Not just COVID: Nursing home neglect deaths surge in shadows

November 19, 2020

(AP) When COVID-19 tore through Donald Wallace’s nursing home, he was one of the lucky few to avoid infection. He died a horrible death anyway. Hale and happy before the pandemic, the 75-year-old retired Alabama truck driver became so malnourished and dehydrated that he dropped to 98 pounds and looked to his son like he’d been in a concentration camp. Septic shock suggested an untreated urinary infection, E. coli in his body from his own feces hinted at poor hygiene, and aspiration pneumonia indicated Wallace, who needed help with meals, had likely choked on his food.

“He couldn’t even hold his head up straight because he had gotten so weak,” said his son, Kevin Amerson. “They stopped taking care of him. They abandoned him.” As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need.

Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

Beyond that, interviews with dozens of people across the country reveal swelling numbers of less clear-cut deaths that doctors believe have been fueled not by neglect but by a mental state plunged into despair by prolonged isolation ̶ listed on some death certificates as “failure to thrive.”

A nursing home expert who analyzed data from the country’s 15,000 facilities for The Associated Press estimates that for every two COVID-19 victims in long-term care, there is another who died prematurely of other causes. Those “excess deaths” beyond the normal rate of fatalities in nursing homes could total more than 40,000 since March.

These extra deaths are roughly 15% more than you’d expect at nursing homes already facing tens of thousands of deaths each month in a normal year. “The healthcare system operates kind of on the edge, just on the margin, so that if there’s a crisis, we can’t cope,” said Stephen Kaye, a professor at the Institute on Health and Aging at the University of California, San Francisco, who conducted the analysis. “There are not enough people to look after the nursing home residents.”

Comparing mortality rates at homes struck by COVID-19 with ones that were spared, Kaye also found that the more the virus spread through a home, the greater the number of deaths recorded for other reasons. In homes where at least 3 in 10 residents had the virus, for example, the rate of death for reasons besides the virus was double what would be expected without a pandemic.

That suggests the care of those who didn’t contract the virus may have been impacted as healthcare workers were consumed attending to residents ill from COVID-19 or were left short-handed as the pandemic infected employees themselves.

Chronic understaffing at nursing homes has been one of the hallmarks of the pandemic, with a few homes even forced to evacuate because so many workers either tested positive or called in sick. In 20 states where virus cases are now surging, federal data shows nearly 1 in 4 nursing homes report staff shortages.

On New York’s Long Island, Dawn Best saw that firsthand. Before COVID-19 arrived at Gurwin Jewish Nursing Home, she was pleased with the care her 83-year-old mother Carolyn Best received. She enjoyed activities, from tai-chi classes to visits from a pony, and was doted on by staff.

But when the lockdown started and the virus began to spread in the home, Best sensed the staff couldn’t handle what they had been dealt. The second time her mother, a retired switchboard operator, appeared on screen for a scheduled FaceTime call, she looked awful, her eyes closed as she moaned, flailed her arms above her head and just kept repeating “no.” Best insisted a doctor check her out.

A few hours later, the doctor called, seemingly frantic, saying she only had a moment to talk. “The COVID is everywhere,” Best remembered her saying. “It’s in every unit. The doctors have it, the nurses have it and your mother may have it.”

In the end, 59 residents at Gurwin would be killed by the virus, but Best’s mother never contracted it. She died instead of dehydration, her daughter said, because the staff was so consumed with caring for COVID-19 patients that no one made sure she was drinking.

“My mom went from being unbelievably cared for to dead in three weeks,” said Best, who provided medical documents noting her mother’s dehydration. “They were in over their head more than anyone could imagine.”

Representatives for Gurwin said they could not comment on Best’s case. The home’s administrator, Joanne Parisi, said “COVID-19 has affected us all” but that “our staff at Gurwin has been doing heroic work.”

West Hill Health and Rehab in Birmingham, Alabama, where Wallace lived prior to his Aug. 29 death, said he was “cared for with the utmost compassion, dedication and respect.” Wallace's son provided medical documents outlining the conditions he described.

The nursing home trade group American Health Care Association disputed that there has been a widespread inability of staff to care for residents and dismissed estimates of tens-of-thousands of non-COVID-19 deaths as “speculation.”

Dr. David Gifford, the group’s chief medical officer, said the pandemic created “challenges” in staffing, particularly in states like New York and New Jersey hit hard by COVID-19, but added that, if anything, staffing levels have improved because of a drop in new admissions that has lightened the patient load.

“There have been some really sad and disturbing stories that have come out,” Gifford said, “but we’ve not seen that widespread.” When facilities sealed off across the country in March, advocates and inspectors were routinely kept out too, all while concerning reports trickled in, not only of serious injuries from falls or major medical declines, but of seemingly banal problems that posed serious health issues for the vulnerable.

Mairead Painter, Connecticut's long-term care ombudsman, said with dentists shut out, ill-fitting dentures went unfixed, a factor in mounting accounts of malnutrition, and with podiatrists gone, toenails went untrimmed, posing the possibility of painful conditions in diabetes patients.

Even more widespread, as loved ones lost access to homes, was critical help with residents’ feeding, bathing, dressing and other tasks. The burden fell on aides already working tough shifts for little pay.

“I don’t think anyone really understood how much time friends and family, volunteers and other people spent in the nursing home and supplemented that hands-on care,” Painter said. Strict rules barring in-person visitation persist in many homes, but as families and advocates have inched back inside, they’ve frequently been stunned by what they found.

When June Linnertz returned to her father’s room at Cherrywood Pointe in Plymouth, Minnesota, in June for the first time in three months, she was struck by a blast of heat and a wall thermometer that hit 85 degrees. His sheets were soaked in sweat, his hair was plastered to his head and he was covered in bruises Linnertz would learn came from at least a half-dozen falls. His nails had been uncut so long, they curled over his fingertips and his eyes crusted over so badly he couldn’t get them open.

The father, 78-year-old James Gill, screamed, thinking he had gone blind, and Linnertz grabbed an aide in a panic. She snipped off his diaper, revealing genitals that were deep red and skin sloughing off.

Two days later, Gill was dead from Lewy Body Dementia, according to a copy of his death certificate provided to the AP. Linnertz always expected her father to die of the condition, which causes a progressive loss of memory and movement, but never thought he would end his days in so much needless pain.

“What the pandemic did was uncover what was really going on in these facilities. It was bad before, but it got exponentially worse because you had the squeeze of the pandemic,” Linnertz said. “If we weren’t in a pandemic, I would have been in there … This wouldn’t have happened.”

The assisted living facility’s parent company, Ebenezer, said: “We strongly deny the allegations made about the care of this resident,” adding that it follows “strict regulatory staffing levels” required by law.

Cheryl Hennen, Minnesota’s long-term care ombudsman, said dozens of complaints have poured in of bedsores, dehydration and weight loss, and other examples of neglect at various facilities, such as a man who choked to death while he went unsupervised during mealtime. She fears many more stories of abuse and neglect will emerge as her staff and families are able to return to homes.

