Shortages effecting medical equipment like CPAPs

Rev 6:6 NAS “And I heard something like a voice in the center of the four living creatures saying, “A quart of wheat for a denarius, and three quarts of barley for a denarius; and do not damage the oil and the wine.”

Important Takeaways:

  • DEALING WITH THE CPAP AND CHIP SHORTAGE
  • Almost one year ago, Philips issued a recall on millions of its PAP therapy devices, yet as we approach the anniversary of that event, a major shortage of PAPs remains and providers are struggling to supply these machines to their patients.
  • Additionally, while shortages are prevalent across numerous industries, the semiconductor chips needed to produce medical devices are extremely difficult for the industry to get their hands on

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U.S. chip subsidy effort faces pushback over China issues

By Stephen Nellis, David Shepardson and Michael Martina

WASHINGTON (Reuters) – A series of amendments for a $190 billion U.S. Senate bill aimed at countering China’s technology challenge are in limbo after business groups protested proposals intended to ensure that none of the money finds its way to China or other U.S. rivals.

New regulations or reviews of investments or deals in China could disrupt U.S. businesses’ future operations in that country, which include semiconductors and medical equipment. The bilateral trade deficit has run more than $100 billion a year since 2002.

Senators from both sides of the aisle want “guardrails,” such as mandatory security disclosures and interagency reviews to stop U.S. businesses from compromising national security by outsourcing critical technologies to China.

The Senate bill authorizes $120 billion for high-tech research and another $54 billion to subsidize U.S. semiconductor production. For chip factories, it makes no distinction between foreign recipients and U.S.-based firms in determining who gets funds for U.S. facilities.

A key goal of the funding is to bring the world’s most advanced chip plants to the United States, and only Taiwan Semiconductor Manufacturing Co and Korea’s Samsung Electronics Co Ltd have the technology to do that.

Florida Republican Senator Marco Rubio has proposed an amendment requiring U.S. national security officials to screen recipients and require disclosure of funding or support from foreign entities, including the Chinese government or Chinese state-owned enterprises.

TSMC and Samsung both have operations in China.

Another amendment from Democratic Senator Bob Casey and Republican Senator John Cornyn would require an interagency review of any U.S. investments in China or a shortlist of adversarial countries. That would mark a huge change for U.S. law, which for decades has had provisions for screening inbound investments, but not for outbound.

“If a company wants to offshore semiconductors to China, we need to know about it,” Casey said from the Senate floor on Wednesday. “Yet, business interests, like the U.S. Chamber of Commerce and the U.S.-China Business Council, are organizing against this commonsense proposal.”

Casey took to task Republicans opposing the measure, saying they talk tough on China, but they “cut and run” when it comes to taking on big business.

John Murphy, the U.S. Chamber’s senior vice president for international policy, said existing laws, such as the Export Control Reform Act of 2018 (ECRA), could address the China investment issue, and that the proposal needed more discussion in the Senate before being added to such a sweeping package.

“Congress and the administration should focus on using the legal tools on which the paint is barely dry,” he said, referring to ECRA.

One Senate aide cited fierce opposition to the Casey-Cornyn amendment from businesses and some Republicans, including Senator Mike Crapo, the ranking member on the Senate Finance Committee, adding: “We’re not confident that it’s going to come to a vote.”

Crapo declined to comment.

FUNDAMENTAL FLAW?

Senate Majority Leader Chuck Schumer has sought to get the U.S. Innovation and Competition Act passed this week, but Republicans insist the bill is not ready.

“There is an increasing consensus that the lack of guardrails is the fundamental flaw of the bill,” a Republican House aide said of the Senate package.

The House of Representatives is planning its own version of a China bill and could add other provisions on chips funding as well.

Rubio’s office said it was still working on getting his amendment incorporated. When he proposed his amendment for counterintelligence screening last week, he noted the much needed investments would “mean nothing if they are stolen by foreign adversaries, including the Chinese Communist Party.”

Any restrictions on subsidies to foreign companies would likely benefit Intel Corp, the long-time U.S. national champion in chip-making that has promised to redouble its efforts in the most advanced technologies and spend more than $20 billion on new U.S. plants.

Intel last year moved to sell off its only chip factory in China to SK Hynix.

Derek Scissors, of the conservative American Enterprise Institute, who studies China and security issues, said companies should be forced to make a choice.

