Tag Archives: global pandemic

Coronavirus stay-at-home directives multiply in major U.S. states

By Steve Gorman and Gabriella Borter

(Reuters) – New Jersey’s governor was expected on Saturday to follow four other states – California, New York, Illinois and Connecticut – demanding that millions of Americans close up shop and stay home to slow the spread of coronavirus infections.

The sweeping state-by-state public health restrictions, unprecedented in breadth and scope, added to the distance being experienced among ordinary Americans.

“I know people want to hear it’s only going to be a matter of weeks and then everything’s going to be fine,” New York Governor Andrew Cuomo said at a news conference on Saturday. “I don’t believe it’s going to be a matter of weeks. I believe it is going to be a matter of months.”

Meanwhile, the global pandemic seemed to close in on the highest levels of power in the nation’s capital.

An aide to U.S. Vice President Mike Pence, leading the White House task force formed to combat the outbreak, tested positive for the virus, but neither President Donald Trump nor Pence have had close contact with the individual, Pence’s press secretary, Katie Miller, said in a statement late on Friday.

Pence’s office was notified of the positive test on Friday evening, and officials were seeking to determine who the staffer might have exposed, Miller said.

The aide was not publicly identified, and the vice president’s office did not immediately respond to a request for further details of the diagnosis or whether Pence would be tested.

“He’s recovering and has very, very mild symptoms,” Pence’s chief of staff Marc Short told CNN on Saturday.

The White House said last week that Pence did not require testing after dining with a Brazilian delegation, at least one member of which later tested positive for the respiratory illness. Trump has tested negative for the virus, his doctor said last week.

Two members of the U.S. House of Representatives tested positive on Wednesday, becoming the first members of Congress known to have contracted the disease, which has killed 266 people in the United States.

The total number of known U.S. coronavirus cases has risen exponentially in recent days, climbing past 19,000 in a surge that health officials attributed in large part to an increase in diagnostic testing. More than 270 Americans have died.

Click  for a GRAPHIC on U.S. cases.

Cuomo said New York state was sending 1 million N95 respirator masks to New York City on Saturday. He said the state has identified 6,000 ventilators for purchase, which he described as a major step, but added that it needs 30,000.

“We are literally scouring the globe for medical supplies,” the governor said. New York state has recorded 10,356 cases, he said, 6,211 of them in New York City.

SOCIAL-DISTANCING GOES STATEWIDE

Expanding on social-distancing measures increasingly adopted at the local level, California Governor Gavin Newsom instituted the first statewide directive requiring residents to remain indoors except for trips to grocery stores, pharmacies, gas stations and other “essential businesses.”

Newsom’s order, announced late on Thursday, made allowances for the state’s 40 million people to venture outside for exercise so long as they kept their distance from others.

On Friday, his counterparts in New York state, Illinois and Connecticut followed suit, and New Jersey Governor Phil Murphy said he planned to issue similar directives on Saturday.

The five states where governors have banned or will soon ban non-essential businesses and press residents to stay inside are home to 84 million people combined, about a quarter of the entire U.S. population and account for nearly a third of the nation’s economy.

The state directives were for the most part issued without strict enforcement mechanisms to back them up.

“What we want is for people to be in compliance and we’re going to do everything that we can to educate them,” Chicago Mayor Lori Lightfoot said at a briefing on Saturday. Police officers would “admonish” those found to be on non-essential outings to go home, she said.

“That’s what we hope is the end of any kind of contact that anyone might have with the police department,” Lightfoot said.

Cuomo said there will be a civil fine and mandatory closure for any business that is not in compliance.

Even before the flurry of statewide stay-at-home orders, the pandemic had virtually paralyzed parts of the U.S. economy and upended lifestyles over the past week, as school districts and colleges canceled classes and many companies were shuttered, either voluntarily or by local government mandates.

Washington state, which documented the first known U.S. coronavirus case in January and now accounts for the greatest number of deaths – 83 as of Friday – has since March 16 closed bars, restaurants, recreation venues and entertainment facilities, while banning all gatherings of more than 50 people.