“If we can’t get in there, how do we know what’s really happening?” she said. “We don’t know what we can’t see.” The nagging guilt of unnecessary death is one Barbara Leak-Watkins understands. It was just in February that her 87-year-old father, Alex Leak, went for a check-up and got lab work that made Leak-Watkins think the Army veteran, contractor and farmer would be with her for a long time to come.

“You’re going to outlive all of us,” Leak-Watkins remembered the doctor saying. As nursing home outbreaks of COVID-19 proliferated, Leak-Watkins prayed that he be spared. The prayer was answered, but Leak was nonetheless found unresponsive on the floor at Brookdale Northwest in Greensboro, North Carolina, his eyes rolled back and his tongue sticking out.

After he arrived at the hospital, a doctor there called Leak-Watkins with word: Her father had gone so long without water his potassium levels rocketed and his kidneys started failing. He’d be dead two weeks later of lactic acidosis, according to his death certificate, a fatal buildup of acid in the body when the kidneys stop working. For a man whose military service so drilled the need for hydration into him that he always had a bottle of water at hand, his daughter had never considered he could go thirsty.

“The facility is short-staffed ... underpaid and overworked,” Leak-Watkins said. If they “can’t provide you with liquids and fluids to hydrate yourself, there’s something wrong.” The daughter is considering filing a lawsuit but a North Carolina law granting long-term care facilities broad immunity from suits claiming negligence in injuries or death during the pandemic could stymie her efforts. Similar laws and executive orders have been enacted in more than two dozen states.

The owner of the father’s facility, Brookdale Senior Living, said it couldn’t comment on individual cases but that “the health, happiness and wellbeing of each of our residents will always be our priority.”

Around the country, the heartache repeats, not only among families who have already buried a member, but also those who feel they are watching a slow-moving disaster. In Hendersonville, Tennessee, Tara Thompson was able to see her mother for the first time in more than six months when she was hospitalized in October. The 79-year-old had dropped about 20 pounds, her eyes sunken and her legs looking more like forearms. Doctors at the hospital said she was malnourished and wasting muscle. There were bedsores on her backside and a gash on her forehead from a fall at the home. Her vocabulary had shrunk to nearly nothing and she’d taken to pulling the blankets over her head.

The facility Thompson’s mother lived in had been engulfed in virus outbreaks, with more than half its residents testing positive and dozens of employees infected, too. She never caught it, but shaken by the lack of care, Thompson transferred her mother to a new home.

“It has nothing to do with the virus. She’s declined because she’s had absolutely no contact with anybody who cares about her,” she said. “The only thing they have to live for are their families and, at the end of their life, you’re taking away the only thing that matters to them.”

“Failure to thrive” was among the causes listed for Maxine Schwartz, a 92-year-old former cake decorator whose family had been encouraged prior to the lockdown by how well she’d adjusted to her nursing home, Absolut Care of Aurora Park, in upstate New York. Her daughter, Dorothy Ann Carlone, would coax her to eat in the dining room each day and they’d sing songs and have brownies back in her room. Several times a week, Schwartz walked the length of the hallway for exercise.

When the lockdown began March 13, Carlone feared what would happen without her there. She pleaded to staff: “If you don’t let me in to feed her, she won’t eat, she will starve.” On March 25, when a staffer at the home sent a photo of Schwartz, Carlone was shocked how thin she was. Carlone was told her mother hadn’t been eating, even passing up her favorite brownies.

Two days later, Carlone got an urgent call and when she arrived at the home, her mother’s skin was mottled, she was gasping for breath and her face was so drawn she was nearly unrecognizable. An hour later, she died.

Dawn Harsch, a spokeswoman for the company that owns Absolut Care, noted a state investigation found no wrongdoing and that “the natural progression of a patient like Mrs. Schwartz experiencing advanced dementia is a refusal to eat.”

Carlone is unconvinced. “She was doing so good before they locked us out,” Carlone said. “What did she think when I wasn’t showing up? That I didn’t love her anymore? That I abandoned her? That I was dead?”

Before the lockdown, Carlone’s mother would wait by an elevator for her to arrive each day. She thinks of her mother waiting there when her visits stopped and knows the pain of the isolation must have played a role in her death.

“I think she gave up,” she said.

Sedensky and Condon reported from New York. AP data journalist Larry Fenn contributed to this report.

As virus hits Italy's south, some flee troubled health care

November 18, 2020

GIUGLIANO IN CAMPANIA, Italy (AP) — Patients, some wrapped in blankets that look like they came from home, moan in their beds. What appears to be medical tubing and a wad of gauze or paper towels litter the floor of San Giuliano public hospital, which treats coronavirus patients in a bleak town in Italy's Neapolitan hinterland.

In another surreptitiously filmed scene, 15 kilometers (9 miles) away in Naples, an elderly man suspected of having COVID-19 takes his last, labored breaths in a bathroom at the emergency room of Cardarelli Hospital, his undignified end memorialized on a phone camera by a fellow patient and posted online.

Meanwhile, outside the ER entrance for Cardarelli, the main health care facility for densely populated Naples, those desperate for oxygen for loved ones line up in their cars, waiting for nurses to bring tanks of the life-saving element to ailing passengers anxious to enter the crowded ER.

The pandemic, which has killed more than 46,000 people in Italy, has heightened the urgency of the plight of those seeking medical care in public hospitals in the country's economically underdeveloped south. But these glimpsed moments of drama, while shocking, are nothing new to people here who depend on such care.

In late September, as coronavirus infections surged in Italy after a summer decline, prosecutors put 17 hospital managers and workers under investigation for an insect infestation at a Naples hospital. Cardarelli, meanwhile, was once accused by the consumer group Codacons of leaving patients crowded in corridors like they were “old boxes.”

Naples prosecutors are investigating the bathroom death at Cardarelli, and the hospital’s director has ordered an internal probe. At San Giuliano, hospital officials declined to speak to an AP reporter who visited Saturday, and there was no immediate answer at the hospital's administrative office on Tuesday evening.

Many in the Naples area resign themselves to what the La Repubblica newspaper denounced as hellish, “Dantesque” waits to receive treatment for COVID-19. Others bundle up their loved ones and head north, where Italian health care enjoys a better reputation — but many hospitals there are also overwhelmed.

Lombardy in the north is again the epicenter of Italy's latest coronavirus outbreak, as it was when the virus first hit Europe. In the regional capital of Milan, coronavirus infections rampaged through the city’s most prestigious home for the elderly early in the pandemic.

In the spring, a severe nationwide lockdown meant that while the north suffered the brunt, the south was largely spared. But now, the virus is hitting several regions hard at once — a phenomenon seen in other European countries.

With the Campania region that surrounds Naples now under strain, at least 116 patients sought treatment this month in neighboring Lazio, at Formia’s Dono Svizzero hospital. Some had tested positive for the virus, while others had other ailments and feared becoming infected with the virus in the area's chaotic emergency rooms.

“If patients knock on the door, it’s open,” Paolo Nucero, head of the Formia hospital’s emergency room, told Italian state television. “At the moment, we’re holding up. But if we have a super flood, we will start suffering.”

Leaving one’s region to seek better medical treatment elsewhere in Italy is so prevalent that a foundation studying the quality of the nation’s health care publishes what it calls the “flight index.” The GIMBE Foundation found that nearly all those “fleeing” local health care went north.

In Italy's health care system, each region manages its own spending. In a cruel illustration of the ‘’rich get richer while the poor get poorer" adage, footing the medical bills of Italians who travel outside their regions still falls to the region where they reside. That means a bonanza of funds for the northern regions providing the care but a drain on the coffers of poorer, southern parts.

Along the Naples waterfront, Luigi Orefice perched his 4-year-old son, Giovanni, on the thick wall lining the promenade. With fog ringing the Vesuvius volcano in the background, the postcard-like panorama would be familiar to tourists. But his job delivering beverages to hospitals lets Orefice see the ugly realities beyond the “O Sole Mio” image of the south.

His deliveries take him inside hospitals in the dead of night, when Orefice says he has witnessed lax protocols, like staff walking barefoot. “We might have the best hospital department chief of staffs, but at the bottom, hospital workers are poorly managed,” he said.

Outside San Giuliano Hospital in Giugliano in Campania on a recent day, Feliciano Manna, a representative of the UIL labor syndicate for ambulance crews, noted that Campania lost about 15,000 health care workers in recent years to budget cuts. Italy’s Civil Protection force is currently recruiting 450 doctors to help the region care for COVID-19 patients.

Only weeks before the pandemic began did Campania’s public health care system emerge from years of central government control, part of efforts to cut waste and drive down costs. The person behind the video inside San Giuliano Hospital “took advantage of a moment when he saw some wad of gauze of the floor,” said Manna. “The staff is doing super-human work," he said. The video “doesn’t discredit that.”

In a parking lot behind the hospital, Giuseppe Sguiglia, 30, and his 26-year-old wife waited in their car, inching forward in a long line of people signed up for COVID-19 tests. Last year, Sguiglia said, he had to use a local hospital. Judging from that experience, “we understood that Naples would be a disaster” if the pandemic spread south, he said.

Some cite the insidious influence of organized crime on some of Campania’s institutions. In response to an AP query, the Interior Ministry said Monday that the minister will decide this month whether a sprawling Naples health care district should be put under temporary control of the ministry’s local prefect — depending on if it's determined that the Camorra infiltrated its administration.

According to a separate, criminal investigation before the pandemic, mobsters allegedly demanded payment of hundreds of euros to speed up the release of patients’ bodies at one Naples hospital to their families.

UK's Johnson in quarantine but declares himself fit, working

November 16, 2020

LONDON (AP) — British Prime Minister Boris Johnson said Monday he is as “fit as a butcher’s dog” after being instructed to self-isolate for 14 days because he recently came in contact with someone who has since tested positive for the coronavirus.

In a video message posted on Twitter from his London apartment at Downing Street, Johnson said it didn’t matter that he has already endured COVID-19 and is “bursting with antibodies.” The quarantine requirement comes at the start of a crucial week for Johnson’s Conservative government that includes discussions over a post-Brexit trade deal with the European Union. Negotiators are meeting in Brussels this week with time on a deal fast running out.

Johnson contracted the virus in April and spent three days in intensive care as his symptoms worsened. He met with a small group of lawmakers for about a half-hour on Thursday, including one, Lee Anderson, who subsequently developed symptoms and tested positive.

Johnson was notified by the National Health Service’s Test and Trace system Sunday and told he should self-isolate because of factors including the length of the meeting. “We’ve got to interrupt the spread of the disease and one of the ways we can do that now is by self isolating for 14 days when contacted by Test and Trace,” Johnson said.

Health Secretary Matt Hancock said it was right that the prime minister goes into self-isolation even though he’s already had coronavirus as people “can catch it twice.” "The prime minister is following exactly the same rules as every other person in the country," Hancock told BBC Radio.

Hancock also brushed aside suggestions that Downing Street is not following the advice it preaches as pictures emerged of Johnson and Anderson posing for a photograph seemingly less than two meters (6 1/2 feet) apart and without face coverings. In the early days of the pandemic in the spring, many in the heart of government contracted the virus, including Hancock.

Danny Altmann, professor of immunology at Imperial College London, said the self-isolation rules "probably are sensible.” He told BBC Radio there have been more than 25 confirmed cases of COVID-19 reinfection globally, but that he thought the actual rate of reinfection is "quite a lot higher than that, but not enormous.”

“I think my bottom line is not to be alarmist because whatever the risk is, it is low," he said. “My sense from some of our data and other people’s data is that it’s the people who’ve made the poorest and most negligible antibody response the first time round who are most at risk of reinfection.”

Merkel, German governors to eye results of partial lockdown

November 16, 2020

BERLIN (AP) — German Chancellor Angela Merkel will assess the effects of a nearly two-week-long partial lockdown with state governors in a video conference Monday. Germany went into a partial lockdown at the beginning of November that included closing restaurants, cafes and cultural institutions but left open schools and stores after virus figures spiked exponentially in October.

The rise of new infections has since slowed, but on Friday the country still registered a record of 23,542 newly confirmed cases. On Monday, 10,824 new cases were reported by the country’s disease control center, but figures are usually lower at the beginning of the week due to less testing and delayed reporting.

Merkel and Germany's 16 state governors will begin their evaluation of the country’s situation in the corona pandemic in the afternoon. Local media reported that possible new measures could include recommendations to further reduce social contacts, cut school classes in half and make masks compulsory in elementary schools. So far, only high school students have to wear masks in class and often these regulations differ from state to state.

It was not clear whether any new, stricter measures would be agreed upon Monday or whether Merkel and the state governors would wait for a week to pass new restrictions.

Report: Belgium nursing homes failed patients amid pandemic

November 16, 2020

BRUSSELS (AP) — Amnesty International said Belgium authorities “abandoned” thousands of elderly people who died in nursing homes during the coronavirus pandemic following an investigation published Monday that described the situation as “human rights violations."

One of the hardest-hit countries in Europe, Belgium has reported more than 531,000 confirmed virus cases and more than 14,400 deaths linked to the coronavirus. During the first wave of the pandemic last spring, the European nation of 11.5 million people recorded a majority of its COVID-19-related deaths in nursing homes.

Between March and October, Amnesty International said “a staggering" 61.3% of all COVID-19 deaths in Belgium took place in nursing homes. The group said authorities weren't quick enough in implementing measures to protect nursing home residents and staff during this period, failing to protect their human rights.

Amnesty International said one of the reasons so many people died in homes is because infected residents weren't transferred to hospitals to receive treatment. “The results of our investigation allow us to affirm that (care homes) and their residents were abandoned by our authorities until this tragedy was publicly denounced and the worst of the first phase of the pandemic was over,” said Philippe Hensmans, the director of Amnesty International Belgium.

When the virus struck Europe hard in March, Belgium was caught off guard and unprepared, faced with a critical shortage of personal protective equipment. As infections surged across the country, nursing homes were quickly overwhelmed by the frenetic pace of contamination as local authorities even requested the help of Belgian armed forces to cope.

Belgium had one of the highest death rates worldwide during the first wave. But while nursing home staff was overwhelmed, the country’s hospitals weathered the crisis, as their intensive care units never reached their 2,000-bed capacity. Vincent Fredericq, the general secretary of the care homes federation Femarbel, told Amnesty International that many residents in need of medical assistance were left behind.

“Everyone was struck by the images of the Italian and Spanish hospitals,” he said. “These situations had a great impact on our federal decision-makers, who said from the outset that it was absolutely necessary to avoid overloading intensive care. Nursing homes have been relegated to second line and residents and staff have been the victims.”

Amnesty International based its investigation on testimonies from nursing home residents and staff, employees of non-governmental organizations defending residents’ rights and directors of nursing homes. The group also spoke with families of elderly people currently living in homes or who died during the pandemic. Most of the people interviewed asked to remain anonymous so that they could speak freely.

Quoting figures released by Doctors Without Borders, the group said only 57% of serious cases in care homes were transferred to hospitals because of “a harmful interpretation of sorting guidelines.” “Some older people have probably died prematurely as a result,” Amnesty International said. “It took months before a circular explicitly stated that transfer to hospital was still possible, if it was in accordance with the patient’s interests and wishes, regardless of age.”

Maggie De Block, the former Belgian health minister in charge during the early months of the pandemic, refuted last month accusations that access to hospitals was denied to nursing home residents. “There has never been a message either from the federal government or from my regional colleagues saying that we should not hospitalize people who need it, or that we can refuse elderly or disabled people,” she told local media RTBF.

The prime minister's office didn't immediately respond to a request for comment from The Associated Press. More than half of the care providers quizzed during the group's investigation said they didn't receive training on how to use protective equipment and weren't sufficiently informed about the virus. Amnesty International said systematic testing of nursing home employees in Belgium wasn't introduced before August, with only one test per month.

One nursing home resident identified as Henriette told Amnesty International that she was afraid every time a care worker came in that they would bring the virus in with them. The group also noted that the restrictive measures limiting family visits had negative repercussions on many residents' health. Some relatives told Amnesty International that when they were allowed back, they realized their loved ones had been neglected because staffers were overwhelmed.

“It was very difficult for my husband to eat alone. As time went by, he lost weight,” the wife of one resident said. “When I asked the staff about it, a care worker told me: ‘We can’t feed everyone every day.”

Cyprus locks down southwest over surge in coronavirus cases

November 11, 2020

NICOSIA, Cyprus (AP) — Cyprus put its entire southwest under a strict 19-day lockdown Wednesday, banning any non-essential movement of people and shuttering bars and restaurants after a string of escalating restrictions failed to curb a sharp increase in coronavirus infections.

Health Minister Constantinos Ioannou said the lockdown was deemed necessary after consultations with the European Center for Disease Prevention and Control because infections in the Limassol and Paphos districts jumped from 28% to 70% of the national average in the last six weeks while two-thirds of hospitalized COVID-19 patients now receiving treatment hail from there.

Ioannou said a strict 8 p.m.-5 a.m. curfew will be in effect from Thursday through Nov. 30 and movement to and from the two districts will be barred to all except for emergency medical reasons and for those working in essential services such as health workers.

All public gatherings are banned, religious services will be conducted without any worshippers, public and private high schools and colleges will conduct classes online, and non-essential government employees will work from home. Museums and archaeological sites, theaters and cinemas, shopping malls, beauty parlors and hairdressing salons, gyms, pools and casinos cannot open.

The measures mirror restrictions during a nearly three-month, island-wide lockdown that Cypriot authorities imposed at the start of the pandemic earlier this year, which officials credited with keeping infections low.

Ioannou said the uncertainty created that the eight month-old pandemic has fatigued many, but authorities are under tremendous strain to trace the large number of contacts each infected person has had.

Speaking earlier in a televised address, President Nicos Anastasiades said that he has observed the rising number of infections in recent weeks with “great anxiety” and that neither he nor his government could remain indifferent to the risk of a rising death toll.

“We are witnessing on a daily basis the tragic events unfolding in other countries. I'm sure that none of you would want to live through similar circumstances," said Anastasiades. As in other European countries, a coronavirus resurgence in the island nation of 875,000 people has alarmed authorities that the health care system could be overwhelmed. As of Wednesday, Cyprus has recorded 6,461 confirmed cases and 33 deaths.

Anastasiades pledged to counter the economic impact of the new lockdown with an additional batch of support measures.

Pacific isles, secretive states among last virus-free places

November 12, 2020

WELLINGTON, New Zealand (AP) — From Argentina to Zimbabwe, from the Vatican to the White House, the coronavirus has spread relentlessly. It's been confirmed on every continent but one and in nearly every country. Yet a few places have yet to report even a single case of infection. Some have been genuinely spared so far, while others may be hiding the truth. Here's a closer look:

PACIFIC ISLANDS

The largest cluster of countries without the coronavirus is in the South Pacific. Tonga, Kiribati, Samoa, Micronesia and Tuvalu are among the small island nations yet to report a single case. They haven't been spared from the pandemic's effects, however.

Tonga managed to keep the virus out by stopping cruise ships from docking and closing the airport in March, says Paula Taumoepeau, the president of the Chamber of Commerce and Industry. He says the government even imposed a lockdown, even though there were no known cases. These days, only people who have first tested negative are allowed to return on occasional repatriation flights. He says he finds it hard to believe the confirmed death toll in the U.S. alone exceeds twice his entire nation's population of just over 100,000.

“I think the government has done a good job keeping COVID away from Tonga, but it has had a big impact on businesses, especially tourism and accommodation. It's very, very bad,” Taumoepeau says. “None of the businesses have escaped.”

Indeed, many of the South Pacific islands rely on tourism as a major source of revenue and have seen unemployment spike and their economies struggle since the pandemic began. Much of the South Pacific is relatively poor and has basic health systems that would be ill-equipped to deal with major outbreaks.

Not everywhere in the South Pacific has been spared, either. Over the past two weeks, Vanuatu and the Marshall Islands reported their first cases, from quarantined travelers. Fiji and the Solomon Islands each count a handful, while Papua New Guinea has reported about 600 cases and seven deaths. French Polynesia has been particularly hard hit, with more than 11,000 cases and 50 deaths.

ANTARCTICA

There has been perhaps no place on Earth where people have been more vigilant in keeping out the virus than Antarctica, the only continent which remains virus-free. That's because any outbreak would be difficult to control in a place where people live in close quarters and where medical capabilities are limited. People who do get gravely ill on Antarctica typically must be evacuated, a process that can take days, or even weeks, due to the extreme weather conditions, which can delay flights.

While most countries have been reducing the number of scientists and staff they are sending to Antarctica this Southern Hemisphere summer, hundreds of people still have been arriving to ensure bases are maintained and long-term scientific programs continue to tick over.

Michelle Rogan-Finnemore, the executive secretary of the Council of Managers of National Antarctic Programs, says people planning to travel to Antarctica are typically tested in their home countries before leaving and then quarantined for at least two weeks in their final gateway country before flying to Antarctica. Once there, she says, people are typically tested again and are required at first to remain socially distanced and wear masks.

Rogan-Finnemore says they're making every effort to keep the virus out. “We're doing our best in a global pandemic,” she says.

