Bill against outsourcing jobs reintroduced in US Congress

Johannesburg, Feb 22: To meet shortage of skilled nursing staff, private hospitals in South Africa are recruiting senior Indian nurses for their good work ethics and ability to become efficient trainers for the local staff, according to a media report.

A report at a 2018 jobs summit indicated that the country had a shortage of more than 47,000 nurses.

The shortage of the skilled nursing staff has been attributed to several factors, including preference of highly qualified nurses to emigrate or take up contract employment in countries such as the UK, the United Aarb Emirates, Saudi Arabia or New Zealand for want of higher salaries, a report in the weekly Business Times said.

Mediclinic, one of South Africa's largest private hospital groups, confirmed that it is recruiting 150 nurses from India this year.

“To supplement our training, as an internal strategy, we will continue to recruit senior registered nurses from India,” a Mediclinic spokesperson told the Business Times.

Mediclinic started recruiting nurses from India in 2005 but could not provide details about how many among the more than 8,800 nurses it employs at its hospitals are from India.

Another company, Life Healthcare SA, said it employed 135 Indian nurses between 2008 and 2014.

Top managements at the hospital groups lauded senior Indian nurses as being very efficient trainers for local staff.

“But we find that many of them prefer coming here on short-term contracts due to family commitments," a hospital executive said on the basis of anonymity.

The official said that the few who apply for long-term positions are usually young newly-qualified nurses, which is not the group in demand.

“They work hard, with a patient-oriented work ethic, and do not have the nine-to-five approach of many local nurses, especially those who are unionised," the official said.

“We would be very happy to take in more nursing staff from India," the official added.

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."

Mexico City, Jun 13: The number of people, who have died of COVID-19 in Mexico, has risen by 544 to 16,448 within the past 24 hours, Jose Luis Alomia, the director of epidemiology at the Health Ministry, said.

He also said on late Friday that the number of confirmed coronavirus cases had increased by 5,222 to 139,196 within the same period of time.

A day earlier, the Latin American nation has recorded 4,790 new confirmed cases of the coronavirus, with 587 fatalities.

The World Health Organization declared the COVID-19 outbreak a pandemic on March 11. To date, more than 7.6 million people have been infected with the coronavirus worldwide, with over 425,000 fatalities, according to Johns Hopkins University.