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Coroner Stphanie Gamache is investigating the death of Raphal Andr, 51, whose body was discovered inside a portable outdoor toilet steps away from a shelter in January 2021.

Published May 14, 2024 Last updated 10hours ago 4 minute read

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For unhoused people living in the street, there is a sort of order provided by the resources in place that helps to orchestrate the day-to-day lives of most.

When you live or survive in the street, things still work in a way, emergency shelter co-ordinator Jonathan Lebire said Tuesday at the coroners inquest into the death of Raphal Andr. You know where you can go to sleep, to get the things you need.

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COVID-19 destroyed all of those things.

On Jan. 17, 2021, at the height of the COVID-19 crisis and just eight days after Quebec instituted a curfew to stop mounting infections, Andr, a 51-year-old Innu man, was found dead inside a portable outdoor toilet steps away from a homeless shelter. Three years later, the inquest of coroner Stphanie Gamache started this week to look at the causes that could have contributed to his death, and for possible solutions.

Lebire knew Andr well because he was a regular at the Projet Autochtones du Qubec (PAQ) emergency shelter serving Indigenous men and women in downtown Montreal. The news of Andrs death came as a shock.

Raphal was full of life, he was always smiling, Lebire said. He wasnt someone who was depressive, he wasnt aggressive or violent. He was resilient.

I found he had a good place in his community, he had the respect of people.

The arrival of COVID-19, which saw the closing of shelters and soup kitchens, threw things into chaos, Lebire said.

People were completely broken. They didnt have any money to survive. Often they didnt know where to go to eat or sleep.

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When the Canadian government started distributing COVID-19 payments, organized crime groups got homeless people on the payment rolls, Lebire said, for a cut of the proceeds. The influx of money resulted in increased drug use. When the dpanneurs had to close early because of the curfew, crack dealers started hanging around the shelters, knowing the chronic alcoholics would need something else.

COVID-19 unbalanced everything, Lebire said. People who didnt consume drugs in the past started using.

On the day before Andr was found dead, Lebire told him that new COVID-19 regulations in Quebec stipulated anyone wanting to stay in an emergency shelter must take a COVID test first. Andr told Lebire that would be a problem for him and many others in the Indigenous community. Lebire said he knew that, but his hands were tied. He had to enforce the rules if he wanted to keep his job. They shook hands before Andr departed.

Andr went to the Open Door shelter afterward, but COVID-19 restrictions meant it was no longer accommodating overnight stays. Workers there offered to call him a taxi to stay at the PAQ shelter, but he refused. Andrs body was found the next morning in a portable toilet steps away from the closed Open Door shelter.

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Miraculously, after Raphal passed away, all of a sudden we were allowed to open at night again, said John Tessier, a former employee at Open Door. Which was very frustrating, especially as the person who had to ask him to leave.

Earlier in the day, Dr. Julie St-Cyr Bourque, the nurse and emergency room doctor who treated Andr at the Centre hospitalier de lUniversit de Montral (CHUM) the day before he died, testified that he was inebriated, but not in a severely depressed state of consciousness. He had been admitted because he fell in a dpanneur, cutting open his head.

The coroner asked if St-Cyr Bourque was aware Andr had been to the same ER more than half a dozen times in the month prior to their meeting. She said she was not, but said it would not affect her treatment of him. She treated his minor head wounds, asked if he had access to a shelter and discharged him around 6 p.m.

Blood samples showed Andr had imbibed the equivalent of 14 drinks and his levels were four times the legal driving limit on the night he died, a chemist and toxicologist with the laboratory of medical and legal sciences testified. It was enough alcohol to put the usual person into a deep stupor or sleep from which it would be hard to revive, she said. There was also valium in his system, which had been prescribed by St-Cyr Bourque earlier that day to treat his anxiety and distress. The two together would have the effect of decreasing the central nervous system.

Pathologist Dr. Yann Daz testified that an autopsy determined the likely cause of death was hypothermia, in a heavily intoxicated man. It was not thought the amounts of alcohol and valium were enough to cause his death alone.