NORTH KOREA

With a population of more than 25 million, North Korea is by far the largest nation yet to report a single case, although there’s widespread skepticism over leader Kim Jong Un's claim of a perfect record in keeping out the “evil” virus.

North Korea says its anti-virus campaign is a matter of “national existence." It has severely restricted cross-border traffic, banned tourists, flown out diplomats and mobilized tens of thousands of health workers to screen entry points, monitor residents and isolate those with symptoms.

In September, North Korean troops shot and killed a South Korean government official who was found drifting near the sea boundary. The North said its troops then burned the man's makeshift flotation device in an anti-virus step.

The North's lockdown and its extreme anti-virus measures are believed to be stressing its already crippled economy. But an outbreak could be devastating in a country that lacks medical supplies and modern healthcare infrastructure. Most analysts believe North Korea has had at least some cases of COVID-19 because it shares a porous border with China, where smuggling activities are common. Some believe the North may be in the grip of a significant outbreak.

TURKMENISTAN

As with North Korea, there is significant doubt about Turkmenistan's claim of zero cases. Authorities in the secretive and authoritarian Central Asian nation of 6 million have rejected allegations they’re hiding information about the outbreak. And yet health officials have recommended people wear masks and keep a distance of 2 meters (7 feet) from each other in public places.

In March, Turkmenistan restricted travel in and out of the country and restricted mass religious events. A World Health Organization delegation that visited Turkmenistan in July said the country should take stronger actions. The WHO recommended “activating critical public health measures" as if the virus was already circulating, delegation head Dr. Catherine Smallwood said at the time.

Smallwood did not directly comment on the credibility of the country having zero cases. “The responsibility of reporting outbreaks sits firmly with the member state and we rely on health authorities to inform WHO of any outbreaks,” she said.

Associated Press reporters Kim Tong-hyung in Seoul, South Korea, and Daria Litvinova in Moscow contributed to this report.

UK becomes 5th country to exceed 50,000 coronavirus deaths

November 11, 2020

LONDON (AP) — The United Kingdom on Wednesday became the fifth country in the world to record more than 50,000 coronavirus-related deaths, a level that one of the nation's leading doctors says “should never have been reached.”

Figures from the British government showed that 595 more people in the country died within 28 days of testing positive for the virus, the highest daily number since May. The figure took the U.K.'s total death toll from the pandemic to 50,365.

The U.K, which has the highest virus-related death toll in Europe, joins the United States, Brazil, India and Mexico in reporting more than 50,000, according to a tally maintained by Johns Hopkins University.

The U.K.’s overall death toll is widely considered to be far higher than that as the total reported only includes those who have tested positive for the virus and doesn’t include those who died of COVID-related symptoms after 28 days.

Like other nations in Europe, the U.K. is experiencing a resurgence of the virus and has imposed new restrictions to curb infections over the past few weeks. Though England was put under lockdown last week, the government has been criticized for having imposed it too late, a charge it also faced when it imposed a U.K.-wide lockdown in March.

Following the news about the death toll exceeding 50,000, Prime Minister Boris Johnson said the U.K. is better equipped to handle outbreaks than it was during the first wave in the spring, when the country reported more than 40,000 deaths.

In addition to the prospect of a vaccine or vaccines against the coronavirus, Johnson pointed to a ramp-up in testing. Last week, the government started its first citywide testing program in the northwest England city of Liverpool. It is planning more mass testing, including of university students in early December ahead of their return home for the holidays.

“We have two boxing gloves to pummel the disease in the weeks and months that follow,” said Johnson, who was hospitalized with COVID-19 in April. “But I have got to stress that we are not out of the woods yet. It does require everybody to follow the guidance.”

In Wednesday's daily update, the British government also said that another 22,950 people tested positive for the virus. While the number of new cases is much higher than 24-hour statistics recorded in the summer, daily confirmed cases appear to be stabilizing, or at least, growing far more slowly.

Because of time lags, the number of people being hospitalized and dying are expected to continue rising for weeks, even after the number of confirmed infections do start going down. “Sadly the upward trend is likely to continue, and it will be several weeks before any impact of the current measures — and the sacrifices we are all making — is seen and is reflected in the data," said Dr. Yvonne Doyle, medical director of Public Health England.

Under the terms of the current lockdown in England, non-essential places such as pubs, restaurants, hairdressers, golf courses, gyms, swimming pools, entertainment venues and stores selling items like books, clothing and sneakers, must remain closed until at least Dec. 2.

Unlike the U.K.’s spring lockdown, schools and universities in England are remaining open this time, as are construction sites and factories. In a visit to a supermarket in southeast London, Johnson said that “hopefully” the four-week lockdown in England will be eased enough for people to have a Christmas that is “as normal as possible.”

Whatever happens in the near-term, there are calls for a public inquiry to assess a range of issues that many think have led to more deaths in the U.K. than should otherwise have occurred, from problems with the testing program to shortages of personal protective equipment at the outset of the pandemic, as well as the high death rates in care homes and within ethnic minority groups.

“Today’s figure is a terrible indictment of poor preparation, poor organization by the government, insufficient infection control measures, coupled with late and often confusing messaging for the public,” said Dr. Chaand Nagpaul, council chair of the British Medical Association, a union for doctors.

“This is a point that should never have been reached."

Thousands in Leipzig protest German coronavirus restrictions

November 07, 2020

BERLIN (AP) — More than 20,000 people demonstrated Saturday in eastern Germany against government-imposed restrictions meant to slow the spread of the coronavirus after a court rejected the city of Leipzig's attempt to move the protest away from a central square, police said.

By the city's calculations, only 5,000 people could gather in Augustusplatz plaza and keep 1.5 meters (5 feet) away from one another. With protest organizers saying they expected at least 16,000 participants, administrators had sought to have the demonstration moved to a larger location outside the city's center.

“It is hard to explain how only two households are permitted to meet together and yet 16,000 people are allowed to demonstrate on one plaza,” city spokesman Matthias Hasberg told German news agency dpa after the appeals court issued its decision,

The court did not issue details about its reasoning. Few people at the protest wore masks or kept their distance from others despite police warning from megaphones and officers walking through the crowds on foot to caution them. One woman carried a sign that read “For: truth, justice and freedom” while wearing a mask over her eyes and leaving her nose and mouth uncovered.

The city ordered the event shut down a little more than two hours after it began due to mask non-compliance. Many protesters refused to leave. Police warned on social media that they were videotaping participants to document who was committing crimes or civil infractions with their behavior. About half the crowd remained when it got dark outside.

At a smaller counter-demonstration nearby, people waved signs urging respect for coronavirus restrictions. The demonstration came as Germany finished its first week of what is being called “lockdown light” with new restrictions to try and slow spiking coronavirus cases.

The country's disease control center, the Robert Koch Institute said Saturday that Germany’s states had reported 23,300 new daily cases, surpassing the record of 21,506 set the day before when Germany for the first time registered more than 20,000 confirmed cases in 24 hours.

A four-week partial shutdown that took effect Monday closed bars, restaurants, leisure centers and sports facilities, and imposed new restrictions on contact with other people. Shops and schools remain open.

