Nirankari sect head Baba Hardev Singh killed in Canada accident: reports

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."

The ILO has warned that if another Covid-19 wave hits in the second half of 2020, there would be global working-hour loss of 11.9 percent - equivalent to the loss of 340 million full-time jobs.

According to the 5th edition of International Labour Organisation (ILO) Monitor: Covid-19 and the world of work, the recovery in the global labour market for the rest of the year will be uncertain and incomplete.

The report said that there was a 14 percent drop in global working hours during the second quarter of 2020, equivalent to the loss of 400 million full-time jobs.

The number of working hours lost across the world in the first half of 2020 was significantly worse than previously estimated. The highly uncertain recovery in the second half of the year will not be enough to go back to pre-pandemic levels even in the best scenario, the agency warned.

The baseline model – which assumes a rebound in economic activity in line with existing forecasts, the lifting of workplace restrictions and a recovery in consumption and investment – projects a decrease in working hours of 4.9 percent (equivalent to 140 million full-time jobs) compared to last quarter of 2019.

It says that in the pessimistic scenario, the situation in the second half of 2020 would remain almost as challenging as in the second quarter.

“Even if one assumes better-tailored policy responses – thanks to the lessons learned throughout the first half of the year – there would still be a global working-hour loss of 11.9 per cent at the end of 2020, or 340 million full-time jobs, relative to the fourth quarter of 2019,” it said.

The pessimistic scenario assumes a second pandemic wave and the return of restrictions that would significantly slow recovery. The optimistic scenario assumes that workers’ activities resume quickly, significantly boosting aggregate demand and job creation. With this exceptionally fast recovery, the global loss of working hours would fall to 1.2 per cent (34 million full-time jobs).

The agency said that under the three possible scenarios for recovery in the next six months, “none” sees the global job situation in better shape than it was before lockdown measures began.

“This is why we talk of an uncertain but incomplete recovery even in the best of scenarios for the second half of this year. So there is not going to be a simple or quick recovery,” ILO Director-General Guy Ryder said.

The new figures reflect the worsening situation in many regions over the past weeks, especially in developing economies. Regionally, working time losses for the second quarter were: Americas (18.3 percent), Europe and Central Asia (13.9 percent), Asia and the Pacific (13.5 percent), Arab States (13.2 percent), and Africa (12.1 percent).

The vast majority of the world’s workers (93 per cent) continue to live in countries with some sort of workplace closures, with the Americas experiencing the greatest restrictions.

During the first quarter of the year, an estimated 5.4 percent of global working hours (equivalent to 155 million full-time jobs) were lost relative to the fourth quarter of 2019. Working- hour losses for the second quarter of 2020 relative to the last quarter of 2019 are estimated to reach 14 per cent worldwide (equivalent to 400 million full-time jobs), with the largest reduction (18.3 per cent) occurring in the Americas.

The ILO Monitor also found that women workers have been disproportionately affected by the pandemic, creating a risk that some of the modest progress on gender equality made in recent decades will be lost, and that work-related gender inequality will be exacerbated.

The severe impact of Covid-19 on women workers relates to their over-representation in some of the economic sectors worst affected by the crisis, such as accommodation, food, sales and manufacturing.

Globally, almost 510 million or 40 percent of all employed women work in the four most affected sectors, compared to 36.6 percent of men, it said.

The report said that women also dominate in the domestic work and health and social care work sectors, where they are at greater risk of losing their income and of infection and transmission and are also less likely to have social protection.

The pre-pandemic unequal distribution of unpaid care work has also worsened during the crisis, exacerbated by the closure of schools and care services.

Even as countries have adopted policy measures with unprecedented speed and scope, the ILO Monitor highlights some key challenges ahead, including finding the right balance and sequencing of health, economic and social and policy interventions to produce optimal sustainable labour market outcomes; implementing and sustaining policy interventions at the necessary scale when resources are likely to be increasingly constrained and protecting and promoting the conditions of vulnerable, disadvantaged and hard-hit groups to make labour markets fairer and more equitable.

“The decisions we adopt now will echo in the years to come and beyond 2030. Although countries are at different stages of the pandemic and a lot has been done, we need to redouble our efforts if we want to come out of this crisis in a better shape than when it started,” Ryder said. 

