UK faces vaccine shortfall, could delay shots for under 50s

March 18, 2021

LONDON (AP) — Britain is facing a shortfall in COVID-19 vaccine supplies that may delay the start of shots for people under 50 after deliveries from two suppliers were curtailed due to production and testing issues.

Prime Minister Boris Johnson described the delays as the inevitable consequence of a complicated program. But he acknowledged that in the short term, the country would receive fewer vaccines than planned a week ago, in part because of a shortfall from India's Serum Institute.

“That is because of a delay in a shipment from the Serum Institute, who are doing a Herculean job in producing vaccines in such large quantities, and because of a batch that we currently have in the U.K. that needs to be retested as part of our vigorous safety program,"' he told reporters Thursday at a Downing Street news conference.

Johnson’s comments came a day after the National Health Service told doctors that vaccine supplies would be “significantly constrained” beginning March 29. As a result, people under 50 shouldn’t be inoculated for the time being, unless they have underlying health conditions that put them at higher risk from COVID-19, the NHS said in a letter to public health officials.

The news damped the hopes of the U.K. beginning to vaccinate younger people next month. This next phase of the vaccination program is likely be pushed back until May, said Dr. Martin Marshall, chairman of the Royal College of General Practitioners.

“It was disappointing news when we heard yesterday that the supplies weren’t going to be available during April,” he told the BBC. “It’s a massively successful program overall, and this is a bit of a setback.”

Despite the supply constraints, the government still expects to meet its target of delivering a first vaccine dose to everyone over 50 by mid-April and to all adults by July 31, Health Secretary Matt Hancock said. He also said no vaccination appointments would be canceled and everyone who has had a first shot will get their second shot on schedule.

Britain is using vaccines developed by U.S. drugmaker Pfizer and Anglo-Swedish rival AstraZeneca, with vaccine deliveries from Moderna expected to start soon. More than 25 million people across the U.K. — almost 38% of its population — have received at least one dose of vaccine so far.

The nation’s medicines regulator on Thursday recommended that people continue to receive the AstraZeneca vaccine, despite concerns about blood clots raised in some European countries. The Medicines and Healthcare Products Regulatory Agency said a “rigorous review” of all the data available found no evidence that the AstraZeneca vaccine caused clots in veins.

Another review of five U.K. cases involving a rare type of clot in the brain is under way. This type of clot, which can occur naturally, has been reported in fewer than 1 in every million people vaccinated and no causal link to the vaccine has been established, the MHRA said.

“The benefits of the vaccines against COVID-19 continue to outweigh any risks and that the public should continue to get their vaccine when invited to do so,” the agency said. Underlining the vaccine's safety, Johnson told reporters that he would receive the AstraZeneca vaccine on Friday. The prime minister had a serious case of COVID-19 last spring.

“Let's get the jab done!'' he said. COVID-19 has killed some 126,000 people in Britain, the highest toll in Europe. The government had previously said the Serum Institute of India, the world’s biggest vaccine maker, would supply Britain with 10 million doses of the AstraZeneca vaccine this month. But the Serum Institute said Thursday that there were no “stipulated timelines” for delivery of the vaccine.

The company said 5 million doses have already been delivered “and we will try to supply more later, based on the current situation and the requirement for the government immunization program in India.”

India’s foreign ministry says vaccine exports would be calibrated to domestic production, “as well as requirements of our national vaccine program.” COVID-19 is linked to more than 159,000 deaths in India, the world’s fourth-highest death toll.

Dr. Simon Clarke, associate professor of cellular microbiology at the University of Reading, said the disruption in U.K. vaccine supplies is more than just a “bump in the road.” It could have knock-on effects that last for months, including potential delays in lifting COVID-19 restrictions, he said.

Johnson has announced plans to slowly lift a national lockdown in England, though some measures are expected to remain in place until late June. Scotland, Northern Ireland and Wales have also begun to ease restrictions. With the lockdown expected to last past Easter, Britons have been looking at summer holidays as a way to make up for months of living under heavy restrictions.

“By pushing back the under-50s first doses, their second doses are also being pushed back,” Clarke said. “If full vaccination becomes required for holidays abroad or even more mundane things like going to the cinema, millions of younger people may end up being excluded from participating for the whole summer.”

Aniruddha Ghosal in New Delhi and Pan Pylas in London contributed.

EU regulator reviews AstraZeneca shot and blood clot links

March 18, 2021

LONDON (AP) — The world awaited the results Thursday of an initial European investigation into whether there is any evidence that the AstraZeneca coronavirus vaccine is linked to blood clots reported in small numbers of recipients of the shot.

Concerns over the clotting led more than a dozen European countries to suspend use of the vaccine over the past week, even though the company and international health agencies said there was no indication the vaccine caused the clotting and recommended continuing inoculations.

The European Union drug regulator's expert committee was expected to report its analysis Thursday, including whether any new precautions should be taken regarding the vaccine. While many countries have continued to use the vaccine, there are concerns the debate could seriously undermine confidence in the shot, which is key to efforts to vaccinate the world's population, especially in poorer countries. Even in Europe, where countries have a choice of vaccines, it has complicated an already slow rollout at a time when infections are rising again in many countries.

The head of the European Medicines Agency said this week that the drug regulator's priority is confirming the product is safe and that it would consider a range of actions, including the addition of extra warnings to the vaccine.

“We are worried that there may be an effect on the trust of the vaccines," Executive Director Emer Cooke said. "But our job is to make sure that the products that we authorize are safe and we can be trusted by the European citizens.”

Blood clots have been reported in 37 people among the 17 million who have received at least one dose of the AstraZeneca vaccine in Europe. Both the EMA and the World Health Organization have said that there is no evidence to suggest the vaccine was responsible and that the benefits of immunization far outweighed the potentially small risk. The drugmaker said that after a careful review of its COVID-19 immunization data, it found no evidence of any increased risk of blood clots in any age group or sex in any country.

The pause in vaccinations using the shot comes as tens of thousands of new daily cases have prompted new lockdown measures in Italy, caused hospitalizations in France to spike and led German officials to announce a third surge of COVID-19 has begun.

In Britain, which has raced ahead in vaccinating its most vulnerable, officials said Wednesday that the number of people getting their first dose of the COVID-19 vaccine would be “significantly constrained” from April because of a reduction in the vaccine supply to the country.

A letter to regional health leaders said they should expect a “significant reduction in weekly supply available from manufacturers” beginning from the week of March 29. The reduction will continue for four weeks, it said.

Figures from the European Centers for Disease Prevention and Control this week show there are about 7 million unused AstraZeneca vaccines across the 27-nation EU. The German government defended its decision to suspend use of the vaccine, saying it was based on expert advice.

Government spokeswoman Ulrike Demmer said Wednesday that the move could “strengthen trust" in the vaccines. “Concerns are taken seriously and examined. And as soon as these concerns are cleared up, a vaccine can be used again without hesitation," she said.

But some experts have expressed concern that the opposite might happen: that the very public and dramatic suspensions could feed already high skepticism of vaccines that were developed in record time.

Germany will rely on the EMA decision for how to proceed, Health Ministry spokesman Hanno Kautz said. Other countries including France have also indicated they will follow the advice issued Thursday. Any time vaccines are rolled out widely, scientists expect some serious health problems and deaths to be reported, simply because tens of millions of people are receiving the shots. Determining whether or not the vaccine is to blame can be difficult, especially since the COVID-19 vaccination campaigns are focusing for now on vulnerable people who may have other health problems.

But because there is no long-term data on any of the COVID-19 vaccines, any potential signal of trouble must be thoroughly investigated. Because clinical trials are only done in tens of thousands of people, extremely rare side effects often aren't detected until vaccines are used in many millions of people, long after they have been licensed.

For example, it took nearly a year after vaccination campaigns began against the 2009 swine flu pandemic for European officials to notice an increase in narcolepsy in children and teenagers who got the GlaxoSmithKline vaccine.

“It’s right to investigate any potential signals of problems, but you can do that while you continue immunization,” said Michael Head, a senior research fellow in global health at the University of Southampton. “If we pause the vaccine rollout every time there’s a possible signal, it won’t be much of a rollout.”

Head cautioned that there are costs to going slowly: The longer the coronavirus is allowed to circulate widely, the more chance it has to mutate into a deadlier version. “People may well be more hesitant to take an AstraZeneca vaccine when immunization resumes," he said. "And this is at a time when we need to stop the virus circulating to the reduce the chances of further variants emerging.”

Jordans reported from Berlin.

Europe staggers as infectious variants power virus surge

March 06, 2021

MILAN (AP) — The virus swept through a nursery school and an adjacent elementary school in the Milan suburb of Bollate with amazing speed. In a matter of just days, 45 children and 14 staff members had tested positive.

Genetic analysis confirmed what officials already suspected: The highly contagious coronavirus variant first identified in England was racing through the community, a densely packed city of nearly 40,000 with a chemical plant and a Pirelli bicycle tire factory a 15-minute drive from the heart of Milan.

“This demonstrates that the virus has a sort of intelligence. ... We can put up all the barriers in the world and imagine that they work, but in the end, it adapts and penetrates them,’’ lamented Bollate Mayor Francesco Vassallo.

Bollate was the first city in Lombardy, the northern region that has been the epicenter in each of Italy’s three surges, to be sealed off from neighbors because of virus variants that the World Health Organization says are powering another uptick in infections across Europe. The variants also include versions first identified in South Africa and Brazil.

Europe recorded 1 million new COVID-19 cases last week, an increase of 9% from the previous week and a reversal that ended a six-week decline in new infections, WHO said Thursday. “The spread of the variants is driving the increase, but not only,’’ said Dr. Hans Kluge, WHO regional director for Europe, citing “also the opening of society, when it is not done in a safe and a controlled manner.”

