good to have you with. a strong earthquake in turkey and greece. at least 14 people known to have died. the magnitude seven quake collapsed buildings and caused a scene surge which flooded streets -- a sea surge and flooded streets. >> it was felt and the greek islands. it was one of the places affected by the earthquake. there was a partial tsunami and

the governor's office said it was contained good one turkish citizen was injured. it is a coastal city and there is a risk for flood and tsunami always. but according to officials, it was a small risk. >> two men sentenced to 18 years in prison for their role in the westgate shopping attack in kenya, nairobi. the two were convicted earlier this month for helping fighters. vigils have been held across france to honor three people killed in an attack thursday. the suspect is in custody. investigators said he is from tunisia and arrived to europe last month area tens of thousands rallied in several nations against the french president's remarks on islam.

azerbaijan set to close in on a key town. separatist leaders say the troops have advanced to within five kilometers and urging people there to help resist the attack. health minister's from across the eu have stressed the importance four and wore native wrist -- for a coordinated response to covid-19. more news after inside story, next. >> back to lockdown lockdowns as coronavirus cases surge. there are warnings things may get even worse.

this is "inside story o." ♪ welcome to the program. europe is once again at the epicenter of the global pandemic. it is so far seen more than 44 million infections and over one million deaths worldwide. the region is struggling with rising numbers of infections while deaths from covid-19 go by 32% last week. while france has imposed a month-long lockdown that went into effect midnight thursday. for the second time this year, people are living under tough restrictions. president emmanuel macron says

the measures will help reduce infections from about 50,000 a day to 5000, according to the johns hopkins university. france has reported more than a million cases and over 36,000 deaths. across the border, people in germany also preparing for a month of restrictions. chancellor angela was once praised for handling of the -- angela merkel was once praised for her handling of the virus. authorities say they're unable to identify where 75 percent of new infections are coming from. the second wave in europe is rapidly outpacing the original outbreak lee this year. -- outbreak earlier this year. this time they are better prepared. they have unveiled plans to

transfer covid patients from hard-hit member states to neighbors with spare hospital beds. >> the commission an ounce tonight we are making to hunt a euros available -- are making 220 euros available. it requires good information in exchange. >> britain has decided to go its own way on how to handle the pandemic. boris johnson is resistant following germany and france in ordering a second lockdown. it is a decision that has led to criticism of the government, especially since the u.k. has the largest numbers of coronavirus deaths in europe, within 46,000. instead, it imposed local lockdowns speight a new study showing cases in england are doubling every nine days. the u.s. registered nearly 90,000 new infections on

thursday. it is the highest number of daily cases since the start of the pandemic. the virus is spreading rapidly in the western half of the country, affecting every swing state crucial to the next week's election. at least 228,000 deaths have been linked to the virus. president donald trump, who was hospitalized earlier this month with covid-19, continues to downplay the threat. india struggling with the largest number of infections, more than 8 million cases and over 121,000 deaths have been recorded. health authorities believe actual numbers may be higher. experts estimate at least 130 million people may be infected. joining me now are our guests in milan. the president-elect of the society of intensive care

medicine and head of intensive care medicine at research hospital. in boston, matthew fox, infectious disease, epidemiologist and professor of epidemiologist at boston school of health. and the director of the medical biotechnology laboratory and director of the research center. german chancellor angela merkel said this winter will be hard for long, difficult months. are you bracing for a surge in the cases of people that will be admitted to the intensive care unit in the coming weeks? >> hello, everyone. yes, i think we are. we have been bracing for a while, because even if the first wave was occurring in the first months of the year before the summer and the majority of countries in europe experiencing

a relatively quiet summer with coronavirus cases, we were actually never able to have zero transmission of cases in the community. the patients arrive even in the summer. now the numbers that we are seeing in europe very high. it has reached exponential values in many countries. i would say in the recent weeks, and son of the countries that have experienced -- and that some of the countries that have experienced the first -- in some of the countries that have experienced cases, we have seen rise in intensive care cases. intensive care across europe in many countries seeing a surge

and we can see the range and sometimes in 50%. the surge is here and we have to try to control the spread of the virus as much as possible in the community to avoid any bigger difficulty in the health care systems. >> the highway cases in the u.s. , more than 9 million infections since the start of the pandemic. stu you get the impression the government is not moving towards more restrictions like the ones we are seeing in europe. >> that is exactly right. the patterns we have seen here in the united states are very similar to the patterns you are seeing in europe, except with the difference that they are quite regional. so in parts of the country that have already seen a spike already intensify, whereas in the northeast where i am, it is just starting to begin. we are not taking the actions we need to be taking in order to

stave this increase in the spread. so we are seeing some states starting to go to more intensive mitigation measures, but we are not going towards the full lockdowns that we saw in april. we really do need to be taking more concrete action to stave off a really terrible winter. >> two things happening simultaneously. in morocco, infections increasing and mortality rate is spiking. are we expecting the government to reinstate the same measures taken a few months ago? >> i don't know if the government will be taking this decision, but it is between europe and the u.s. and morocco, you see what is happening in morocco and compared to what is happening in europe. in the u.s., the decision to do something is a political decision. but in morocco, we are thinking what to do.