“If you receive federal government money, you cannot expand your business in China from that point. The end. And if you don’t like that, don’t take the federal money,” Scissors said.

(Reporting by Stephen Nellis, Michael Martina and David Shepardson; Editing by Richard Chang)

U.S. House budget committee approves $1.9 trillion COVID-19 aid bill

WASHINGTON (Reuters) – The U.S. House of Representatives Budget Committee on Monday approved legislation with $1.9 trillion in new coronavirus relief, advancing a top priority of President Joe Biden.

The measure passed the panel on a largely party-line vote of 19-16. The full House, which has a slim Democratic majority, hopes to pass the bill later this week. It would stimulate the U.S. economy and carry out Biden’s proposals to provide additional money for COVID-19 vaccines and other medical equipment.

Last week, Democratic Senate Majority Leader Chuck Schumer predicted his deeply divided chamber would approve the bill before March 14, when the latest round of federal unemployment benefits expires.

Biden and his fellow Democrats want to pass the plan quickly to speed a new round of direct payments to U.S. households as well as extend federal unemployment benefits and assist state and local governments. The U.S. economy has struggled over the past year under job layoffs and shuttered businesses resulting from a pandemic that has killed 500,000 Americans.

But the Democrats are using a procedural strategy called reconciliation to advance the bill, which will allow them to pass it in the Senate without Republican support.

“We are in a race against time. Aggressive, bold action is needed before our nation is more deeply and permanently scarred by the human and economic costs of inaction,” Representative John Yarmuth, chairman of the Budget Committee, said before the vote.

Republicans pushed back on the president’s price tag, which follows $4 trillion in COVID-19 aid last year.

“An estimated $1 trillion of those funds is actually yet to be spent,” Representative Buddy Carter told the committee. “Why do we need to spend an additional $2 trillion of money that is being taken from current generations?”

(Reporting by Susan Cornwell; Editing by Chizu Nomiyama and Peter Cooney)

Turkey turns to medical diplomacy to heal damaged relations

By Tuvan Gumrukcu

ANKARA (Reuters) – Emblazoned with Turkish flags and presidential seals, crates packed with medical equipment are loaded onto planes, part of a major aid campaign by Ankara which has dispatched supplies to dozens of countries since the new coronavirus pandemic erupted.

“There is hope after despair and many suns after darkness,” says a message on every shipment – a line from 13th-century Sufi poet Jalaluddin Rumi, which looks to better days not just in the battle against COVID-19 but also for Turkey’s fraught diplomacy.

With its relations with NATO allies in Europe and the United States darkened by disputes over Russian missile defenses, human rights, and Western sanctions on Iran, Turkey hopes the virus crisis is an opportunity to soothe recent tensions.

Despite battling one of the world’s biggest coronavirus outbreaks at home – where the death toll now exceeds 3,700 -, Turkey has sent medical aid to 61 countries, including the United States, Spain, Italy, France, and Britain.

By its own calculations, Ankara has been the world’s third-biggest aid distributor during the outbreak, sending face masks, protective suits, testing kits, disinfectant, and respirators.

In a letter to President Donald Trump sent with one shipment, President Tayyip Erdogan said he hoped the “spirit of solidarity” Turkey had shown would help U.S. politicians “better understand the strategic importance of our relations”.

Ankara faces potential U.S. sanctions over its purchase of Russian S-400 missile defenses, which it bought last year but has not yet fully deployed. Despite the threat of sanctions, it says the systems will ultimately be activated.

On Saturday, Erdogan also called on the European Union to increase its cooperation with Turkey in light of the support Ankara provided member states during the outbreak. “I hope the EU now understands that we are all in the same boat,” he said.

Turkey remains a candidate for EU membership but the process has long stalled amid disputes over Turkey’s human rights record, the handling of Syrian refugees, and gas exploration around Cyprus and the eastern Mediterranean.

PROBLEMS PERSIST

Foreign Minister Mevlut Cavusoglu said the aid initiative had lifted the mood with Washington.

“Has there been a positive atmosphere after the latest aid Turkey sent? Yes, and there is a positive atmosphere in the eyes of the (U.S.) public too,” Cavusoglu said, adding however that “the core problems with the United States still persist”.

Turkish aid shipments were also sent to Libya, Iraq, Iran, the Palestinian Authority, Russia, the Balkans and to China, where the new coronavirus first emerged.