The variant first found in the U.K. is spreading significantly in 27 European countries monitored by WHO and is dominant in at least 10 countries: Britain, Denmark, Italy, Ireland, Germany, France, the Netherlands, Israel, Spain and Portugal.

It is up to 50% more transmissible than the virus that surged last spring and again in the fall, making it more adept at thwarting measures that were previously effective, WHO experts warned. Scientists have concluded that it is also more deadly.

“That is why health systems are struggling more now,” Kluge said. “It really is at a tipping point. We have to hold the fort and be very vigilant.” In Lombardy, which bore the brunt of Italy’s spring surge, intensive care wards are again filling up, with more than two-thirds of new positive tests being the UK variant, health officials said.

After putting two provinces and some 50 towns on a modified lockdown, Lombardy's regional governor announced tightened restrictions Friday and closed classrooms for all ages. Cases in Milan schools alone surged 33% in a week, the provincial health system's chief said.

The situation is dire in the Czech Republic, which this week registered a record-breaking total of nearly 8,500 patients hospitalized with COVID-19. Poland is opening temporary hospitals and imposing a partial lockdown as the U.K. variant has grown from 10% of all infections in February to 25% now.

Two patients from hard-hit Slovakia were expected to arrive Saturday for treatment in Germany, where authorities said they had offered to take in 10 patients. Kluge cited Britain’s experience as cause for optimism, noting that widespread restrictions and the introduction of the vaccine have helped tamp down the variants there and in Israel. The vaccine rollout in the European Union, by comparison, is lagging badly, mostly because of supply problems.

In Britain, the emergence of the more transmissible strain sent cases soaring in December and triggered a national lockdown in January. Cases have since plummeted, from about 60,000 a day in early January to about 7,000 a day now.

Still, a study shows the rate of decline slowing, and the British government says it will tread cautiously with plans to ease the lockdown. That process begins Monday with the reopening of schools. Infection rates are highest in people ages 13 to 17, and officials will watch closely to see whether the return to class brings a spike in infections.

While the U.K. variant is dominant in France, forcing lockdowns in the French Riviera city of Nice and the northern port of Dunkirk, the variant first detected in South Africa has emerged as the most prevalent in France's Moselle region, which borders Germany and Luxembourg. It represents 55% of the virus circulating there.

Austria's health minister said Saturday the U.K. variant is now dominant in his country. But the South Africa variant is also a concern in a district of Austria that extends from Italy to Germany, with Austrian officials announcing plans to vaccinate most of the 84,000 residents there to curb its spread. Austria is also requiring motorists along the Brenner highway, a major north-south route, to show negative test results.

The South Africa variant, now present in 26 European countries, is a source of particular concern because of doubts over whether the current vaccines are effective enough against it. The Brazilian variant, which appears capable of reinfecting people, has been detected in 15 European countries.

WHO and its partners are working to strengthen the genetic surveillance needed to track variants across the continent. The mayor of Bollate has appealed to the regional governor to vaccinate all 40,000 residents immediately, though he expects to be told the vaccine supply is too tight.

Bollate has recorded 3,000 positive cases and 134 deaths — mostly among the elderly — since Italy was stricken a year ago. It took the brunt in the resurgence in November and December, and was caught completely off guard when the U.K. variant arrived, racing through schoolage children before hitting families at home.

“People are starting to get tired that after a year there is no light at the end of the tunnel,” Vassallo said.

AP correspondents Jill Lawless in London, Karel Janicek in Prague, Vanessa Gera in Warsaw, Jamey Keaten in Geneva, Sylvie Corbet in Paris, Geir Moulson in Berlin and Jovana Gec in Belgrade contributed.

After mixed messages, Europe warns against vaccine shopping

March 05, 2021

PARIS (AP) — First, France's president suggested that the AstraZeneca vaccine was “quasi-ineffective” in protecting older people from COVID-19. Now, Emmanuel Macron's government is begging people to take it.

Germany finds itself in a similar situation. Berlin shifted gears on its cautious policy this week after an independent vaccine panel said the AstraZeneca shots should be used in people over 65. Top German officials on Friday argued against “vaccine shopping” and urged people to take whatever potential protection they’re offered.

Mixed messaging has left many people in both countries confused or distrustful of governmental guidance on the AstraZeneca jab. Meanwhile, Europe's infections are rebounding and other people around the continent and the world are clamoring for access to any COVID-19 vaccine they can get.

European governments' initial hesitancy around AstraZeneca's vaccine was based on limited data on whether it works on those over 65. But new data on its effectiveness — and pressure to accelerate the EU’s slow vaccine rollout and utilize unused AstraZeneca doses — prompted health authorities in multiple European countries this week to reverse course and allow its use for all ages.

In France, all those who work with the sick or elderly have been eligible for weeks to get the AstraZeneca vaccine — but only 30% have taken it so far. Some have argued they want a Pfizer-BioNTech or Moderna vaccine instead, which are currently only available in France to the elderly or those with pre-existing health conditions.

So French Health Minister Olivier Veran was sending a letter Friday to all health workers urging them to get vaccinated. And if that doesn't work, he said he could convene a special ethics committee to weigh requiring them to do so.

“Clearly that (30%) is not enough,” Veran told a news conference Thursday night. While paying homage to health workers, he said: “When you are a medical professional, it is your responsibility to protect ... yourself and your patients."

At his side, a family doctor echoed the plea. “I appeal to my colleagues: Please come and get vaccinated," said Dr. Marie-Laure Alby, noting that her patients are eager to get any vaccine. The head of Germany’s disease control agency on Friday urged people to get vaccinated when given the opportunity. The comments from Robert Koch Institute President Lothar Wieler came amid reports that many in the country have declined the AstraZeneca shot over concerns it may not work as well as others.

“If you are offered a vaccine, please get yourself vaccinated. They are safe and effective,” Wieler said, adding that getting large numbers of people inoculated is “the way out of the pandemic.” The vaccine made by British-Swedish company AstraZeneca is one of three authorized for use in the 27-nation European Union, though it has not yet received the green light from U.S. regulators. EU countries are also administering the Pfizer-BioNTech and Moderna vaccines — and French nurse Michele Freret said she’d prefer one of those.

“If they vaccinate us with AstraZeneca and it is not as effective as Pfizer or others, then we will get COVID and there will be no medical staff to care for the people I care for,” she told The Associated Press.

She's concerned about the virus — “I constantly test myself” — and the doctors and nurses who have lost their lives fighting it. But she said she and some colleagues feel the government is trying to get rid of extra AstraZeneca vaccines by foisting them on medical staff.

France, which at more than 87,000 dead has among the highest coronavirus tolls in Europe, had as of Tuesday used only 25% of the 1.6 million AstraZeneca vaccines it has received. Restrictive rules and a rush of deliveries left Germany sitting on a stockpile of more than 2 million AstraZeneca doses this week.

France's skeptics often repeat a comment last month by Macron, when he told reporters: “The real problem on AstraZeneca is that it doesn’t work the way we were expecting it to ... today everything points to thinking it is quasi-ineffective on people older than 65.” Hours after he spoke, the European Medicines Agency approved the vaccine's use for all ages, but the damage to its image had been done.

Some also cite confusing early data on AstraZeneca's effectiveness, or question whether it works against new virus variants. The company is working on a new version to respond to evolving variants. The European efforts to rehabilitate the vaccine's reputation come as new infections rose 9% across the continent in the past week, halting six weeks of decline.

Rising contributed from Berlin.

Amid pandemic, pope goes to Iraq to rally fading Christians

March 05, 2021

BAGHDAD (AP) — Pope Francis heads to Iraq on Friday to urge the country’s dwindling number of Christians to stay put and help rebuild the country after years of war and persecution, brushing aside the coronavirus pandemic and security concerns to make his first-ever papal visit.

Iraqis were keen to welcome him and the global attention his visit will bring, with banners and posters hanging high in central Baghdad, and billboards depicting Francis with the slogan “We are all Brothers” decorating the main thoroughfare. In central Tahrir square, a mock tree was erected emblazoned with the Vatican emblem, while Iraqi and Vatican flags lined empty streets.

Iraqi Foreign Minister Fuad Hussein said Iraqis were eager to welcome Francis’ “message of peace and tolerance” and described the visit as a historic meeting between the “minaret and the bells.” Among the highlights of the three-day visit is Francis' private meeting Saturday with the country's top Shiite cleric, Grand Ayatollah Ali al-Sistani, a revered figure in Iraq and beyond.

The government is eager to show off the relative security it has achieved after years of wars and militant attacks that nevertheless continue even today. Francis and the Vatican delegation are relying on Iraqi security forces to protect them, including with the expected first use of an armored car for the popemobile-loving pontiff.

Tahsin al-Khafaji, spokesman for Iraq's joint operations, said security forces had been increased. “This visit is really important to us and provides a good perspective of Iraq because the whole world will be watching,” he said. The high stakes will give Iraqi forces “motivation to achieve this visit with safety and peace.”

Francis is breaking his year-long COVID-19 lockdown to refocus the world’s attention on a largely neglected people whose northern Christian communities, which date from the time of Christ, were largely emptied during the violent Islamic State reign from 2014-2017.

For the pope, who has often traveled to places where Christians are a persecuted minority, Iraq's beleaguered Christians are the epitome of the “martyred church" that he has admired ever since he was a young Jesuit seeking to be a missionary in Asia.

In Iraq, Francis is seeking to not only honor its martyrs but deliver a message of reconciliation and fraternity. That's a tough sell given the few Christians who remain in Iraq harbor a lingering mistrust of their Muslim neighbors and face structural discrimination that long predated IS and the 2003 U.S.-led invasion that threw the country into chaos.

