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Hundreds of thousands of people will die of tuberculosis because of disruption to healthcare systems in poor countries caused by the Covid-19 pandemic, a global aid fund has said.

In a few of the world’s poorest countries, excess deaths from Aids and tuberculosis (TB) could even exceed those from the coronavirus itself, said the head of the Geneva-based aid body, known as the Global Fund.

The Fund’s annual report for 2020, released on Wednesday, showed that the number of people treated for drug-resistant TB in countries where it operates fell by 19%. A decline of 11% was reported in HIV prevention programmes and services.

“Essentially, about a million people less were treated for TB in 2020 than in 2019 and I’m afraid that will inevitably mean that hundreds of thousands of people will die,” executive director Peter Sands told Reuters.

While precise death tolls are as yet unknown, Sands said that for some poor countries, such as parts of the Sahel region in Africa, excess deaths from the setback in the fight against diseases such as TB or AIDS might prove higher than from Covid itself.

The Global Fund is an alliance of governments, civil society and private sector partners investing more than $4 billion per year to fight tuberculosis, malaria and AIDS. The United States is its top donor.

Sands said services were affected by Covid lockdowns while clinics, staff and diagnostics normally used for TB were instead deployed for Covid in countries such as India and across Africa. He added that he expected further disruptions this year due to the Delta variant.

He said the decline in treatment for other diseases “underscores the need to look at the total impact of Covid and measure success in combating it not just by the reduction in deaths due to Covid itself but to the knock on impact”.

Malaria proved to be an exception to the trend in 2020, and prevention activities remained stable or increased compared to 2019, the Global Fund said.

Performers and audiences who are clinically extremely vulnerable (CEV) are being shut out of the arts due to a lack of ongoing safety provisions, according to a number of people within the UK’s sector who cite a “two-tier” cultural reopening.

While the rest of the population has been able to return to watching and taking part in live music and performance as of the end of July, those who are clinically vulnerable, who number around 3.7m or 6.7% of the British population, are still waiting for their freedom day.

Musician Catherine Anne Davies, who performs as the Anchoress, hasn’t played a live show since June 2019 and recently had to postpone her 2021 tour dates until March, and cancel her support shows for Manic Street Preachers, following advice from her doctor. While she’s double-vaccinated, she’s also immunocompromised, and it isn’t safe for her to return to performing while Covid-19 infection rates continue to rise, there’s evidence of vaccine efficacy dropping over time, and all restrictions have been lifted.

“It’s financially devastating,” she says, having been unable to capitalise on the success of her critically acclaimed second album, The Art of Losing, which was released in March. “It should be the start of something new, a chance to grow my audience, but will that interest still be there next spring? Are people willing to wait when the attention span of the industry is quite short? This could have a really detrimental impact on what happens next in my career.”

Davies isn’t alone – 70% of musicians, songwriters and composers who are still shielding in order to protect their health or that of someone they live with are facing financial hardship, according to a new survey by the Musicians’ Union and the Ivors Academy. Rich Legate, artist development manager at Attitude is Everything – a charity that supports the music industry to make live events more accessible – said he’s witnessing many clinically vulnerable musicians questioning whether they can continue a career in music. “This is almost the final straw for many artists in this group.”

My colleague Rhian Jones has the story:

The number of patients in hospitals across the US with Covid-19 this Labor Day weekend was nearly 300% higher than this time last year, according to data from Johns Hopkins University. The average number of deaths was over 86% higher than the same period last year.

The surge in patients comes as the highly contagious Delta variant continues to spread across the US, and coincided with a weekend that saw a spike in travel. According to the Transportation Security Administration, more than 3.5 million people travelled across the country on Friday and Saturday for the Labor Day holiday, despite the Centers for Disease Control and Prevention’s recommendation of unvaccinated people to refrain from traveling.

Hospitalisations and deaths are a lagging indicator of Covid spread, so the impact of people’s travels this week will not be clear right away, but the agency is continuing to advise caution.

“We have actually articulated that people who are fully vaccinated and who are wearing masks can travel,” said Rochelle Walensky, director of the CDC , last week. “Although given where we are with disease transmission right now, we would say that people need to take their own – these risks – into their own consideration as they think about traveling,” she added.

