Mission of Mercy: On duty at Japan's 'last-chance' hospital for coronavirus

KAWASAKI, Japan (Reuters) – Two paramedics jump out the back of an idling ambulance with Tokyo plates, carefully lowering an elderly woman on a stretcher. The patient, her small face covered with an oxygen mask, disappears behind St. Marianna’s automatic doors.

Another suspected COVID-19 patient has arrived.

In the midst of a global pandemic, St. Marianna University Hospital, a Catholic institution in a working-class suburb south of Tokyo, has become synonymous with the virus.

In the three months since the first wave of sick passengers arrived from the cruise ship Diamond Princess, the hospital has treated some 40 people seriously ill with the disease, more than almost any other medical facility in Japan. It has even taken in patients when other hospitals turned them away.

Doctors have intubated patients in a tent set up in the carpark and performed tracheostomies in a saran-wrapped operation room. Nurses in full protective gear gather in groups of six to shift patients connected to a tangle of lifesaving machines. And hanging in the staff room is an illustration of “Amabie,” a mythic Japanese creature thought to ward against plagues.

By most metrics, Japan has so far weathered the global pandemic better than many other countries. Infections haven’t spiked here as in other countries, and new cases have slowed since mid-April. So far, Japan has confirmed 16,251 infections, and 777 people have died, out of a global death toll of more than 300,000 people.

But it hasn’t always felt like success at St. Marianna, where every hallway and room inside the emergency and critical-care center has been allocated one of three colors: green, yellow and red. Daily life revolves around these boundaries now, with nurses and doctors moving between the world of waiting relatives wearing surgical masks in the “green” zone to the “red” ward, where they dress like astronauts, donning heavy-duty tyveks and HALO respirators.

Yasuhiko Taira, a professor at the medical school here, says that when the first COVID-19 patients started arriving in February, he reminded staff members they had an obligation to take in coronavirus patients who had nowhere else to go.

“We told them, yes, there’s a high chance you may get the virus, and since we’re doctors, we can’t do much about that,” says Taira, 66, who previously ran the ICU. “If we ran away from this, who’s going to do it?”

When St. Marianna was overwhelmed with patients early in the crisis, some private and public hospitals were still turning patients away for a number of reasons, including their lack of specialized staff and protective gear, with ICUs often citing their capacity constraints.

In April, Japan doubled the funds hospitals receive for taking in critical COVID-19 patients, easing the burden on places such as St. Marianna.

But over the period of several days spent with “Team C,” a group tasked with caring for coronavirus patients at St. Marianna’s ICU, there is a sense of resignation among the staff over what awaits them in the grueling months ahead, caring for patients who can seem on the verge of recovery, only to slip away a few days later.

“THE STRESS STARTS TO PILE ON”

It’s 8 a.m. and doctors from the overnight shift step up one by one to a senior doctor on duty, reading off an array of numbers and acronyms that make up the various conditions of each of the 11 patients inside the ICU. Shigeki Fujitani strides down a cramped hallway toward the central nurse station, thumbing a well-worn cellphone and nodding at staff in blue and purple scrubs.

“We had one death this morning,” says Fujitani, the 54-year-old director of the ICU, walking up to a large whiteboard divided into a grid with masking tape. The names of critical patients, all men in their 50s and 60s, are listed on the left, next to a condensed history of their time in the ward.

The dead man’s name has already been removed from the chart. The three beds now available in the ICU will likely be filled by evening.

“It’s common to see no change for weeks and then for the patient to not make it,” Fujitani says later, pacing in his office.

He mentions an ICU doctor who died by suicide in New York after seeing dozens of coronavirus patients die in her hospital.

“Everyone is trying to cure the patient, and then when you can’t … the stress starts to pile on after two, three months of this,” he says.

“YOU CAN’T SEE THE END OF THIS”

Outside the sliding doors of the ICU, Naoya Kohamoto takes a deep breath.

“You can’t see the end of this,” says Kohamoto, 37, a nurse practitioner who joined the coronavirus team a month ago. “They just don’t get better. You see data that says 80 percent of intubated patients don’t make it, but you always hope it’s not the case for your patient.”

When doctors in the ICU sense a patient is nearing death, Kohamoto calls the patient’s relatives and asks them to come to the hospital. Although they can’t physically be close to their ill relative, they’re able to talk to them over Facetime.