He noted that Andrs blood samples showed he did not have COVID-19.

rbruemmer@postmedia.com

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'COVID-19 unbalanced everything' for unhoused people, inquest told - Montreal Gazette

swissinfo.ch / Keystone

Four years ago, our lives were upended by the Covid-19 pandemic. Countries locked down, millions became ill, millions died. And when the vaccine finally arrived, it was not fairly distributed. Rich countries bought too many, poor countries waited, with nothing.

This content was published on May 14, 2024 - 10:00

Imogen Foulkes

Imogen Foulkes reports from Geneva for SWI swissinfo.ch as well as the BBC.

What we saw during the Covid-19 pandemic was collapse. Basically, a complete failure of international cooperation, says Suerie Moon, from the Global Health Centre at the Geneva Graduate Institute.

Surely we can do better? Countries are gathering in Geneva to try to hammer out a pandemic treaty. Do they have the vision? And the courage?

Theres been so much lip service paid to equity, but when it actually comes to nailing down what that means, and how to avoid a repeat, it seems like governments are struggling, says Kerry Cullinan, deputy editor of Health Policy Watch.

What about the vaccine manufacturers? Are they ready to share?

Thomas Cueni, outgoing head of the International Federation of Pharmaceutical Manufacturers, says: Ive always been of the view that no treaty is better than a bad treaty. Have a good treaty, I think it would be great.

Are we going to be better equipped for the next pandemic?

I think it would be an insult to the seven million people plus who died during the pandemic for there not to be a historic agreement, says Cullinan.

Join host Imogen Foulkes on our Inside Geneva podcast to learn more about this treaty.

Sign up! The latest updates from International Geneva in your inbox

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Why is Switzerland so sweet on cryptocurrency? Whats it like to be a Swiss expat in America? Swiss women couldnt vote until when?!

Read more

Opinion

This content was published on May 26, 2022 The WHO should allow for greater civil society participation to ensure that human rights are taken into account during pandemic treaty negotiations.

This content was published on Nov 30, 2021 Vaccines have been developed in record time, yet nearly half the worlds population has not received a single dose. What has gone wrong?

Link:

Inside Geneva: is the world brave enough to agree on a pandemic treaty? - SWI swissinfo.ch in English

Interventions such as testing patients for COVID-19 on admission, isolation of ill healthcare workers (HCWs), and universal HCW masking from March 2020 to July 2022 significantly reduced SARS-CoV-2 transmission among patients and staff in UK hospitals, suggests asimulation study led by UK Health Security Agency researchers in London.

The findings were published last week in BMC Infectious Diseases.

The scientists used an individual-based model of in-hospital SARS-CoV-2 spread and a panel of infection-prevention experts to estimate the effectiveness of disease-mitigation measures during the first 2 years of the COVID-19 pandemic. The study period spanned the predominance of different viral variants and the availability of different vaccines and doses.

"Model parameters and associated uncertainty were derived using national and local data, literature review and formal elicitation of expert opinion," the study authors wrote. "We simulated scenarios to explore how many nosocomial [hospital-related] infections might have been seen in patients and HCWs if interventions had not been implemented."

Results of the simulation suggest that, without COVID-19 testing at hospital admission, other infection-prevention protocols, and limits on occupancy and visitors, twice as many patients could have been infected in the first 2 years of the pandemic.

"Testing and cohorting of patients and isolation of HCWs were the most important interventions for reducing transmission to patients and HCWs preventing up to 34% (3040%) of infections," the researchers wrote. "We also identified a significant role for masking, with universal masking being more impactful than masking around patients alone (40% (3052%) vs 17% (1420%) reduction)."

They cautioned, however, that their study focused on the overall impact of masking but didn't distinguish between the use of respirators or surgical masks. Also, it assumed total compliance with measures such as testing and isolation and didn't consider individual HCW differences in risk of infection when outside the hospital.