(Reporting by Steve Gorman in Los Angeles and Gabriella Borter in New York; Additional reporting by Caroline Spezio in New York; Editing by Gerry Doyle and Daniel Wallis)

Germany ‘heading for epidemic’ as virus spreads faster outside China

By David Stanway and Josh Smith

SHANGHAI/SEOUL (Reuters) – Germany said on Wednesday that it was heading for a coronavirus epidemic and could no longer trace all cases, as the number of new infections inside China – the source of the outbreak – was for the first time overtaken by those elsewhere.

Asia reported hundreds of new cases, Brazil confirmed Latin America’s first infection and the new disease – COVID-19 – also hit Pakistan, Greece and Algeria. Global food conglomerate Nestle suspended all business travel until March 15.

Stock markets across the world lost $3.3 trillion of value in four days of trading, as measured by the MSCI all-country index, but on Wednesday Wall Street led something of a rebound.

U.S. health authorities, managing 59 cases so far, have said a global pandemic is likely, but President Donald Trump accused two cable TV channels that frequently criticise him of “doing everything possible to make (the coronavirus) look as bad as possible, including panicking markets”.

The disease is believed to have originated in a market selling wildlife in the central Chinese city of Wuhan late last year and has infected about 80,000 people and killed more than 2,700, the vast majority in China.

While radical quarantining measures have helped to slow the rate of transmission in China, elsewhere it is accelerating.

Germany, which has around 20 cases, said it was already impossible to trace all chains of infection, and Health Minister Jens Spahn urged regional authorities, hospitals and employers to review their pandemic planning.

“Large numbers of people have had contact with the patients, and that is a big change to the 16 patients we had until now where the chain could be traced back to the origin in China,” he said.

The U.S. Centers for Disease Control and Prevention had also spoken on Tuesday of a nascent pandemic. “It’s not a question of ‘if’. It’s a question of ‘when’ and how many people will be infected,” said its principal deputy director, Anne Schuchat.

‘PANDEMIC’ – OR NOT?

The World Health Organization (WHO) said China had reported 411 new cases on Tuesday – against the 427 logged in 37 other countries.

However, WHO chief Tedros Adhanom Ghebreyesus advised diplomats in Geneva on Wednesday against speaking of a pandemic.

“Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralysing systems,” he said.

“It may also signal that we can no longer contain the virus, which is not true.”

Dr Bruce Aylward, head of a joint WHO-Chinese mission on the outbreak, told reporters on his return to Geneva:

“Think the virus is going to show up tomorrow. If you don’t think that way, you’re not going to be ready … This a rapidly escalating epidemic in different places that we have got to tackle super-fast to prevent a pandemic.”

Trump tweeted that he would attend a briefing on Wednesday. But the White House denied a report by the Politico outlet that it was considering appointing a “coronavirus czar”.

The WHO says the outbreak peaked in China around Feb. 2, after measures that included isolating Hubei province.

China’s National Health Commission reported 406 new infections on Wednesday, down from 508 a day earlier and bringing the total confirmed cases in mainland China to 78,064. Its death toll rose by 52 to 2,715.

The WHO said only 10 new cases were reported in China on Tuesday outside Hubei.

FEARS FOR OLYMPICS

South Korea, which with 1,261 cases has the most outside China, reported 284 new ones including a U.S. soldier, as authorities prepared to test more than 200,000 members of a Christian church at the centre of the outbreak.

Brazil reported the first case in Latin America, a source said on Wednesday – a 61-year-old who had visited Italy.

In Japan, Prime Minister Shinzo Abe called for sports and cultural events to be scrapped or curtailed for two weeks to stem the virus as concern mounted for the 2020 Tokyo Olympics.

Japan has nearly 170 cases, besides the 691 linked to a cruise ship that was quarantined off its coast this month. Six people have died there, including four from the ship.

There have been nearly 50 deaths outside China, including 12 in Italy and 19 in Iran, according to a Reuters tally.

While Iran has reported only 139 cases, epidemiologists say the death rate of around 2% seen elsewhere suggest that the true number of cases in Iran must be many times higher, and cases linked to Iran have been reported across the Middle East.

In Europe, Italy has become a front line in the global outbreak with 322 cases. Italians or people who had recently visited Italy have tested positive in Algeria, Austria, Croatia, Romania, Spain and Switzerland.