The Robert Koch Institute says any effects from the measures will be seen two to three weeks from the start of the closures. In Munich, an appeals court on Saturday upheld the southern city’s ban on demonstrations against coronavirus restrictions that were scheduled for Saturday and Sunday.

The court ruled authorities in the Bavarian city were within their rights to ban the demonstrations under infection protection regulations, dpa reported.

Avalanche warnings after heavy snowfall in Alps

January 15, 2021

BERLIN (AP) — Authorities in Switzerland have warned of high avalanche risk in mountainous regions of the Alpine nation after heavy snowfall in recent days. Zurich's public transport company halted all tram and bus services in Switzerland's biggest city Friday, saying snow had brought down trees and blocked access to three vehicle depots overnight.

Some eastern Swiss regions saw up to 80 centimeters (2.6 feet) of snowfall in 24 hours. Parts of the Goms valley on the border with Italy were cut off from the world due to blocked roads. Many roads were also closed due to avalanche risk or fallen trees in the western Austrian region of Tyrol. In the Vorarlberg region a power cut left some 7,400 households without electricity.

Police in southwestern Germany said a 72-year-old woman died after a tree laden with snow fell on her while she was walking her dog near the Swiss border. The woman’s son found her seriously injured and with hypothermia, but she later died in a hospital.

Hot again: 2020 sets yet another global temperature record

January 14, 2021

(AP) Earth's rising fever hit or neared record hot temperature levels in 2020, global weather groups reported Thursday. While NASA and a couple of other measurement groups said 2020 passed or essentially tied 2016 as the hottest year on record, more agencies, including the National Oceanic Atmospheric Administration, said last year came in a close second or third. The differences in rankings mostly turned on how scientists accounted for data gaps in the Arctic, which is warming faster than the rest of the globe.

“It’s like the film ‘Groundhog Day.’ Another year, same story — record global warmth,” said Pennsylvania State University climate scientist Michael Mann, who wasn’t part of the measurement teams. “As we continue to generate carbon pollution, we expect the planet to warm up. And that’s precisely what we’re seeing.”

Scientists said all you had to do was look outside: “We saw the heat waves. We saw the fires. We saw the (melting) Arctic,” said NASA top climate scientist Gavin Schmidt. “We’re expecting it to get hotter and that’s exactly what happened.”

NOAA said 2020 averaged 58.77 degrees (14.88 degrees Celsius), a few hundredths of a degree behind 2016. NASA saw 2020 as warmer than 2016 but so close they are essentially tied. The European Copernicus group also called it an essential tie for hottest year, with 2016 warmer by an insignificant fraction. Japan’s weather agency put 2020 as warmer than 2016, but a separate calculation by Japanese scientists put 2020 as a close third behind 2016 and 2019. The World Meteorological Organization, the British weather agency and Berkeley Earth’s monitoring team had 2016 ahead.

First or second rankings really don’t matter, “but the key thing to take away is that the long-term trends in temperature are very very clearly up and up and up,” said Schmidt, who heads NASA’s Goddard Institute for Space Studies that tracks temperatures. “We’re in a position where we’re pushing the climate system out of the bounds that it’s been in for tens of thousands of years, if not millions of years.”

All the monitoring agencies agree the six warmest years on record have been the six years since 2015. The 10 warmest have all occurred since 2005, and scientists say that warming's driven by the burning of coal, oil and natural gas.

Temperatures the last six or seven years “really hint at an acceleration in the rise of global temperatures,” said Russ Vose, analysis branch chief at NOAA’s National Centers for Environmental Information. While temperature increases have clearly accelerated since the 1980s, it’s too early to discern a second and more recent acceleration, Schmidt said.

Last year's exceptional heat “is yet another stark reminder of the relentless pace of climate change, which is destroying lives and livelihoods across our planet,” United Nations Secretary-General António Guterres said in a statement. “Making peace with nature is the defining task of the 21st century.”

The United States, which had its fifth warmest yea r, smashed the record for the number of weather disasters that cost at least $1 billion with 22 of them in 2020, including hurricanes, wildfires, tornadoes and a Midwest derecho. The old record of 16 was set in 2011 and 2017. This was the sixth consecutive year with 10 or more billion-dollar climate disasters, with figures adjusted for inflation.

Earth has now warmed 1.2 degrees Celsius (2.2 degrees Fahrenheit) since pre-industrial times and is adding another 0.2 degrees Celsius (0.36 Fahrenheit) a decade. That means the planet is nearing an international warming threshold set in Paris in 2015, Vose and Schmidt said. Nations of the world set a goal of preventing at least 2 degrees Celsius (3.6 degrees Fahrenheit) of warming, with a tougher secondary goal of limiting warming to 1.5 degrees (2.7 degrees Fahrenheit).

“We cannot avoid 1.5 C above pre-industrial now -- it is just too late to turn things around,” University of Oklahoma meteorology professor Jason Furtado, who wasn’t on any of the measurement teams, said in an email. “I also fear that the 2 C threshold is slipping away from us too unless changes become much more immediate in the US and other nations.”

Earth has warmed 1.6 degrees (0.9 degrees Celsius) since 1942, when President-elect Joe Biden was born, and 1.2 degrees (0.6 degrees Celsius) since 1994, when pop star Justin Bieber was born, according to NOAA data.

The main reason the agencies have varying numbers is because there are relatively few temperature gauges in the Arctic. NOAA and the British weather agency take a conservative approach in extrapolating for the missing data, while NASA factors that the Arctic is warming much faster than the rest of the globe, hitting 100 degrees (38 Celsius) in the Russian Arctic last June, said NASA's Schmidt.

The pandemic may have added ever so slightly to last year’s warming, enough to edge 2020 past 2016 in NASA's calculations, Schmidt said. Around the globe, people were driving less — and that reduced short-term aerosol pollution which acts as a cooling agent by reflecting heat. Schmidt said fewer cooling aerosols could be responsible for .09 to .18 degrees (.05 to .1 degrees Celsius) warming for the year.

NOAA's Vose and Schmidt expect 2021 to be among the top five hottest years but probably not a record breaker because of natural temporary cooling in parts of the Pacific called La Nina. NOAA and NASA measurements go back to 1880, while the United Kingdom Met Office has readings back to 1850.

World warily watches America's postelection aftershocks

January 13, 2021

PARIS (AP) — For America's allies and rivals alike, the chaos unfolding during Donald Trump's final days as president is the logical result of four years of global instability brought on by the man who promised to change the way the world viewed the United States.

From the outside, the United States has never looked so vulnerable — or unpredictable. Alliances that had held for generations frayed to a breaking point under Trump — from his decision to back out of the Paris climate accord and the Iran nuclear deal, to quitting the World Health Organization amid a pandemic.

And then, by seeking to overturn his loss to Joe Biden, Trump upended the bedrock principle of democratic elections that the United States has tried — and sometimes even succeeded — in exporting around the world. How long those aftershocks could endure is unclear.

“It is one of the biggest tasks of the future for America and Europe — to fight the polarization of society at its roots,” German Foreign Minister Heiko Maas said. “We will only be able to preserve the belief in togetherness, in democracy as the most humane form of statehood, and the conviction in science and reason if we do it together.”

But in many ways Europe has already moved on, forging ahead on the deal with Iran, negotiating a trade agreement with China spearheaded by Germany, and organizing global actions to protect the environment.

On the same day an angry mob stormed the Capitol to try to overturn the presidential election won by Biden, a record number of Americans died of coronavirus. One other recent event also showed U.S. vulnerability: the cyberespionage operation still working its way through an untold number of government computers and blamed on elite Russian hackers.

World leaders who saw the deadly violence in Washington “will need to consider whether these events are an outlier event — a ‘black swan’ — or whether these extremist white supremacist groups will continue to be a significant influence on the direction of U.S. foreign and domestic policy, instead of receding with the end of the Trump administration," the Soufan Group, a global intelligence and security firm, wrote Tuesday.

People tend to think of fragile countries “in terms of war as the biggest problem, rather than violence, and thinking in terms of state collapse as the biggest problem rather than states that internally disintegrate,” said Rachel Kleinfeld, a scholar of democracy and violence at the Carnegie Endowment for International Peace. Kleinfeld, like many others, said the assault on the U.S. Capitol may have come to a head in a matter of weeks but was years in the making.

And the U.S. capacity to fight for democracy was already tarnished before the mob egged on by Trump sought to overturn his election loss. For many, those events were merely confirmation. Adversaries including Russia, China and Iran used the violence to question U.S. democracy more generally.

In an internal note on the State Department's “dissent channel” obtained by The Associated Press, American diplomats said Trump’s actions had made their job harder. “It is critical that we communicate to the world that in our system, no one — not even the president — is above the law or immune from public criticism,” the note said. “This would be a first step towards repairing the damage to our international credibility.”

Trump showed no contrition, however, saying Tuesday his fiery rally remarks to supporters were “totally appropriate.” In Iraq, a country that still struggles with the controversial legacy of a U.S.-led invasion in the name of democracy, many people followed the Washington events with a mixture of shock and fascination.

Then-U.S. President George W. Bush boasted that Iraq would become a model of democracy in a region ruled by dictators. Instead, the country fell into protracted war between Sunnis and Shiites in which tens of thousands of people died. Although it has an active parliament and regular elections, it is a dysfunctional democracy based on a sectarian power sharing agreement, with corrupt parties haggling over ministries and posts so they can give jobs to supporters while lining their own pockets.

Ahmad al-Helfi, a 39-year-old Iraqi political cartoonist, said what happened at the U.S. Capitol is a blow to the democracy it tried to bring to Iraq and other countries. “By mobilizing his followers in an effort to overturn the results of the election, Trump confirmed that instead of exporting democracy to Iraq, America imported the chaos, non-peaceful transition of power, and failure to accept election results,” al-Helfi said.

Anahita Thoms, a German lawyer and trade expert who spent years living and working in the United States, said last week's events would indelibly mark America’s image abroad. Thoms is a board member of the Atlantic Bridge, a think tank promoting cooperation between Europe and the U.S. — the kind of organization founded in the aftermath of World War II when the U.S. helped to rebuild the economies of many countries in western Europe that had been destroyed by the war.

Germany was one country that benefited the most from those U.S. financial and democracy-building efforts. Looking ahead, she said American officials may have a tougher time promoting democracy abroad.

“The U.S. remains a country that lives its democratic values. But this aspiration, which is presented very strongly to the outside world, mustn’t get too many cracks," Thoms said. "I think a lot of diplomatic skill is going to be necessary to counter those pictures.”

The International Crisis Group, which normally focuses on global war zones, wrote its first assessment ever about the risk of election-related violence in the United States in October. Stephen Pomper, who helped lead the work on the report and lives in the D.C. area, said in the best of circumstances, the United States could eventually point to the decision of Congress to resume certification of Biden's election after the breach as a first step in successfully protecting its democracy.

“Look, we created these institutions. They did become a source of resiliency for us. They helped us get through this very difficult period. Let us help you develop the same kind of resiliency,” he said, describing a hypothetical future conversation between the U.S. and a struggling government. “That would be a positive story to be able to tell at some point, but I don’t think the pieces are quite there yet.”

Pope Francis was more optimistic, telling Italian broadcaster Mediaset: "Thank God this exploded” into the open because “we have been able to see why this is, and how it can be remedied.”

Associated Press writers Kirsten Grieshaber and Frank Jordans in Berlin, Abdulrahman Zeyad in Baghdad, Matt Lee in Washington; and Frank Bajak in Boston contributed.

Blizzard covers Spain in white, brings Madrid to standstill

January 09, 2021

MADRID (AP) — An unusual and persistent blizzard has blanketed large parts of Spain with snow, freezing traffic and leaving thousands trapped in cars or in train stations and airports that had suspended all services as the snow kept falling on Saturday.

The capital, Madrid, and other parts of central Spain activated for the first time a red weather alert, the highest, and called in the military to rescue people from vehicles trapped on everything from small roads to the city's major thoroughfares.

The national AEMET weather agency had warned that some regions would be receiving more than 24 hours of continuous snowfall due to the odd combination of a cold air mass stagnant over the Iberian Peninsula and the arrival of the warmer Storm Filomena from the south.

AEMET had said that up to 20 centimeters (nearly 8 inches) of snow could accumulate in large parts of the country but the build-up reached more than 50 centimeters even in urban areas. The storm is expected to move northeast throughout Saturday, the agency said.

Carlos Novillo, head of the Madrid emergency agency, said that more than 1,000 vehicles had become trapped, mostly on the city's ring road and the main motorway that leads from the capital to the south, toward the Castilla La Mancha and Andalucia regions.

“The situation remains of high risk. This is a very complex phenomenon and a critical situation," Novillo said Saturday morning in a message posted on social media. “We ask all those who remain trapped to be patient, we will get to you," he added.

Airport operator AENA said that the Adolfo Suárez Madrid-Barajas International Airport, the main gateway in and out of the country, would remain closed throughout the day after the blizzard bested machines and workers trying to keep the runways clear of snow.

All trains into and out of Madrid, both commuter routes and long-distance passenger trains, as well as railway lines between the south and the northeast of the country, were suspended, railway operator Renfe said.

The storm had caused serious disruptions or closed altogether over 430 roads by Saturday morning, according to Spain’s transit authorities, which urged people to stay indoors and avoid all non-essential travel.

The wintry weather even halted the country's soccer league, with some of the La Liga top teams unable to travel for games. A flight to Madrid carrying players of the current leader in the championship, Athletic Bilbao, had to return to the Bilbao airport, while the second-place Real Madrid team was unable to take off for its match against Osasuna on Saturday night.

The blizzard also yielded unusual images for many Madrileños, including a few brave people heading out with their ski gear on a main commercial avenue and in the central Puerta del Sol square, and even a dog sled that was seen on videos widely circulated on social media.

Stunned EU leaders yearn for Biden presidency -- ASAP

January 07, 2021

BRUSSELS (AP) — For European Union nations, Joe Biden's Jan. 20 inauguration as the next U.S. president cannot come fast enough. Following the storming of the U.S. Capitol by supporters of President Donald Trump, most national governments have shed any inhibition at aiming withering criticism at a sitting U.S. president. Several already embrace his rival as a beacon of hope to rebuild trans-Atlantic ties that have crumbled over the past four years.