This past weekend saw 1.146m weekly cases, compared to 287,235 last year. Despite the decline in cases in certain states including Florida, other states such as Idaho are seeing hospitals begin to ration healthcare amid patient surges.

My colleague Maya Yang reports:

Justin Trudeau has been hit by a handful of gravel as anti-vaccination protesters targeted the Canadian prime minister’s campaign for re-election.

A CTV camera captured what appears to be white gravel hitting Trudeau and one of his bodyguards as he walked toward his campaign bus in London, Ontario. The Liberals cancelled an event late last month because of safety concerns linked to anti-vax protesters.

Trudeau played down the incident, later saying he may have been hit on the shoulder and adding that once he had pumpkin seeds thrown at him.

Earlier on Monday, Trudeau had assailed Conservative leader Erin O’Toole’s opposition to vaccine mandates, including for his own candidates, and called the hecklers “angry mobs” of anti-vaxxers.

“Erin O’Toole is at least taking some of his cues from [the anti-vax crowd],” Trudeau said.

About 74% of eligible Canadians are fully vaccinated, but a fourth wave of the coronavirus pandemic is currently building, mostly among the unvaccinated.

More on this story here:

More than 200,000 people have died from Covid-19 in Africa since the start of the pandemic, according to an AFP tally compiled from official records as of 5pm GMT.

A total of 200,254 fatalities have been registered on the continent, home to more than 1.3 billion people, since the coronavirus emerged in China in December 2019.

After several deadly months, including some 27,000 deaths in July and 26,000 in August, the pandemic appears to be easing on the continent, with current daily figures of 617 compared to up to 990 in late July, a record for the region.

The figures are based on tolls communicated daily day by health authorities in each country or by the World Health Organization (WHO).

The WHO has said that if excess deaths directly or indirectly linked to Covid are taken into account, the real toll could be double or triple.

Researcher Glenda Davidson of South Africa’s Cape Peninsula University of Technology said the total number of infections is also likely to be an under-estimate, given insufficient testing capacity in Africa.

Death registration processes were often delayed and inaccurate, she added.

The current fall in the continent’s tally is a result of sharp drops in the hardest-hit countries.

South Africa has recorded 83,899 deaths so far. But last week’s daily average of 7,400 new cases and 234 deaths is significantly lower than in late July, when the daily average was up to 20,000 new cases and 420 deaths.

Saudi Arabia removed the United Arab Emirates, Argentina and South Africa from its banned country list and reallowed citizens to travel to the three from 8 September, state TV reported on Tuesday.

The Ministry of Interior said the decision was based on the Kingdom’s evaluation of the current Covid-19 situation, state media reported.

Good evening from London. I’m Lucy Campbell, I’ll be bringing you all the latest global developments on the coronavirus pandemic for the next few hours. Please feel free to get in touch with me as I work if you have a story or tips to share! Your thoughts are always welcome.

Email: lucy.campbell@theguardian.com
Twitter: @lucy_campbell_

Zimbabwe is demanding civil servants and teachers get vaccinated or give up their jobs, AFP reports.

Despite already facing anger over requiring vaccination for market traders, sitting exams and access to gyms and restaurants, Zimbabwe is pushing further to ensure higher vaccination rates.

“If you are a government employee, for the protection of others and the people you are serving, get vaccinated,” the justice minister, Ziyambi Ziyambi, said on local radio.

“But if you want to enjoy your rights ... you can resign,” he said.

Just over 2.7 million of Zimbabwe’s 15 million inhabitants have so far received a first vaccine dose but vaccination centres have often been overwhelmed by people queueing early to receive vaccines.

Zimbabwe recently approved the Johnson & Johnson vaccine for emergency use, having relied on jabs from China, India and Russia.

The pandemic has left thousands of migrants stranded in Yemen because of restrictions on movement.

The UN’s migration agency IOM said 32,000 are stuck in Yemen, which is a transit hub for migrants leaving the Horn of Africa and trying to cross through Saudi Arabia.

