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Saturday, October 31, 2020

US passes nine million coronavirus cases as infections spike and presidential election on the way



WASHINGTON: The United States passed nine million reported coronavirus cases on Friday and broke its own record for daily new infections for the second day in a row, according to a tally from Johns Hopkins University, as Covid-19 surges days before the country chooses its next president.

The U.S, which has seen a resurgence of its outbreak since mid-October, has now notched up 9,034,295 cases, according to a real-time count by the Baltimore-based school.

On Friday the country set a record for new daily infections of more than 94,000 in 24 hours, breaking the record of 91,000 it had set just one day earlier.

With the virus spreading most rampantly in the Midwest and the South, hospitals are also filling up again, stretching the health care system just as the nation heads in to flu season.

“We are not ready for this wave,“ Ashish Jha, dean of the Brown University school of public health, warned on ABC’s Good Morning America on Thursday.

Authorities in El Paso, Texas, imposed a curfew this week to protect “overwhelmed” health care workers and began setting up field hospitals.

But a judge’s attempt to shut down non-essential businesses in the city has been challenged by the mayor and the state’s attorney general, the Washington Post reported.

Midwestern state Wisconsin has also set up a field hospital in recent weeks, and hospital workers in Missouri were sounding warning bells as cases there rise.

Hospitals in the western state of Utah were preparing to ration care by as early as next week as patients flood their ICUs, according to local media.

‘Utterly disqualifying’

The pattern of the pandemic so far shows that hospitalizations usually begin to rise several weeks after infections, and deaths a few weeks after that.

More than 229,000 people have died of the virus in the US since the pandemic began, the Hopkins tally showed as of Friday, with the daily number of deaths creeping steadily upwards in recent weeks also — though at present it remains below peak levels.

For months public health officials have been warning of a surge in cases as cooler fall weather settles over the U.S, driving more people indoors.

As the weather changes, New York and other parts of the northeast, which were the epicenter of the U.S outbreak in the spring but largely controlled the virus over the summer, were reporting a worrying rise.

Some epidemiologists believe that Covid-19 spreads more easily in drier, cool air.

Rural areas, which in the spring appeared to be getting off lightly compared to crowded cities, were also facing spikes with states like North Dakota charting one of the steepest rises in recent weeks.

The state is so overwhelmed that earlier this month it told residents they have to do their own contact tracing, local media reported.

With four days to go until the election, Donald Trump was battling to hold on to the White House against challenger Joe Biden, who has slammed the president’s virus response.

“It is as severe an indictment of a president’s record as one can possibly imagine, and it is utterly disqualifying,“ Biden said Friday as the toll passed nine million.

Trump downplays the virus even as the toll has been accelerating once more, holding a slew of rallies with little social distancing or mask use.

He has repeatedly told supporters that the country is “rounding the curve” on Covid infections.

But Americans, wary of crowded polling booths on Election Day as the virus spreads, are voting early in record numbers. — AFP

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Trump Is Encouraging a Lawless Election

The president wants every ballot counted on Election Day, regardless of the law or decades of precedent. It’s part of a pattern.


Mapping the Coronavirus
Outbreak Across the World

The world is bracing for a new wave of Covid-19 infections, as the coronavirus pandemic has infected more than 45.5 million people and killed more than 1,180,000 globally since late January. Efforts many countries took to stamp out the pneumonia-like illness led to entire nations enforcing lockdowns, widespread halts of international travel, mass layoffs and battered financial markets. Recent attempts to revive social life and financial activities have resulted in another surge in cases and hospitalizations, though new drugs and improved care may help more people who get seriously ill survive.


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Friday, October 30, 2020

China 13th Five-Year Plan 2016-20 Summary, sets ‘pragmatic’ targets through 2035

Summary of the 13th Five-Year Plan 2016-20 Infographic: GT

During the 13th Five-Year Plan period, from 2016 to 2020, China has made great strides in improving the economy, people's livelihood and other fields. China has contributed over 30 percent to global economic growth, with GDP hitting almost 100 trillion yuan ($14.9 trillion). Over 50 million people have been relieved from poverty, and 53.78 million new urban jobs have been created. New standard bearers in technology emerged, including high-speed trains, the BeiDou Navigation Satellite System and domestic passenger aircraft C919. This rapid technological development can be attributed to investment in research and development, which totaled 2.17 trillion yuan in 2019, accounting for 2.19 percent of GDP and up 56.3 percent from 2015. 

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With decisive progress in the past five years and a strategic victory against the COVID-19, top leadership of the Communist Part of China (CPC) on Thursday unveiled a steady and bright picture for the country's future, as it sets sweeping social and economic development goals for the next five to 15 years that aim to build the world's most populous nation into a modern socialist power in the economic, technological and other fields by 2035.

In a wide-ranging communiqué released after the fifth plenary session of the 19th Central Committee of the CPC ended in Beijing, top officials conclude that  China remains in a major strategic development period, citing "decisive achievements" in the past five years and "major strategic results" of the COVID-19 epidemic, and offered sweeping solutions in a wide range of areas, from economy, to security, and to governance.

While the communiqué projected confidence in China's development paths and prospects, certain targets, particularly in economic areas, reflected a cautious and pragmatic sentiment among top officials, given mounting domestic and external pressure on growth, while other goals such as greenhouse gas reductions underscored the country's determination to pursue high-quality growth and tackle global issues, experts said.

Sweeping targets

"Having deeply analyzed the profound and complex changes our country faces in its development, the plenary session believes that China's development remains in an important strategic period," the communiqué said, calling for strategic patience in overcoming challenges and striving for progress.