Two hotels, one in Austria and one on Tenerife in Spain’s Canary Islands, were locked down over cases linked to Italy.

Authorities said the more than 700 guests at Tenerife’s four-star Costa Adeje Palace could leave their rooms after a day of confinement but would have to stay in the hotel for 14 days.

“It’s very scary because everyone is out, in the pool, spreading the virus,” said 45-year-old Briton Lara Pennington, fearing for her two young sons and her elderly in-laws.

(Interactive graphic tracking global spread of coronavirus https://graphics.reuters.com/CHINA-HEALTH-MAP/0100B59S39E/index.html)

(Reporting by Julie Steenhuysen and Susan Heavey in Washington, Diane Bartz in Chicago, Gavin Jones, Francesca Piscioneri and Crispian Balmer in Rome, Ryan Woo, Yilei Sun and Lusha Zhang in Beijing, Kate Kelland in London, Hyonhee Shin and Josh Smith in Seoul, Geert De Clercq in Paris, Paresi Hafezi and Alexander Cornwell in Dubai and Stephanie Nebehay and Michael Shields in Geneva; Writing by Michael Perry, Nick Macfie and Kevin Liffey; Editing by Pravin Char and John Stonestreet)

South Korea city deserted after coronavirus church ‘super-spreader’

y Hyonhee Shin and Ryan Woo

SEOUL/BEIJING (Reuters) – The streets of South Korea’s fourth-largest city were abandoned on Thursday, with residents holed up indoors after dozens of people caught the coronavirus in what the authorities described as a “super-spreading event” at a church.

The deserted shopping malls and cinemas of Daegu, a city of 2.5 million people, became one of the most striking images outside China of an outbreak that international authorities are trying to prevent from spreading into a global pandemic.

New research suggesting the virus was more contagious than previously thought added to the alarm. And in China, where the virus has killed more than 2,100 people, officials changed their methodology for reporting infections, creating new doubt about data they have been citing as evidence of success in fighting its spread.

Deagu Mayor Kwon Young-jin told residents to stay indoors after 90 people who worshipped at the Church of Jesus the Temple of the Tabernacle of the Testimony showed symptoms of infection and dozens of new cases were confirmed.

The church had been attended by a 61-year-old woman who tested positive, known as “Patient 31”. Korea’s Centers for Disease Control and Prevention described the outbreak there as a “super-spreading event”.

“We are in an unprecedented crisis,” Kwon told reporters, adding that all members of the church would be tested. “We’ve asked them to stay at home isolated from their families.”

Describing the abandoned streets, resident Kim Geun-woo, 28, told Reuters by telephone: “It’s like someone dropped a bomb in the middle of the city. It looks like a zombie apocalypse.”

South Korea now has 104 confirmed cases of the flu-like virus, and reported its first death.

In China, officials have been pointing to evidence that new cases were declining as proof they are succeeding in keeping the virus largely contained to Hubei Province and its capital Wuhan, where the virus initially emerged.

But revisions to their methodology have raised doubts about the data. Under the latest methodology, which excludes chest X-rays, China reported fewer than 400 new cases over the past day, less than a quarter of the number it had been finding in recent days under the previous method.

Only last week, another change in Chinese methodology created an overnight spike of nearly 15,000 new cases, reversing a trend of falling numbers that Chinese officials had previously touted as evidence their disease-fighting strategy was working.

Scientists in China who studied nose and throat swabs from 18 patients infected with the virus said it behaves much more like influenza than other closely related viruses, suggesting it may spread even more easily than previously believed.

In at least in one case, the virus was present even though the patient had no symptoms, suggesting symptom-free patients could spread the disease, they wrote in preliminary findings published in the New England Journal of Medicine.

“If confirmed, this is very important,” said Dr Gregory Poland, a vaccine researcher with the Mayo Clinic in Rochester, Minnesota, who was not involved with the study.

China has imposed severe controls in Wuhan, a city of 11 million people, to halt the spread of the virus, and has taken urgent steps to keep the overall economy from crashing.

On Thursday, its central bank cut a borrowing rate, while the authorities extended an order for businesses in Wuhan to shut down until March 11. Schools in the city, which had been due to re-open on Friday, will also stay shut.