“The Pope’s visit is to support the Christians in Iraq to stay, and to say that they are not forgotten,” the Chaldean patriarch, Cardinal Luis Sako, told reporters in Baghdad this week. The aim of Francis’ visit, he said, is to encourage them to “hold onto hope.”

The visit comes as Iraq is seeing a new spike in coronavirus infections, with most new cases traced to the highly contagious variant first identified in Britain. The 84-year-old pope, the Vatican delegation and travelling media have been vaccinated; most Iraqis have not.

The Vatican and Iraqi authorities have downplayed the threat of the virus and insisted that social distancing, crowd control and other health care measures will be enforced. The Vatican spokesman, Matteo Bruni, said this week the important thing is for Iraqis to know that the pope came to Iraq as an “act of love.”

“I come among you as a pilgrim of peace, to repeat ‘you are all brothers,’” Francis said in a video-message to the Iraqi people on the eve of his visit. “I come as a pilgrim of peace in search of fraternity, animated by the desire to pray together and walk together, also with brothers and sisters of other religious traditions.”

Christians once constituted a sizeable minority in Iraq but their numbers began dwindling after the 2003 U.S.-led invasion, and then fell further when IS militants in 2014 swept through traditionally Christian towns across the Nineveh Plains. Their extremist brand of Islam forced residents to flee to neighboring Kurdistan or further afield, to Europe, the U.S. or beyond.

Few have returned and those who have found their homes and churches destroyed. Returnees have had to contend with more struggles. Many cannot find work, and blame discriminatory practices in the public sector, Iraq's largest employer. Since 2003, public jobs have been mostly controlled by majority Shiite political elites, leaving Christians feeling marginalized.

While hard numbers are hard to come by, there were an estimated 1.4 million Christians in Iraq in 2003. Today the number is believed to be around 250,000. During his visit, Francis will pray in the Baghdad church that was the site of one of the worst massacres of Christians, the 2010 attack by Islamic militants that left 58 people dead. He will honor the dead in a Mosul square surrounded by shells of destroyed churches and meet with the small Christian community that returned to Qaraqosh, where he will bless their church that was used as a firing range by IS.

The Vatican and the pope have frequently insisted on the need to preserve Iraq’s ancient Christian communities and create the security, economic and social conditions for those who have left to return. But that hasn’t necessarily translated into reality.

“I am the only priest in Mosul. Every Sunday I hold mass at 9 a.m., and only around 70 people attend," said the Rev. Raed Adil Kelo, parish priest of the Church of the Annunciation in Mosul, the onetime de-facto IS capital.

Before 2003, the Christian population was 50,000, he said. It had dwindled to 2,000 before IS overran northern Iraq. He doesn't expect more to return, but he nevertheless said Francis' visit would have immeasurable importance for those who stayed.

“This visit will bring peace to Iraq” he said.

Winfield reported from Vatican City.

Famed Madrid flamenco venue closes amid virus restrictions

March 04, 2021

MADRID (AP) — Artists at one of Madrid’s best-known flamenco bars put on a final outdoor show Thursday, marking its closure after 140 years because of COVID-19 pandemic restrictions that have shuttered entertainment venues.

A female flamenco dancer dressed in black performed in the street outside Villa-Rosa, while others threw flamenco costumes from balconies into the street and male singer Juañarito performed a flamenco song.

Others laid flowers at the venue’s entrance, lit candles and put up handwritten signs saying “R.I.P.” The Villa-Rosa, with its distinctive tiled facade, is a landmark of the Madrid neighborhood called Las Letras, known for its nightlife.

“The situation is now unsustainable, with so many overheads for a year with the bar closed without any (financial) assistance," the flamenco show’s director, Rebeca Garcia, said. "It has forced us to take the drastic decision to shut down.”

COVID-19 pandemic fuels attacks on health workers globally

March 02, 2021

(AP) Two Nigerian nurses were attacked by the family of a deceased COVID-19 patient. One nurse had her hair ripped out and suffered a fracture. The second was beaten into a coma. Following the assaults, nurses at Federal Medical Centre in the Southwestern city of Owo stopped treating patients, demanding the hospital improve security. Almost two weeks passed before they returned to work with armed guards posted around the clock.

“We don’t give life. It is God that gives life. We only care or we manage,” said Francis Ajibola, a local leader with the National Association of Nigeria Nurses and Midwives. The attack in Nigeria early last month was just one of many on health workers globally during the COVID-19 pandemic. A new report by the Geneva-based Insecurity Insight and the University of California, Berkeley’s Human Rights Center identified more than 1,100 threats or acts of violence against health care workers and facilities last year.

Researchers found that about 400 of those attacks were related to COVID-19, many motivated by fear or frustration, underscoring the dangers surrounding health care workers at a time when they are needed most. Insecurity Insight defines a health care attack as any physical violence against or intimidation of health care workers or settings, and uses online news agencies, humanitarian groups and social media posts to track incidents around the world.

“Our jobs in the emergency department and in hospitals have gotten exponentially more stressful and harder, and that’s at baseline even when people are super supportive,” said Rohini Haar, an emergency physician in Oakland, California, and Human Rights Center research fellow. “To do that work and to do it with commitment while being attacked or with the fear of being attacked is heartbreaking to me.”

Medical professionals from surgeons to paramedics have long confronted injury or intimidation on the job, especially in conflict zones. Experts say many attacks are rooted in fear or mistrust, as family members react to a relative’s death or a community responds to uncertainty around a disease. The coronavirus has amplified those tensions.

Ligia Kantún has worked as a nurse for 40 years in Mexico and never felt threatened until last spring. As she was leaving a hospital in Merida in April, she heard someone shout the word “Infected!” She was drenched in hot coffee before she could turn around.

“When I got home 10 minutes later my daughter was waiting for me and I hugged her crying, all scared, thinking, ‘How is it possible that they have done this to me?’” she told The Associated Press. Kantún said many people in Mexico at the time thought health workers wore the same uniforms in public that they wore when treating coronavirus patients. “That ignorance was what made them act that way,” she said.

Researchers saw the most attacks last spring and summer as the coronavirus swept across the globe. Yet recent events from Nigeria to the Netherlands, where in January rioters set fire to a coronavirus testing center, prove the threat remains.

Haar said she expected health care workers to be widely celebrated for their lifesaving work during the pandemic, just as Italians sang tributes to doctors during the lockdown. “But actually that didn’t happen in many, many places,” she said. “There’s actually more fear, more distrust, and attacks grew rather than decreased.”

Many attacks may have gone undetected because they are never reported to police or in the media. Insecurity Insight scrambled to expand its monitoring as a flood of attacks were detected in countries that have traditionally been safe for health workers, said director Christina Wille.

In the United States, for example, researchers counted about a dozen threats to health care workers last year. Several incidents involved the injury or arrest of street medics during Black Lives Matter protests.

“I think in the U.S. the culture has been more of trusting health workers,” Haar, the emergency physician, said. “There hasn’t been a longstanding conflict where there’s been a dissonance between health workers and the community.”

Yet health workers in the U.S. are still subject to great risk. Hospital employees in the U.S. are nearly six times as likely as the average worker to be the victim of an intentional injury, according to the Bureau of Labor Statistics, and last month a Minnesota medical assistant was killed during a shooting at a clinic by a former patient unhappy with his treatment.

Misinformation has spurred violence in some cases. Wille said her team looked closely at social media postings in April after three Ebola treatment centers were ransacked in the Democratic Republic of Congo.

“We could actually see that there was a build-up over several days of misinformation about what they call the ‘Ebola business,’ that this was all related to people inventing the disease,” she said. Experts say that even though health workers are in many cases the target of attacks, entire communities suffer when they lose access to medical care after a clinic or medical facility is forced to close due to threats.

“You’re robbing the community of the service they would have provided,” said Nyka Alexander, who leads the World Health Organization’s communications on health emergencies. With or without a pandemic, the most dangerous places for health workers are often areas of conflict and political upheaval. Last year, hundreds of threats and acts of violence were tracked in Syria, Afghanistan, Yemen and the Democratic Republic of Congo.

Naser Almhawish, surveillance coordinator for Syria’s Early Warning Alert and Response Network, said he faced threats several times while working as a doctor in the city of Raqqa. He recalled the day in 2012 at Ar-Raqqa National Hospital when armed men confronted him in the middle of an operation, saying they’d kill him if the patient died.

“You just freeze and you know that you are working and you are trying to save this guy,” he said. “This is our duty. I didn’t ask if this guy was a military, civilian or anything. He’s a human being who needed an operation.”

Almhawish said such attacks on health care settings in Syria had waned in the last year. Researchers said declining violence in the country was the reason they didn't see a greater surge in total health care attacks in 2020.

Kantún, the nurse in Mexico, said she went almost eight months after the attack last April without wearing her nursing scrubs in public. Now, one year into the pandemic, she feels health workers are more respected. But she still worries.

“I’ve had that fear of going out and finding my car scratched, or my car window broken,” she said. “I do have that fear, since I lived it.”

Helen Wieffering is a Roy W. Howard Fellow. Joshua Housing is an investigative fellow on the global investigative team.

Contributing to this report are AP video journalist Federica Narancio and Anne Daugherty and Devon Lum at the University of California, Berkeley Human Rights Center Investigations Lab.

Swiss bask in reopened shops as COVID-19 cases drop

March 01, 2021

GENEVA (AP) — The timing couldn’t have been better for Michele Pesson for Swiss authorities to order a reopening of stores across Switzerland amid a recent drop in coronavirus cases and deaths: Her son’s birthday is coming up, and she wanted to get her hands on something special for him to read.