Among the key takeaways from the communiqué are sweeping targets sets for the 14th Five-Year Plan (2021-25) and long-range goals through the year 2035. Coming at a critical inflection point for China, the four-day meeting and the targets for the coming five to 15 years are essential steps in China's long-term goal for national rejuvenation. The 14th Five-Year Plan would also mark the start of the pursuit of the second centenary goal to build a modern socialist country.

"Previously, we usually set five-year plans, but this time we mentioned the 'long-range goals for 2035' for the first time. The time span extended from five years to 15 years. That shows we have become more strategic," Yang Xuedong, a professor of political science at Tsinghua University, told the Global Times on Thursday.

Under the goals in the communiqué, China will achieve modern socialism by 2035. What that entails includes achieving "big leaps" in economic strength, technological prowess as well as overall national strength, the document said. Total economic output and urban and rural income will reach a "new level," and major breakthroughs would be made in core technologies.

"I think those targets are very pragmatic as they reflect our advantages and long-term development goals, as well as the many challenges we have to face," Tian Yun, vice director of the Beijing Economic Operation Association, told the Global Times on Thursday.

Though the document refrained from offering specific empirical targets, Tian said that those goals could mean that China would double its current GDP of around 100 trillion yuan in 2035, and double current per capita GDP of $10,000. "That would require a real GDP growth of around 3.5 percent annually; it is a big target but can be done if China's full potential is realized," he said.

In keeping with a decades-long tradition, the communiqué also included goals for the 14th Five-Year Plan. During the coming five-year period, China will aim for "new achievements" and "sustained and sound growth" based on improvements in quality. The domestic market will be further boosted and economic structure would be improved, it said.

In a breakaway from previous five-year plans, the 14th Five-Year Plan did not include an annual growth target. In the 13th Five-Year Plan, an annual growth target of around 6.5 percent, which, experts say, could be missed due to the COVID-19 epidemic.

That decision reflected the considerable risks and challenges the country is confronted with, including the COVID-19 pandemic, experts noted.

The new five-year plan came at a critical juncture for the Chinese economy. Though China has effectively reined in the epidemic and embarked on a steady economic recovery path with a 4.9 percent growth in the third quarter in the year, the deadly virus continues to ravage across the world, which is already mired in rising trade and geopolitical tensions.

While the 6,200-word communiqué focused mostly on economic issues, it also touched on a long list of issues, including governance system, security, social fairness, education, healthcare, and environmental protection - all part of China's long-term strategy to build a modern socialist society.

In security, the communiqué called for modernizing its military. On environmental protection, the communiqué said that China will continue to reduce carbon dioxide emissions after reaching a peak by 2035, which experts called a "bold" pledge that reflects China's determination to tackle climate and environment issues.

Paths to success

The communiqué also outlined strategies and paths that China would take to overcome those challenges, and reach its goals in the medium-to-long term.

Among the major steps listed in the document is a strategy that has already gained widespread attention - the "dual circulation" model. In line with previous speeches from top officials, the communiqué called for forming a "powerful" domestic market and establishing a new growth model, where the internal circulation would play a main role in driving growth, though the external circulation would also be boosted. "Consumption would be boosted and room for investments would be expanded fully," the document said.

Though China is at a transitory period where both opportunities and challenges are abundant, "fully grasping the 'dual circulation' would turn this into a period of opportunities," Wang Huiyao, an adviser to China's State Council and president of the think tank Center for China and Globalization, told the Global Times on Thursday.

With China's exports, which have already been declining in recent years, facing a tough situation due to the raging pandemic and tensions, Chinese policymakers are counting on the massive domestic market to ensure economic growth and security. China, which already has a middle-income population of over 400 million, is set to overtake the US as the world's biggest consumer market in the coming years.

Aside from the "dual circulation" strategy, the communiqué also highlighted the country's focus on technological innovation to drive sustainable growth, calling it an "innovation-driven" development strategy, and aiming to become a global leader in innovation. The Chinese character for innovation appeared nearly 20 times in the document, and for technology, 13 times.

"One of the most important points in the communiqué is mentioning innovation as a core national strategy… Facing the complex global situation, China needs to improve these areas," Wang said.

However, as the communiqué has made clear, focusing on the internal circulation does not mean China will turn inward and stop its long-standing opening-up policies. China will firmly adhere to its opening-up paths, and will continuously expand opening-up at a higher level, the document said.

"When we talk about the 14th Five-Year Plan, we shouldn't stress its effect on domestic development. It also has a significant meaning globally. China's economy is the engine for the global economy. China achieving a strategic victory against the epidemic and sustained economic growth is also a dose of confidence for the world," Yang said. 

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Thursday, October 29, 2020

US profited from its weapons of deaths sales to Taiwan can be curbed? Yes and undoubtedly

A Taiwan warship launches a US-made Harpoon missile during the annual "Han Kuang" military drill on July 15, 2020. Photo: AFP

The US has decided to sell 100 Harpoon Coast Defense Systems to the island of Taiwan for $2.37 billion, a deal that Taiwan authorities have welcomed and appreciated, according to Western media reports. It is reportedly the fourth of seven arms sales that Washington announced in September, and the second to have been approved in a week.

US arms sales to Taiwan have broken some previous restrictions under the Trump administration, becoming significantly more aggressive with an increase in the attack capability of the weapons. It appears that the country aims to gradually eliminate the taboo of selling defensive weapons to Taiwan by doing so. In the past, the US refrained on aggressive arms sales to Taiwan, except for the deal that the George H. W. Bush administration made in 1992 when the US sold 150 F-16 fighter jets to the island.

With the intention of using the "Taiwan card" to undermine China's development strengthens, the US is now seeing arms sales to Taiwan as a favorite trick of straight flush as it not only plays up the island's increased dependence on it and hope of "Taiwan secessionists" on the US over security, but also provokes the Chinese mainland. Washington has put itself on a position of being both player and banker in the risky game across the Taiwan Straits.

However, the increasing strength provides the Chinese mainland with a theoretically higher control of the situation. We should have the courage and wisdom to activate this capability, create leverage to exert strong influence and limit US arms sales to the island, and gradually seize the initiative in the game.

First, we should make an objective and firm judgment on the comparison of military strength across the Taiwan Straits - that is to say, the military strength of the mainland have formed an overwhelming advantage over Taiwan, which cannot be changed by US arms sales to Taiwan.

This gives us the strategic advantage to resolve the issue of US arms sales to Taiwan once and for all. We have the initiative in hand to decide how to eliminate this problem - on how long, at what intensity, and at what cost.

The momentum of US arms sales to Taiwan must be checked to fight the arrogance of "Taiwan secessionists." The sales have become the most substantial link between the US and the island of Taiwan, from which more interest chains and space for collusion can derive. We should not be indifferent to the sales despite our stronger military power over the island. Preventing US arms sales to the island from upgrading should become one of the main battlefields for the next cross-Straits struggle.

In the interest chain of US arms sales to Taiwan, the weak part is the Taiwan authorities and relevant US enterprises and interest groups. China in the next step should carefully investigate the institutions and individuals that have played a role in the US arms sales to Taiwan, and step up sanctions on them, making them pay the price.

We must make it clear to Taiwan authorities that purchasing weapons, especially offensive ones on a large scale, from the US will never be accepted by the Chinese mainland. The mainland will therefore take punitive measures, just like military actions as a warning if higher-level US officials visit Taiwan. As a result, Taiwan's purchase of US arms will be of no help in deterring the mainland, but the process itself is highly risky. The more US weapons the island buys, the more insecure it will become.

The mainland's punitive measures will, first of all, include making it routine to fly military aircraft across the so-called middle line of the Taiwan Straits. The mainland can also dispatch its jets over the island of Taiwan, normalize aircraft patrols approaching the island, and launch economic blockade against the island.

If these still cannot curb the military collusion between the US and the island of Taiwan, the mainland can resort to the ultimate warning - the People's Liberation Army would destroy the US offensive weapons Taiwan newly deploys. If Taiwan authorities refuse to be restrained, the mainland will end the dirty arms trade between the US and the island with a crisis. When there is a severe clash between the US, the Chinese mainland and the island of Taiwan, Taiwan authorities must be crushed first.

The long-term peace in the Taiwan Straits has emboldened Taiwan secessionists. The strength of the mainland is growing, while the "Taiwan secession" has come to a dead end. However, the Democratic Progressive Party authorities are becoming increasingly unbridled, thinking they have gained more support from the US. They misjudge the situation. The mainland must exert unprecedented pressure on the island to curb the evil trend. 

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The spirit of CPV soldiers resisting US aggression in Korean War inspires generations of Chinese people

The Memorial Hall of the War to Resist US Aggression and Aid Korea in Dandong, Northeast China's Liaoning Province Photo: Li Qiao/GT

It's hard to imagine visitors bursting into song when they visit a memorial hall. But it occurs often in the Memorial Hall of the War to Resist US Aggression and Aid Korea in Dandong, Northeast China's Liaoning Province. The border city attracts many seeking to learn the history and commemorate the spirit of the Chinese People's Volunteers (CPV) army.

Visitors hum the nationally renowned anthem of the CPV army. "This song and the heroic deeds of CPV soldiers were with us growing up," a visitor in her seventies, with a Chinese national flag sticker on her face, told the Global Times.

October 25 was the CPV army's first fighting day of the war, exactly 70 years ago in 1950. Seventy years have passed and more CPV soldiers have left us in recent years. It may be difficult for the next generation to hear their stories in person. However, the CPV army's sacrifice of resisting US aggression, aiding Korea and defending national security is not forgotten, and their heroism is inspiring generations of Chinese committed to serving their country.

CPV soldier Han Tingfu, 94, is wheeled on a visit to the exhibition of the War to Resist US Aggression and Aid Korea in the Military Museum of the Chinese People's Revolution in Beijing on Sunday. Photo: Li Hao/GT

Heroes not forgotten

More than 29 million CPV soldiers participated in the War to Resist US Aggression and Aid Korea, with 197,653 soldiers confirmed as martyrs by China's Civil Affairs Ministry. Many of the surviving soldiers are in their nineties. For some veterans, it might be difficult to visit the memorial hall or other historical sites of the war in Dandong. But people related to CPV soldiers and who experienced that period of history still commemorate their legacy in various ways.

"Inspired by the CPV soldiers I admire most, I became a radar operator in Air Force when I grew up," He Shufang, an 84-year-old visitor from Fencheng city, Northeast China's Liaoning Province, told the Global Times.

While looking at a CPV exhibit in the memorial hall, He sang "Heroic Auto Driver," a song about the War to Resist US Aggression and Aid Korea. "It was a CPV soldier who taught me this song when we lived together. My biggest regret was seeing them go to the battlefield but not seeing them come back," He said.

Fengcheng is only 73 kilometers away from Dandong. Seventy years ago, his family lent a room to CPV soldiers. Half of his school building was lent to CPV soldiers.

"Even though we were far behind the US in terms of weaponry, I felt that our CPV soldiers were still full of courage to rush to the battlefield to defeat US aggressors under difficult conditions. The days living with them inspired me to join the army and defend our country later," He said.

He said he would enlist in the army again if he could and expects young people to work hard and love their country. "We Chinese love peace and don't want to get involved in wars but we are not afraid of wars if there are aggressions," He noted.