IOM called for $3m (£2.2m) for repatriation flights, with more than 5,000 Ethiopians willing to return but waiting on a chance.

The pandemic has made it harder to move and also less lucrative for the smugglers migrants rely on to get across the border to Saudi Arabia, according to IOM.

Sweden will remove virtually all coronavirus restrictions on 29 September with the pandemic under control and the vaccination rollout well-advanced, the government said today (via AFP).

Hygiene rules and social distancing to combat the virus will still be encouraged in public places, according to the authorities.

“Our aim has always been to lift the restrictions as soon as possible,” health minister Lena Hallengren told a press conference.

Sweden made global headlines for its decision to combat the spread of the virus with mostly non-coercive measures rather than the type of lockdowns seen across Europe.

Those measures began to be eased from May under a five-point plan, with the fourth stage due to be reached at the end of September.

The European Union is likely to remove Japan and five other countries from its list of safe travel destinations, meaning visitors or people returning from those countries could face tighter controls such as Covid-19 tests or quarantine, Reuters reports.

A special EU health committee has proposed removing Japan, along with Albania, Armenia, Azerbaijan, Brunei and Serbia, EU diplomats said. It has also suggested Uruguay be added.

EU ambassadors, who will review the proposal tomorrow, typically follow the committee’s advice. A decision would normally be formalised by the end of the week.

The list seeks to unify travel rules across the 27-nation bloc, although it does not bind individual EU nations, which are free to determine their own border policies.

Germany, for example, already added Albania, Azerbaijan, Japan and Serbia on Sunday to its list of “high-risk areas” for which tighter entry restrictions apply.

Average daily Covid-19 cases in the six countries have risen sharply from below 40 a million in late June to more than 100 in the week to 6 September, figures from Our World in Data show, with Serbia at 500. However, the case rate in Japan has dipped in the past two weeks to almost exactly the same as in Germany.

With the proposed changes, the EU safe list would compromise 12 countries, including Australia, Canada and Saudi Arabia. Chinese territories Hong Kong and Macao are also considered safe.

The bloc still lets in most non-EU visitors who are fully vaccinated, although tests and periods of quarantine can apply, depending on the EU country of arrival.

Italy has today reported 71 coronavirus-related deaths, up from 52 on Monday, while the daily tally of new infections rose to 4,720 from 3,361, Reuters reports.

Earlier today, Italy’s health minister, Roberto Speranza, announced that third doses of Covid-19 will be made available to groups of “clinically vulnerable” people this month, making it the latest country in the west to push forward with booster jabs.

Italy has registered 129,638 deaths linked to Covid-19 since its outbreak emerged in February last year, the second-highest toll in Europe after Britain and the eighth-highest in the world. The country has reported 4.58 million cases to date.

Patients in hospital with Covid-19, not including those in intensive care, stood at 4,307 today, up from 4,302 a day earlier.

There were 40 new admissions to intensive care units, increasing from 32 on Monday but the total number of intensive care patients fell from 570 to 563.

Some 318,865 tests for Covid-19 were carried out in the past day, compared with 134,393 in the previous 24 hours, the health ministry said.

Public health leaders in the north-west US state of Idaho have today activated “crisis standards of care” for the state’s northern hospitals because there are more coronavirus patients than the institutions can handle, AP reports.

The Idaho department of health and welfare made the announcement, warning residents that they may not be able to get the care they normally expect if they need to be hospitalised.

The agency cited “a severe shortage of staffing and available beds in the northern area of the state caused by a massive increase in patients with Covid-19 who require hospitalisation.”

The designation includes 10 hospitals and healthcare systems in the Idaho panhandle and in north-central Idaho.

The move allows hospitals to allot scarce resources such as intensive care unit rooms to patients most likely to survive. Other patients will still receive care, but they may be placed in classrooms or conference rooms rather than traditional hospital rooms or go without some life-saving medical equipment.

The head of Britain’s exams regulator told MPs plans are “quite advanced” for a backup plan in case exams cannot go ahead in 2022.

“We are planning a joint consultation with the Department for Education (DfE) again later this autumn to propose a contingency plan should the unthinkable happen and examinations are again disrupted,” said Ian Bauckham, interim chairman of Ofqual.