TWO CRUISE SHIP PASSENGERS DIE

Japan reported the deaths of two elderly passengers from the quarantined Diamond Princess cruise ship anchored off Yokohama. They appear to be the first people to have died from the disease from aboard the ship, the biggest cluster of infection outside mainland China with more than 620 cases.

Japan has begun allowing passengers who test negative to disembark from the ship. Hundreds departed on Wednesday and hundreds more were set to leave on Thursday.

The ship was carrying about 3,700 people when quarantined on Feb. 3, about half of them from Japan. Japanese passengers were permitted to go home once cleared to leave; other countries are flying passengers home and keeping them isolated on arrival.

Japan, which is due to host the summer Olympics in July, had faced criticism over its strategy of quarantining people on board the ship. Its National Institute of Infections Diseases published data which it said supported its strategy, showing that the onset of symptoms from confirmed cases had peaked on Feb. 7 and tailed off to zero by Feb. 15.

The NIID report was “very reassuring,” said Kentaro Iwata, an infectious disease specialist from Kobe University Hospital who had been one of the harshest critics of the quarantine.

(Reporting by Hyonhee Shin in Seoul and Ryan Woo in Beijing; Additional reporting by Linda Sieg, Chang-Ran Kim, Akiko Okamoto, Ju-min Park and Daewong Kim in Tokyo, Sangmi Cha in Seoul, Babak Dehghanpisheh and Parisa Hafezi in Dubai, Keith Zhai and Patpicha Tanakasempipat in Vientiane; Writing by Peter Graff, Editing by Angus MacSwan)

Countries rush to build diagnostic capacity as coronavirus spreads

By Julie Steenhuysen and Stephanie Nebehay

CHICAGO/GENEVA (Reuters) – A week ago, only two laboratories in Africa could diagnose the novel coronavirus that originated in China and is rapidly spreading around the world. As of Sunday, the World Health Organization (WHO) expected every nation in Africa to be able to diagnose the disease.

The rush reflects a global push for diagnostic capabilities, particularly in developing countries, in hopes of averting a global pandemic. But it is being slowed by a desperate need for virus samples necessary to validate the tests.

“Without vital diagnostic capacity, countries are in the dark as to how far and wide the virus has spread and who has coronavirus or another disease with similar symptoms,” WHO chief Tedros Adhanom Ghebreyesus told a news conference in Geneva on Monday.

As of early Tuesday, there had been 42,708 confirmed cases reported in China and 1017 deaths, as well as 319 cases in 24 other countries, including one death.

Most of the testing is being done by public health laboratories. But several companies including Thermo Fisher Scientific Inc, GenScript Biotech Corp and Co-Diagnostics Inc have developed tests and are taking steps to get them validated for clinical use.

Roche is distributing coronavirus tests developed by Tib Molbiol of Berlin for research use on some of its instruments while developing a test of its own. Abbott Laboratories also is working on a test.

WHO has activated a network of 15 referral laboratories that can support national efforts in confirming new cases, and has identified 168 labs globally with the technology to diagnose the virus.

FILE PHOTO: Workers wearing protective suits drive an ambulance near the cruise ship Diamond Princess, as they prepare to transfer passengers tested positive for the novel coronavirus, at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 10, 2020. REUTERS/Kim Kyung-Hoon/File Photo

Technicians must be trained to run the tests locally to avoid delays associated with having to send them to centralized labs.

On Tuesday, WHO is convening a two-day meeting of hundreds of researchers and manufacturers to address the outbreak.

WORKLOAD ON LABS IS ‘EXTREME’

Researchers are also working to develop antibody tests that can tell whether someone has been exposed to the virus. They could help answer how broadly this virus has spread, and whether there are milder cases not being detected, Dr. Mike Ryan, head of the WHO emergency program, told reporters.

China appears to have adequate stock of the materials needed to perform diagnostic tests, but there is a limited number of trained technicians who can run them. “The workload on those labs is extreme,” Ryan said.

Outside of China, manufacturers are quickly developing tests based on the genetic code of the virus. Those tests still need to be validated with actual virus samples, for which access has been challenging.

Live isolation of the virus allows a huge advance in diagnostics and potential advances in therapeutics and vaccine development, Ryan said.