Turkey says it has also sent aid to Israel, despite tensions over Israeli settlement building in the West Bank and the status of Jerusalem. Both sides expelled their top diplomats in 2018.

Turkey has sent aid to 15 countries in Africa, where it is seeking to expand influence and commercial ties.

Not all aid shipments have gone smoothly. A commercial shipment of ventilators to Spain was delayed over export licenses. Another commercial shipment of 400,000 protective suits to Britain was criticized after some failed quality checks, but both Ankara and London said that was not a government-to-government shipment, and that there had been no problem with aid sent directly by Turkey.

While the diplomatic outreach may have brought a change of tone to some of Ankara’s troubled international relations, analysts say lasting results are unlikely without concrete steps to address fundamental differences.

“No amount of goodwill, no amount of medical diplomacy will alter the negative repercussions that Turkey’s deployment of the S-400s has produced in Washington,” said Fadi Hakura, consulting fellow at the Royal Institute of International Affairs in London.

“If Turkey wants to curry favor with Washington, it has to terminate the S-400s.”

Gonul Tol, founding director of The Middle East Institute’s Center for Turkish Studies in Washington, said Turkey’s differences with the EU would also not be resolved overnight.

“While some countries have welcomed Turkish aid, Ankara’s problems with its neighbors and Western allies are too serious to be resolved by a few symbolic steps,” she said.

(Additional reporting by Dominic Evans; Editing by Daren Butler and Gareth Jones)

Trump says he might lock down New York as health workers call for more supplies

By Alexandra Alper and Jonathan Stempel

WASHINGTON/NEW YORK (Reuters) – President Donald Trump said on Saturday he might prohibit travel in and out of the New York area to limit the spread of the coronavirus from its U.S. epicenter, as healthcare workers in the hard-hit region said they did not have enough masks and medical equipment.

With the number of known cases soaring past 115,000, the highest tally in the world, Trump said he might impose a quarantine on New York, and parts of New Jersey and Connecticut to protect other states that have yet to bear the brunt.

“They’re having problems down in Florida. A lot of New Yorkers are going down. We don’t want that,” Trump told reporters.

Since the virus first appeared in the United States in late January, Trump has vacillated between playing down the risks of infection and urging Americans to take steps to slow its spread.

Trump has also been reluctant to invoke emergency powers to order U.S. companies to produce much-needed medical supplies, despite the pleas of governors and hospital workers.

He also appeared to soften his previous comments calling for the U.S. economy to be reopened by mid-April. “We’ll see what happens,” he said.

It was not clear whether Trump would be able to block road, air and sea travel out of a region that serves as the economic engine of the eastern United States, accounting for 10 percent of the population and 12 percent of GDP.

New York Governor Andrew Cuomo said he had no details on a possible quarantine order.

“I don’t even know what that means. I don’t know how that would be legally enforceable, and from a medical point of view I don’t know what you would be accomplishing,” Cuomo told reporters. “I don’t even like the sound of it.”

Some states have already imposed limits on interstate travel. New Yorkers arriving in Florida and Rhode Island face orders to self-isolate if they intend to stay, and West Virginia Governor Jim Justice asked New Yorkers to avoid citizens in his state.

New coronavirus cases in China leveled off after the government imposed a strict lockdown of Wuhan, the epicenter of the disease.

The body count continues to climb in Italy, where authorities have blocked travel across the country and prevented people from leaving their houses for all but essential reasons.

In the United States, the number of cases stood at 119,327 on Saturday afternoon with at least 1,992 deaths, according to a Reuters tally. The number of cases in the United States eclipsed those of China and Italy on Thursday.

TOO LATE FOR A LOCKDOWN?

Trump said any New York-area lockdown would only apply to people leaving the region. It would not cover truckers making deliveries or driving through the area, he said.

U.S. courts would likely uphold a presidentially imposed quarantine, but Trump would not be able to enlist local police to enforce it, said Louisiana State University law professor Edward Richards.

“The logistics of deciding who is an essential person or essential cargo could shut down the ability to transport essential personnel and supplies,” he said.

Even if it were possible, a New York-area lockdown might come too late for the rest of the country.

Los Angeles Mayor Eric Garcetti said Southern California was on track to match New York City’s infection figures in the next week.

In New Orleans, where Mardi Gras celebrations late last month fueled an outbreak, the number of coronavirus patients “have been staggering,” said Sophia Thomas, a nurse practitioner at DePaul Community Health Center.