“President Trump is already a thing of the past," Prime Minister Antonio Costa of Portugal, which holds the EU's rotating presidency, said Thursday. “I don’t dabble much in provocation, but for me this page is turned,” EU Council President Charles Michel said.

All eyes are now on the future and Biden. “Above all, I am looking forward to the new American President," said EU Commission chief Ursula von der Leyen. The sentiment was shared in much of the 27-nation bloc.

Italian Premier Giuseppe Conte said Italy “can’t wait to work together with President Biden." But right now it is unclear to what extent U.S. foreign policy has already fundamentally changed in a way that Biden could not — or might not want to — fully rectify. And as Wednesday's historic riots at the nation's legislature showed, he might have to center an overwhelming amount of his energy at home.

Two relatively simple moves from Washington though would please the EU no end — rejoining the Paris climate accord, the five-year-old global deal that commits participating nations to curb the worst of pollution and warming excesses, and the World Health Organization, which is focusing on the coronavirus pandemic.

President Obama joined the Paris climate pact but Trump unilaterally pulled out, much to the Europeans' dismay. The same goes for the WHO, which Biden has also promised to rejoin. “One of Biden’s first gestures will be to include the United States in the Paris agreement, and this will allow us to face up to the reality of climate change," said Costa.

The Portuguese prime minister also said he hoped the incoming president will reinvigorate U.S. standing in multilateral bodies like the United Nations. “This will mean that there is hope,” he said. President Trump often criticized European allies for cowering under the U.S. defense and security umbrella while seeking economic advantage through subsidies and other trade tactics. This did little to endear him to them.

“The truth is that contacts at the highest level between Trump and the EU were very limited, and not only the past few weeks," Michel, the EU Council President, told RTBF network. “Cooperation on many issues was extremely difficult."

Nevertheless, the forthcoming change of administration doesn't mean Washington will give the EU an easy time on issues like subsidies for European aircraft builder Airbus and other commercial matters. It has been a thorn in the side of good relations for many years.

“There are the US interests and EU interests that must both be defended, each on their side," Costa said. “However, we must remain on friendly terms, the allies, and we hope that we will be able to overcome the difficulties."

To smooth the way, the EU has already invited President-elect Biden to visit Brussels at the earliest opportunity, which Costa hopes might be during Portugal's six-month presidency that ends in June.

“After four very barren years that we have lived through, we are now looking forward to four fruitful years," said von der Leyen.

Nicole Winfield contributed from Rome.

World reaction to the storming of the US Capitol

January 07, 2021

Reaction from around the world to the storming of the U.S. Capitol by supporters of President Donald Trump:

“A fundamental rule of democracy is that, after elections, there are winners and losers. Both have to play their role with decency and responsibility so that democracy itself remains the winner....President Trump regrettably has not conceded his defeat since November, and didn’t yesterday either, and of course that has prepared the atmosphere in which such events, such violent events, are possible.” — German Chancellor Angela Merkel.

“What is happening is wrong. Democracy — the right of people to exercise a vote, have their voice heard and then have that decision upheld peacefully — should never be undone by a mob.” — New Zealand Prime Minister Jacinda Ardern.

“Shocking scenes in Washington, D.C. The outcome of this democratic election must be respected.” — NATO Secretary General Jens Stoltenberg.

"American democracy is obviously limping on both feet....This, alas, is actually the bottom. I say this without a shadow of gloating. America no longer charts a course and therefore has lost all rights to set it — and even more so to impose it on others.” — Konstantin Kosachev, head of the foreign affairs committee in Russia's upper house of parliament.

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“The rampage at the Capitol yesterday was a disgraceful act and it must be vigorously condemned.” — Israeli Prime Minister Benjamin Netanyahu.

“Last year, President Trump extended painful economic sanctions placed on Zimbabwe, citing concerns about Zimbabwe’s democracy. Yesterday’s events showed that the U.S. has no moral right to punish another nation under the guise of upholding democracy. These sanctions must end.” — Zimbabwe President Emmerson Mnangagwa.

“Distressed to see news about rioting and violence in Washington DC. Orderly and peaceful transfer of power must continue. The democratic process cannot be allowed to be subverted through unlawful protests.” — Indian Prime Minister Narendra Modi.

“I unreservedly condemn encouraging people to behave in the disgraceful way that they did in the Capitol. And all I can say is I’m very pleased that the president-elect has now been duly confirmed in office and that democracy has prevailed.” — British Prime Minister Boris Johnson.

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“We call on leaders from across the political spectrum, including the President of the United States, to disavow false and dangerous narratives, and encourage their supporters to do so as well. We note with dismay the serious threats and destruction of property faced by media professionals yesterday.” — U.N. High Commissioner for Human Rights Michelle Bachelet.

“The world considered America as a successful model of democracy, but we have witnessed the chaos, the assault against congress members and the looting. Same as third-world countries!” — Iraqi lawmaker Hakim al-Zamili.

“We must call this out for what it is: a deliberate assault on Democracy by a sitting President & his supporters, attempting to overturn a free & fair election! The world is watching!” — Irish Foreign Minister Simon Coveney.

“I warned you: it’s bad when (people) walk down the street, it’s even worse when they walk into the courtyards, it will be unbearable when they come to your apartments. We must not allow this.” —- Belarusian President Alexander Lukashenko.

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“The scenes we saw are the result of lies and yet more lies, of division and contempt for democracy, of hatred and rabble-rousing, including from the very highest level. This is a historic turning point for the United States, and it is an attack on liberal democracy as a whole. But I am sure that American democracy is stronger than this hatred.” — German President Frank-Walter Steinmeier.

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“Everywhere there is a Trump, so each of us has to defend the Capitol." — Donald Tusk, former European Union leader, former prime minister of Poland.

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“This is an internal affair of the United States. At the same time, we draw attention to the fact that the electoral system in the United States is archaic; it does not meet modern democratic standards, creating opportunities for numerous violations, and the American media have become an instrument of political struggle." — Russian Foreign Ministry spokeswoman Maria Zakharova.

“The scenes from the U.S. Capitol show how dangerous the rhetoric of hatred is. Contempt for democratic institutions erodes citizens’ rights and can undermine political order.” — Slovakian President Zuzana Caputova.

“All should be very troubled by the violence taking place in Washington D.C. We hope American democracy is resilient, deeply rooted and will overcome this crisis. Democracy presupposes peaceful protest, but violence and death threats —from Left or Right— are ALWAYS wrong.” — Slovenian Prime Minister Janez Jansa.

“This is a lesson to be learnt: that strong institutions and not strong personalities are the bulwark of a rich democratic culture.” — former Nigerian vice president Atiku Abubakar, a recent losing presidential candidate.

—

“Presidents who don’t do much good and are unwilling to leave, we know that in Afghanistan.” — former Afghan government adviser Torek Farhadi.

“The right to vote, the voice of the citizen exercising their democratic rights, alongside the strength of the judiciary and maintaining the rule of law, must be principles shared by us all. Even with the pain, the disagreement and the atmosphere of mistrust, we must never forget that.” — Israeli President Reuven Rivlin.