Schools minister Nick Gibb said: “We don’t want to cancel exams.

“We do know that teachers and the school sector does want details of the contingency because they want to know what data they might or might not need to collect should the worst happen and we end up having to cancel exams.”

A handful of gravel hit the Canadian prime minister, Justin Trudeau, as he made his way past a crowd of anti-vaccine protesters shouting their opposition to Covid-19 vaccines, Reuters reports.

His party cancelled an event last month because of concerns about anti-vaccine protesters, who he has described as “angry mobs”.

The percentage of fully vaccinated people over the age of 16 is more than 80% in the UK, according to the latest figures.

There have now been 43,535,098 second doses delivered since the vaccination rollout began at the end of last year.

Wales has the highest proportion of the population who have had second doses, with 84.1% of over-16s.

An estimated 88.8% have received one dose in the UK.

Delivering jabs in schools will be the most efficient way to vaccinate pupils if approved for 12- to 15-year-olds, British schools minister Nick Gibb said.

“It is the swiftest and most efficient way of delivering the vaccination programme, as with other vaccination programmes for that age group,” he said. “The consent from parents will always be sought before the child is vaccinated in the school.”

The UK’s chief medical officers are reviewing approval after the Joint Committee on Vaccination and Immunisation declined recommending a widespread rollout.

Britain’s NHS could face a “remarkably hard” winter that increases the backlog caused by Covid-19, a leading doctor told MPs.

Dr Andrew Goddard, president of the Royal College of Physicians, said the £5.4bn set aside by Downing Street to help the NHS deal with backlogs was welcome but there are major challenges for the health service.

“So I think that the £5.4bn funding is fantastic news, but let’s be under no illusions this winter is going to be remarkably hard, and it’s going to impact waiting lists, probably more than anywhere else,” said Goddard.

Goddard said that alongside routine winter challenges, Covid-19 and an expected bad flu season will increase the pressure.

He also said a shortage of tubes used for blood testing meant treatment for many patients could not progress, which made it harder to work through the backlog.

Amanda Pritchard, the chief executive of the NHS in England, urged people to come forward if they needed care at a parliamentary session on the health and care bill.

“We just don’t know really how Covid is going to play out over the course of the next few months and years and one of the things that I know colleagues have talked about is that a lot of people didn’t come forward for care over the course of the past two years.

“One of the messages I would like to just give again is that anyone who is concerned about symptoms, the NHS is absolutely open for business, please do come forward and seek diagnosis, treatment, support for anyone who needs it.”

Rowena Mason and Nicola Davis report on the British government’s approached to a rumoured October “firebreak” lockdown:

Downing Street has not ruled out a “firebreak” lockdown as a last resort if the NHS were to be overwhelmed by Covid cases, but denied there were plans for one during October’s half-term school holiday.

With cases expected to rise further this autumn, some scientists have been warning that restrictions could be necessary in the coming months, such as limits on gatherings and a return to compulsory indoor masking.

A member of the Scientific Advisory Group for Emergencies (Sage) told the i paper that a “precautionary break” could be part of “contingency plans”, with another saying that “a firebreak lockdown is by no means out of the question”. They speculated this could take place during October half-term, with the break lengthened to two weeks rather than one.

Asked about the idea, Boris Johnson’s official spokesman said it was “not true that the government is planning a lockdown or firebreak around the October half-term”.

However, he made clear that further restrictions such as a two-week circuit breaker remained an option if the NHS were to be overwhelmed.

India faces a “disaster” for its schoolchildren – especially in rural areas – unless it begins reopening schools, according to experts.

Health experts are saying the benefits outweigh the risks and are hoping that a feared new wave of outbreaks will not be as devastating as this April’s because of how many people were infected then and the levels of vaccinations now.

A report released by Indian academics today warned of a “looming disaster” and criticised the policy of keeping schools closed.

“Soon after the Covid-19 crisis struck in early 2020, all schools were closed without batting an eyelid and most of them are still closed today,” the report said.