that is what everybody is thinking about. we are almost two weeks behind europe. if there is something to be taken as a decision, it has to be right now. right now is the right time to do it because we are searching. the number of infected people are searching. the second thing is basically we are having more and more death. when we see the projection of washington university of what in morocco that by december 1, i think that will be exponentially increasing and we might have a big problem. >> since the start of the pandemic, the debate has been, should we listen more to experts or to politicians? now ultimately it is politicians who have the upper hand and are now bracing for tougher restrictions. do you think the lockdown is the efficient way given what has happened in the way of infections? >> we have learned an important thing during the first wave, at

least in europe. countries that were faster in reacting to the advice of scientists and clinicians were those who minimize the rise of sick patients initially. there were also able as clinicians and scientists, and i can speak for many colleagues across europe, have been demanding stricter measures when we saw the cases starting to increase in the virus starting to increase more exponentially. it is not the problem of one single sick patient, it is when the number of patients starts to multiply. to give an example, we will see the double of patients and then five to seven days they double again these numbers can put any health care system to their knees. we are not clearing for just covid patients, we want to care for all patients in the

hospitals and health care systems. if we overload the health care system just with covid patients, we start to compete for resources and some of the activities to care for patients have to be second to caring for covid. we have to take fast and stringent measures. clearly we cannot -- but certainly stringent measures and lockdowns have become necessary at some point when the spread of the virus in the community is out of control and we see exponentially it can bring a lot to the hospitals. by the nature of when you start to get symptoms, everything that you do today as a public health measure will have it in tact on the health care system in two weeks. when the situation is out of control, we can still see significant cases into the icus

even if measures are taken now. >> the optics are different in the united states of america, because we are in the midst of an unprecedented, bitter presidential race with polarizing issues and a president who discredits the medical community. are we likely to see the handling of covid-19 change post november 2? >> i think we don't yet know that. obviously partly that will depend on who wins the election. we know really what it is that we need to do. we have the tools available to us to both mitigate the spread and reduce the amount of tallassee without needing to necessarily need to go to -- reduce the amount of talent he -- fatality without needing to necessarily -- if we can go

towards that as a country regardless of who is in charge, we have an opportunity to bring down the community spread and hopefully not overwhelm the hospitals and continue to see progress. obviously that takes will of the people and leadership. i am hopeful that we continue to move in that direction. >> morocco is a country that does not have the same resources the europe -- the united states or europe has. you have any concern if the pattern continues we are likely to see intensive care units overwhelmed in the coming weeks in morocco? >> i am talking to my colleagues in the europe and the u.s.. for africa, it was a big thing to see this pandemic, because we don't have any models or benchmarking to do, because usually in africa would look to the north to see what happening and what is happening in the u.s. and europe is not something that is helpful. i feel really sad is what is

happening in the u.s., because i think a lost life anywhere is a lost life and it is not the question of numbers but families and lots of things. when you compare what is happening in africa went as you said with resources that a really limited, and we try to compare to what is happening in europe and the u.s., it is difficult to understand with 1.3 billion in africa, with 35,000 deaths and you see what is happening in the u.s. with 225,000 deaths. i think we don't assimilate what is happening around the world. i agree with you completely. i think we are reaching the capacity of our icus and i think we will have to make a tough decision. without a very stringent

decision and very courageous decision, i think by the first of december it will be very difficult to catch up to the infections. >> italy has been traumatized a few months ago by the increasing cases and infections and we have seen the pictures from intensive care units in parts of italy. they have been mitigation and ventilation for severe cases. is it likely to continue to be the same protocol for the upcoming months with all learning we have managed to accumulate an understanding about the disease itself? >> it is a very good question and it goes back to prevention is the best policy. that's is why we have to stick with masks and washing and distancing. one important message we have to pass to the community is that we

don't have a specific therapy for covid-19. for patients who can be managed at home, we can give aspirin and supportive therapy. they need adequate nutrition and hydration and rest. if they are admitted to the hospital, we now have evidence that steroids for those patients who require oxygen can help decrease mortality. that was one of the biggest advancements we made in research over the last few months. we realize when to use steroids and this is really a great advancement. however, we don't have other specific therapies for the virus and what is left is supportive therapy, again something we can do in the hospital and in the intensive care unit if a patient can benefit from mechanical