Visitors tour the Military Museum of the Chinese People's Revolution in Beijing on the first day of a special exhibition marking the 70th anniversary of the CPV army's participation in the War to Resist US Aggression and Aid Korea on Sunday. Photo: Li Hao/GT

There are also many relatives of CPV soldiers who visited the memorial hall in memory of their loved ones. "I came to visit the memorial hall for the sake of my brother who passed away two years ago," said Xiao Yumei, a 75-year-old woman from Dalian, a four-hour's drive away from Dandong.

Her older brother, Xiao Peiyuan, was a CPV soldier who was transferred back home after losing a toe on his left foot during the war. The soldiers who fought with him all died in combat.

"Looking at the mock scene of the war, it's as if my brother is one of the unnamed heroes here on display. If only my brother could come see it and celebrate the 70th anniversary with us." Xiao said.

Xiao noted the living should appreciate heroes who sacrificed their lives for the safety of a neighboring country and the motherland, and that the living should follow in their footsteps of history.

Zhang Fasong, 90, traveled 1,223 kilometers from Hegang, Northeast China's Heilongjiang Province to observe the war's 70th anniversary in Dandong. He described this trip as his dream journey.

Seventy years ago, Zhang failed to join the CPV army because he was two centimeters short of the height requirement.

Standing on the Yalu River Broken Bridge watching North Korea on the other side, Zhang told the Global Times that, "I'm 90 and I don't know how long I'll live. Before I die, I just want to see the Yalu River and tell the CPV soldiers who crossed the river 70 years ago that China is today prosperous and we are enjoying a peaceful and happy life now."

Six-year-old Huhu, dressed in CPV army clothing, commemorates the War to Resist US Aggression and Aid Korea, which his great-grandfather had participated in, on the Yalu River Broken Bridge in Dandong on Friday. Photo: Cui Meng/GT

Inheriting the spirit

Many young Chinese only learn about the history from textbooks and have little personal connection with the war. Some of them specifically come to Dandong to learn about this history, saying they are touched and inspired by the spirit of the CPV after learning of their heroism.

Zhang Yating, 32, expects to completely learn about the war history in Dandong. She is a nurse from Beijing who battled on the anti-epidemic front line earlier this year. She was honored as one of "the most admirable people in the new era."

Zhang was responsible for conducting nucleic acid tests.

"It was a very difficult time being wrapped in protective clothing every day and not being able to see my children and parents for safety reasons. However, compared with dangers which CPV soldiers suffered from, the difficulties which I experienced for anti-epidemic work were nothing," Zhang said after visiting the memorial hall.

Zhang said she was disappointed by US smears toward China's anti-epidemic work. "Our CPV heroes defeated US aggression 70 years ago. Our medical staff, inheriting their heroic spirit, struck down US slander by effectively controlling COVID-19," Zhang noted.

During Qingming Festival, Mid-autumn Festival and other national holidays, people from all over the country come to sweep tombs for CPV martyrs, Sun Dali, the director of the Dandong Cemetery of the War to Resist US Aggression and Aid Korea Martyrs, told the Global Times.

Because of anti-epidemic measures, the cemetery held an online memorial service for the Qingming Festival in April. A CPV martyr's relative in the epidemic's most affected city, Wuhan, Central China's Hubei Province, was quarantined at home and burst into tears seeing the tombstone online, Sun said.

China introduced the Heroes and Martyrs Protection Law in 2018, which protects the reputation of heroes and promotes commemoration of their legacy.

"The nation and society have paid more and more attention to the CPV martyrs in recent years. The young generation will inherit the spirit of our heroes," Sun said.

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US Military Bases Are Key Pieces of the Global War Machine


China blasts 'bully' US ahead of Pompeo's Sri Lanka stop ...

Targeting China no cure to woes of the US, India

China is steadily on its path of peaceful development and safeguards just interests. It does not view India or the US as a foe. As some engage in plots or conspiracies, just let them be. They are bound to suffer the consequences.


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Monday, October 26, 2020

Startups can apply for seed financing from S’pore fund

LuneX to provide funding to blockchain firms based in Malaysia

“Together with MAVCAP, we are actively looking for Malaysian-based blockchain startups, particularly in the early stage"

 - LuneX Ventures founding partner Kenrick Drijkoningen

 Meanwhile, MAVCAP CEO Shahril Anas said with blockchain technology being increasingly adopted in Malaysia, the VC firm saw the opportunity to increase availability of funding for innovative start-ups in this space and invested in LuneX.

PETALING JAYA: Blockchain startups based in Malaysia can apply for growth funding from LuneX Ventures (LuneX), a Singapore-based dedicated blockchain and cryptocurrency fund.

Launched in 2018, LuneX partners Golden Gate Ventures, a venture capital firm that invests across South-East Asia.

Government-backed Malaysia Venture Capital Management Bhd (MAVCAP), the country’s largest venture capital (VC) firm, also invested in LuneX in 2019.

“Together with MAVCAP, we are actively looking for Malaysian-based blockchain startups, particularly in the early stage, to back and grow, ” said LuneX Ventures founding partner Kenrick Drijkoningen, noting that Malaysia has a lot of tech talent and a relatively young population picking up new trends rapidly.

“In Malaysia, we see the crypto finance movement being adopted by young people in droves, meaning for many of these products, there is a large market to find product market fit, ” he added.

Drijkoningen also pointed out there were bright prospects for blockchain start-ups in Malaysia as the country has a very open economy with a lot of cross border movement and finance - areas that blockchain technology will make significantly more efficient in years to come.

LuneX usually invests at the seed stage of financing, meaning the company is raising anywhere from US$100,000 to a few million dollars.

LuneX looks at whether the blockchain start-ups fits its investment thesis and the size of the markets they are operating in, in addition to the experience and passion of the founding teams.