The infection-prevention measures had the greatest effect during times of limited immunity (beginning of the pandemic and during the Omicron variant surge) and were least effective during times of high immunity from COVID-19 vaccination and previous infection.

These results highlight the importance of maintaining high levels of compliance to infection prevention and control measures in hospitals and have important implications as hospitals prepare for a surge in demand due to emerging winter pressures and COVID-19.

"Model findings suggest that collectively the interventions introduced over the SARS-CoV-2 pandemic in England averted 400,000 (240,000 500,000) infections in inpatients and 410,000 (370,000 450,000) HCW infections," the researchers wrote.

The authors said that the findings point to a role for limited patient visitation during times of high community prevalence.

"These results highlight the importance of maintaining high levels of compliance to infection prevention and control measures in hospitals and have important implications as hospitals prepare for a surge in demand due to emerging winter pressures and COVID-19," they concluded.

Read more here:

COVID patient testing, isolation of sick staff cut in-hospital viral spread, modeling study suggests - University of Minnesota Twin Cities

POCATELLO Bannock County Commissioners have set aside $17 million in American Rescue Plan Act Funds for 29 new projects.

ARPA was passed by Congress in 2021 to help local communities recover from the COVID-19 pandemic.

The commissioners finished committing these funds on April 15 when they voted against putting funding towards the proposed forensic pathology center. The $4.5 million that wouldve gone towards the center was redistributed throughout the rest of the ARPA projects.

RELATED | Bannock County commissioners vote down East Idaho Forensic Pathology Center

We wanted to have something that would be lasting and not just throw it into something that youre going to forget about next year, Commissioner Ernie Moser says.

Here are the projects that have been approved but have yet to be completed:

Here are the projects that have been completed so far:

Moser said all of these projects offer a variety of benefits.

One example he pointed to was The Village, a safety and recovery center for juveniles. In seven months of operation, its already served 500 people.

RELATED | The Village: Instead of criminalizing kids help them

He also pointed to projects that will benefit south Bannock County, one of which is the new ambulance bay in McCammon.

We felt like it would have great longevity, it would bring safety and it provides a lot of services for the south end of the county, and so that became a priority, Moser said.

The county received about $200 million worth of requests for ARPA funds. Due to the finite amount of funds, many people who put in requests were disappointed not to receive any.

Moser wishes they were able to provide funding for everyone who gave them a request. He felt everyone who came before them treated the process seriously, but they had to evaluate projects by the impact they would have for the county.

When it comes down to it, we had to look at county funds being spent to benefit all the people of the county, Moser said.

Original post:

Here's how Bannock County will use its remaining COVID-19 recovery funds - East Idaho News

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A DJ who traveled the world before he suddenly became bedridden for a year with long Covid, causing memory loss and mobility issues, has since lost his career and now predominantly spends his days lying down.

Rowan Clarke, 32, a part-time video editor and sound designer from Colchester, contracted Covid-19 in 2021 and progressively got sicker and sicker to the point where he was in constant pain, could not remember his own phone number and could hardly walk.

On top of this, Rowan had constant headaches, meaning he could barely work and look at his emails, and ended up having to close his recording studio.

At the time, Rowan was the fittest he had ever been, running 15km a day, and was preparing to take a fire service exam to become a part-time firefighter he also had to give this up because of his condition.

When he went to the doctors about his symptoms, he said he felt like they were medically gaslighting him, and was told there was nothing wrong and it may just be anxiety one doctor even asked him Do you want me to wave my magic wand?

After going back and forth to the doctors for a year, he was eventually diagnosed with long Covid, chronic fatigue syndrome and fibromyalgia, and prescribed low-dose naltrexone (LDN) to manage his pain and fatigue.

In recent months, he has been experimenting with alternative medicines, including a small earpiece that sends electrical signals to his brain, but he still spends most of the day lying down and admits he has lost a lot of friends since being unwell, and has almost given up trying to explain it to people.

Rowan told PA Real Life: I spend most of the day lying down, but I work now, not full time, but I can do that.

Its changed my entire life Ive lost a lot of friends from it, Ive lost my career, Ive lost everything.

(At the beginning) they told me it was just anxiety, they denied that anything was wrong with me the mental toll of that was awful, it was like medical gaslighting.

Immediately the doctors were like Theres nothing wrong with you the more I just listened to them, I believed them.

I had one doctor tell me Do you want me to wave my magic wand?

I just couldnt believe it, I just thought Why would I be here? You know, why would I quit my job and quit the fire service? It just didnt make any sense at all

You think having headaches every day for a year they would do brain scans or assume things would be taken seriously.

Before the pandemic, Rowan was living the dream travelling the world, DJing internationally and even presented television shows in the Philippines.

But this soon came crashing down in 2021, he contracted the delta variant of Covid-19.

At first, he had the usual symptoms of a sore throat and a cough when going to the doctors, he was told he may have an allergy, but after doing a Covid test, he realised he had the virus.

I tried going back to normal but I just got sicker and sicker and got to the point where I was completely bed-bound for a year, it was very confusing really, he explained.

I was in constant pain I had a headache for like a year straight and nothing worked at all.

It felt like my muscles were pushing out of my body I couldnt remember my phone number, I couldnt remember peoples names.

I was out of breath, like I couldnt walk downstairs and Id wake up and it felt like I had been hit by a bus.

It was just the most scary thing.

Rowan could also not look at screens or deal with sounds, meaning he could not look at emails and struggled to get any work done, so ended up closing his recording studio.

On top of this, around a month into being sick, he was meant to take a fire service exam as he was planning to become a part-time firefighter, but this also had to be put on hold.

Over time, Rowan unfortunately had to accept that he was not able to train as a firefighter, and decided to go to the doctors as his condition was not improving.

A year after Rowan first got sick, and continued going to the doctors, he was finally diagnosed with long Covid, chronic fatigue and fibromyalgia.

He said: I was referred to a long Covid clinic but the advice was mainly just to pace myself which didnt really help at all.

My life is built around pacing myself, I try to have some kind of life.

Like right now its a beautiful sunny day and I really want to go for a run but I feel like Ive been hit by a car.

Its like prison.

You give up trying to explain it to people, and its been hard trying to have relationships.

However, Rowan has a girlfriend of one year, Rosie Helliwell, 27, and said: Shes known people with similar illness and could understand it so I was quite lucky to meet her I think, but you cant keep up with the expectations of a relationship, to be honest.

Rowan has since been privately prescribed low-dose naltrexone (LDN) to help with his chronic pain and fatigue, which has made him able to move around a lot more, but, he has still not been able to go on a run since contracting Covid.

Looking to the future, Rowan said: I have mixed emotions (about the future) because Im disabled and so much has changed, Ill never have the life I previously had.

But on the bright side, it looks like theres a lot of research coming out about long covid.

Theres a lot of people in this community that are very upset, angry and depressed but I just think you have to look at everything positively as much as you can.

Asked whether Rowan will one day get back behind the decks, he said: I dont know because I couldnt stand for that long.

I hope so, but I really dont know.

See the original post:

International DJ forced to give up dream after being left bedridden for a year - The Independent

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These are the top stories on Fox 32's Week in Review.

CHICAGO - The Northern Lights were visible in Chicago Friday night amid a historic geomagnetic storm; a new group of COVID-19 variants has been on the rise across the country; and a Bolingbrook man reported missing in 2022 was found dead in Chicago.

These are the top stories on Fox 32's Week in Review.

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The Northern Lights were seen all over the Chicago area on Friday night.

For the first time in nearly 20 years, a Severe (G4) Geomagmetic Storm Watch was issued on Thursday, after a series of solar flares were observed.

According to the Space Weather Prediction Center, the Northern Lights could be visible as far south as northern Alabama overnight and early Saturday morning.

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A new group of COVID-19 variants is sweeping across the country right now. The new variants, nicknamed "FLiRT," are the new dominant strains in the United States, according to the CDC.

A new group of COVID-19 variants is circulating across the United States.

According to tracking by the Centers for Disease Control and Prevention, the family of variants, nicknamed "FLiRT" after their mutations, are currently the dominant strains in the country.

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A 22-year-old Bolingbrook man who was reported missing in 2022 has been found dead in Chicago.

A 22-year-old Bolingbrook man who was reported missing in 2022 has been found dead in Chicago.

Edward "Eddie" Gardner was last seen in Woodridge, as well as Griffith, Indiana, on March 13, 2022.

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A historic geomagnetic storm brought the Northern Lights over Chicago on Saturday night. We made a timelapse video of our footage that captured the lights downtown.

The magnificent Northern Lights were captured in photos across the Chicago area on Friday night.

Photos of the aurora borealis were sent in by FOX 32 viewers from across the Chicago-area. Auroras occur when a solar storm emits extra charged particles into space, and those charged particles interact with Earth's atmosphere to create a natural colorful light display in the sky.

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A village board meeting was underway in Dolton Monday night, marking the first meeting since FBI agents delivered subpoenas that named Mayor Tiffany Henyard.

A village board meeting was held in Dolton Monday night, marking the first meeting since FBI agents delivered subpoenas that named Mayor Tiffany Henyard.

Outside the Village of Dolton, residents were eager to address Henyard and her administration.

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A Cinco de Mayo parade that celebrates Mexican heritage in Chicago was disrupted Sunday due to gang violence.

A Cinco de Mayo parade that celebrates Mexican heritage in Chicago was disrupted Sunday due to gang violence.

The long-running event was scheduled to start near Damen Avenue and Cermak Road at noon in the Little Village neighborhood.

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The Lake County Sheriff's Office is turning up the heat in their search for a drug dealer who's been on the run for three years.

The Lake County Sheriff's Office is turning up the heat in their search for a drug dealer who's been on the run for three years.

In a Fox 32 special report, Tia Ewing has the latest on the search for Anthony Brown.

The man fatally shot after getting caught in a "street takeover" in Chicago Lawn over the weekend has been identified.

At about 3:17 a.m. on Sunday, a 20-year-old man was driving in his black Honda Accord when he was caught in a "street takeover" at the intersection of West 59th Street and South Western Avenue.

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A Will County man was charged after he allegedly shot his neighbor outside his home in Unincorporated Lockport Township on Tuesday.

A Will County man was charged after he allegedly shot his neighbor outside his home in Unincorporated Lockport Township on Tuesday.

Will County Sheriff's deputies responded to a home near 144th Place and Rickerman Road at approximately 5:37 p.m. for reports of a shooting in the area.

A sign stands outside of a McDonald's restaurant February 9, 2009 in San Francisco, California. Fast food chain restaurant McDonald's reported a 7.1 percent increase in same store sales for January as people look towards cheaper food alternatives in

McDonalds reportedly planning to launch a $5 meal deal in the U.S. to attract customers deterred by rising fast-food prices, according to a source who spoke to Bloomberg anonymously.

The value meal will offer a choice between a McChicken or a McDouble, accompanied by fries and a drink.

Read more here:

Week in Review: Northern Lights visible in Chicago New COVID variants spreading Missing man found dead - FOX 32 Chicago

MUMBAI: The state has identified 91 cases of the new Covid-19 Omicron subvariant KP.2 that has outpaced the previously circulating JN.1 variant and is now driving cases in many countries. Pune reported 51 cases and Thane 20 cases of KP.2, first detected globally in Jan. Currently, KP.2 is the dominant variant in the US. Maharashtra identified KP.2 cases in January. By March and April, it became the dominant strain in the region. However, there hasnt been any proportionate increase in hospitalisations or serious cases, said Dr Rajesh Karyakarte, states genome sequencing coordinator. KP.2 descended from JN.1, which was the predominant Covid strain by the end of 2023. In March, the state witnessed a slight surge in cases, averaging around 250 detections, which is likely attributable to the spread of the KP.2 variant. Besides Pune and Thane, seven cases each were identified in Amravati and Aurangabad. Solapur had two cases while Ahmednagar, Nashik, Latur and Sanglione each of the KP.2 variant. None was from Mumbai.