The Indian Express reported the survey found only 8% of Indian children in rural areas accessed online learning regularly. More than a third were not studying at all. Very few homes had access to smartphones and those that did often were used by working adults.

The Indian Association of Preventive and Social Medicine also called for all schools to be reopened, saying it was wrong to only prioritise older children.

They said primary school children were less likely to develop symptoms and that many children in India had already been infected, reducing the risk of the virus spreading.

Singapore has recorded its highest rise in infections for more than a year, the health ministry said.

It announced 328 new locally transmitted cases on Tuesday, after reporting more than 100 new cases daily for the past two weeks.

Singapore includes in its data the number of “unlinked” cases – those where the source of infection cannot be identified, despite aggressive track and trace efforts.

The Straits Times newspaper reported that the 185 unlinked cases amounted to triple the number of a week ago.

British workers are getting back on public transport as they head back to their offices, Downing Street has said.

The British prime minister’s spokesperson said transport data shows “significant increases” in passengers.

The Transport for London network said it had its busiest morning yesterday since before the first coronavirus lockdowns last year - aided by the return of children to schools.

“What we want to see is the civil service and, indeed, the broader workforce, returning in a gradual way,” said the spokesperson, after a government minister had said only a quarter of his staff worked from the office at one time.

“I’ll repeat that throughout, even at the height of the pandemic, it was civil servants, many of whom were continuing to work from the office because they were on the front line to the response to this pandemic.”

The rate of registered suicides in England has returned to pre-pandemic levels following disruption to coroners’ inquests, provisional figures from the Office of National Statistics (ONS) suggest.

There were 10.4 registered suicides per 100,000 people in the first half of 2021. The suicide rate in the second quarter of 2021 was statistically significantly higher than the rate in the second quarter of 2020, when there were 7.0 registered suicides per 100,000.

PA reports the ONS said the increase reflects the resumption of coroners’ inquests, following disruption during the coronavirus crisis, rather than a genuine increase in suicides.

• In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at www.befrienders.org

Russia’s Covid cases and deaths remain steady, according to today’s figures, as reported by Reuters. There were 17,425 cases in the last 24 hours, compared with 7,856 in the previous period, and there were 795 deaths.

Our Andrew Sparrow has just launched his UK politics live blog for the day, and he says “today I will be mostly focusing on the social care announcement. For Covid coverage, do read our global coronavirus live blog.”

But if you do want to jump over to UK politics, then you can find that here …

David LV Bauer is head of the RNA virus replication laboratory at the Francis Crick Institute in London, and he writes for us today that he is shocked his work has been hijacked by anti-vaxxers:

As a virologist, I’ve spent the past year or more studying the novel coronavirus that has upended all our lives. Communicating our work to the public and speaking to the media is an important part of my job, and I’ve always tried to be clear and accurate about the science: I believe the available vaccines against Covid-19 are safe, and they are our best route back to a more normal way of living.

I’ve been concerned about the anti-vaccination movement since before the pandemic. But I never imagined that my own work could actually be part of their misinformation arsenal. So I was shocked to discover that a recent TV interview I did for ITV London News had been seized on by anti-vax and conspiracy activists and now has thousands of likes, shares and retweets across social media.

The original interview was about our research on the Pfizer vaccine, which found that the antibody levels it generates are not as good at neutralising the Delta variant than against the original Wuhan strain – a simple update on likely vaccine protection. But the widely shared versions of the video were often edited, or taken out of context, to make me out to be some sort of supervillain, or the unlikely hero of the anti-vax world.

In some videos, I’m shown playing the part of the brave dissenter inside the establishment, blowing the whistle against some imagined harm of the vaccine. In another, I’m introduced as the head of the “UK bioweapons programme”, being caught admitting that the Covid vaccine could somehow destroy your immune system. Like the virus itself, the videos seemed to be mutating and spreading, with new, more virulent variants catching on online.

Read more here: David LV Bauer – As a virologist I’m shocked my work has been hijacked by anti-vaxxers

Reuters are carrying news this morning of a study from China looking at mixing Covid-19 vaccines which showed that receiving a booster shot of CanSino Biologics’ vaccine after one or two doses of Sinovac Biotech’s vaccine yielded a much stronger antibody response than using the Sinovac shot as a booster.