Wearing two layers of gloves, a face shield, a respirator mask and multiple plastic gowns, Kohamoto holds up an iPad to the unconscious patient so family members can share memories and say their farewell.

“I tell them their father is doing everything he can to still come home,” he says. When a patient dies, Kohamoto holds the iPad up to the doctor writing the official death certificate.

On a nearby notice board a clear file filled with consent forms for the experimental drug Avigan is tacked next to a handwritten letter sent by a family member of a patient who died last month.

“I never thought such a horrible thing could happen and I still can’t believe it’s true,” the sender wrote. “For all of you who worked under the risk of infection, with your own fear and worries, our entire extended family would like to express our gratitude for all that you have done.”

Kohamoto holds his tablet against his chest. After a pause, he adjusts his glasses and returns to the ICU through its automatic doors.

“A LONG BATTLE”

As governments contemplate reopening their economies after months of lockdown and people hope to return to their normal routines, it remains unclear even to front-line medical professionals to what extent the reopening may cause new spikes in infections.

“What we’re preparing for now is months of this, a lull, then a small cluster or spike,” Fujitani says. “It’s going to be a long battle, and we can’t have staff, especially nurses, burning out.”

Yasunobu Tsuda, a critical-care nurse specialist whose wife is preparing to return to work as a midwife at St. Marianna after maternity leave, says the work takes its toll.

“You go home and the first thing you want to do is hug your child at the door, but you can’t,” he says. Even at home, Tsuda wears a mask.

“I don’t think my child even knows my face yet.”

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Stocks slip on U.S.-China tensions; oil rises to 2-1/2-month high

NEW YORK/LONDON (Reuters) – Global equities slid on Thursday on concerns about the long-term impact of the new coronavirus and resurgent U.S.-China tensions, though oil markets ignored those worries and marched to 2-1/2 month highs.

European equities .FTEU3 fell about 0.8%, while the S&P 500 and Nasdaq on Wall Street declined about the same.

The dollar edged higher as investors weighed the impact of global business lockdowns and the euro’s four-day rally against the U.S. currency ran out of steam. The strong dollar pushed gold down more than 1%, off this week’s 7-1/2 year peak.

Rising tensions between Washington and Beijing raised doubts about the “Phase 1” trade deal reached early this year and also supported the safe-haven dollar.

President Donald Trump warned the United States would react “very strongly” against China trying to gain more control over Hong Kong through new national security legislation. Tension between the two countries has heightened in recent weeks, as they exchange accusations on the handling of the coronavirus pandemic.

“The biggest threat to the U.S. market this year is actually the potential for ignition of the tariff war, between the U.S. and China,” said Kristina Hooper, chief global market strategist at Invesco in New York.

MSCI’s gauge of stocks across the globe .MIWD00000PUS shed 0.76%, while the pan-European STOXX 600 index lost 0.75%.

On Wall Street, the Dow Jones Industrial Average .DJI fell 101.78 points, or 0.41%, to 24,474.12. The S&P 500 .SPX lost 23.1 points, or 0.78%, to 2,948.51 and the Nasdaq Composite .IXIC dropped 90.90 points, or 0.97%, to 9,284.88.

Purchasing manager index surveys (PMIs) in Europe confirmed economic activity has begun to return, though they were far from stellar.

Euro zone-wide figures came in better than expected overall but Germany’s improvement undershot forecasts. It was the third month in a row that the surveys were plonked firmly in economic contraction territory.

Oil rose on the view that fuel demand should rebound. Brent, the international benchmark, has bounced up $20 a barrel over the past month.

U.S. crude futures CLc1 rose 43 cents to settle at $33.92 a barrel, while Brent LCOc1 settled up 31 cents at $36.06 a barrel.

The market absorbed the latest glut of government debt to pay for coronavirus support programs fairly smoothly. The United States on Wednesday auctioned $20 billion of 20-year debt, the first such sale since 1986.

Italy sold roughly the same on Thursday and Spain said it will need to raise almost 100 billion euros more than planned.

The benchmark U.S. 10-year notes US10YT=RR fell 0.4 basis points to yield 0.6753%.

