, alcohol and chlorine, because peroxide dissolves the virus protein, but you have to use it pure and it hurts your skin.

* NO BACTERICIDE SERVES. The virus is not a living organism like bacteria; they cannot kill what is not alive with anthobiotics, but quickly disintegrate its structure with everything said.

* NEVER shake used or unused clothing, sheets or cloth. While it is glued to a porous surface, it is very inert and disintegrates only between 3 hours (fabric and porous), 4 hours (copper, because it is naturally antiseptic; and wood, be

cause it removes all the moisture and does not let it peel off and disintegrates). ), 24 hours (cardboard), 42 hours (metal) and 72 hours (plastic). But if you shake it or use a feather duster, the virus molecules float in the air for up to 3 hours, and can lodge in your nose.

* The virus molecules remain very stable in external cold, or artificial as air conditioners in houses and cars. They also need moisture to stay stable, and especially darkness. Therefore, dehumidified, dry, warm and bright environments will degrade it faster.

* UV LIGHT on any object that may contain it breaks down the virus protein. For example, to disinfect and reuse a mask is perfect. Be careful, it also breaks down collagen (which is protein) in the skin, eventually causing wrinkles and skin cancer.

* The virus CANNOT go through healthy skin.

* Vinegar is NOT useful because it does not break down the protective layer of fat.

* NO SPIRITS, NOR VODKA, serve. The strongest vodka is 40% alcohol, and you need 65%.

* LISTERINE IF IT SERVES! It is 65% alcohol.

* The more confined the space, the more concentration of the virus there can be. The more open or naturally ventilated, the less.

* This is super said, but you have to wash your hands before and after touching mucosa, food, locks, knobs, switches, remote control, cell phone, watches, computers, desks, TV, etc. And when using the bathroom.

* You have to HUMIDIFY HANDS DRY from so much washing them, because the molecules can hide in the micro cracks. The thicker the moisturizer, the better. * Also keep your NAILS SHORT so that the virus does not hide there.
Asst. Prof in infectious diseases John Hopkins University

PakTigerPTI said...

Thank you Riaz sb. Your blog is a ray of hope for many poor Pakistanis who lack the intellectual capacity of overseas Pakistanis. As you are doctor please advise what dosage of RASOCHIN can be used and how many times per day to cure corona virus.

Riaz Haq said...

#Trump leans on #India's #Modi to export his unproven #coronavirus drug of choice—but it’s #China that determines supply of active ingredients (API) in #choloroquine and #hydroxycholoroquine. #China is the source for over 90% of all #APIs for drugs. https://fortune.com/2020/04/07/coronavirus-hydroxychloroquine-trump-india-china/

The U.S. wants to import more hydroxychloroquine, a common antimalarial drug that’s emerged as an unproven coronavirus treatment, but to do so, it will have to rely on a precarious supply chain from India and—ultimately—China.

On Saturday, India banned all foreign exports of hydroxychloroquine, after previous export restrictions left some exemptions. Hours later, U.S. President Donald Trump called India Prime Minister Narendra Modi to request that India release the drug to the U.S., and Trump on Monday warned of retaliation if India upheld the ban.

On Tuesday, India announced that it would partially ease restrictions on exports of the drug for humanitarian purposes once domestic demand had been met. India also lifted restrictions on Tuesday of exports of 24 pharmaceutical ingredients and medicines first imposed in early March.