“The best entrepreneurs are those who are able to pivot quickly if they see changing market conditions, ” said Drijkoningen.

He added that an oft-overlooked criteria is whether there is good working chemistry between the blockchain start-up and LuneX.

“An investment is very much a long-term commitment and working with each other should be productive, fun and an overall good experience for both parties, ” he said.

Drijkoningen said South-East Asia has boomed as a start-up ecosystem over the past 10 years and LuneX aims to ensure it also develops as a leading region for blockchain start-ups.

He recalled that while the blockchain ecosystem was heating up in 2017, there was no dedicated VC fund in South-East Asia specialising in the industry.

With this knowledge gap at traditional venture capital companies, it was hard for blockchain entrepreneurs to raise equity financing. Thus, tapping on the emerging blockchain ecosystem in South-East Asia, LuneX invests in blockchain and cryptocurrency-related early stage start-ups, as well as application tokens, protocol tokens, app coins andother digital and cryptofinance technology.

LuneX has a portfolio that is diversified across tokens in key players like Ethereum, Terra and Kyber; to equity in crypto finance infrastructural companies like Propine (custody), Merklescience (AML solution), Sparrow (Exchange) as well as blockchain application technology like Accredify and Keyless.

Other companies LuneX has invested in include Fleek,, DEXTF, Blue Wallet, Accredify and Bank of Hodlers.

Drijkoningen said LuneX draws on a wide network to support its portfolio companies and help with business strategy, hiring, marketing and fund raising.

“Specific examples include placing senior management, working on a rebrand, introducing new round lead investors and helping prepare pitch decks, ” he said.

According to Drijkoningen, the Covid-19 pandemic has been positive for digital transformation and growth in blockchain and crypto finance has accelerated, as more things need to be done digitally.

“That being said, it has been more difficult to make investment decisions, as we do prefer to meet people in person, visit their office and spend some time socially.

“Nonetheless, we are in active talks with a number of start-ups and will continue to seek out opportunities to expand our portfolio, ” he said.

Regarding LuneX’s partnership with MAVCAP, Drijkoningen said both companies share similar long-term views and look to grow the industry together.

“MAVCAP has an amazing reputation and this helps with finding great talent and companies and providing them with the resources needed to succeed.

“Also, MAVCAP really understands how the future of finance, fintech and blockchain are merging into a new era of innovation, ” he said.

Meanwhile, MAVCAP CEO Shahril Anas said with blockchain technology being increasingly adopted in Malaysia, the VC firm saw the opportunity to increase availability of funding for innovative start-ups in this space and invested in LuneX.

“With our participation in this fund, we can provide greater opportunities for Malaysians entrepreneurs with innovative blockchain-based solutions, combining the expertise of LuneX in the blockchain industry with MAVCAP’s track record and deep knowledge of the local VC ecosystem, ” said Shahril.

He noted that LuneX has a wealth ofexperience in blockchain, which for MAVCAP is an uncharted sector.

“We are able to tap into the knowledge and experience of LuneX to provide training and actively engage with industry players, including regulatory bodies and start-ups, to create a conducive and secure blockchain framework for Malaysia.

“Also, our local VC talent pool gains technical know-how to be able to identify local start-ups with good potential and make investments in this sector, ” said Shahril.

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Sunday, October 25, 2020

Better access for stroke patients, and Helping stroke survivors in a pandemic

Knowing the Signs of Stroke Can Save Lives - Avera Health

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The Health Ministry is mulling over an additional six stroke centres by 2024, while more medical teams will be trained by the Malaysia Stroke Council to address the lack of neurologists to treat the condition.

WHEN it comes to stroke, every second counts.

The bigger the delay in getting treated, the smaller the chances of full recovery.

In fact, two million brain cells die every minute until blood flow is restored.

“In other words, time is brain.

“The more time passes, the more brain cells are lost and may not be re-generated, ” says Malaysia Stroke Council president Assoc Prof Dr Hoo Fan Kee.

As it will be World Stroke Day this Thursday (Oct 29), there’s a need to look into main issues involving the disease here – the lack of neurologists to treat patients and limited access to stroke centres, especially in rural areas.

The good news is steps are underway to smoothen the road ahead for patients.

Currently, there are a total of 61 public and private stroke centres in Malaysia, according to Dr Hoo.

“It’s almost a double-fold increase from 34 in 2017.

“But we still need about 90 centres in the country, ” Dr Hoo adds.

For this, the Health Ministry is proposing to increase the number of public stroke centres to beef up treatment here.

“A proposal to add six more centres by 2024 is being considered.

“This is subject to budget availability to develop or upgrade such facilities, ” the ministry tells Sunday Star.

On Aug 14, the World Stroke Organisation recognised five Malaysian hospitals for achieving international standards in their stroke care practices.

Such news is encouraging but the challenge remains that there aren’t enough neurologists, or specialist doctors who treat diseases involving the brain, spinal cord, nerves and muscles.

“There are 99 registered practising neurologists in Malaysia.

“Of this total, 25 are working under the ministry, 24 are with the Education Ministry while the remaining 50 are in the private sector, ” the ministry says.

But this is a far cry from the recommended ratio of one neurologist per 100,000 population.

“Now, the ratio in Malaysia stands at one neurologist per 330,303 population, ” the ministry explains.

At the current population of 32.7 million, we would need to have another 228 neurologists.

Boosting medical help

Nevertheless, more trainees are being accepted for sub-specialisation training compared to the past.

“Over the last few years, about 10 trainees were accepted annually in public hospitals under the ministry while academic hospitals accepted one to two trainees each year, ” says the Health Ministry.

Concurring about the lack of neurologists, Dr Hoo says it doesn’t help that the distribution of such specialists is uneven, with most or about 40% being based in the Klang Valley.