Pesson, a school teacher and administrator, was one of the droves of shoppers who turned out on Monday in a Geneva shop of well-known Swiss bookstore chain Payot to buy up magazines, books and other wares after a six-week shutdown that left only essential stores in Switzerland open because of the pandemic.

“Honestly, it does a lot of good," she said. “You get the feeling that it's something that's not just the stores that are opening — but it's a whole social aspect that's reopening.” Swiss authorities last week gave a go-ahead to what they called a “cautious” reopening despite a new, more-transmissible COVID-19 variant that first appeared in Britain that is increasingly circulating in the rich Alpine country.

In mid-January, authorities ordered the closure of stores except for supermarkets, pharmacies and other essential businesses — around the time that the country of 8.5 million was tallying more than 3,000 new coronavirus cases per day based on a seven-day average. That rate has gradually dropped in recent weeks, now to about 1,000 per day — or less.

The seven-day average of deaths has come in in the single digits in recent days, declining steadily from more than 70 on New Year's Day and a plateau of over 80 per day in most of November and December.

The new measures don't just affect stores: museums, zoos, library reading rooms and outdoor sports facilities like tennis courts and skating rinks can reopen. The government also is allowing more people to gather in public or private — 15 people, up from five.

President Guy Parmelin last week acknowledged public pressure for a faster reopening, but called for “discipline” in the face of the new variant's spread. A reopening of restaurants and bars is planned for April 1, but that could be moved forward “if the situation continues to improve,” he said.

He cited rising vaccinations and COVID-19 testing in Switzerland as reasons to be confident. Shop owners too expressed relief Monday that life was getting a bit closer to normal. Nabil Slimani, manager of a Geneva store of snowboard, freeski, surf, skate and streetwear vendor Blue Tomato, said the closures last month and other forced closures in November “were really starting to weigh us as much as on the customers."

He said more customers flooded into the store after a previous shutdown last year, and this time, “it's been pretty calm ... it hasn't been crazy.” Ikea reported a few longer lines than usual. Spokesman Aurel Hosennen said Monday wasn’t nearly as busy as after a reopening from a longer lockdown last spring, when visits to reopened stores were nearly twice as much as on a normal day. On Monday, traffic was up about 30% from a normal Monday.

But the managers of the Payot bookshop said a combination of a back-to-school rush after university holidays and an eagerness to return to the feel of new books — after some online shopping in recent weeks — was driving up traffic on Monday.

"For a month and a half, people missed coming to bookstores," said Christophe Jacquier, the Payot store manager. “There's a real pleasure for people to come to hunt for and chose their books — it's not the same thing as searching on the Internet.”

Experts notice pandemic's mental health toll on German youth

February 27, 2021

BERLIN (AP) — Pollina Dinner returned to school in Berlin for the first time this week after two months of lockdown. The 9-year-old third-grader was thrilled to see her classmates and teachers again but frets about the coronavirus pandemic's effect on her life.

“I'm not afraid of the coronavirus, I'm afraid that everything will continue like this — that my school will close again, I won't be able to see my friends, and that I can't go to the movies with my family,” the girl said, fingering her blue medical mask and sighing deeply. “And wearing this mask is even worse than all the shops being closed.”

Psychiatrists, psychologists and pediatricians in Germany have voiced growing alarm that school closings, social restrictions and other precautions are magnifying the fear, disruption and stress of the pandemic among Germany’s 13.7 million children and teenagers, raising the prospect of a future mental health crisis.

“We don’t have any long-term studies yet, but there’s lots of anecdotal evidence of a crisis-driven rise in hospitalizations and overflowing psychologists’ practices,” Julia Asbrand, a professor of child and youth psychology at Berlin’s Humboldt University, told The Associated Press.

A recent survey by the University Medical Center Hamburg-Eppendorf found that about one child in three is suffering from pandemic-related anxiety or depression or is exhibiting psychosomatic symptoms like headaches or stomach aches. Children from poorer and immigrant families are disproportionally affected, according to the survey.

Pollina, who immigrated from Russia with her family in 2019, worries about forgetting much of her German since she only speaks Russian at home. She's one of 150 youngsters from underprivileged families who, before the pandemic. regularly spent time after school at a youth support program on the eastern outskirts of the German capital.

Arche — Ark in English — is based in Berlin's Hellersdorf district, a neighborhood of drab concrete buildings constructed during the former Communist regime of East Germany. Some children are still allowed to come in person, but only once every two weeks. The rest of the time, the social workers and educators try to stay in touch through video chats while helping their young clients with remote learning.

“Many have completely withdrawn and don’t want to get out of their rooms anymore. They’ve gained a lot of weight, are playing online games nonstop and don’t have any more structure in their everyday lives,” Arche founder Bernd Siggelkow said.

The second major lockdown in Germany started before Christmas. Students in grades 1-3 were allowed to return to classrooms this week with reduced class sizes and limited lessons. The government hopes to ease further restrictions in coming weeks and has said that the re-opening of all schools is a top priority.

However, there's concern the country is slipping into a third wave of infections due to more contagious variants of the virus. Virologists have repeatedly said it is still unclear to what extent the virus spreads from children attending school into homes and communities. More than 2 million people have contracted the virus in Germany and almost 70,000 have died of COVID-19, although only 10 under the age of 20, according to the country's disease control center.

Even though children are not at as much risk of severe COVID-19 complications as older adults, they may be more vulnerable to the collateral mental health effects of the pandemic, according to experts.

An analysis by German health insurer DAK regarding youth psychological issues confirms the first-person observations of the staff at Arche. The evaluation, which was obtained by German news agency dpa, showed that the number of children and teenagers hospitalized for psychiatric treatment in Berlin almost doubled during the first half of 2020, when schools were closed for over two months during the country's first lockdown, compared with first six months of 2019.

The statistic underscores the psychological strain the pandemic is putting on young people but does not illustrate the scope of the problem, Christoph Correll, the director of child and youth psychiatry at Berlin’s Charite hospital, told dpa.

“Hospitalizations are the tip of the iceberg," he said. Teenagers, especially girls, are more prone to eating disorders and self-harming, and many children's psychological problems are going undetected while parents are overwhelmed and teachers, social workers and pediatricians don’t have regular contact with students, clients and patients, experts warn.

Psychology professor Asbrand worries that the mental health of children and teenagers has not gotten enough attention during the pandemic. Together with other professionals in the field, she wrote an open letter to the government this month to push for youth needs to get better addressed in the ongoing health crisis and prioritized when society reopens.

An immediate action government authorities could take to help mitigate possible problems would be to allow groups to gather for school and youth sports, in line with hygiene and distancing precautions.

“We all don't know yet how this is going to develop long-term, but we must focus on youth mental health now," she said. While attending Arche this week for help with homework assigned online, 16-year-old Robin Reyer said not being able to hang out with friends has been one of the hardest parts of the pandemic restrictions.

“I want to celebrate birthdays again, go out and play soccer with my friends in the park or meet them at Burger King,” he said while taking a break outside in the spring sun. “Now, I'm only allowed to meet one friend at most," he said. "That really sucks.”

Pandemic leaves many Romanian patients without critical care

February 26, 2021

BUCHAREST, Romania (AP) — Andrei, a 32-year-old Romanian man who has been HIV positive since he was a baby, began missing his regular medical check-ups when the coronavirus pandemic hit a year ago. “That was the first thing that led me to a general state of frustration and fear,” said Andrei. “After that, I got used to the idea of taking the antiretroviral treatment blindly without knowing if the parameters are OK or if the therapy works.”

A year ago this week, Romania reported its first case of COVID-19, prompting the country's strapped medical system to turn its focus to treating COVID-19 patients. As a result, many patients with other conditions — including cancer — have either been denied critical care or have stopped going to their regular appointments, fearful of becoming infected.

“Many of my close associates lost their battle against their diseases due to the loss of access to treatment, hospitals and specialists,” Andrei, who didn’t want his full name used due to the stigma surrounding his condition, told The Associated Press.

Romania's government is acknowledging the problem and has announced plans to reorganize the country’s hospitals so more non-COVID-19 patients can get access to health care. The attempts to reform the health care system come as a third virus surge looms and as a vaccine rollout is proceeding slowly across the 27-member European Union, to which Romania belongs.

“Patients who didn’t have COVID-19 didn’t seek medical care because they were afraid of becoming infected,” Dr. Andreea Moldovan, a state secretary in the Health Ministry, told the AP. Previously, she said, there was “a lot of pressure to have as many beds available for COVID-19 patients as possible."

With a population of over 19 million, Romania has reported 792,000 COVID-19 infections and over 20,000 deaths. Romania's Health Ministry says its hospital reorganization scheme will aim to create separate red and green zones in hospitals so both non-COVID-19 patients and those infected with the disease can be segregated yet receive the medical care they require.

In an interview at Bucharest’s Colentina Hospital, interim hospital manager Victor Cauni said health care services in the long term must adapt to life with COVID-19 and not “discriminate” against other patients.

“Whether we like it or not, we have more patients with many other illnesses compared to COVID patients," he said. “We need to open for them at least partially. We’re discriminating against patients with serious conditions.”

Highlighting the problem, Cauni noted that the hospital's urological ward used to perform from 400 to 500 medical interventions a month, but has barely had 50 in the past year. “For the last year, patients did not have access to this hospital, and they were supposed to be transferred to different hospitals — but not many managed to find the required solutions,” Cauni said.

“You cannot just function as a COVID-19 hospital," he said. “We have many important wards here.” The organizational changes in Romania’s hospitals come amid growing concerns about new virus variants, including the variant first found in the U.K., which scientists say is both more transmissible and more deadly.

Romania faces these challenges as the EU nation with the lowest health care spending relative to GDP — 5.2%, compared with almost 10% on average in the bloc. Romania already has the highest rate of avoidable deaths of under-75s in the EU, according to EU statistics.

