Demonstrations turn aggressive as Indian tricolour ripped during PM Modi's UK visit

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."

Feb 6: India has been ranked 40th out of 53 countries on a global intellectual property index, even as the country has shown improvement in terms of scores when it comes to the protection of IP and copyright issues, a top American industry body said on Wednesday.

India was placed at 36th position among 50 countries in 2019.

India's score, however, increased from 36.04 per cent (16.22 out of 45) in 2019 to 38.46 per cent (19.23 out of 50) in 2020, a 2.42 per cent jump in an absolute score.

However, India's relative score increased by 6.71 per cent, according to the International IP Index released by Global Innovation Policy Center or GIPC of the US Chambers of Commerce.

This year, it finds itself on the 40th place among 53 countries. Two new Index economies (Greece and the Dominican Republic) scored ahead of India. The Philippines, and Ukraine leapfrogged India.

"Since the release of the 2016 National IPR Policy, the government of India has made a focused effort to support investments in innovation and creativity through increasingly robust IP protection and enforcement," the GIPC said.

Since 2016, India has improved the speed of processing for patent and trademark applications, increased awareness of IP rights among Indian innovators and creators, and facilitated the registration and enforcement of those rights, it added.

According to the eighth edition of the annual report, India's score on the Chamber's International IP Index demonstrates the country's growing investment in IP-driven innovation and creativity. The Index specifically highlights a number of reforms over the last year that strengthen India's overall IP ecosystem, it said.

"In 2019, the Delhi High Court used dynamic injunctions to disable access to copyright-infringing content online, resulting in an increase in India's score on two of the copyright-related indicators," it said.

"The use of these injunctions places India alongside global leaders in copyright enforcement, including Singapore and the UK. As a result, India scores ahead of 24 other economies in the copyright indicators," the report said.

The Delhi High Court also issued a series of judgements that provide clarity on existing statutes related to trademark protection online, resulting in a score increase on one of the trademark-related indicators, it added.

The courts issued two precedential rulings that raised the bar for the damages awarded in IP-infringement cases and may provide a deterrent for future infringement. This resulted in an increase in score on one of the trademark-related indicators, it said.

Global Innovation Policy Center or GIPC said India also continues to score well in the Systemic Efficiency indicator, scoring ahead of 28 other economies in these indicators.

"This is a result of a concerted effort by the Indian government to consult with stakeholders during IP policy formation and create greater awareness about the importance of IP protection,” it said adding that India also remains a leader in the use of targeted incentives and IP assets for small and medium-sized enterprises (SMEs).

“To continue this upward trajectory, much work remains to be done to introduce transformative changes to India’s overall IP framework and take serious steps to consistently implement strong IP standards," the report said.

GIPC has identified several challenges for India. Prominent among them being patentability requirements, patent enforcement, compulsory licensing, patent opposition, regulatory data protection, transparency in reporting seizures by customs, and Singapore Treaty of Law of TMs and Patent Law Treaty.

"We are encouraged that Indian policymakers seem to recognize this Index as a valuable resource in their efforts to strengthen the country’s promising innovation ecosystem and enhance its competitiveness in an increasingly knowledge-based global economy,” the report said.

Observing that no other economy stands to gain more from strong Indian IP than India itself, the report said for example, no industry has been hurt more by copyright violations in India than the country’s own Bollywood industry, which loses almost USD3 billion to piracy each year.

"The number one way the Modi administration can demonstrate its commitment to the success of the Atal Innovation Mission, Accelerating Growth for New India’s Innovations, Make in India, Digital India, and Startup India is to strengthen its IP framework in ways that promote the legal and regulatory certainty necessary for greater R&D investment, high-value jobs, and greater innovative and creative outputs,” it said.

"Strong IP standards can further solidify India's position as the world’s fastest-growing economy, bolstering its reputation as a destination for doing business, foreign businesses’ ability to invest and make in India, thereby supporting the growth of India’s own innovative and creative industries," the report said.

New Delhi, Mar 5: The primary classes of all schools in the national capital will remain closed till March 31 to prevent a possibility of spread of coronavirus, Deputy Chief Minister Manish Sisodia announced on Thursday.

According to Directorate of Education (DoE) officials, while elaborate guidelines have been issued about preventive measures for coronavirus, students of nursery and primary classes are too young to understand the risk, making them more prone to infectious diseases.

Sisodia, who also holds the education portfolio, tweeted, "As a precautionary measure to prevent the possibility of spread of COVID-19 amongst our children, Delhi Government has directed the immediate closure of all primary schools (Govt/ aided/ private/MCD/NDMC) till 31/3/20(sic)."

A senior DoE official said, "Elaborate guidelines have already been issued. However, students of nursery and primary classes are too young to understand the risks associated with COVID-19. Thus they are more prone to infectious diseases and mingle around with classmates more often."

"It will be good if they are trained in the do's and dont's under the care and supervision of their parents at home. However, students of classes other than primary will continue to come to schools or examination centres for writing their examination as per schedule. The teaching, as well as non-teaching staff, will also attend regular school," the official said.

As of now, the number of confirmed COVID-19 cases in the country stands at 30, including 16 Italian tourists. The figure includes the first three cases reported from Kerala last month who have already been discharged following recovery.

Alerted by the coronavirus case reported in Delhi-NCR, schools in the region have sent out advisories to parents suggesting that they do not send their wards to attend classes even in case of mild cough or cold, and saying that they may declare holidays if the need arises. A few schools have announced already holidays and others have advanced their spring break.