450K illegal immigrants in US are from India: Report

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."

Minneapolis, Jun 2: An official autopsy released Monday ruled that George Floyd, the African-American man whose death at police hands set off unrest across the United States, died in a homicide involving "neck compression".

George, 46, died of "cardiopulmonary arrest complicating law enforcement subdual, restraint, and neck compression," and the manner of death was "homicide," the Hennepin County Medical Examiner in Minneapolis said in a statement.

Floyd's other significant health conditions were listed as "arteriosclerotic and hypertensive heart disease; fentanyl intoxication; recent methamphetamine use."

The statement added that the "manner of death is not a legal determination of culpability or intent."

It emphasized that under Minnesota state law "the Medical Examiner is a neutral and independent office and is separate and distinct from any prosecutorial authority or law enforcement agency."

Oakland, Jun 2: Facebook employees are using Twitter to register their frustration over CEO Mark Zuckerberg's decision to leave up posts by President Donald Trump that suggested protesters in Minneapolis could be shot.

While Twitter demoted and placed a warning on a tweet about the protests that read, in part, that “when the looting starts the shooting starts,” Facebook has let it stand, with Zuckerberg laying out his reasoning in a Facebook post Friday.

“I know many people are upset that we've left the President's posts up, but our position is that we should enable as much expression as possible unless it will cause imminent risk of specific harms or dangers spelled out in clear policies,” Zuckerberg wrote.

Trump's comment evoked the civil-rights era by borrowing a phrase used in 1967 by Miami's police chief to warn of an aggressive police response to unrest in black neighborhoods.

On Monday, Facebook employees staged a virtual “walkout” to protest the company's decision not to touch the Trump posts according to a report in the New York Times, which cited anonymous senior employees at Facebook.

The Times report says “dozens” of Facebook workers “took the day off by logging into Facebook's systems and requesting time off to support protesters across the country." “I work at Facebook and I am not proud of how we're showing up.

The majority of coworkers I've spoken to feel the same way. We are making our voice heard,” tweeted Jason Toff, a director of product management at Facebook who's been at the company for a year.

Toff, who has a verified Twitter account, had 131,400 “likes” and thousands of retweets of his comment. He did not immediately respond to a message seeking comment on Monday.

“I don't know what to do, but I know doing nothing is not acceptable. I'm a FB employee that completely disagrees with Mark's decision to do nothing about Trump's recent posts, which clearly incite violence. I'm not alone inside of FB.

There isn't a neutral position on racism,” tweeted another employee, design manager Jason Stirman.

Stirman did not immediately respond to a request for comment on Monday. Sara Zhang, a product designer at the company, tweeted that Facebook's “decision to not act on posts that incite violence ignores other options to keep our community safe.

The policy pigeon holes us into addressing harmful user-facing content in two ways: keep content up or take it down.” “I believe that this is a self-imposed constraint and implore leadership to revisit the solution,” she continued. Zhang declined to comment to The Associated Press.

Representatives for Facebook did not immediately respond to messages for comment.

Twitter has historically taken stronger stances than its larger rival, including a complete ban on political advertisements that the company announced last November.

That's partly because Facebook, a much larger company with a broader audience,targeted by regulators over its size and power, has more to lose. And partly because the companies' CEOs don't always see eye to eye on their role in society.

Over the weekend, Twitter changed the background and logo if its main Twitter account to black from its usual blue in support of the Black Lives Matter protesters and added a #blacklivesmatter hashtag. Facebook did the same with its own logo on its site, though without the hashtag.