Health Minister Vlad Voiculescu expressed his concerns in a video address last week to hospital managers and public health officials, explaining the hospital reorganization effort. “The pandemic has not wiped out all other chronic or acute health problems,” Voiculescu said. “We need to make sure that all other patients have access to the medical services they need."

Andrei, who became infected with HIV as a baby while being treated in a hospital, says he considers himself “one of the lucky ones." He has managed to pay privately for a few medical analyses in the past year. But he worries about his longer-term prospects if he doesn't return to the close monitoring of his illness.

“The situation is critical,” he said. “If I keep blindly taking my treatment without proper monthly visits and analyses to check if the treatment is working … there is only one outcome — the loss of life.”

Medical oxygen scarce in Africa, Latin America amid virus

February 25, 2021

DAKAR, Senegal (AP) — A crisis over the supply of medical oxygen for coronavirus patients has struck nations in Africa and Latin America, where warnings went unheeded at the start of the pandemic and doctors say the shortage has led to unnecessary deaths.

It takes about 12 weeks to install a hospital oxygen plant and even less time to convert industrial oxygen manufacturing systems into a medical-grade network. But in Brazil and Nigeria, as well as in less-populous nations, decisions to fully address inadequate supplies only started being made last month, after hospitals were overwhelmed and patients started to die.

The gap in medical oxygen availability “is one of the defining health equity issues, I think, of our age,” said Peter Piot, director of the London School of Hygiene & Tropical Medicine, who said he survived a severe coronavirus infection thanks to the oxygen he received.

Doctors in Nigeria anxiously monitor traffic as oxygen deliveries move through the gridlocked streets of Lagos. There and in other countries, desperate families of patients sometimes turn to the black market. Governments take action only after hospitals are overwhelmed and the infected die by the dozens.

In Brazil’s Amazonas state, swindlers were caught reselling fire extinguishers painted to look like medical oxygen tanks. In Peru, people camped out in lines to get cylinders for sick relatives. Only after the lack of oxygen was blamed for the deaths of four people at an Egyptian hospital in January and six people at one in Pakistan in December did governments address the problems.

John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said medical oxygen is a “huge critical need” across the continent of 1.3 billion people and is a main reason that COVID-19 patients are more likely to die there during a surge of cases.

Even before the pandemic, sub-Saharan Africa’s 2,600 oxygen concentrators and 69 functioning oxygen plants met less than half the need, leading to preventable deaths, especially from pneumonia, said Dr. John Adabie Appiah of the World Health Organization.

The number of concentrators has grown to about 6,000, mostly from international donations, but the oxygen produced isn't pure enough for the critically ill. The number of plants that can generate higher concentrations is now at 119.

Nigeria was “struggling to find oxygen to manage cases” in January, said Chikwe Ihekweazu, head of its Centre for Disease Control. A main hospital in Lagos, a city of 14.3 million, saw its January virus cases increase fivefold, with 75 medical workers infected in the first six weeks of 2021. Only then did President Muhammadu Buhari release $17 million to set up 38 more oxygen plants and another $670,000 to repair plants at five hospitals.

Some oxygen suppliers have dramatically raised prices, according to a doctor at the Lagos University Teaching Hospital who spoke on condition of anonymity because he was not allowed to talk to reporters. That has driven up the cost of a cylinder by 10 times, to $260 — more than the average monthly wage — and a critically ill patient could need up to four cylinders a day.

Money and influence don't always help. Femi Odekunle, a Nigerian academic and close ally of the president, went without adequate oxygen for nearly 12 days at the Abuja University Teaching Hospital until two state governors and Ministry of Health officials intervened. He died anyway, and relatives and friends blame the oxygen shortage, the online newspaper Premium Times reported. The hospital attributed his death to his severe infection.

In Malawi, the president promised funding for protective gear for medical workers and the immediate purchase of 1,000 oxygen cylinders, adding that he would fly them in, if needed. Corruption was blamed for defects in a new oxygen plant at a hospital in Uganda's capital of Kampala, the Daily Monitor newspaper reported in November. Workers had to rely on rusty oxygen cylinders that were blamed for the deaths of at least two patients.

“While top health officials basked in the oxygen of good publicity, patients were literally choking to death,” the newspaper said. “It appears that behind the delays and the funding gaps, corners were being cut.”

Leith Greenslade, coordinator of the Every Breath Counts Coalition, which advocates for wider access to medical oxygen, said the looming shortages were apparent last spring. “Very little was done. Now you have a second wave, not just in Africa but in Latin America and Asia and the oxygen shortages are becoming at crisis levels,” she said.

The World Bank has set aside $50 billion for the world’s poorest countries alone, but only $30.8 billion has been committed, including $80 million for oxygen-related upgrades after requests from Afghanistan, Bangladesh, Benin, the Central African Republic, Chad, Congo, Gambia, Ghana, Grenada, Kenya, Mali, Rwanda, Sierra Leone and Tajikistan. That leaves nearly $20 billion available between now and a June 2021 deadline to spend it, the World Bank said.

“We make money available for countries, but it’s countries, governments who have to make a decision about how much they spend and what they spend it on,” said Dr. Mickey Chopra, who helps with the World Bank’s global medical logistics response.

Many countries view oxygen supplies primarily as an industrial product for more lucrative sectors such as mining, not health care, and it has not been a focus of many international donors. Oxygen manufacturing plants require technicians, good infrastructure and electricity — all in short supply in developing nations.

The main provider of medical oxygen to Brazil’s Amazonas state, White Martins, operated at half capacity before the pandemic. The first infections hit the isolated city in March and led to so many deaths that a cemetery was carved out of the jungle.

Doctors in its capital of Manaus were forced last month to choose which patients to treat as oxygen supplies dwindled. Brazil’s Supreme Court began an investigation into management of the crisis after White Martins said an “unexpected increase in demand” led to shortages.

“There was a lack of planning on behalf of the government,” said Newton de Oliveira, president of Indústria Brasileira de Gases, a major oxygen supplier. Only after deaths averaged 50 a day did the government say it would build 73 oxygen plants in the state. Within a month, 26 were up and running.

Shortages remain critical in Peru, where Dani Luz Llamocca waited five days outside a distribution center in Lima, saying her virus-stricken father was down to less than half a tank of oxygen. She was willing to wait as long as it took. "If not, my father will die,” said Llamocca.

The WHO's Appiah said countries with mining industries could, with few changes, convert their systems to produce medical-grade oxygen. India's national trade body for gas makers suggested just that in April 2020, when the virus caseload was relatively low. Industrial storage tanks were repurposed at hospitals, said Surendra Singh, a manager for the Indian division of the multinational Linde corporation.

“It’s not rocket science,” said Saket Tiku, president of the All India Industrial Gases Manufacturers Association. “The decision saved thousands of lives.”

Hinnant reported from Paris. Aniruddha Ghosal in New Delhi, Franklin Briceño in Lima, Peru; Sam Magdy in Cairo, Diane Jeantet in Rio de Janeiro, Sam Olukoya and Lekan Oyekanmi in Lagos, Nigeria, Cara Anna in Nairobi, Kenya, Riaz Khan in Peshawar, Pakistan, and Rodney Muhumuza in Kampala, Uganda, contributed.

With heavy hearts, Italians mark year of COVID-19 outbreak

February 21, 2021

CODOGNO, Italy (AP) — With wreath-laying ceremonies, tree plantings and church services, Italians on Sunday marked one year since their country experienced its first known COVID-19 death. Towns in Italy's north were the first to be hard-hit by the pandemic and put under lockdown, and residents paid tribute to the dead. Italy, with some 95,500 confirmed virus dead, has Europe’s second-highest pandemic toll after Britain. Experts say the virus also killed many others who were never tested.

While the first wave of infections largely engulfed Lombardy and other northern regions, a second surge starting in the fall of 2020 has raced throughout the country. The number of new coronavirus infections has remained stubbornly high despite a raft of restrictions on travel between regions, and in some cases between towns. In addition, gyms, cinemas and theaters have been closed and restaurants and bars must shut early in the evening. There's a 10 p.m. to 5 a.m. nationwide curfew.

So far, Italy has confirmed 2.8 million cases. It was in the hospital at the Lombard town of Codogno where a doctor recognized what would go down in medical history as the first known COVID-19 case in the West in a patient with no links to the outbreak in Asia, where coronavirus infections initially emerged. The diagnosis was made on the evening of Feb. 20, 2020, in a 38-year-old otherwise healthy, athletic man.

Near the Red Cross office in Codogno on Sunday, Lombardy's governor and the town mayor attended a ceremony to unveil a monument to COVID-19 victims. The memorial consists of three steel pillars, representing resilience, community and starting over. A wreath was laid, and townspeople stood in silence to honor the dead.

“Panic, total panic,'' was how one of Codogno's 15,000 residents, Rosaria Sanna, on Sunday remembered what she felt at the start. And a year later ”I am still scared because it is not over yet." Some of her fellow townspeople lit candles during morning Sunday Masses in Codogno's St. Blaise Church.

The Codogno hospital patient survived, after being transferred to another hospital and spending weeks on a respirator. But it was in the northeastern town of Vo, in the neighboring Veneto region, where Italy's first known COVID-19 death was registered on Feb. 21, 2020.

In Vo's memorial ceremony, officials planted a tree. A plaque has been installed, quoting a line from the Italian poet Ugo Foscolo, whose works are widely studied by the nation's schoolchildren. The inscription reads: “A man never dies if there is someone who remembers him.”

Italy's first known fatality from COVID-19 was a 77-year-old Vo man, a retired roofer who liked to play cards.

