COVID-19: China's socialist political system has shown it can overcome any challenge, says Xi Jinping

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. 

Brussels/Amsterdam, Apr 16: As the novel coronavirus continues to wreak havoc in the western world since its outbreak in Wuhan last December, researchers believe that the Chinese leadership is trying to absolve President Xi Jinping by using a section of the western media to influence public opinion globally.

"There are clear indications that China is conducting activities in a persistent and systematic manner to influence public opinion-making, academia, think tanks and political decision-making among the member states of the Belt and Road Initiative (BRI) in general and western capital cities in particular," Siegfried O Wolf, Director of Research at Brussels-based think tank South Asia Democratic Front, said.

Some western media say some Chinese officials were secretly aware that they were facing a pandemic from the new coronavirus but allowed Wuhan to host a mass banquet for tens of thousands of people and millions began their annual trip home for the Lunar New Year celebrations.

The pandemic has since then affected 210 countries and territories around the world. Over 2 million people have been declared positive in which over 134,000 lost their lives.

"The frequency and extra-ordinary large scale of Chinese sponsored events in European political hubs, like in Brussels, and the subsequent media coverage can be seen as evidence for Beijing's public diplomacy efforts. However, the rising skepticism within the EU regarding Xi Jinping's development projects and the emerging questioning of Chinese sources funding Free Universities, like the one in Berlin, shows that this strategy produced mixed results so far," Wolf said.

He added, "However, one must also state that these efforts helped China to gain certain leverage among many non-Chinese media, western as well as non-western ones. Today, we can observe that China's political leadership tries to instrumentalise this influence for a major image campaign to distract from the fact that it carries the initial responsibility for the dramatic spread of COVID-19 by holding back key information."

Wolf also said that the current internal dynamics in China, like the shirking of responsibilities by the local authorities, are most-likely part of a twofold strategy. Firstly, there is the strategic component - namely, to reaffirm to the general public that the Communist Party of China is still in full control of the situation. The second strategic pillar is one of 'whitewashing'.

"Concretely, Beijing's obvious aim is to distract the domestic and international attention from the real, but hidden causes of the Coronavirus outbreak and its potential reputational and political consequences for Xi Jinping and his BRI," he stated.

Yoana Barakova, a Research Analyst at European Foundation for South Asian Studies (EFSAS), an Amsterdam-based think-tank, said, "The death of Dr. Li Wenliang, one of the very few medical professionals who tried to warn the world in December 2019 about the looming threat, sparked widespread condemnation around the international community in early February. Yet, little did he know that his legacy would continue much later after his demise, with the emboldened Chinese government trying to cover up its missteps through hardcore censorship after being exposed for undermining and underestimating the initial danger."

The researchers believe that the deterioration in press freedom under Jinping's regime has become more evident in recent days, with local authorities trying to control the state narrative by cosmetically placing media's focus on government's superficial attempts to tackle the crisis.