Moscow, Jul 2: Russian voters approved changes to the constitution that will allow President Vladimir Putin to hold power until 2036, but the weeklong plebiscite that concluded Wednesday was tarnished by widespread reports of pressure on voters and other irregularities.

With most of the nation's polls closed and 20% of precincts counted, 72% voted for the constitutional amendments, according to election officials.

For the first time in Russia, polls were kept open for a week to bolster turnout without increasing crowds casting ballots amid the coronavirus pandemic a provision that Kremlin critics denounced as an extra tool to manipulate the outcome.

A massive propaganda campaign and the opposition's failure to mount a coordinated challenge helped Putin get the result he wanted, but the plebiscite could end up eroding his position because of the unconventional methods used to boost participation and the dubious legal basis for the balloting.

By the time polls closed in Moscow and most other parts of Western Russia, the overall turnout was at 65%, according to election officials. In some regions, almost 90% of eligible voters cast ballots.

On Russia's easternmost Chukchi Peninsula, nine hours ahead of Moscow, officials quickly announced full preliminary results showing 80% of voters supported the amendments, and in other parts of the Far East, they said over 70% of voters backed the changes.

Kremlin critics and independent election observers questioned the turnout figures.

We look at neighboring regions, and anomalies are obvious there are regions where the turnout is artificially (boosted), there are regions where it is more or less real, Grigory Melkonyants, co-chair of the independent election monitoring group Golos, told The Associated Press.

Putin voted at a Moscow polling station, dutifully showing his passport to the election worker. His face was uncovered, unlike most of the other voters who were offered free masks at the entrance.

The vote completes a convoluted saga that began in January, when Putin first proposed the constitutional changes.

He offered to broaden the powers of parliament and redistribute authority among the branches of government, stoking speculation he might seek to become parliamentary speaker or chairman of the State Council when his presidential term ends in 2024.

His intentions became clear only hours before a vote in parliament, when legislator Valentina Tereshkova, a Soviet-era cosmonaut who was the first woman in space in 1963, proposed letting him run two more times.

The amendments, which also emphasize the primacy of Russian law over international norms, outlaw same-sex marriages and mention a belief in God as a core value, were quickly passed by the Kremlin-controlled legislature.

Putin, who has been in power for more than two decades longer than any other Kremlin leader since Soviet dictator Josef Stalin said he would decide later whether to run again in 2024.

He argued that resetting the term count was necessary to keep his lieutenants focused on their work instead of darting their eyes in search for possible successors.

Analyst Gleb Pavlovsky, a former Kremlin political consultant, said Putin's push to hold the vote despite the fact that Russia has thousands of new coronavirus infections each day reflected his potential vulnerabilities.

Putin lacks confidence in his inner circle and he's worried about the future, Pavlovsky said.

He wants an irrefutable proof of public support.

Even though the parliament's approval was enough to make it law, the 67-year-old Russian president put his constitutional plan to voters to showcase his broad support and add a democratic veneer to the changes.

But then the coronavirus pandemic engulfed Russia, forcing him to postpone the April 22 plebiscite.

The delay made Putin's campaign blitz lose momentum and left his constitutional reform plan hanging as the damage from the virus mounted and public discontent grew.

Plummeting incomes and rising unemployment during the outbreak have dented his approval ratings, which sank to 59%, the lowest level since he came to power, according to the Levada Center, Russia's top independent pollster.

Moscow-based political analyst Ekaterina Schulmann said the Kremlin had faced a difficult dilemma: Holding the vote sooner would have brought accusations of jeopardizing public health for political ends, while delaying it raised the risks of defeat.

Holding it in the autumn would have been too risky, she said.

In Moscow, several activists briefly lay on Red Square, forming the number 2036 with their bodies in protest before police stopped them.

Some others in Moscow and St. Petersburg staged one-person pickets and police didn't intervene.

Several hundred opposition supporters rallied in central Moscow to protest the changes, defying a ban on public gatherings imposed for the coronavirus outbreak. Police didn't intervene and even handed masks to the participants.

Authorities mounted a sweeping effort to persuade teachers, doctors, workers at public sector enterprises and others who are paid by the state to cast ballots. Reports surfaced from across the vast country of managers coercing people to vote.

The Kremlin has used other tactics to boost turnout and support for the amendments.