Powdering sleeping beauty's nose: Virus eases Louvre works

February 20, 2021

PARIS (AP) — The 518-year-old Mona Lisa has seen many things in her life on a wall, but rarely this: Almost four months with no Louvre visitors. As she stares out through bulletproof glass into the silent Salle des Etats, in what was once the world's most-visited museum, her celebrated smile could almost denote relief. A bit further on, the white marble Venus de Milo is for once free of her girdle of picture-snapping visitors.

It’s uncertain when the Paris museum will reopen, after being closed on Oct. 30 in line with the French government’s virus containment measures. But those lucky enough to get in benefit from a rare private look at collections covering 9,000 years of human history -- with plenty of space to breathe.

That's normally sorely lacking in a museum that's blighted by its own success: Before the pandemic, staff walked out complaining they couldn't handle the overcrowding, with up to 30,000-40,000 visitors a day.

The forced closure has also granted museum officials a golden opportunity to carry out long-overdue refurbishments that were simply not possible with nearly 10 million visitors a year. Unlike the first lockdown, which brought all Louvre activities to a halt, the second has seen some 250 of the museum employees remain fully operational.

An army of curators, restorers and workers are cleaning sculptures, reordering artifacts, checking inventories, reorganizing entrances and conducting restorations, including in the Egyptian Wing and the Grande Galerie, the museum’s largest hall that is being fully renovated.

“We’re taking advantage of the museum’s closure to carry out a number of major works, speed up maintenance operations and start repair works that are difficult to schedule when the museum is operating normally,” Laurent le Guedart, the Louvre’s Architectural Heritage and Gardens Director told AP from inside the Grande Galerie.

As le Guedart spoke, restorers were standing atop scaffolds taking scientific probes of the walls in preparation for a planned restoration, travelling back to the 18th century through layer after layer of paint.

Around the corner the sound of carpenters taking up floorboards was faintly audible. They were putting in the cables for a new security system. Previously, these jobs could only be done on a Tuesday, the Louvre's only closed day in the week. Now hammers are tapping, machines drilling and brushes scrubbing to a full week schedule, slowed down only slightly by social distancing measures.

In total, ten large-scale projects that were on hold since last March are under way — and progressing fast. This includes works in the Etruscan and Italian Halls, and the gilded Salon Carre. A major restoration of the ancient Egyptian tomb chapel of Akhethotep from 2400BC is also underway.

“When the museum reopens, everything will be perfect for its visitors — this Sleeping Beauty will have had the time to powder her nose,” said Elisabeth Antoine-Konig, Artifacts Department Curator. “Visitors will be happy to see again these now well-lit rooms with polished floors and remodeled display cases.”

Initially, only visitors with pre-booked reservations will be granted entry in line with virus safety precautions. Those who cannot wait are still able to see the Louvre's treasure trove of art in virtual tours online.

Adamson reported from Leeds, England.

G-7 vows 'equitable' world vaccine access, but details scant

February 19, 2021

LONDON (AP) — Leaders of the Group of Seven economic powers promised Friday to immunize the world’s neediest people against the coronavirus by giving money, and precious vaccine doses, to a U.N.-backed vaccine distribution effort.

But the leaders, under pressure over their vaccination campaigns at home, were unwilling to say exactly how much vaccine they were willing to share with the developing world, or when. Chancellor Angela Merkel said after the G-7 leaders held a virtual meeting that fair distribution of vaccines was “an elementary question of fairness.”

But she added, “No vaccination appointment in Germany is going to be endangered.” After their first meeting of the year -- held remotely because of the pandemic -- the leaders said they would accelerate global vaccine development and deployment” and support “affordable and equitable access to vaccines” and treatments for COVID-19. They cited a collective $7.5 billion from the G-7 to U.N.-backed COVID-19 efforts.

“This is a global pandemic, and it’s no use one country being far ahead of another," British Prime Minister Boris Johnson said as he opened the virtual summit with the leaders of the United States, France, Germany, Italy, Canada and Japan. The U.K. holds the G-7 presidency this year.

“We’ve got to move together,” Johnson said, speaking from the prime minister's 10 Downing St. residence to the other leaders in their far-flung offices. “So, one of the things that I know that colleagues will be wanting to do is to ensure that we distribute vaccines at cost around the world.”

Wealthy nations have snapped up several billion doses of COVID-19 vaccines, while some countries in the developing world have little or none. G-7 leaders are eager to avoid looking greedy — and don't want to cede the terrain of vaccine diplomacy to less democratic but faster-moving countries such as China and Russia.

Johnson, whose country has reported almost 120,000 virus-related deaths, promised to give “the majority of any future surplus vaccines” to the U.N.-backed COVAX effort to vaccinate the world’s most vulnerable people.

But Foreign Office Minister James Cleverly said it was “difficult to say with any kind of certainty” when or how much Britain could donate. French President Emmanuel Macron gave a firmer target, saying Europe and the U.S. should allocate up to 5% of their current COVID-19 vaccine supplies to the poorest countries quickly.

“This is worth an enormous amount. It is worth our credibility,” Macron said after the meeting, “If we can do this, then the West will have a presence” in African countries, he said. If not, those countries will turn to Chinese and Russian vaccines and “the power of the West will...not be a reality.”

Macron's office said France was ready to hand over 5% of its doses but would not give exact numbers or a date. As the African continent awaits delivery of doses through COVAX, an African Union-created vaccines task force said Friday that it would be getting 300 million doses of Russia’s Sputnik V vaccine in May. The AU previously secured 270 million doses from AstraZeneca, Pfizer and Johnson & Johnson for the continent of 1.3 billion people.

The governments of Canada and the European G-7 nations are under pressure to speed up their domestic vaccination campaigns after being outpaced by Britain and the U.S. Asked later Friday about Macron’s proposal, Germany's Merkel said that “we have not yet spoken about the percentage.”

“We haven’t yet spoken about the timing" either, the chancellor told reporters in Berlin. "That still has to be discussed.” Development and aid groups welcomed the commitments but said rich Western countries needed to do more, and soon.

Gayle Smith, chief executive of anti-poverty group the ONE Campaign, said “world leaders are finally waking up to the scale of this crisis.” “It beggars belief that in the midst of a global pandemic a handful of countries have accumulated over a billion vaccines more than they will need, while 130 countries have no vaccines at all," she said.

The summit marked Biden's his first major multilateral engagement since taking office. America's allies hope that U.S. re-engagement with the world following the “America first” years under former President Donald Trump will mean a more coordinated response on issues such as the pandemic and climate change.

Biden signed the U.S. up to the COVAX initiative, which Trump refused to support, and has pledged to distribute $4 billion in U.S. funding to the program. The G-7 meeting — and a speech by Biden at the Munich Security Conference on Friday — comes the day the United States officially rejoins the Paris climate agreement, the largest international effort to curb global warming. Trump pulled the U.S. out of the landmark accord in 2017.

The Biden administration also said it was ready to join talks with Iran and world powers to discuss a return to the 2015 deal to curb Tehran's nuclear ambitions, which was repudiated by Trump. In a joint statement reflecting the United States’ re-embrace of international institutions, the G-7 leaders vowed to “make 2021 a turning point for multilateralism and to shape a recovery that promotes the health and prosperity of our people and planet.”

They said post-pandemic economic recovery efforts must put the fight against climate change and dwindling biodiversity “at the center of our plans.” A full G-7 summit is scheduled to take place in June at the Carbis Bay seaside resort in southwest England.

Associated Press writers Sylvie Corbet and Angela Charlton in Paris, Samuel Petrequin in Brussels, Geir Moulson in Berlin and Cara Anna in Nairobi, Kenya, contributed to this story.

'Alone': How Italian town with 1st known virus death fared

February 19, 2021

VO, Italy (AP) — Italy delivered the first shocking confirmation of locally transmitted coronavirus infections outside of Asia a year ago Sunday, with back-to-back revelations of cases more than 150 kilometers (nearly 100 miles) apart in the country's north.

First, a 38-year-old man in Codogno, an industrial town in the Lombardy region, tested positive for COVID-19, sending panicked residents to pick up their children from school, stock up on provisions at grocery stores and search in vain for surgical masks at pharmacies.

By the evening of Feb. 21, a 77-year-old retired roofer from Vo, a wine-making town in the Veneto region, had died — at the time, the first known fatality from a locally transmitted case of the virus in the West, setting off alarm bells far and wide.

In the days and weeks that followed, densely populated Lombardy would become the epicenter of Italy’s outbreak and, by the end of March, countries the world over would be under lockdowns to slow the spread of the virus that has now taken 2.4 million lives. But Vo, as one of the first towns in the West to be isolated, has a unique story, providing some of the first scientific insights into the deadly virus.

Adriano Trevisan’s death sent shockwaves through the town west of Venice. Trevisan, well-known around Vo and a regular at a card game in a local bar, had been hospitalized for two weeks with circulatory issues related to a heart condition that could not be resolved with drugs, according to his physician, Dr. Carlo Petruzzi. There was no reason to suspect the coronavirus — as the retiree had had no contact with China, until then a key element in diagnosis.

After being advised of the death, Mayor Giuliano Martini, who doubles as the town’s chief pharmacist, ordered schools and nonessential businesses to close and forbade residents from leaving the town, even for work. He asked local volunteer groups to help ensure food and pharmaceutical supplies entering the town were ferried to shelves. The town's three family doctors were put into quarantine because of suspected contact, and the closest hospital, a 30-minute drive away, was closed.

“It was like a war film,” Martini said. “We were completely alone.” Surrounded by vineyards and farmland, the town of 3,270 people nestled against Monte Venda has long enjoyed bucolic isolation. But by three days after Trevisan’s death, its isolation was ensured by government decree: Rome dispatched soldiers to seal the town's 12 access roads. Blockades were also set up around the 10 towns near Milan where the other early case of local transmission was confirmed.

