14 dead in Kazakhstan plane crash, 17 seriously injured

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

United Nations, May 21: At least 19 million children in parts of Bangladesh and India are at "imminent risk" from flash flooding and heavy rain as Cyclone Amphan makes landfall and the state of West Bengal is expected to take a direct hit from the powerful storm, the UN's children agency has warned.

The extremely severe cyclonic storm Amphan made a landfall at Digha in West Bengal and Bangladesh on Wednesday, leaving a trail of destruction. At least three persons were killed in India and seven in Bangladesh.

The UNICEF said that at least 19 million children in parts of Bangladesh and India are at “imminent risk from flash flooding, storm surges and heavy rain as Cyclone Amphan makes landfall.”

West Bengal, “home to more than 50 million people, including over 16 million children, is expected to take a direct hit from the powerful storm,” the UN agency said in a statement on Wednesday.

The UNICEF said it is also very concerned that the COVID-19 could deepen the humanitarian consequences of Cyclone Amphan in both the countries. Evacuees who have moved to crowded temporary shelters would be especially vulnerable to the spread of respiratory diseases like COVID-19, as well as other infections.

“We continue to monitor the situation closely,” said UNICEF Regional Director for South Asia Jean Gough.

“The safety of children and their families in the areas that will be impacted is a priority and it is good to see that the authorities have planned their urgent response factoring in the on-going COVID-19 pandemic.”

Across the region, the UNICEF is “working closely with the governments of Bangladesh and India and stands ready to support humanitarian operations to reach children and families affected by Cyclone Amphan.”

Based on the storm’s current trajectory, Cox’s Bazar in Bangladesh – now sheltering over 850,000 Rohingya refugees – is likely to experience high winds and heavy rains which may cause damage to homes and shelters in the refugee camps and Bangladeshi communities. This population is already highly vulnerable and cases of COVID-19 have recently been confirmed in the camps and host communities.

The UNICEF said it is working with the Deputy Commissioner’s Office in Cox’s Bazar, the Office of the Refugee Relief and Repatriation Commissioner, and humanitarian partners to help ensure Bangladeshi and Rohingya children and families remain protected.

These efforts include raising awareness among Rohingya and Bangladeshi communities on cyclone preparedness and prepositioning emergency life-saving water, sanitation, hygiene and medical supplies to meet immediate humanitarian needs.

Meanwhile, UN Secretary-General Antonio Guterres’ spokesperson Stephane Dujarric said at the daily press briefing that UN teams on the ground continue to work with the Government of Bangladesh to prepare and support those in need in the wake of the cyclone.

“Given the current pandemic, this support includes distributing personal protective equipment, disinfectants and other materials to evacuation shelters. To reduce the person-to-person contact during the delivery of aid, e-cash distributions will be used,” he said adding that the UN along with its partners is mobilising more than 1,700 mobile health teams and preparing for emergency food deliveries.

“The Super Cyclone is taking a westerly trajectory towards India, but nearly 8 million people in Bangladesh remain at risk,” he said adding that the Bangladesh government has evacuated more than 2 million people in high-risk areas. 

New Delhi, Feb 18: A Delhi court today sent Sharjeel Imam, who has been named as an "instigator" by the Delhi Police in its chargesheet on violent protests against the amended citizenship act at New Friends Colony near Jamia in Delhi last year, to judicial custody till March 3.

Sharjeel Imam was arrested on sedition charges last month.

The Delhi Police has filed a chargesheet before Chief Metropolitan Magistrate Gurmohina Kaur, naming Sharjeel Imam as an instigator of the violence.

It said it has attached CCTV footage, call detail records and statements of over 100 witnesses as evidence in the chargesheet.

The court had on Monday sent Sharjeel Imam to one-day custody of Delhi Police in the case.

Protestors had torched four public buses and two police vehicles as they clashed with police in New Friends Colony near Jamia Millia Islamia in Delhi during the demonstration against the CAA on December 15, leaving nearly 60 people including students, cops and fire fighters injured.