Boris Johnson thanks National Health Service medics for saving his life from coronavirus

Washington, Apr 18: The United States on Friday passed 700,000 confirmed coronavirus cases, according to a tally maintained by Johns Hopkins University.

With the highest number of cases and deaths of any country in the world, the US had recorded 700,282 cases of COVID-19 and 36,773 deaths as of 8:30 pm (0030 GMT Friday), according to the Baltimore-based university.

That marked an increase of 3,856 deaths in the past 24 hours, but that figure likely includes "probable" virus-linked deaths, which had not previously been counted.

This week, New York City said it would add 3,778 "probable" virus deaths to its official count.

The US Centers for Disease Control and Prevention gave a toll Friday night of 33,049 dead, including 4,226 probable virus-linked deaths.

The United States has seen the highest death toll in the world in the coronavirus pandemic, ahead of Italy (22,745 deaths) although its population is just a fifth of that of the US.

Spain has recorded 19,478 deaths, followed by France with 18,681.

Trump announces $19 billion relief for farmers amid COVID-19 epidemic

President Donald Trump on Friday announced a $19 billion financial rescue package to help the agriculture industry weather the staggering economic downturn sparked by measures to defeat the coronavirus.

Trump told a press conference the government "will be implementing a $19 billion relief program for our great farmers and ranchers as they cope with the fallout of the global pandemic."

The program will include direct payments to farmers, ranchers and producers who Trump said have experienced "unprecedented losses during this pandemic."

Agriculture Secretary Sonny Perdue said US farmers have been hit hard by a sharp shift in demand, as schools and restaurants close and more Americans eat at home.

That has disrupted the food supply chain, forcing farmers in many places to destroy dairy output and plow under crops that no longer have buyers.

"Having to dump milk and plow under vegetables ready to market is not only financially distressing, but it's heartbreaking as well to those who produce them," Perdue said.

Perdue said some $3 billion of the money would go to buying produce and milk from such farmers, and redistribute it to community food banks.

Millions of Americans have recently turned to food pantries for meals and groceries after losing their jobs.

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."