“There’s still a need to boost the number of stroke-ready hospitals – centres with doctors and medical teams who are trained to handle cases.

“Some states only have a handful of hospitals that can treat stroke, ” he says.

For example, Kelantan, Terengganu and Pahang each have only two stroke centres.

To address this, Dr Hoo says the Malaysia Stroke Council will be coming up with a virtual training programme to grow the pool of medical teams that are able to treat stroke.

This will help equip non-neurologists to be able to treat stroke patients and increase the number of stroke-ready hospitals.

“The council will set up an online certification programme for the theory section of the training by the end of this year.

“After going through the theory online, the doctors and the rest of the medical team will go through practical training before they can be certified to treat stroke patients, ” Dr Hoo explains.

Previously, the council had also trained non-neurologists who are likely to come across stroke cases like geriatricians, general physicians and emergency physicians.

So far, he estimates that there are 12 hospitals now operating with non-neurologists who have been trained to accept stroke cases.

In order to be a stroke-ready hospital, such hospitals need to have a physician trained to read computerised tomography (CT) scans to diagnose stroke and have neurosurgery support.

Dr Hoo says the council hopes to improve the outcome of treatment, with the aim of having 60.2% of patients being fully independent after suffering a stroke by 2024.

Currently, only 34.4% of patients are independent after the episode.

At present, the mortality rate is 8.7% for stroke but by 2024, the council hopes that it can be decreased to 5%.  

Getting more common

For now, Malaysia needs to be prepared as stroke has become more prevalent over the years.

From a prevalence rate of 0.3% among Malaysians in 2006, it jumped to 0.7% in 2011.

This is based on the Health Ministry’s National Health and Morbidity Surveys in past years.

The ministry also notes that stroke is becoming more common among young Malaysians these days.

“It’s mainly caused by the increase in non-communicable diseases (NCDs) among the younger age group, including obesity, ” it says.

With about 50,000 new cases of stroke every year, it’s also worrying that 40% of those affected are aged below 60, says the National Stroke Association of Malaysia (Nasam).

As such, Nasam rehabilitation head Tracy Chan says there is a need to have greater awareness about stroke among the young.

“It is when people are young that prevention should start.

“Educate them on healthy lifestyles and have an environment that promotes greater healthy living.

“Start them young on healthy living, work ethics and balanced lifestyles, ” she says.

Employers should also understand that staff wellbeing is just as important as a healthy balance profit and loss sheet.

“In fact, happy staff always improves the balance sheets, ” Chan quips.

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 ‘It’s not an old person’s disease 

I am 33 - and I just had a stroke | The Star

BING hit with a stroke at the age of 32 was something he did not expect at all.

For Joshua Lim Shaun Wu, it also happened when he was going through a difficult time in May last year.

He was caring for his grandfather who was admitted to hospital due to a fall.

After four days, Lim suffered a stroke and had to be admitted to hospital himself.

Sadly, his grandfather did not make it, but Lim managed to be discharged after several months of speech, occupational and physical therapy.

“I was discharged late last year with further doctor appointments every three months, ” says the former community manager and student services worker.

As the stroke impacted his communication skills, Lim says it took some time to ensure other people understood him when he tried to talk.

“We often think stroke is an ‘old person’s disease’. Well, it’s not.

“More needs to be done to inform and educate youths in Malaysia about stroke, ” he says.

Lim believes his underlying hypertension and existing medical conditions triggered the stroke.

“Also, I was stressed out – over my job, life and grandfather, ” he says.

But the incident did teach him many things – he now eats a healthier diet and monitors his blood pressure regularly.

Lim says perhaps, it was also a sign that he needed to slow down – he had spent 10 years in the United States before coming back in 2018 and immediately found a job in Malaysia within a month.

For Pang Sook Lee, 45, and a mother of three, a stroke hit her five years ago without prior signs.

“I went jogging every weekend, and had regular medical check ups, which showed good results.

“The stroke came suddenly after I didn’t get much sleep from the night before, ” she says.

Today, her left hand and leg has yet to fully recover but she is still able to do things independently.

“I can still drive my son around, go to the gym daily, buy groceries on my own and cook during weekends, ” Pang says. Having survived the stroke, she hopes others will maintain a positive mindset and never give up if they are struggling to recover from an attack. Ong Kian Leong, 45, a playground equipment salesperson, suffered a stroke when he woke up one morning in June this year and couldn’t stand up.

After his wife called the ambulance, he was rushed to the hospital.

“I’m better now but I can’t eat normally yet and the left side of my body is weak, ” he says.

“My advice to everyone is to look after their health, regardless of their age.

“Everyone should exercise and get sufficient rest, ” Ong adds.

Helping stroke survivors in a pandemic

 THE Covid-19 pandemic has made things tougher for stroke patients.

There’s been a decline in stroke admissions worldwide this year compared to the same period last year, according to the World Stroke Organization (WSO).

“The most likely explanation is that patients with mild symptoms are ignoring them and do not want to come to the hospital for evaluation because of fear of being exposed to Covid-19, ” says WSO president-elect Prof Marc Fischer in a recent statement.

A similar trend is also seen in most hospitals in Malaysia, based on a preliminary survey by the Malaysia Stroke Council.

With the Covid-19 pandemic, there are extra steps needed to be taken: the stroke patients have to be tested for the coronavirus.

“We will treat the patient first for their stroke, but admission will be in a different ward while waiting for confirmation on their Covid-19 test, ” explains council president Assoc Prof Dr Hoo Fan Kee.

The question also arises as to whether the doctor needs to wear the full PPE (personal protective equipment) or not.

“This may cause a delay. A stroke patient should receive treatment within 4.5 hours.