“There was a sense of bewilderment, I would call it,’’ said Dr. Luca Rossetto, one of the practitioners in Vo. “Even myself, with an old specialization in preventative hygiene, should have the right mindset. But there was an absolute disorientation.”

Rossetto reviewed his recent cases and realized he had seen seven people in the previous days with pneumonia-like symptoms. A week later, the 69-year-old physician himself was hospitalized with the virus, a light case from which he recovered.

Veneto Gov. Luca Zaia, meanwhile, instinctively ordered blanket testing for all of the residents of Vo, with the aim of understanding the outbreak’s origin. That he was even able to make such a call is thanks to the foresight of University of Padua virologist Andrea Crisanti, who had ordered the necessary tools after the virus appeared in China. Many places around the world struggled to institute testing so quickly.

Crisanti recognized that there would be value in testing the entire town immediately after the contagion was confirmed and then again after two weeks. And his work offered early insight into how the virus spread — clarity that Crisanti said was never properly translated into action.

The results of the first round of nasal swab tests, available on Feb. 27, showed that nearly 3% of the population had been infected. That indicated that the virus had been circulating in the town since the end of January, according to Crisanti.

“With that data, we should have closed both Veneto and Lombardy, immediately,” Crisanti said. But decision-makers, he said, “didn’t perceive the extent of the problem.” The question of whether more more restrictions on movement should have been instituted sooner has been hotly debated in Italy, with many politicians noting that such decisions were extremely difficult given that the measures come with a heavy economic and social cost and infringe on freedoms. There is even a criminal investigation into whether officials waited too long to lock down two towns in Lombardy.

Shutting down Vo proved remarkably effective in stopping the transmission. When Crisanti conducted the second round of testing on March 7, no new cases were detected. Crisanti said that the findings — which were published by the journal Nature in June but known to Italian officials immediately — made clear that isolation and mass testing were the best way to contain the virus before vaccines.

While Crisanti succeeded in persuading the Veneto region to increase testing, it wasn’t until March 9 — 17 days after the virus had been simultaneously detected in two Italian regions, with cases multiplying and a mass exodus toward the south under way — that then-Premier Giuseppe Conte ordered the entire country on a near-total lockdown that would last seven weeks.

By the end of May, as cases began to recede in Italy, more than 232,684 people had been infected, mostly in the north, and 33,415 had died. Scientists still don’t know how the virus arrived in Vo. Though struck at the same time, Veneto fared much better than Lombardy, which became the epicenter of both of Italy's surges. It has half the population and its industry is more spread out, but experts have also credited its health system, which enables close contact among family doctors, district administrators and hospital officials and which is less reliant on private facilities. Another key element in its virus fight was the testing system created by Crisanti.

Crisanti urged the government in Rome in August to expand its capacity for nasal swab tests in the hopes of keeping transmission low after a successful lockdown. While the government has, Crisanti is disappointed that it has relied heavily on rapid tests — as many other places have and as some experts have recommended — rather than strategically deploying more reliable nasal swabs to isolate outbreaks.

By October, Italy was battling a resurgence that has proved even deadlier than the spring peak, with the toll now at nearly 95,000. New clusters of a variant first found in Britain have led to localized lockdowns around the country, forcing the cancellation of one of the virus anniversary commemorations this weekend in Lombardy.

If the virus’ arrival last February caught the country off-guard, the long-predicted fall resurgence was “madness,” Crisanti said. Vo, too, suffered a resurgence that is only now abating. The town’s pandemic death toll doubled, to 6.

Boasting an unusually high number of restaurants per capita at 45 eateries, Vo is now an echo of its former self. The weddings, baptisms and first communions that drew dwellers of nearby cities to the hillside town have been limited by restrictions. Restaurant closures also forced the Vo wine cooperative to reduce 2020 production. The local dance hall has never reopened.

Things might have been different, Martini believes. “The virus in Vo arrived in Vo and died in Vo,” the mayor said of the first cases a year ago. The failure to repeat the model: “Ruinous,” he said.

Dutch parliament approves new coronavirus curfew law

February 18, 2021

THE HAGUE, Netherlands (AP) — The Dutch parliament approved hastily drawn-up legislation Thursday underpinning the country's coronavirus curfew after a judge ordered the measure scrapped earlier this week.

The legislation is now expected to be debated by the senate on Friday — the same day that government lawyers go to court to appeal the order banning the 9 p.m.-to-4:30 a.m. curfew. If the senate approves the legislation, the curfew will remain in place and the appeal court's decision will become largely irrelevant.

Maarten Hijink of the opposition Socialist Party gave the legislation his backing, but told the government: “Don’t take the support as an appreciation of the way this Cabinet made such an unbelievable mess of the judicial underpinning of the curfew.”

Populist Geert Wilders was among opposition lawmakers who do not support the legislation introduced by Prime Minister Mark Rutte's government. “What an embarrassment for Prime Minister Rutte, and what a hammer blow for the credibility of the corona policies of his Cabinet in general and the curfew in particular,” said Wilders, who has repeatedly described the measure as disproportionate. He demanded that fines meted out for breaches of the curfew be canceled or repaid.

The curfew, which sparked rioting last month but is very broadly supported and followed, remains in force pending the outcome of the government's appeal. A judge in The Hague banned the curfew, saying the law the government used when it introduced the measure last month can only be wielded in pressing emergencies such as a massive dike breach.

The government argues that the curfew became an urgent necessity because of the swift rise of new, more transmissible variants of the virus, particularly the one first discovered in Britain which has already gained ground in the Netherlands.

Rutte told lawmakers Thursday: “Of course, we regret the situation because it creates a lack of clarity. That's why the Cabinet has tried to create clarity as quickly as possible via ... the urgent appeal against the court decision and also the legislation we're talking about.”

The Netherlands has been in a tough lockdown since mid-December, with all nonessential stores closed, along with bars, restaurants and other public venues. Elementary schools reopened this month, but all other schools and universities remain shut.

Infections have been slowly declining, with the 7-day rolling average of daily new cases decreasing over the past two weeks from 23.38 new cases per 100,000 people to 21.28 on Feb. 17. The country has more than 15,000 confirmed COVID-19 deaths.

Italy's COVID anniversary commemoration nixed by new variant

February 18, 2021

ROME (AP) — One of this weekend's main events commemorating the anniversary of the start of Italy’s COVID-19 outbreak was canceled Thursday after a cluster of new infections traced to the British variant forced localized lockdowns in hardest-hit Lombardy and around the country.

Italy’s Superior Institute of Health reported last week that the British variant represented some 18% of all new infections, but predicted that the number would rise quickly as the variant spread. The institute has warned that new restrictions could become necessary to keep the health care system from once again buckling under.

Brescia’s public hospital, which was overwhelmed during the initial outbreak last year, had planned a daylong conference Saturday on lessons learned from the pandemic. It was to feature the intensive care doctor who diagnosed Italy’s first locally transmitted case, as well as the opening of a commemorative art exhibit dedicated to health care workers worldwide.

But the hospital announced Thursday that it was postponing the event out of a sense of responsibility “considering the rapid evolution of the epidemiological situation.” It noted that four cities in Lombardy region, including one in the province of Brescia, have recently been placed under the strictest “red zone” lockdown measures following spikes of British variant infections. In those cities, all schools were closed and non-essential commercial activities halted, while personal movement was also restricted.

Other red zones have been imposed in cities in the central regions of Umbria, Tuscany, Abruzzo and Lazio, sparking calls for another nationwide lockdown from hospital doctors who are once again seeing their ICU beds fill up.

“I foresee that the national health care system will suffer very heavily," said Dr. Alberto Albani, the regional COVID-19 coordinator in Abruzzo, where the provinces of Chieti and Pescara have been placed under red zone lockdown measures because of variant spikes.

He acknowledged that the economic impact of another national lockdown would be hard to accept, “but I believe that only a serious lockdown of three weeks across all the national territory would block the pandemic.”

Italy's outbreak officially began Feb. 21 in the Lombardy town of Codogno, when officials announced that a 38-year-old marathoner with no ties to China or a known positive case tested positive. Italy would go on to become the epicenter of the outbreak in Europe, though it won international praise for having largely tamed infections after a strict 10-week spring lockdown and production shutdown.

Infections roared back in the fall, killing more people than during the initial outbreak. But the government has shied away from another full-fledged national lockdown, instead placing individual regions into various levels of restrictions based on infection rates and hospital capacity.

In addition to the Brescia anniversary event, officials in Codogno were planning a daylong commemoration, featuring a Mass and the inauguration of a memorial to COVID-19 victims. On Thursday, Italy added another 13,762 infections in line with its average daily caseload for the past several weeks, bringing its confirmed total caseload to nearly 2.76 million. Another 347 people died, bringing the confirmed death toll to 94,887, the second highest in Europe after Britain.

The country is now trying to ramp up its vaccination campaign, and Lombardy on Thursday finally began inoculating residents over age 80. Italy had prioritized health care workers and residents of nursing homes with its first doses, but many regions are already two weeks into the over-80 vaccination campaign.

AP visual journalist Andrea Rosa reported from Pescara, Italy.

Dutch lawmakers debate new law backing coronavirus curfew

February 18, 2021

THE HAGUE, Netherlands (AP) — Dutch lawmakers are holding a debate Thursday on hastily drawn up legislation underpinning the country's coronavirus curfew after a judge ordered the measure scrapped earlier this week.

The lower house of parliament is expected to support the legislation, which would then go to the senate on Friday — the same day that government lawyers go to court to appeal the order banning the 9 p.m.-to-4:30 a.m. curfew.