American healthcare workers are appealing for more protective gear and equipment as a surge in patients pushes hospitals to their limits.

Doctors are also especially concerned about a shortage of ventilators, machines that help patients breathe and are widely needed for those suffering from COVID-19, the pneumonia-like respiratory ailment caused by the highly contagious novel coronavirus.

Hospitals have also sounded the alarm about scarcities of drugs, oxygen tanks and trained staff.

On Saturday, nurses protested outside the Jacobi Medical Center in New York, saying supervisors asked them to reuse their masks, putting their own health at risk.

“The masks are supposed to be one-time use,” one nurse said, according to videos posted online.

One medical trainee at New York Presbyterian Hospital said they were given just one mask.

“It’s not the people who are making these decisions that go into the patients’ rooms,” said the trainee, who spoke on condition of anonymity.

 

(Additional reporting by Jonathan Stempel, Gabriella Borter and Brendan Pierson in New York, and Joel Schectman, Andy Sullivan and Michelle Price in Washington; and Lisa Shumaker in Chicago; Writing by Andy Sullivan; Editing by Daniel Wallis)

UK calls in army and warns people to stay home or face lockdown

By Kate Holton and Sarah Young

LONDON (Reuters) – Britain sent in the army to deliver protective equipment to hospitals on Monday and told people to stay at home and heed warnings over social distancing or the government would bring in more extreme measures to stop the coronavirus spread.

With some doctors saying they felt like “cannon fodder”, the government said the military would help ship millions of items of personal protective equipment (PPE) including masks to healthcare workers who have complained of shortages.

So far, 281 Britons have died from coronavirus and, in the last few days, British authorities have rapidly stepped up action to try to limit the spread of the disease and prevent a repeat of the death toll seen in other countries where thousands have died.

However, there have been complaints from frontline medical staff about shortages of kit, saying they did not feel safe at work. In a letter pleading with Prime Minister Boris Johnson to increase PPE supplies, more than 6,000 frontline doctors said they were being asked to put their lives at risk with out-of-date masks, and low stocks of equipment.

Health Secretary Matt Hancock admitted there had been issues but promised action was being taken. He said the army would drive trucks throughout the day and night to get supplies to medical staff.

“It’s like a war effort, it is a war against this virus and so the army have been incredibly helpful in getting those logistics so we can get the supplies to protect people on the front line,” he told the BBC, saying the health service now had 12,000 ventilators, 7,000 more than at the start of the crisis.

Britain has brought in a series of measures to try to curb the spread of the virus.

On Monday, a much-reduced rail service was introduced and jury trials were suspended, coming days after Johnson advised Britons to work from home if possible and ordered the closure of pubs, gyms and leisure centers.

ADVICE IGNORED

But advice to stay at home and avoid social gatherings went unheeded by millions at the weekend who took advantage of sunny weather to flocked to parks and beauty spots over the weekend, ignoring instructions to stay 2 meters (6 feet) apart.

Emyr Williams, chief executive of the Snowdonia National Park Authority in Wales, said the past 24 hours had been unprecedented.

“We have experienced the busiest visitor day in living memory. The area has been overwhelmed with visitors,” he said.

The government warned that Britain would face a shutdown with curfews and travel restrictions if people continued to flout the advice.

“Well, we’re perfectly prepared to do that if we need to because the objective here is really clear which is to stop the spread of the virus. Of course we will enforce and bring in further strong measures if we need to,” Hancock told Sky News.

The government was also pondering whether to close all non-essential retail shops, the BBC’s political editor reported.

Some firms have already acted because of slowing demand, with clothing retailer Primark and department store John Lewis saying on Monday they would temporarily close all of their shops.

It comes as Britain opened the first part of a 330 billion pound ($384 billion) loan guarantee scheme for businesses , which will help small and medium-sized firms borrow up to 5 million pounds to deal with coronavirus stoppages.

(Additional reporting by Costas Pitas and David Milliken; Writing by Michael Holden; Editing by Guy Faulconbridge and Alison Williams)

WHO warns of global shortage of medical equipment to fight coronavirus

By Andrea Shalal and Stephanie Nebehay

WASHINGTON/GENEVA (Reuters) – The World Health Organization (WHO) on Tuesday warned of a global shortage and price gouging for protective equipment to fight the fast-spreading coronavirus and asked companies and governments to increase production by 40% as the death toll from the respiratory illness mounted.

