Bob Dylan accepts Nobel, says it left him 'speechless'

Washington, Jul 14: Florida on Sunday reported a record 15,300 new coronavirus cases, the most by any state in a single day even as the coronavirus cases in the country have surged to 3,363,056.

The Washington Post reported that the huge number was result of both increased testing and widespread community transmission. The numbers shattered previous highs of 11,694 reported by California last week and 11,571 reported by New York on April 15.

Natalie E. Dean, an assistant professor of biostatistics at the University of Florida wrote that with Florida largely open for business, he doesn't expect this surge to slow.

Nationally, the conversation over reopening has become increasingly fraught amid the newly soaring case numbers, with much of the debate centering on whether schools should open their doors in the fall, reported the Post.

The Health workers in California and Texas too are facing an influx of COVID-19 patients where officials reported seven day averages for new cases - 8,664 and 9060 respectively.

According to the report, Florida has reported nearly 70,000 cases in last week alone, the most of any state.

Even though the COVID-19 cases are surging, Florida Gov. Ron DeSantis has stuck to an aggressive reopening plan with state officials recently ordering schools to reopen five days a week in the new academic year.

The state is also set to hold the Republican National Convention next month in Jacksonville's VyStar Veterans Memorial Arena, an indoor facility that seats about 15,000, reported Washington Post.

Seven-day averages for new cases -- considered a more reliable indicator of the virus's impact than single-day totals -- hit new highs in Alabama, Florida, Mississippi, Montana, North Carolina, Oklahoma and Puerto Rico.

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."

London, May 3: The British government had a contingency plan for prime minister Boris Johnson’s death as his condition deteriorated while he battled COVID-19 last month in intensive care, Johnson said in an interview with The Sun newspaper.

Johnson returned to work on Monday, a month after testing positive for COVID-19. Johnson, 55, spent 10 days in isolation in Downing Street from late March, but was then was taken to London’s St Thomas’ Hospital where he received oxygen treatment and spent three nights in intensive care.

“They had a strategy to deal with a ‘death of Stalin’-type scenario,” Johnson, 55, was quoted as saying by The Sun. “It was a tough old moment, I won’t deny it.”

After Johnson was discharged, St Thomas’ said it was glad to have cared for the prime minister, but the hospital has given no details about the gravity of his illness beyond stating that he was treated in intensive care.

Johnson and his fiancée, Carrie Symonds, on Saturday announced the name of their newly born son as Wilfred Lawrie Nicholas, partly as a tribute to two of the intensive care doctors who they said had saved Johnson’s life.

“The doctors had all sorts of arrangements for what to do if things went badly wrong,” Johnson said of his COVID-19 battle. “The bloody indicators kept going in the wrong direction.”

He said doctors discussed invasive ventilation.

“The bad moment came when it was 50-50 whether they were going to have to put a tube down my windpipe,” he said. “That was when it got a bit . . . they were starting to think about how to handle it presentationally.”