The curfew, which sparked rioting last month but is very broadly supported and followed, remains in force pending the outcome of that appeal. A judge in The Hague banned the curfew, saying the law the government used when it introduced the measure last month can only be used in pressing emergencies such as a massive dike breach.

The government argues that the curfew became an urgent necessity because of the swift rise of new, more transmissible variants of the virus, particularly the variant first discovered in Britain, which has already gained ground in the Netherlands.

The Netherlands has been in a tough lockdown since mid-December, with all nonessential stores closed, along with bars, restaurants and other public venues. Elementary schools reopened this month, but all other schools and universities remain shut.

Infections have been slowly declining, with the 7-day rolling average of daily new cases decreasing over the past two weeks from 23.38 new cases per 100,000 people to 21.28 on Feb. 17. The country has more than 15,000 confirmed COVID-19 deaths.

Reports: Myanmar forces kill 82 in single day in city

April 11, 2021

YANGON (AP) — At least 82 people were killed in one day in a crackdown by Myanmar security forces on pro-democracy protesters, according to reports Saturday from independent local media and an organization that keeps track of casualties since the February coup.

Friday’s death toll in Bago was the biggest one-day total for a single city since March 14, when just over 100 people were killed in Yangon, the country’s biggest city. Bago is about 100 kilometers (60 miles) northeast of Yangon. The Associated Press is unable to independently verify the number of deaths.

The death toll of 82 was a preliminary one compiled by the Assistance Association for Political Prisoners, which issues daily counts of casualties and arrests from the crackdown in the aftermath of the Feb. 1 coup that ousted the elected government of Aung San Suu Kyi.

Their tallies are widely accepted as highly credible because cases are not added until they have been confirmed, with the details published on their website. In its Saturday report, the group said that it expected the number of dead in Bago to rise as more cases were verified.

The online news site Myanmar Now also reported that 82 people had been killed, citing an unnamed source involved with charity rescue work. Myanmar Now and other local media said the bodies had been collected by the military and dumped on the grounds of a Buddhist pagoda.

At least 701 protesters and bystanders have been killed by security forces since the army’s takeover, according to the Assistance Association for Political Prisoners. The attack on Bago was the third in the past week involving the massive use of force to try to crush the persistent opposition to the ruling junta.

Attacks were launched Wednesday on hardcore opponents of military rule who had set up strongholds in the towns of Kalay and Taze in the country’s north. In both places, at least 11 people -- possibly including some bystanders -- were reported killed.

The security forces were accused of using heavy weapons in their attacks, including rocket-propelled grenades and mortars, though such allegations could not be independently confirmed by The Associated Press. Photos posted on social media from Bago appeared to show fragments of mortar shells.

Most protests in cities and town around the country are carried out by nonviolent demonstrators who consider themselves part of a civil disobedience movement. But as the police and military escalated the use of lethal force, a hardcore faction of protesters armed themselves with homemade weapons such as firebombs in the name of self-defense. In Kalay, activists dubbed themselves a “civil army” and some equipped themselves with rudimentary hunting rifles that are traditional in the remote area.

A report by Myanmar Now said residents of Tamu, a town in the same region as Kalay, used hunting rifles Saturday to ambush a military convoy, and claimed to kill three soldiers. The junta has taken other measures as well to discourage resistance. It recently published a wanted list of 140 people active in the arts and journalism charged with spreading information that undermines the stability of the country and the rule of law. The penalty for the offense is up to three years’ imprisonment. Arrests of those on the list have been highly publicized in state media.

State television channel MRTV reported Friday night that a military court had sentenced to death 19 people -- 17 in absentia -- for allegedly killing an army officer in Yangon on March 27. The attack took place in an area of the city that is under martial law, and the court action appeared to be the first time the death sentence has been imposed under the junta’s rule.

The U.N. special envoy for Myanmar, Christine Schraner Burgener, arrived Friday in the Thai capital Bangkok on a regional mission to resolve the crisis in Myanmar. She intends to sound out several Southeast Asian governments for their ideas but has been denied permission to visit Myanmar.

Myanmar forces arrest comedian, break up doctors' protest

April 06, 2021

YANGON, Myanmar (AP) — Authorities in Myanmar arrested the country’s best-known comedian on Tuesday as they continue to crack down on people they accuse of helping incite nationwide protests against February's military coup.

The comedian Zarganar was taken from his home in Yangon by police and soldiers who arrived in two army vehicles, fellow comedian Ngepyawkyaw said on his own Facebook page. Zarganar, 60, is a sharp-tongued satirist who has been in and out of prison since he was active in a failed 1988 popular uprising against a previous military dictatorship. He is also well known for his social work, especially arranging assistance for victims of Cyclone Nargis in 2008.

In the past week, the junta has issued arrest warrants for at least 60 people active in the fields of literature, film, theater arts, music and journalism on charges of spreading information that undermines the stability of the country and the rule of law. It was not immediately clear what Zarganar, whose real name is Maung Thura, has been charged with.

Many ordinary protesters and activists are also being arrested every day, according to numerous reports on social media. In Mandalay, the country’s second-biggest city, security forces used stun grenades and fired guns Tuesday to break up a march by medical workers who have defiantly continued to protest almost every day against the Feb. 1 coup that ousted the elected government of Aung San Suu Kyi. The army's takeover set back Myanmar’s gradual return to democracy after five decades of military rule.

A participant who asked to remain anonymous for his own safety told The Associated Press that doctors, nurses and medical students were attacked as they gathered at about 5 a.m. by security forces who also used cars to run into protesters on motorbikes. The online news site The Irrawaddy reported that four doctors were arrested.

At least 570 protesters and bystanders, including 47 children, have been killed in the crackdown since the takeover, according to the Assistance Association for Political Prisoners, which monitors casualties and arrests. The group says 2,728 people, including Suu Kyi, are in detention.

Activists have begun organizing a boycott of next week’s official celebration of Thingyan, the country’s traditional New Year, usually a time for family reunions and merry-making. In leaflets and social media posts, they are imploring people not to hold any Thingyan celebrations, saying it would be disrespectful to “fallen martyrs” to enjoy the festival.

The leaders of Brunei and Malaysia announced Monday that leaders of the Association of Southeast Asian Nations will meet to discuss the situation in Myanmar. No date was given in the announcement, issued during a visit by Malaysian Prime Minister Muhyiddin Yassin to Brunei. He and Sultan Hassanal Bolkiah said they “expressed serious concern on the ongoing crisis in Myanmar and the rising number of fatalities.” Indonesian President Joko Widido had proposed a summit on Myanmar last month.

There was no word on whether the ASEAN leaders would participate in person or by video, or if Myanmar, one of the group's 10 members, would attend. Myanmar's junta also has been battling in some border areas where ethnic minority groups maintain their own armed forces. Several major groups, most notably the Karen and the Kachin, have expressed solidarity with the anti-coup movement and vowed to protect protesters in the territory they control.

The Kachin in the country’s north have engaged in combat with government forces, but the Karen in the east have borne the brunt of the junta’s military assaults. The area where the Karen National Union holds sway has been subject to air attacks by the Myanmar military from March 27 through Monday, said David Eubank of the Free Burma Rangers, a humanitarian organization that has for many years provided medical assistance to Karen villagers. Burma is another name for Myanmar.

Eubank said his group has verified that 14 civilians died and more than 40 were wounded in the air strikes. He said Tuesday that Myanmar’s military is mounting a ground offensive into Karen territory, driving villagers from their homes and increasing the number of displaced people in the area to more than 20,000, many of whom have to hide in caves or the jungle and are in desperate need of food and other necessities.

“The situation now seems, from our perspective, to be all-out war to the finish,” Eubank wrote Monday in an emailed message. “Unless there is a miracle, the Burma Army will not hold back in their attempt to crush the Karen and any other ethnic group that stands against them, just as they have not held back killing their own Burman people in the cities and plains of Burma.”

Greenland election shows divide over rare-earth metals mine

 April 06, 2021

HELSINKI (AP) — Greenland is holding an early parliamentary election Tuesday focused in part on whether the semi-autonomous Danish territory should allow international companies to mine the sparsely populated Arctic island's substantial deposits of rare-earth metals.

Lawmakers agreed on a snap election after the center-right Democrats pulled out of Greenland's three-party governing coalition in February, leaving the government led by the center-left Forward party with a minority in the national assembly, the 31-seat Inatsisartut.

One of the main reasons the Democrats withdrew was a deep political divide over a proposed mining project involving uranium and rare-earth metals in southern Greenland. Supporters see the in the Kvanefjeld mine project as a potential source of jobs and economic prosperity.

Former Prime Minister Kim Kielsen pushed to give the green light to mine owner Greenland Minerals, an Australia-based company with Chinese ownership, to start operation. Erik Jensen - Kielsen’s recent successor as Forward party leader - is opposed to granting the company a mining license.

Recent election polls showed the left-leaning Community of the People party (Inuit Ataqatigiit), a staunch opponent of the mine project, in position to become the largest party in the Greenlandic Parliament.

The opposition party has stated that a majority of Greenland’s 56,000 inhabitants, most of them indigenous Inuit people, are against the project, largely for environmental reasons. The mining proposal is relevant beyond Greenland. The largely ice-covered island has the world’s largest undeveloped deposits of rare-earth metals, according to the U.S. Geological Survey.

Estimates show the Kvanefjeld mine could hold the largest deposit of rare-earth metals outside China, which currently accounts for more than 90% of global production. Rare-earth metals are used in a wide array of sectors and products, including smartphones, wind turbines, microchips, batteries for electric cars and weapons systems.

Greenland, the world’s largest island that is not a continent, has its own government and Parliament, and relies on Denmark for defense, foreign and monetary policies. Voting in Tuesday's election is set to end at 2200 GMT. Initial results are expected on Wednesday.