“After 4.5 hours, the risk of disability is increased. If treated within three hours, chances of fully recovering is higher, ” Dr Hoo says.

Some stroke patients also delayed follow-up checks or reviews at hospitals due to fears of the virus, says National Stroke Association of Malaysia (Nasam) rehabilitation head Tracy Chan.

“I have heard of urinary catheters not changed for the entire movement control order (MCO) period from March to June.

“There were other messy and unhealthy situations as a result of this pandemic, ” she says.

It doesn’t help that stroke survivors are part of the group of people that respond very poorly to Covid-19 infections.

“They also need quick access to services and medical treatment even though there is a pandemic that may kill them out there, ” Chan adds.

She says fewer stroke admissions has led WSO, of which Nasam is a member, to launch campaigns to encourage those with signs of acute stroke to rush to hospitals for emergency treatment on the onset of a stroke.

“Delaying and avoiding going to the hospital can lead to greater disability and mortality, ” she stresses.

Due to Covid-19, Chan says many non-essential services and follow ups were moved to later dates to allow the hospitals to accommodate the coronavirus cases and to put into place the standard operating procedures to reduce its spread.

“Some services like collection of medication were moved to delivery services which required a certain amount of mobile phone literacy and skill, ” she points out.

Outpatient rehabilitation services at some hospitals were suspended for a while during the MCO.

“Hence, many who were in the rehabilitation stage of stroke recovery had their progress hindered.

“When services resumed there were issues of fear while for many, there was the issue of affordability.

“Many families had reduced income and could not afford or spare the time to bring a family member for therapy, ” she adds.

With its nine centres across the country, Nasam provides rehabilitation facilities and services for stroke survivors but with the pandemic, it has been tough.

“Following the MCO, one of the first things we did was to create a helpline (018- 2221878), for our stroke community and also to serve anyone having a stroke. It has been a busy line.

“During the MCO, stroke survivors had to learn to use social media to continue with interaction.

“It was difficult for most of our stroke survivors who were already having a tough time coping with everyday struggles. The added burden of the new normal was very challenging, ” Chan describes.

Nasam lost contact with many stroke survivors especially those from the disadvantaged groups who lacked access and support to handle the social media platforms.

“Many have been affected as their recovery was halted abruptly and we were unable to undertake reviews of their progress in recovery.

“While we are still not offering our popular face-to-face group therapy session, we have started Telehealth to complement the one-on-one therapies offered at our centres and to help those not living near a Nasam centre, ” Chan adds.

Under their Telehealth programme, Nasam conducts group sessions on aerobics, exercises to improve strength and balance and qi gong for body and mind relaxation on the teleconferencing app Zoom. “Nasam believes it is essential for stroke survivors to remain as active as possible and that rehab is critical for a stroke survivor’s recovery.

“It is a trying time for Nasam and also the community at large on whom we rely to help sustain the recovery of stroke survivors and at the same time keep them safe in this pandemic, ” she says.

Nasam is also offering free rehabilitation for stroke survivors in the low income group or B40 community.

“They can receive free rehab care at Nasam centres. The participating stroke survivors will be sponsored for a period by Yayasan Hasanah.

“The rehab offer is open to only 300 participants on a first-come, first-served basis and has been running since September, ” she says.

Nasam’s centres are located in Petaling Jaya, Ampang, Melaka, Johor Baru, Kuantan, Ipoh, Penang, Kulim in Kedah and Kota Kinabalu.

For more information, call Nasam’s helpline at 018-2221878 or log on to for details.

Confusion, stroke, memory loss: How coronavirus affects the brain

Damage to brain: Some people hospitalised with Covid-19, experience delirium. A few others suffer from stroke, brain haemorrhage, memory loss and other neurological symptoms.

CONFUSION, loss of smell, behavioural changes – these are some of the neurological symptoms of the novel coronavirus as witnessed in Covid-19 patients lately.

Some people, hospitalised with Covid-19, experience delirium – they are confused, disorientated and agitated. Stroke, brain haemorrhage and memory loss are some other serious impacts coronavirus has on few patients.

Robert Stevens, MD, Johns Hopkins University, estimated that at least half of the patients he’s seeing in the Covid-19 units have neurological symptoms. However, scientists are struggling to understand why the brain may be harmed due to the virus.

Stevens listed some theories by scientists researching the subject in an article.

It pointed out that several Covid-19 cases across the world can have a variety of conditions related to the brain. These include confusion, loss of consciousness, seizures, stroke, loss of smell and taste, headaches, trouble focusing and changes in behaviour.Less common peripheral nerve issues, which may lead to paralysis and respiratory failure, have also been noticed among some Covid patients. Similar symptoms have been seen in outbreaks such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), also caused by coronaviruses, another report in a leading science journal said.

How Covid-19 affects the brain

The Johns Hopkins article mentions four ways, based on current research, how Covid-19 may harm the brain. It stressed nonetheless that each “needs to be studied rigorously before any conclusions can be made”.

Severe infection: “The first possible way is that the virus may have the capacity to enter the brain and cause a severe and sudden infection, ” the article read.

It further said that some cases reported in China and Japan found the “virus’s genetic material in spinal fluid, and a case in Florida found viral particles in brain cells. This might occur due to the virus entering the bloodstream or nerve endings.”

According to the article, the loss of smell that occurs in some Covid-19 patients could indicate that the “virus entered through the olfactory bulb, which is located right above the nose and communicates information about smell to the brain”.

Immune system: The immune system is affected in an attempt to fight the novel coronavirus, producing a “maladaptive” inflammatory response that may cause much of the tissue and organ damage seen in this disease.

Physiological changes: The physiological changes induced in the body by coronavirus – ranging from high fevers to low oxygen levels to multiple organ failures – contribute to, or account for, brain dysfunction, such as delirium or coma seen in many severe Covid-19 patients.