GenScript, which has offices in New Jersey and Nanjing, China, has developed a test available to researchers. It cannot be used as a diagnostic until it has been tested in hundreds of virus samples.

“In China, we couldn’t get to the samples directly because we don’t have a lab that can handle the virus,” said Hong Li, a GenScript scientist.

The company has sent its test kits to Chinese health officials to assess their validity. “Because other companies in China are also doing that, we don’t know when it will be our turn,” said Eric Wang, GenScript’s head of marketing.

Utah-based Co-Diagnostics on Monday said it has started shipping its test, which is available for research purposes, to clients. Chief Scientific Officer Brent Satterfield said last week that the company has been struggling to find clinical virus samples to validate the test for use as a diagnostic.

Thermo Fisher developed its tests based on the genetic code of the virus, and ran computer models to validate it.

The company has been providing its test to countries and health ministries with access to virus samples, said Thermo Fisher executive Joshua Trotta. “They will evaluate our kits and make a determination of what is the best test to deploy.”

Meanwhile, Thermo Fisher is scaling up production as countries prepare for more cases. Demand is “growing every day,” Trotta said.

(Reporting by Julie Steenhuysen in Chicago and Stephanie Nebehay in Geneva; Editing by Bill Berkrot)

China orders ‘unprecedented’ lockdown of two cities at virus epicenter

China orders ‘unprecedented’ lockdown of two cities at virus epicenter
By Yawen Chen and Se Young Lee

BEIJING (Reuters) – China on Thursday locked down two cities at the epicenter of a coronavirus outbreak that has killed 17 people and infected nearly 600, as health authorities around the world took action to prevent a global pandemic.

Health officials fear the transmission rate will accelerate as hundreds of millions of Chinese travel at home and abroad during week-long holidays for the Lunar New Year, which begins on Saturday.

The previously unknown virus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan.

Most transport in Wuhan, a city of 11 million people, was suspended on Thursday morning and people were told not to leave. Hours later, neighboring Huanggang, a city of about 7 million people, announced a similar lockdown.

“The lockdown of 11 million people is unprecedented in public health history, so it is certainly not a recommendation the WHO has made,” Gauden Galea, the World Health Organization’s representative in Beijing, told Reuters.

Other cities were also taking steps to restrict movement and contact. Nearby Ezhou shut its train stations. The capital Beijing canceled major public events, including two well-known Lunar New Year temple fairs, the state-run Beijing News said.

Airports worldwide were screening passengers arriving from China.

There is no vaccine for the virus, which can spread through respiratory transmission. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses.

Preliminary research suggested it was passed on to humans from snakes, but government medical adviser Zhong Nanshan has also identified badgers and rats as possible sources.

WHO MEETING

The WHO has said it will decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade. A WHO news conference is expected some time after 1800 GMT.

Chinese authorities gave no new details on the numbers of virus infections but it has been reported in Beijing, Shanghai and Hong Kong. Of eight known cases worldwide, Thailand has confirmed four, while Japan, South Korea, Taiwan and the United States have reported one each.

Authorities had confirmed 571 cases and 17 deaths by the end of Wednesday, China’s National Health Commission said. Earlier, it said another 393 suspected cases had been reported.

In a report on Wednesday, Imperial College London said it estimated a total of 4,000 cases of the coronavirus in Wuhan alone as of Jan. 18, an infection rate based on the number of cases reported in China and elsewhere.

Wuhan shut down all urban transport networks and suspended outgoing flights from 10 a.m. (0200 GMT). Domestic media said some airlines were operating after the deadline, however.

Wuhan’s Hankou rail station was nearly deserted, with gates blocked, state broadcasts showed. The government urged citizens not to leave the city.

State media reported highway toll booths around Wuhan were closing down, which would effectively cut off road exits. Guards were patrolling highways, one resident told Reuters.

As the city slipped into isolation, residents thronged into hospitals for checks and scrambled for supplies, clearing out supermarket shelves and queuing for petrol.

Authorities in Huanggang ordered indoor entertainment venues including cinemas and internet cafes to close.

FACE MASKS

In contrast with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS) that killed nearly 800 people, China’s Communist Party government has provided regular updates to avoid panic ahead of the holidays.