ventilation, we give time for the body to heal and rest while you take care of the organs with techniques and we protect the organs and hope the patient can recover. >> matthew, the trop administration has been said a vaccine will be available before the end of the year -- the trump administration has set a vaccine will be available for the -- before the end of the year. anthony fauci is basically saying we maybe have to wait longer. what does it mean for the americans? >> it means that things are going to continue roughly as they are over the next few months we are heading into winter. that means more people inside and schools have reopened and that is going to mean more transmission. until we have both a safe and effective vaccine, we are not going to be able to completely control the spread. all the measures for prevention will need to double down on those area i am still hopeful

that we do get a vaccine that -- on those. i am still hopeful that we do get a vaccine early next year and we can scale it and roll it out and then we could see a dent in the amount of transition -- transmission that is occurring. over time, things should start to get better. >> the world is waiting to see which company will manufacture the first vaccine, we are talking about very few trusted companies basically in europe and the united states. give me an idea about the debate you're having with your colleague over the medical biotechnology laboratories paid what are you thinking about today and tomorrow to get a vaccine? what would be the potential for countries like morocco and neighboring africa? >> i think the vaccine will be a solution. but as mathew said, it will take a bit of time.

we don't want to give false hope. it will not before tomorrow. we have to develop the vaccine and get accepted approval by december and then we have to go through mass vaccination and that will take a long time. we are not looking at a fast solution, but morocco doesn't have the capabilities right now to develop its own vaccine. so it has partnered with a couple of companies from asia, china, north korea and is acquiring the vaccine for -- from astrazeneca. i agree with both colleagues. the best way to fight the coronavirus right now is the mitigation that is the big problem that we have in morocco, we have less than 60% with 50% of the population adhering to a

face masks. we know that without having a face mask, you cannot have any protection. think it is tough to do what is in the moroccan culture in the western countries. >> i would like to unto tackle a different issue. do you think that the virus has become less vreeland compared to seven to eight months ago? when you look at europe, the mortality rate is becoming less and less. >> i don't think we have anything -- any evidence to say that. we know more how to fight the virus. in the last months of the summer, there was a lot of preparation ongoing in europe with intensive care medicine and we worked closely with the commission. one message we tried to pass was

that we need to find a fast way to increase competencies to care for patients during a surge. an icu ventilator, it is not an icu without competent people there. we launched a program in europe to train health care workers. we hope we will have enough during the search. >> as we move forward, we are starting to learn more about covid night teen and the syndrome is leaving patients with crippling issues like lasting repertory conditions, cardiac conditions, could this be the moment or have to rethink the way we deal with medicine itself? to put more investments aside for the near future, because we seem to be entering a new territory here. >> i do think that is right but

he gets back to the issue that our rigell here isn't to only get good at treating this disease. our goal is to prevent people from getting it in the first place. it is true we don't have great evidence to suggest whether the virus is getting weaker or we are just getting better at treating it. what we do know is the mortality is dropping, but that people are suffering severe consequences. so the goal is to prevent people from getting infected in the first place. that is a really difficult thing to convince people of when they see that mortality dropping. i agree with you that we certainly need to invest in our ability to care for people who are dealing with the severe consequences but our primary goal seems to be preventing infection in the first place. >> if you push ahead with the lockdown in morocco, a means many people will suffer economically and financially in the near future. then it boils down to people

like you to step in and try to raise awareness about how to move forward particularly in countries like north africa. if this will stay with us longer, how do you see the future in a place like morocco in north africa? >> is definitely going to be for at least one year. it will be somewhere and it will be everywhere. the virus isn't increasing and through our work, we showed that the virus is stable. the equilibrium between the economy and health will be important. i think all the people and that scientists and all the decision-makers have to communicate.

to let them know what to do and it is clear. >> in less than 30 seconds, for us, intensive care units are ventilators and the desperate attempt to save people. is this something we have to rethink with covid-19? >> intensive care beds are intensive care people. we have defined flexible ways to increase this competency so we can stop more beds during periods of surges. we need cities to help us to take down the transmission and the community. and then we can take care of many icu patients, not just covid, but care after everyone. >> thank you very much indeed. i promise you we will continue visiting this particular subject in the coming days and weeks.

thank you for watching you can see the program again any time by visiting our website, al jazeera.com. go to our facebook page and you can join the conversation on putter. for me, and the entire team, live for now. ♪

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