Stroke: The blood-clotting system in Covid-19 patients with illness is highly abnormal. Clots are much more likely to occur in these patients than in others. “Clots can form in veins deep inside the body or in the lungs, where they can cut off blood flow. A stroke could occur if a blood clot were to block or narrow arteries leading to the brain.”

How common is brain damage in Covid patients?

According to a study published in The Lancet in June, research was conducted with a sample size of 125 Covid patients in the UK who had neurological or psychiatric effects.

According to the results, 62% of the sample size had experienced damage to the brain’s blood supply, such as strokes and haemorrhages, and 31% had altered mental states, such as confusion or prolonged unconsciousness – sometimes accompanied by encephalitis, the swelling of brain tissue.

Ten people, who had altered mental states, developed psychosis.

“Not all people with neurological symptoms have been seriously ill, ” the study revealed.

A similar study published in July compiled detailed case reports of 43 people with neurological complications from Covid-19.

According to Michael Zandi, a neurologist at University College London and a lead author on the study, the most common neurological effects are stroke and encephalitis.

The study revealed that some of the worst-affected patients had only mild respiratory symptoms. “This was the brain being hit as their main disease, ” says Zandi.

It is not unheard of for serious diseases to cause such effects, but the scale of the Covid-19 pandemic means that thousands or even tens of thousands of people could already have these neurological effects, and some might be facing lifelong problems as a result.

As Alysson Muotri, a neuroscientist at the University of California, San Diego, put it in science journal Nature, “The neurological symptoms are only becoming more and more scary”. — Wires

Leading cause of disability, fatality

 ACCORDING to the Institute of Health Metrics and Evaluation, stroke is the third leading cause of male mortality in Malaysia after ischaemic heart disease and pneumonia, and the second leading cause of female mortality after ischaemic heart disease. Stroke is expected to become the second leading cause of mortality by 2040, according to the Global Burden of Disease report. The increasing trends of noncommunicable diseases such as diabetes, hypertension and obesity are posing substantial threats to stroke incidences in Malaysia.

On average, there are about 90 stroke admissions at Malaysian hospitals daily – with 40% comprising those aged below 60, and an average of 30 deaths owed to stroke. Almost 70% of stroke survivors live with many disabilities.

Stroke is a clinical entity characterised by a sudden disruption to brain functions through a disturbance in the brain’s blood supply. With the sudden cessation of blood supply, the brain cells receive neither adequate oxygen, nor the necessary nutrients to function – and eventually, the brain cells die.

 MSU Medical Centre consultant neurosurgeon Prof Dr Badrisyah Idris says, “There are two types of stroke – ischaemic and haemorrhagic. Occurring in 80% of stroke cases, an ischaemic stroke is owed to a narrowing of blood vessels by fat deposits or blood clots disrupting blood supply to the brain. The other 20%, owed to ruptured blood vessels, can be caused by uncontrolled high blood pressure or a weakened blood vessel wall.

“Stroke survivors suffer different deficits according to the affected brain area. They may suffer from memory and/or emotional disturbances, or be challenged by speech, vision, sensory or movement difficulties. In a transient ischaemic attack, commonly called a mini-stroke, the symptoms hit for only a few minutes or hours and then disappear. Mini-strokes happen when blood supply to the brain is interrupted only momentarily, though the chance of getting a permanent stroke within 48 hours rises tenfold and the risk remains high within the subsequent three months.

“With increasing age, the likelihood of getting an ischaemic stroke rises with the increased narrowing of blood vessels. Other factors that would lead to a stroke include smoking, obesity, alcoholism, high blood pressure, high blood cholesterol and high blood sugar. Lifestyle changes and treatment optimisation may reduce the risk of getting a stroke.”

Anyone who has had a stroke should receive treatment at a hospital within three hours after the onset of stroke signs to reduce further damage to the brain. Yet, the majority of stroke patients reach the hospital only after seven hours when the window of opportunity to save the brain has narrowed.

Recognising an onset of stroke is crucial to reducing deaths and disabilities from delayed stroke treatment. Techniques such as BE FAST help make an informed society and enable individuals to seek early stroke treatment.

• B –Balancing difficulties • E –Eye, vision disturbances • F –Facial weakness • A –Arm and/or leg weakness • S –Speech difficulties • T –Time to call an ambulance

When a person with stroke reaches the hospital, a doctor will establish the circumstances leading to the stroke event by noting the patient’s history and then performing a physical examination to identify the risks and associated deficits. A brain scan will be done to determine whether the stroke is ischaemic or haemorrhagic, and which part of the brain is involved.

Another test known as an angiography may be performed to assess the brain’s blood flow pattern and blood vessel structure.

Treatment for stroke depends on the stroke type. For ischaemic strokes, restoring blood flow to the affected area is crucial and should be carried out within four hours of the stroke’s onset. This can be done by injecting a blood-thinning medication called alteplase into a vein in the arm to dissolve blood clots inside the brain’s blood vessel.

Another technique called endovascular therapy dissolves blood clots inside the blocked brain vessel by directly injecting alteplase through a small catheter placed inside the affected blood vessel, or removes blood clots by retrieving them with a special device through a catheter placed inside the affected blood vessel.

For haemorrhagic strokes, the main goal of treatment is to control bleeding and to reduce the increased pressure in the brain. The high blood pressure has to be controlled by antihypertensive drugs, and the effect of the bloodthinning medication has to be reversed to reduce further bleeding. Ruptured blood vessels caused by cerebral aneurysms or arteriovenous malformations need to be treated by surgical intervention or endovascular

Following the stroke treatment, the recovery phase for each patient will depend on the extent of disabilities resulting from the stroke. 



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