Meanwhile, the U.S. Federal Reserve cut interest rates on Tuesday in an emergency move to try to prevent a global recession and the World Bank announced $12 billion to help countries fight the coronavirus, which has taken a heavy toll on air travel, tourism and other industries, threatening global economic growth prospects.

The virus continued to spread in South Korea, Japan, Europe, Iran and the United States, and several countries reported their first confirmed cases, taking the total to some 80 nations hit with the flu-like illness that can lead to pneumonia.

Despite the Fed’s attempt to stem the economic fallout from the coronavirus, U.S. stock indexes closed down about 3%, safe-haven gold rose 3% and analysts and investors questioned whether the rate cut will be enough if the virus continues to spread.

U.S. lawmakers were considering spending as much as $9 billion to contain local spread of the virus.

In Iran, doctors and nurses lack supplies and 77 people have died, one of the highest numbers outside China. The United Arab Emirates announced it was closing all schools for four weeks.

The death toll in Italy, Europe’s hardest-hit country, jumped to 79 on Tuesday and Italian officials are considering expanding the area under quarantine. France reported its fourth coronavirus death, while Indonesia, Ukraine, Argentina and Chile reported their first coronavirus cases.

About 3.4% of confirmed cases of COVID-19 have died, far above seasonal flu’s fatality rate of under 1%, but the virus can be contained, the WHO chief said on Tuesday.

“To summarize, COVID-19 spreads less efficiently than flu, transmission does not appear to be driven by people who are not sick, it causes more severe illness than flu, there are not yet any vaccines or therapeutics, and it can be contained,” WHO chief Tedros Adhanom Ghebreyesus said in Geneva.

Health officials have said the death rate is 2% to 4% depending on the country and may be much lower if there are thousands of unreported mild cases of the disease.

Since the coronavirus outbreak, prices of surgical masks have increased sixfold, N95 respirators have tripled in cost and protective gowns cost twice as much, the WHO said.

It estimates healthcare workers each month will need 89 million masks, 76 million gloves and 1.6 million pairs of goggles.

The coronavirus, which emerged in the central Chinese city of Wuhan late last year, has spread around the world, with more new cases now appearing outside China than inside.

There are almost 91,000 cases globally of which more than 80,000 are in China. China’s death toll was 2,943, with more than 125 fatalities elsewhere.

In a unanimous decision, the Fed said it was cutting rates by a half percentage point to a target range of 1.00% to 1.25%.

Finance ministers from the G7 group of rich countries were ready to take action, including fiscal measures where appropriate, Japanese Finance Minister Taro Aso said. Central banks would continue to support price stability and economic growth.

AGGRESSIVE CONTAINMENT

In the United States, there are now over 100 people in at least a dozen states with the coronavirus and nine deaths, all in the Seattle area.

New York state reported its second case, a man in his 50s who works in Manhattan and has been hospitalized.

The public transportation agency in New York, the most densely populated major U.S. city of more than 8 million, said on Twitter it was deploying “enhanced sanitizing procedures” for stations, train cars, buses and certain vehicles.

China has seen coronavirus cases fall sharply, with 129 in the last 24 hours the lowest reported since Jan. 20.

With the world’s second largest economy struggling to get back on track, China is increasingly concerned about the virus being brought back into the country by citizens returning from new hotspots elsewhere.

Travelers entering Beijing from South Korea, Japan, Iran and Italy would have to be quarantined for 14 days, a city official said. Shanghai has introduced a similar order.

The worst outbreak outside China is in South Korea, where President Moon Jae-in declared war on the virus, ordering additional hospital beds and more masks as cases rose by 600 to nearly 5,000, with 34 deaths.

WHO officials also expressed concerns about the situation in Iran, saying doctors lacked respirators and ventilators needed for patients with severe cases.

WHO emergency program head Michael Ryan said the need in Iran was “more acute” than for other countries.

While the case numbers in Iran appear to be bad, he said, “things tend to look worse before getting better.”

The International Olympic Committee on Tuesday said the summer games in Tokyo set to begin on July 24 were still expected to happen despite Japan having nearly 1,000 coronavirus cases and 12 deaths. Health officials said they would continue to monitor the situation in Japan before any final decision on the Olympics is made.