U.S. weekly jobless claims came in at a seasonally adjusted 2.4 million, in line with a Reuters survey of economists ahead of the data and well off the record 6.867 million at the end of March.

The dollar index =USD rose 0.287%, with the euro EUR= down 0.31% to $1.0943. The Japanese yen weakened 0.05% versus the greenback at 107.60 per dollar.

U.S. gold futures GCv1 settled 1.7% lower at $1,721.90 an ounce.

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JGBs dip before 20-year debt sale, in line with U.S. Treasuries

TOKYO, May 19 (Reuters) – Government bond prices dipped across all maturities on Tuesday, ahead of a 20-year debt sale, and also tracked a rise in U.S. treasuries yields as investors cheered encouraging trial results of a potential COVID-19 vaccine.

Benchmark 10-year JGB futures fell 0.21 point to 152.27, with a trading volume of 13,472 lots.

In the cash bond market, the 10-year JGB yield rose 1 basis point to minus 0.005%.

Market players refrained from taking a big position ahead of an upcoming 20-year JGBs auction for which the finance ministry will offer 900 billion yen ($8.38 billion).

The 20-year JGB yield rose 0.5 basis point to 0.345%.

Also in the superlong maturities, the 30-year JGB yield and the 40-year JGB yield gained half a basis point each to 0.475% and 0.495%, respectively.

At the short end of the market, the two-year JGB yield and the five-year yield both rose 1.5 basis points, to minus 0.165% and minus 0.125%.

Tokyo’s benchmark Nikkei average added 1.5%, hitting a two-and-a-half-month high.

($1 = 107.4400 yen)

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Global shares, oil rally on vaccine hopes, lockdown easing

NEW YORK (Reuters) – A gauge of global equity markets surged almost 3% on Monday and oil rallied to highs last seen in mid-April as data from an early-stage trial for a coronavirus vaccine lifted hopes of a faster recovery from the pandemic-driven economic slump.

Warm weather enticed people in countries across the world to emerge from coronavirus lockdowns as centers of the outbreak from New York to Italy and Spain gradually lift restrictions that have kept millions cooped up for months.

Investors have cheered any positive development by drugmakers’ vaccine trials amid fears of a second wave of infections as restrictions are eased.

Drugmaker Moderna Inc (MRNA.O) said its experimental COVID-19 vaccine showed promising results in a small early-stage trial, and its stock closed up 20.0%.

A workable vaccine that can be mass-produced by year-end or early 2021 would be a “game-changer” for industries whose challenges may not be resolved by the economy’s reopening, said Rick Meckler, partner at Cherry Lane Investments, a family investment office in New Vernon, New Jersey.

Global economic output will take two or three years to recover to pre-pandemic levels, IHS Markit said in a note, projecting worldwide gross domestic product would fall 5.5% in 2020, or three times the contraction of 2009 after the global financial crisis.

Under the best of circumstances, it will be a long road for the U.S. economy to recover, with additional job losses likely through June, Federal Reserve Chairman Jerome Powell said in an interview on Sunday.

MSCI’s gauge of stocks around the globe .MIWD00000PUS gained 2.90%, its biggest single-day percentage gain since April 6 when it jumped 5.5% after signs the death toll from the coronavirus was slowing in Europe.

The pan-European STOXX 600 index closed up 4.1%, its biggest one-day percentage gain since March 24.

Germany’s auto-heavy DAX index .GDAXI surged 5.7% to its highest level in more than two weeks, while France’s main CAC 40 index .FCHI rose 5.2%. The two countries called for the creation of a European Recovery Fund worth 500 billion euros ($544 billion) to help the region quickly exit the crisis.

The deal, described by French President Emmanuel Macron as a major step forward, seeks to break the impasse over joint euro debt and act as a blueprint for a wider European Union agreement. The euro rose on the news.

On Wall Street the benchmark S&P 500 posted its biggest one-day percentage gain in almost six weeks.

On Wall Street, the Dow Jones Industrial Average .DJI rose 911.95 points, or 3.85%, to 24,597.37. The S&P 500 .SPX gained 90.21 points, or 3.15%, to 2,953.91 and the Nasdaq Composite .IXIC added 220.27 points, or 2.44%, to 9,234.83.

“The resilience of stock markets relative to the awful economic data that we’ve been seeing over the past fortnight speaks to an optimism that … as economies come out of lockdown we can expect to see improvements as we head into the second half of the year,” said Michael Hewson, chief market analyst at CMC Markets.

Japan’s preliminary GDP data showed that the world’s third- biggest economy contracted an annualized 3.4% in the first quarter, slipping into recession for the first time in more than five years.

Hopes of a worldwide economic recovery lifted oil prices, with prices settling 7%-8% higher, supported by output cuts.

“Optimism on the demand side of the oil equation has helped prices climb further, with gasoline demand coming back as governments ease confinement measures,” said Rystad Energy senior oil markets analyst Paola Rodriguez Masiu.

U.S. crude CLc1 added $2.39 to settle at $31.82 a barrel, while Brent LCOc1, the international benchmark, rose $2.31 to settle at $34.81 a barrel.

The jump in oil prices lifted commodity currencies such as the Norwegian crown and the Canadian dollar against the U.S. dollar.

The dollar index =USD fell 0.771%, with the euro EUR= up 0.93% to $1.0916. The Japanese yen JPY= weakened 0.26% versus the greenback at 107.33 per dollar.

Italian government bond yields fell to their lowest level in over a month on the proposed Franco-German recovery fund.

Benchmark 10-year U.S. Treasury notes US10YT=RR fell 26/32 in price to push their yield up to 0.7224%.

Gold retreated from a more-than seven-year high as stocks and oil surged. U.S. gold futures GCcv1 settled 1.3% lower at $1,734.40 an ounce.

Gold traded sideways “because everybody is thinking ‘risk-on,’ get into equities – as markets across the board are up 3%,” said Michael Matousek, head trader at U.S. Global Investors. But the trend “is still to the upside, there’s still plenty of reason to buy gold.”

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Japan to put off bid to raise prosecutors' retirement age after backlash

TOKYO (Reuters) – Japan’s government will postpone a bid to raise the retirement age of public prosecutors, media said on Monday, given an intense public backlash fuelled by fears for judicial independence.

Opposition to a bill raising the retirement has been among the top-trending topics on social media this month, with singer Kyary Pamyu Pamyu and other celebrities adding their voices.

NHK public broadcaster said the decision to put off the bid to raise the retirement age was made in a meeting between Prime Minister Shinzo Abe and Toshihiro Nikai, secretary general of the ruling Liberal Democratic Party.

“I have agreed with the prime minister that it’s difficult to move forward the discussion without public understanding,” Nikai told reporters after the meeting with Abe.

Under the bill, prosecutors would retire at 65 instead of 63, and the cabinet would be able to defer the retirement of senior prosecutors for a further three years.

But critics say the law would jeopardise the independence of the judiciary by allowing government-friendly prosecutors to be kept on.

“Forcing this bill through would unleash public fury,” an unidentified lawmaker was quoted as saying in the Yomiuri Shimbun newspaper.

Abe had hoped to pass the bill during this session of parliament, which runs until June 17. Its withdrawal would mark a rare instance in Japan of public opinion swaying political deliberations.

The controversy has been a new blow to Abe, whose support has dropped after what many saw as his administration’s slow response to the novel coronavirus outbreak.

An opinion poll in the Asahi newspaper on Monday showed 64% of respondents opposed the bill and 15% in favour. The same poll had Abe’s approval rating at 33%, versus 41% a month ago.

Earlier, government spokesman Yoshihide Suga sidestepped questions on the issue at a news conference saying he was aware there were “various opinions” about the bill.

In a rare move, a group of former prosecutors has also protested to the justice ministry, saying “prosecutors wouldn’t be able to keep the trust of the people” if they could not maintain their independence.

Abe also faced criticism this year when the chief of the Tokyo High Public Prosecutor’s Office, seen as close to the premier, was allowed to stay on after turning 63.

Debate on the bill has stalled in parliament after opposition parties submitted a no-confidence resolution on Friday against the minister overseeing the legal revision.

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JGBs dip, 10-year yield turns positive on hopes of reopening of economies

TOKYO, May 11 (Reuters) – Japanese government bond prices dipped on Monday, with the benchmark 10-year yield rising into positive territory for the first time in more than two weeks, as hopes of re-openings of economies in many countries undercut the attraction of bonds.