During a visit to Wuhan, Vice Premier Sun Chunlan said authorities needed to be open about the virus and efforts to contain it, the official Xinhua news agency said.

Some experts believe the new virus is not as dangerous as previous coronaviruses such as SARS and Middle East Respiratory Syndrome (MERS), which has killed more than 700 people since 2012.

“The early evidence at this stage would suggest it’s not as severe,” Australia’s Chief Medical Officer Brendan Murphy told reporters.

Despite China’s response, world shares fell on Thursday, led by the biggest tumble in Chinese stocks in more than eight months, as concern mounted about the outbreak. China’s yuan fell to a two-week low. [MKTS/GLOB]

The economic impact of such outbreaks are hard to quantify but a 2006 estimate by the International Air Transport Association (IATA) calculated that SARS shaved just over 1 percentage point off the GDP of China in 2003.

InterContinental Hotels and Hyatt are allowing guests to change or cancel stays at most Chinese hotels.

A general view shows the monitors of thermal scanners that detect temperatures of passengers at the security check inside the airport in Guatemala City, Guatemala January 22, 2020. REUTERS/Luis Echeverria

Many Chinese were cancelling trips, buying face masks and avoiding shopping centers.

The release of seven movies over the Lunar New Year has been postponed. The holiday is the high season for distributors and cinemas attract huge crowds.

Airports globally, including in Britain, stepped up screening of passengers from China and the European Centre for Disease Control and Prevention said the further global spread of the virus was likely.

“All the fatalities have so far been contained to mainland China, however, this is a rapidly developing situation and the number of deaths and the number of cases is likely to be higher than those that have been confirmed so far and I expect them to rise further,” Health Secretary Matt Hancock told the British parliament.

(Reporting by Yawen Chen, Se Young Lee, Sophie Yu and Gabriel Crossley in Beijing, Sam Shen and Engen Tham in Shanghai, Ben Blanchard in Taiwan, Alison Lui and Donny Kwok in Hong Kong, John Geddie and Aradhana Aravindan in Singapore, Stephanie Nebehay in Geneva, Kate Kelland and Elizabeth Howcroft in London; Writing by Michael Perry; Editing by Stephen Coates and Clarence Fernandez and Alison Williams)

World must prepare for inevitable next flu pandemic, WHO says

FILE PHOTO: A logo is pictured on the World Health Organization (WHO) headquarters in Geneva, Switzerland, November 22, 2017. REUTERS/Denis Balibouse

By Kate Kelland

LONDON (Reuters) – The world will inevitably face another pandemic of flu and needs to prepare for the potential devastation that could cause, and not underestimate the risks, the World Health Organization (WHO) said on Monday.

Outlining a global plan to fight the viral disease and get ahead of a potential global outbreak, the WHO said the next influenza pandemic “is a matter of when not if”.

“The threat of pandemic influenza is ever-present,” Tedros Adhanom Ghebreyesus, the WHO’s director-general, said in a statement. “We must be vigilant and prepared; the cost of a major influenza outbreak will far outweigh the price of prevention.”

The world’s last flu pandemic was caused by the H1N1 virus, which spread around the world in 2009 and 2010. Studies of that pandemic found that at least one in five people worldwide were infected in the first year, and the death rate was 0.02 percent.

Global health experts and the WHO warn there is a risk that a more deadly flu virus will one day jump from animals to people, mutate and infect many hundreds of thousands of people.

Flu viruses are multiple and ever-changing, and they infect around a billion people every year around the world in seasonal outbreaks. Of those infections, around 3 to 5 million are severe cases, leading to between 290,000 and 650,000 seasonal flu-related respiratory deaths.

Vaccines can help prevent some cases, and the WHO recommends annual vaccination – especially for people working in health care and for vulnerable people such as the old, the very young and people with underlying illness.

The WHO plan – which it described as its most comprehensive to date – includes measures to try to protect populations as much as possible from annual outbreaks of seasonal flu, as well as prepare for a pandemic.

Its two main goals, the WHO said, are to improve worldwide capacities for surveillance and response – by urging all governments to develop a national flu plan, and to develop better tools to prevent, detect, control and treat flu, such as more effective vaccines and antiviral drugs.

(Reporting by Kate Kelland, editing by Gareth Jones)