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91 cases of new Covid subvariant in Maharashtra: 51 in Pune & 20 in Thane - The Times of India

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Chinese citizen journalist Zhang Zhan, who was jailed for her reporting from Wuhan in the early days of the Covid-19 pandemic, is set to be released after four years.

The lawyer-turned-citizen journalist was in Wuhan in February 2020 to document the Chinese governments efforts to curb the spread of the novel coronavirus at the start of what was to become a global pandemic.

She spoke about the Chinese governments efforts to censor criticism against its response to the pandemic on several social media platforms, including YouTube, WeChat, and X formerly Twitter.

After 4 years in prison for her independent reporting on the Covid-19 pandemic, journalist Zhang Zhan is due for release on 13 May, Reporters Without Borders (RSF) shared on X.

China has faced accusations of delaying the release of crucial information during the initial outbreak and attempting to cover up the situation, actions that are believed to have facilitated the viruss spread to pandemic proportions.

Ms Zhang was arrested in May 2020 and subsequently convicted of picking quarrels and provoking trouble, resulting in a four-year prison sentence. Since then, she has remained incarcerated at Shanghai womens prison.

In a video posted in February 2020, Ms Zhang said Wuhan was paralysed because everything is undercover.

She continued: Thats what this country is facing now They imprison us in the name of pandemic prevention and restrict our freedom. We must not talk to strangers, its dangerous. So without the truth, everything is meaningless. If we cannot get to the truth, if we cannot break the monopoly of the truth, the world means nothing to us.

Ms Zhang also posted a video online showing a hospital overflowing with patients during the early phase of the pandemic, a time when much information on the viruss spread had not yet reached the rest of the world.

While in prison, she went on a prolonged hunger strike that impacted her health and prompted authorities to feed her forcibly.

Her lawyer told reporters that she became very thin during her stay in prison and had a tube up her nose for forced feeding.

International human rights groups have been calling for Ms Zhangs release with Amnesty International saying she should not have been jailed in the first place.

Sarah Brooks, Amnesty Internationals China director, said: We urge the Chinese authorities to ensure that Zhang Zhan is fully free from 13 May. She must be allowed to move freely, to communicate with people inside and outside of China, and to reunite with her family. She and her family must not be subjected to surveillance or harassment, and the Chinese authorities must also ensure there are no restrictions on her access to medical treatment after her traumatic ordeal in jail.

Additional reporting with agencies

View post:

Chinese citizen journalist jailed for Covid reporting in Wuhan set to be released - The Independent

Recently, the World Health Organisation (WHO) acknowledged the continued risk of Middle East Respiratory Syndrome (MERS) infection, particularly in regions where the virus circulates among dromedaries, mainly in the Middle East.

While COVID-19 has dominated recent headlines, MERS remains a persistent concern. Unlike COVID-19, however, MERS lacks proven antiviral treatments, vaccines, or rapid diagnostics. This underscores the ongoing need for advancements in these areas.

Experts have praised Saudi Arabia's expertise in detecting and controlling healthcare-associated MERS transmission but warn that other regions may be less equipped. Efforts to trace the initial case are ongoing, and crucial for understanding and containing future outbreaks.

According to the World Health Organisation, MERS is a viral respiratory illness caused by the MERS coronavirus (MERS-CoV). While not as widespread as some other respiratory viruses, MERS is a concern due to its potential severity.

MERS symptoms can range from mild to severe, and they typically appear within 2 to 14 days after exposure to the virus. Common symptoms include:

In severe cases, MERS can progress to pneumonia, acute respiratory distress syndrome (ARDS), kidney failure, and even death. Individuals with underlying health conditions, such as diabetes, renal failure, or chronic lung disease, are at higher risk of developing severe complications.

Several factors increase the risk of contracting MERS as per the Centres for Disease Control and Prevention:

Preventing the spread of MERS involves a combination of personal and public health measures, shared a study published in the Lancet:

For travellers, staying informed about MERS outbreaks and following travel advisories can help mitigate the risk. Additionally, healthcare facilities should have protocols to identify and isolate suspected MERS cases promptly.

While MERS is not as widespread as other respiratory illnesses, understanding its symptoms, risk factors, and preventive measures is crucial for public health. By practising good hygiene, avoiding close contact with sick individuals, and staying informed, we can work towards minimising the impact of MERS and similar viral diseases.

Also Read:Long COVID Can Lower Your IQ, Finds Study: Here's How Long COVID Can Damage The Brain

The Saudi Arabian outbreak serves as a poignant reminder of the ongoing global battle against infectious diseases. As we navigate through pandemics like COVID-19, it's imperative to remain vigilant and invest in research and preparedness for diseases like MERS, ensuring a more resilient healthcare system for the future.

Original post:

MERS Outbreak In Saudi Arabia Here Are Its Symptoms Risk Factors And Preventive Measures - Onlymyhealth

Countries trying to strike a landmark global agreement on handling future pandemics began discussing how to keep the process alive as they ran out of time to seal a deal Friday.

With the chances fading of concluding an agreement by the end of the day, negotiations turned to what the next steps might be.

Shaken by the failures exposed by Covid-19 -- which killed millions, shredded economies and crippled health systems -- countries have spent two years drafting an international accord on pandemic prevention, preparedness and response.

Despite a common desire for binding commitments aimed at preventing another such disaster, big differences quickly emerged between country blocs on how to go about it.

And though progress has been made on bridging the differences, the clock was always against them.

The World Health Organization's 194 member states were meant to finish the process in March so the agreement could be formally adopted at their annual assembly, which starts on May 27.

This additional fortnight of talks was crammed in amid hopes of achieving a breakthrough. Countries did finally begin thrashing out text wording but could not get everything completed in time.

The talks are being held behind closed doors at the WHO headquarters in Geneva.

WHO chief Tedros Adhanom Ghebreyesus was attending the talks in person, along with the UN health agency's emergencies director Michael Ryan.

WHO spokeswoman Margaret Harris told a media briefing Friday that the overtime round of talks "will end later today".

Fuelled by trolleys full of coffee, bananas, biscuits and sandwiches, negotiators have been pulling 12-hour days since April 29 to try and find a way through.

Several diplomats were already leaving the building with their suitcases on Friday as the talks neared the end.

"During the past two weeks, negotiators have held extensive discussions on multiple aspects of the proposed agreement, meeting often into the early hours of the morning," Harris said.

"Next steps on the way forward will... be discussed today and they will be announced later."

Non-governmental organisations that were deemed to be relevant stakeholders can follow the process outside the room and are briefed daily by the talks' co-chairs.

"Member states are discussing what the next steps will be," Medicines Law and Policy director Ellen 't Hoen told reporters.

"It's fair to say there's progress made. If you look at the outline of the agreement, all the important themes are there.

"But there remain a significant number of thorny issues that simply need more time. No country as far as we can tell has tried to pull the plug."

James Love, the director of Knowledge Ecology International, added: "There is some room for negotiating right now. I don't think we're really there yet.

"I don't think it's the worst outcome if they take more time. I also don't think they're going to quit."

The main disputes revolve around access and equity: access to pathogens detected within countries and to pandemic-fighting products such as vaccines produced from that knowledge; and equitable distribution of not only counter-pandemic tests, treatments and jabs, but also the means to produce them.

Each of the draft agreement's 37 articles has been individually thrashed out, with country negotiators breaking off into working groups to try to figure out a consensus.

While general agreement has been found on some articles -- without formally signing them off -- the core aspects have proved the hardest to negotiate.

rjm/vog/rlp

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Pandemic agreement talks reaching end with deal elusive - Montana Right Now