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

(Reporting by Andrea Shalal in Washington and Tetsushi Kajimoto in Tokyo; Additional reporting by Michael Nienaber in Berlin, Stephanie Nebehay in Geneva, Kate Kelland in London, Takahiko Wada in Tokyo; Writing by Robert Birsel, Nick Macfie and Lisa Shumaker; Editing by Alexander Smith, John Stonestreet and Bill Berkrot)

Dying a desperate death: A Wuhan family’s coronavirus ordeal

By Yawen Chen and Tony Munroe

BEIJING (Reuters) – There were no doctors, nurses or medical equipment at the Wuhan hotel converted into a temporary quarantine facility for suspected coronavirus patients when brothers Wang Xiangkai and Wang Xiangyou arrived two weeks ago.

The next day, Xiangkai, 61, woke to find that Xiangyou, 62, had died.

The Wangs are among tens of thousands of families devastated by the coronavirus in Wuhan, where the medical system has been overwhelmed by the outbreak, despite massive reinforcements and two speedily built new hospitals.

“What did we do to deserve such punishment?” Wang Wenjun, Xiangkai’s daughter, said over the phone to Reuters.

A crematorium sent a car to pick up Xiangyou’s body, but the family was told no mourning ceremony would be allowed. They could only collect his ashes after 15 days.

Two days before Xiangyou died, doctors at the 4th Hospital of Wuhan had written in a diagnosis that both brothers were likely infected by the coronavirus which has now killed over 1,350 people in China. CT scans showed their lungs had turned “white” with patterns resembling cracked glass, symptomatic of severe viral infections.

But the hospital did not have any RNA test kits to confirm their cases, and thus could not admit them for treatment, according to the doctors. They were told to contact their community government, which on Jan. 30 offered to house the brothers at the hotel.

Hubei province on Thursday reported a sharp rise in the number of deaths and cases after changing its methodology to include those diagnosed through CT scans like Xiangyou. More than 63,000 people have now been infected nationwide and 1,380 have died.

Xiangkai, a retired cab driver, refused to remain at the Echarm hotel after his brother died, instead staying alone at a relative’s home. His wife visited daily, bringing food and Chinese medicine, until she too fell ill with what doctors suspect is the coronavirus.

Wenjun lives on the other side of Wuhan. Closed transportation lines means she is unable to visit her parents.

Desperate for treatment for her father, she issued a plea for help on the Twitter-like Weibo. The community government responded, saying the decision was up to the virus taskface.

At around midnight on Monday, the family received a call saying a hospital bed was available. With no public transport, Wang’s 58-year-old wife pushed him in a wheelchair for the 10-minute trip to the hospital.

A new CT scan showed Xiangkai’s lung infection had worsened. He now has trouble walking to the toilet on his own and is awaiting the results of an RNA test.

“On Jan. 22, our entire family had a Lunar New Year dinner, and we even took a photo together. It has been bad news every day since then,” Wenjun said.

(Reporting by Yawen Chen; Editing by Karishma Singh and Kim Coghill)

Venezuela healthcare collapse: Four children die in same hospital this month

Relatives carry a coffin containing the body of Erick Altuve, a 11-year-old boy who died from respiratory problems while in care for stomach cancer at the public Jose Manuel de los Rios hospital, at Petare neighborhood in Caracas, Venezuela, May 30, 2019. REUTERS/Ivan Alvarado

By Vivian Sequera

CARACAS (Reuters) – Under a wooden arch decorated with white balloons in a small house in Caracas’ largest slum, the body of 11-year-old Erick Altuve lay in a small coffin covered in cuddly toys and cartoon drawings, one of four children who have died this month in Venezuela’s main pediatric hospital.

Altuve died on May 26 from respiratory problems while being treated for stomach cancer at the Jose Manuel de los Rios public hospital, a concrete tower ringed by a white security fence in the center of Caracas.

For the past six months, Altuve had not received his medication, his mother, Jennifer Guerrero, said, because of widespread shortages of drugs and medical equipment that have devastated Venezuela’s health system.

“My son really wanted to live,” said Guerrero, a 30-year-old housewife, during a protest over the deaths of the four children by their relatives and nurses outside the hospital.

Children have paid an especially heavy price from the collapse in Venezuela’s healthcare system as the economy has shrunk by over a half during six years of recession.

The most recent figures from Venezuela’s Health Ministry show that infant mortality, covering children age 1 and below, rose 30% to 11,466 cases in 2016 from the year before. There is no official data on children’s’ deaths from cancer.

More broadly, the mortality rate for children under 5 years has risen by 40% since 2000, the humanitarian group Save the Children said in its 2019 report.

Altuve’s death in particular has generated a wave of anger and grief across Venezuela, with outraged newspaper headlines, calls from the opposition for an investigation and an outcry from medical nongovernmental organizations.

Altuve and the three other children who died were part of a group of 30 kids at the hospital, better known as JM, waiting to go to Italy to receive bone marrow transplants under a 2010 agreement financed by the Venezuelan government that was intended to cover the cost of transportation and the operation.

The opposition has blamed their deaths on President Nicolas Maduro, whose socialist administration has presided over the collapse of the once-wealthy nation’s economy and severe reductions in health-care spending.

Maduro’s government, however, says U.S.-imposed sanctions were responsible for the children’s deaths, by freezing funds allocated to buy medicine and send the children to Italy for treatment under the 2010 agreement.

Maduro’s critics noted that his government in 2013 cut the allocation of foreign currency to the health sector by one-fifth.

According to hospital and pharmacy representatives, the supply of medicine and medical equipment has steadily declined since the cuts to dollar funding in 2013, while the U.S. government began to impose sanctions in August 2017.

Virginia Segovia, president of the Foundation to Help Children with Cancer (Fundanica) in Carabobo state west of Caracas, said that in its first 22 years, the charity registered 98 child deaths from the disease in that region.

“In the past two years, we already have 105 dead children … and that is due to the lack of supplies and equipment in hospitals, the extreme emergency we have due to lack of medicines and chemotherapy,” she said.

Venezuela’s Information Ministry, which handles news media inquiries, and the health ministry did not respond to requests for comment.

‘SENTENCED TO DEATH’

Altuve was taken to the JM hospital on Dec. 25, 2018, due to a sharp pain in his stomach, his mother said. The hospital cleared him to go home after a few days but he returned on Jan. 14, 2019 and never left, according to his mother.

“He was saying that he was going to get better and the cancer wouldn’t take him,” his mother said.

On Friday, dozens of mourners carried his coffin through the narrow streets of Caracas’ eastern Petare slum from his grandparents’ house where the wake was held to a cemetery outside the city.

Children from his school clustered around to say goodbye as speakers played Vallenato, accordion-based music from Colombia’s Caribbean coast. “Erick, one more angel in heaven,” read a note on the coffin.

Venezuelan Foreign Minister Jorge Arreaza said on Monday that state-run oil firm PDVSA had signed a cooperation agreement in 2010 with Italy’s bone marrow transplant association. State-funded Venezuelan television network Telesur reported on Tuesday that the agreement had funded treatment and transplants for almost 900 patients since then.

Arreaza said on Twitter that U.S. sanctions had frozen 1.6 billion euros ($1.78 billion) of government funds held at Portugal’s Novo Banco, including 5 million euros ($5.57 million) allocated for fund bone marrow transplants for 24 Venezuelan patients.

Novo Banco and the Italian transplant association did not respond to requests for comment.

There are 52,800 new cases of cancer among adults each year in Venezuela, which has a population of 30 million people, according to Juan Saavedra, director of Venezuela’s anti-cancer society. In 2017, 26,510 people died from cancer, 15% more than the year before, Saavedra said.

“When you are born in Venezuela, you are already sentenced to death,” said Mauricio Navas, whose six-year-old daughter Mariana is being treated for leukemia at the JM hospital.

(Additional reporting by Tibisay Romero; Writing by Angus Berwick; Editing by Daniel Flynn and Jeffrey Benkoe)

Russia orders five-hour daily truce in Syria’s eastern Ghouta

A child and a man are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

By Angus McDowall and Jack Stubbs

BEIRUT/MOSCOW (Reuters) – Russia will establish a humanitarian corridor and implement a five-hour daily truce in Syria’s eastern Ghouta, it said on Monday, after a U.N. Security Council resolution demanding a 30-day ceasefire across the entire country.

Over the past week Syria’s army and its allies have subjected the rebel-held enclave of eastern Ghouta near Damascus to one of the heaviest bombardments of the seven-year war, killing hundreds.

On Sunday health authorities there said several people had suffered symptoms consistent with chlorine gas exposure and on Monday rescue workers and a war monitor said seven small children were killed by air and artillery strikes in one town.

“Eastern Ghouta cannot wait, it is high time to stop this hell on earth,” U.N. Secretary-General Antonio Guterres told the U.N. Human Rights Council in Geneva, calling for implementation of the ceasefire.

Fighting has raged across Syria since Saturday’s resolution, as Turkey presses its offensive against a Kurdish militia in Afrin, rival rebel groups fight each other in Idlib and a U.S.-led coalition targets Islamic State in the east..

Russia’s defense minister was cited by the RIA news agency as saying President Vladimir Putin had ordered a daily ceasefire in eastern Ghouta from 9am to 2pm each day and for the creation of a “humanitarian corridor” to allow civilians to leave.

Russia, along with Iran and Shi’ite militias, is a major backer of Syrian President Bashar al-Assad and it joined the war on his side in 2015, helping him claw back important areas.

The Russian defense minister, Sergei Shoigu, did not say whether the Syrian government or other allied forces had agreed to abide by the five-hour daily truce.

Mohamad Alloush, the political chief of one of eastern Ghouta’s biggest rebel factions, said the Syrian army and its allies had launched “a sweeping ground assault” after the U.N. resolution, adding it was vital that the truce be implemented.

“We hope for real, serious, practical action,” he said.

DEATHS

A picture issued by Civil Defence rescue workers, which Reuters could not independently verify, showed seven small bodies lying next to each other, wrapped in white and blue sheets, after air and artillery strikes on the town of Douma in eastern Ghouta.

The Syrian Observatory for Human Rights, a Britain-based war monitor, said four of them were among a single family of nine killed by an air strike. The other three were among seven killed by shelling in the same town, it said.

Russian Foreign Minister Sergei Lavrov said allegations the Syrian government was responsible for any chemical attack, after reports of people suffering symptoms of chlorine gas poisoning, were aimed at sabotaging the truce.

The Syrian government has consistently denied using chemical weapons in the war, which will soon enter its eighth year having killed hundreds of thousands of people and forced half of Syria’s pre-war population of about 23 million from their homes.

Man with a child are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

Man with a child are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

The bombardment of eastern Ghouta over the past week has been one of the heaviest of the war, killing at least 556 people in eight days, according to a toll compiled by the Syrian Observatory for Human Rights, a UK-based war monitor.

The intensity of the bombardment has diminished since the U.N. resolution, the Observatory said, but it added that 21 people had been killed in eastern Ghouta on Monday, including the seven small children in the photograph.

Rebel shelling has caused 36 deaths and a number of injuries in Damascus and nearby rural areas in the last four days, Zaher Hajjo, a government health official, told Reuters.

Speaking in Riyadh, deputy director general of the World Health Organisation, Peter Salama, said the WHO urgently needed to evacuate 750 medical cases from eastern Ghouta.

“We also need sustained access for medical equipment and for medical drugs and commodities,” he said, adding that some supplies had been “systematically removed from convoys”.

RELATIVE LULL

In eastern Ghouta, people were making use of a relative lull in the bombardment to find provisions, said Moayad Hafi, a rescue worker based there.

“Civilians rushed from their shelters to get food and return quickly since the warplanes are still in the sky and can hit at any moment,” he told Reuters in a voice message.

Lavrov said the ceasefire would not cover either the Ahrar al-Sham or the Jaish al-Islam factions, describing them as partners of the former al Qaeda affiliate, the Nusra Front.

The two major rebel factions in eastern Ghouta are Jaish al-Islam and Failaq al-Rahman. Tahrir al-Sham, an alliance of jihadists including Nusra, also has a small presence there.

A young boy rides a bicycle, near damaged houses, after an air raid in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 23.

A young boy rides a bicycle, near damaged houses, after an air raid in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 23.
REUTERS/Bassam Khabieh

“Partners of al-Nusra are not protected by the ceasefire regime. They are also subject to the legitimate actions of Syrian armed forces and all those who support the Syrian army,” said Lavrov.

In Idlib, Ahrar al-Sham and Tahrir al-Sham have been battling each other in recent days, rather than working in partnership.

Syrian state television reported that army units had advanced against militants near Harasta in eastern Ghouta. State news agency SANA also reported that the army had stopped a car bomb being driven into Damascus.

The Nusra Front has consistently been excluded from ceasefires in Syria, and the opposition says the government has used this as an excuse to keep up its bombardments.

(Additional reporting by Ellen Francis and Dahlia Nehme in Beirut, Stephanie Nebehay in Geneva, Sarah Dadouch in Riyadh and Polina Ivanova in Moscow Editing by Gareth Jones)