Market players also said speculation that Japanese government may compile yet another economic stimulus package and sell more JGBs to finance it.

A number of countries are cautiously easing their lockdown steps, helping to boost risk asset prices globally, while Japan looks to lift a state-of-emergency in many regions this week.

The market showed no reaction to a summary of the Bank of Japan’s last policy meeting, which showed Some policy board members called for even bolder steps than those announced at last month’s policy decision.

Benchmark 10-year JGB futures fell 0.17 point to 152.20.

The 10-year JGB yield rose 1 basis point to 0.005%, the first time it traded above zero percent since April 23.

The 20-year JGB yield rose 0.5 basis point to 0.340% while the 30-year yield rose 2 basis points to 0.475%.

At the shorter end of the market, the two-year JGB yield was flat at minus 0.175% while the five-year yield rose 2 basis points to minus 0.115%. (Reporting by Tokyo Markets Team; Editing by Rashmi Aich)

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Oil surge lifts global stocks out of three-day losing streak

NEW YORK (Reuters) – A gauge of global stock markets snapped a three-day losing streak on Tuesday as moves to ease major economies out of their coronavirus lockdowns lifted the outlook for growth and helped give international oil prices a sixth day of strong gains.

U.S. Treasury yields rose as plans to reopen major economies boosted risk appetite.

Crude prices soared on hopes a recovery in vehicle traffic will boost fuel demand as some U.S. states, as well as countries in Europe and Asia, start to ease lockdown measures. Risk appetite rose, lifting bond yields as gold prices fell.

Oil majors pushed the main stock indices higher across Europe and on Wall Street as Brent crude futures surged 12% to more than $30 a barrel – the first time the global benchmark has traded above that level since April 15.

Royal Dutch Shell and BP PLC in London, Total in Paris, Eni SpA in Milan and Repsol in Madrid led their respective country indices higher, while Exxon Mobil Corp and Chevron Corp were the biggest gainers in the Dow industrials in New York.

“There is some hope that things are starting to get back to normal, and the rally in oil is helping put some confidence back in the markets,” said Keith Temperton, a sales trader at Tavira Securities.

The pan-European STOXX 600 index rose 2.12% while MSCI’s gauge of stocks across the globe gained 1.57%.

On Wall Street, the Dow Jones Industrial Average rose 384.13 points, or 1.62%, to 24,133.89. The S&P 500 gained 50.13 points, or 1.76%, to 2,892.87 and the Nasdaq Composite added 167.17 points, or 1.92%, to 8,877.89.

The change of mood marked a reversal from Monday, when renewed U.S.-China bickering unsettled investors and pushed stocks lower in Europe, Asia and most of the day on Wall Street.

German shares lost some ground at one point after Germany’s top court said the European Central Bank’s bond purchasing program partially violates the constitution.

The euro and the region’s government debt fell, too, though the court said the ECB program did not amount to monetary financing – in which a central bank bankrolls the government – which is banned in Germany. The ruling also did not apply to the bank’s new coronavirus PEPP support program.

In addition to the German court angst, euro zone producer prices fell the most in March since the 2008 financial crisis, Eurostat data showed.

The drop was more than expected as the COVID-19 pandemic reduced demand for energy. Prices at factory gates in the 19 countries sharing the euro fell 1.5% month-on-month in March and 2.8% year-on-year.

The euro slid 0.55% to $1.0846 and a sell-off in bond markets pushed Italy’s ultra ECB-sensitive government yields up past 1.90% again.

The slide in the euro bolstered the dollar. The dollar index rose 0.232%, but the jump in oil meant the big petro currencies like Canada’s dollar, Norway’s crown and Russia’s ruble were all stronger.

For a graphic on Stocks and oil lift out of coronavirus slump, click here

With countries including the United States, Germany, France, Spain, Italy, Nigeria, India, and Malaysia all tentatively easing lockdowns, the hope for oil producers is that the worst of the demand slump is over.

U.S. crude rose 18.44% to $24.15 per barrel and Brent was at $30.51, up 12.17% on the day.

For a graphic on Global markets, click here

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Global shares fall on U.S.-Sino spat but Wall Street rebounds

NEW YORK (Reuters) – The dollar rose on risk aversion and global stock markets fell on Monday as U.S.-Chinese bickering over the origin of the coronavirus outbreak sparked fear of a new trade war, but Wall Street rebounded as the lifting of lockdowns in some U.S. states boosted optimism.

U.S. stocks rallied at then end of the session, with the Nasdaq gaining more than 1 percent, as hard-hit New York became the latest state to announce a phased reopening of business activity, starting with select industries.

“The key turnaround this afternoon stemmed from (the) California governor’s optimistic tone,” said Edward Moya, senior market analyst at OANDA. “Some regional openings in California helped financial markets end the day on a positive note.”

“People want to believe that things are going to get better,” said Rick Meckler, a partner at Cherry Lane Investments in New Vernon, New Jersey. “All these announcements of state plans to reopen has given some optimism to investors that things can only improve from here.”

Oil prices jumped higher after settlement prices showed modest gains, but the strengthening safe-haven dollar and gold held their ground.

A rise in risk aversion came as business surveys showed Asian and European factory activity in April fell deeper into contraction, adding to a dismal outlook as government lockdowns to contain the pandemic froze global production and slashed demand.

U.S. Secretary of State Mike Pompeo on Sunday said there was “a significant amount of evidence” that the coronavirus emerged from a Chinese laboratory, remarks that rattled investors though he did not dispute U.S. intelligence agencies’ conclusion that it was not manmade.

An editorial in China’s Global Times said he was “bluffing” and called on the United States to present its evidence.

“The headlines of further tariffs and supply-chain disruptions come at a time where global growth expectations are already fragile,” said Simon Harvey, currency analyst at broker Monex Europe.

New orders for U.S.-made goods suffered a record decline in March and could sink further as pandemic-related disruptions fracture supply chains and depress exports, the Commerce Department said in a series of increasingly bleak economic data reports.

IHS Markit’s final manufacturing PMI for the euro zone sank to 33.4, its lowest since the survey began in mid-1997 and far below the 50-point line dividing growth from contraction.

The pan-European STOXX 600 index closed down 2.65%, while MSCI’s gauge of stocks across the globe shed 0.66%.

Wall Street rose after the Dow industrials and S&P 500 traded lower almost the entire session.

The Dow Jones Industrial Average rose 26.07 points, or 0.11%, to 23,749.76. The S&P 500 gained 12.03 points, or 0.42%, to 2,842.74 and the Nasdaq Composite added 105.77 points, or 1.23%, to 8,710.72.

The Nasdaq moved the most.

“If you’re going to buy this market, psychologically you want to buy the companies that you think can really do well,” Meckler said. “This has been a very hard market to bottom fish in, to buy the wounded names.”

Airline stocks got hammered after billionaire Warren Buffett’s Berkshire Hathaway dumped stakes in major U.S. airlines, but they pared losses as the market rebounded.

Shares of Delta Air Lines Inc, American Airlines Group Inc, Southwest Airlines Co and United Airlines Holdings Inc fell between 5.1% and 7.7%, as Buffett said “the world has changed” for the aviation industry.

Earlier, MSCI’s broadest index of Asia-Pacific shares outside Japan fell 2.5%, pulled down by the Hang Seng in Hong Kong.

The dollar rose against most major currencies. The dollar index rose 0.288%, with the euro down 0.76% to $1.0899.

The Japanese yen strengthened 0.25% versus the greenback at 106.72 per dollar.

Gold rose as the U.S.-China tensions over the coronavirus outbreak kindled fears of a new trade war, leading investors to seek safe havens.

U.S. gold futures settled 0.7% higher at $1,713.30 an ounce.

Simon Black, head of investment management at wealth management firm Dolfin said investors were also adjusting their forecasts for the depth of the economic damage the pandemic will inflict.

“It’s also the economic reality sinking in,” he said, adding that a rebound by global equities of over 20% from lows hit in March was not likely to be sustainable.

(GRAPHIC: Rebound – here)

Global coronavirus cases have surpassed 3.5 million and deaths have neared a quarter of a million, according to a Reuters tally.

Brent crude futures rose 76 cents to settle up at $27.20 a barrel, while U.S. crude futures added 61 cents to settle at $20.39 a barrel. U.S. WTI later added about $1 a barrel, and Brent almost the same.

Benchmark 10-year notes last rose 4/32 in price to yield 0.6289%.

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