The study, among the first analyses in China combing different Covid vaccines, comes as the country said it would use booster shots in specific groups amid concerns over vaccines’ waning protection over time.

The southern Indian state of Kerala is increasing its efforts to stop a potential outbreak of the deadly Nipah virus, even as the state continues to battle the highest number of coronavirus cases in the country.

Kerala is on high alert after a 12-year-old boy died of the rare virus on Sunday, spurring health officials to start contact-tracing and isolating hundreds of people who came into contact with the boy, who died at a hospital in the coastal city of Kozhikode.

On Tuesday, the state health minister told reporters that the samples of eight primary contacts have come back negative. AP reports that Veena George said: “That these eight immediate contacts tested negative is a great relief.”

Nipah, which was first identified during a late 1990s outbreak in Malaysia, can be spread by fruit bats, pigs and through human-to-human contact. There is no vaccine for the virus, which can cause raging fevers, convulsions and vomiting. The virus has an estimated fatality rate of between 40% and 75%.

George said that more samples will be tested on Tuesday and that a total of 48 contacts, including the eight that have tested negative, are being monitored at a hospital. The state dealt with Nipah in 2018, when more than a dozen people died from the virus.

On Monday, Kerala registered nearly 20,000 Covid-19 infections out of India’s daily total of 31,222.

Tim Mitchell, vice-president of the Royal College of Surgeons of England, has joined calls in the UK for more health service funding this morning in an appearance on BBC Breakfast. PA reports he said:

We have a massive waiting list of nearly five and a half million people waiting for surgery, with about 6,000 people who have been waiting for two years for their operation. The money that was announced yesterday is very welcome and it’s good to have a clarity of the funding of the health service over the next six months.

But the Royal College of Surgeons of England has been calling for a new deal for surgery, with an additional £1bn a year for the next five years to help deal with the backlog, following Covid.

In addition to that, we believe there needs to be substantial investment in the health service to deal with the problems that were present before the pandemic. We know that frequently there are problems, particularly during the winter months – back in 2017, for instance, NHS England asked hospitals to stop all routine activity for a month. So, although this funding is very welcome, we do need additional funding for the future.

As promised, here are the Covid-relevant bits of UK vaccine minister Nadhim Zahawi’s appearance on Sky News. He was asked about newspaper reports around the idea of an “October firebreak” if Covid numbers in the UK start to rise, as is anticipated as schools return.

I think the right thing is that we open schools, we’ve opened them well, with a really comprehensive testing programme, and we want to make sure they stay open. The way we do that is by protecting the most vulnerable, which is why my focus is on the booster programme. I don’t want to adjust the half-term, or go back to any form of lockdown, because that’s the worst thing we can do to the economy and people’s livelihoods.

On that booster programme, he said:

We’ve had the interim advices from the Joint Committee on Vaccination and Immunisation (JCVI). That will help protect the most vulnerable from serious infection, and will actually help us transition this virus from pandemic to endemic status. The important thing is we get that right, because I think if we do that well, we can continue on this sort of one way road towards sustaining the opening of the economy, and by next year hopefully transitioning this virus from pandemic to endemic, and dealing with it on an annual basis.

My colleague Peter Walker last week reported on the somewhat mixed messages coming out of the JCVI on booster shots.

Good morning, it is Martin Belam here in London. UK vaccines minister Nadhim Zahawi is doing the UK media round today this morning. He’s on Sky News first, and so far it is mostly concerned with social care and NHS funding. I’ll bring you the main Covid lines from his appearances in a short while.

New Zealand’s Covid cases continue to plateau, with 21 new cases announced on Tuesday. The country has reported 20 cases a day for the past three days in a row.

All of the new cases are in Auckland, the city that remains in a level 4 lockdown. The rest of the country will come out of lockdown tonight, although some restrictions remain on gathering size and using masks in some public places.

Just over three-quarters of the new cases were in isolation throughout their infectious period, and all but one were epidemiologically linked to existing cases in the current outbreak: