4 Indians, 1 Pakistani plead guilty in 'massive' US call centre scam

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."

Paris, Mar 2: A global agency says the spreading new virus could make the world economy shrink this quarter, for the first time since the international financial crisis more than a decade ago.

The Organization for Economic Cooperation and Development says Monday in a special report on the impact of the virus that the world economy is still expected to grow overall this year and rebound next year.

But it lowered its forecasts for global growth in 2020 by half a percentage point, to 2.4 per cent, and said the figure could go as low as 1.5 per cent if the virus lasts long and spreads widely.

The last time world GDP shrank on a quarter-on-quarter basis was at the end of 2008, during the depths of the financial crisis. On a full-year basis, it last shrank in 2009.

The OECD said China's reduced production is hitting Asia particularly hard but also companies around the world that depend on its goods.

It urged governments to act fast to prevent contagion and restore consumer confidence.

The Paris-based OECD, which advises developed economies on policy, said the impact of this virus is much higher than past outbreaks because "the global economy has become substantially more interconnected, and China plays a far greater role in global output, trade, tourism and commodity markets."

Beijing, Jun 17: Beijing's airports cancelled more than 1,200 flights and schools in the Chinese capital were closed again on Wednesday as authorities rushed to contain a new coronavirus outbreak linked to a wholesale food market.

The city reported 31 new cases on Wednesday while officials urged residents not to leave Beijing, with fears growing about a second wave of infections in China, which had largely brought its outbreak under control.

Tens of thousands of people linked to the new Beijing virus cluster -- believed to have started in the sprawling Xinfadi wholesale food market -- are being tested, with almost 30 residential compounds in the city now under lockdown.

At least 1,255 scheduled flights were cancelled Wednesday morning, state-run People's Daily reported, nearly 70 percent of all trips to and from Beijing's main airports.

The outbreak had already forced authorities to announce a travel ban for residents of "medium- or high-risk" areas of the city, while requiring other residents to take nucleic acid tests in order to leave Beijing.

Meanwhile, several provinces were quarantining travellers from Beijing, where all schools -- which had mostly reopened -- have been ordered to close again and return to online classes.

"The epidemic situation in the capital is extremely severe," Beijing city spokesman Xu Hejian warned Tuesday.

Mass testing under way

Officials have closed 11 markets and disinfected thousands of food and beverage businesses in Beijing after the outbreak was detected.

The city has now reported 137 infections over the last six days, with six new asymptomatic cases and three suspected cases on Wednesday, according to the municipal health commission.

An additional two domestic cases, one in neighbouring Hebei province and another in Zhejiang, were reported by national authorities on Wednesday, while there were 11 imported cases.

Authorities have so far banned group sports, ordered people to wear masks in crowded enclosed spaces, and suspended inter-provincial group tours in response to the outbreak.

Officials said that since May 30, more than 200,000 people had visited Xinfadi market, which supplies more than 70 percent of Beijing's fruit and vegetables.

More than 8,000 workers there were tested and quarantined.

Until the new outbreak, most of China's recent cases were nationals returning from abroad as COVID-19 spread globally, and the government had all but declared victory against the disease.

China's Center for Disease Control and Prevention said Monday that the virus type found in the Beijing outbreak was a "major epidemic strain" in Europe.