A dozen killed as terrorists attack Iran parliament, Khomeini tomb

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."

Washington, Jun 26: The United States reported more than 39,000 new coronavirus cases on Thursday, its highest-ever single-day count as the government relaxed restrictions and is downplaying the threat of the deadly virus.

According to the Washington Post, experts believe there is a troubling lack of consistent, unified messaging from President Donald Trump and Vice President Mike Pence. They have downplayed the danger and denigrated effective disease defences such as mask-wearing, testing, and social distancing.

Churches, beaches, and bars are filling up with people and so are hospital beds, the report said.

The counties home to Dallas, Phoenix, and Tampa all reported record-high averages on at least 15 straight days in June.

The hardest-hit states are California, Texas, Florida and those that thought they had the virus under control, like Utah and Oregon.

"I think the politicians are in denial," said Kami Kim, director of the Division of Infectious Disease and International Medicine at the University of South Florida.

The chief of the Division of Pediatric Infectious Diseases at the University of Utah Health, Andrew T. Pavia, is of the view that the push to reopen quickly even as cases climb sends a dangerous and inaccurate message.

"On the one hand, you get messages from politicians and the business community that we have to go, go, go and open up," he said. "On the other hand, you're seeing epidemiological indicators that we still have to be very careful."

"It's cognitive dissonance," he added.

The Trump administration has tried to downplay the rising number. Pence called concerns about another surge of infections "overblown," the product of media "fearmongering."

Some governors have followed the administration's lead, blaming rising caseloads on more testing.

Testifying before a congressional committee this week, Anthony S. Fauci, the nation's top infectious-diseases expert, said the new cases were "a disturbing surge" spurred by community transmission rather than testing.

"That's something I'm really quite concerned about," Fauci said. "A couple of days ago, there were 30,000 new infections. That's very disturbing to me."

Several states like Arizona, Arkansas, the Carolinas, Mississippi, Tennessee, Texas and Utah have recently reported new highs in the number of coronavirus patients hospitalized.

"We're seeing a 40 per cent increase in the last two weeks in hospitalizations," said Dallas County Judge Clay Jenkins (D), the jurisdiction's top elected official. "We're by far at our record numbers, and we're at record numbers in north Texas. Houston is at a record, the state is at a record." The Texas Medical Center in Houston, a massive medical complex, reported Thursday that 100 per cent of the beds in its intensive care unit are occupied.

Washington, Jan 2: The number of people killed in large commercial airplane crashes fell by more than 50% in 2019 despite a high-profile Boeing 737 MAX crash in Ethiopia in March, a Dutch consulting firm said on Wednesday. Aviation consulting firm To70 said there were 86 accidents involving large commercial planes - including eight fatal incidents - resulting in 257 fatalities last year. In 2018, there were 160 accidents, including 13 fatal ones, resulting in 534 deaths, the firm said.

To70 said the fatal accident rate for large airplanes in commercial passenger air transport was just 0.18 fatal accident per million flights in 2019, or an average one fatal accident every 5.58 million flights, a significant improvement over 2018. The fatality numbers include passengers, air crew such as flight attendants and any people on the ground killed in a plane accident

Large passenger airplanes in the study are aircraft used by nearly all travelers on airlines worldwide but excludes small commuter airplanes in service, including the Cessna Caravan and some smaller turboprop airplanes, according to To70.

On Dec. 23, Boeing's board said it had fired Chief Executive Dennis Muilenburg after a pair of fatal crashes involving the 737 MAX forced it to announce it was halting output of its best-selling jetliner. The 737 MAX has been grounded since March after an October 2018 crash in Indonesia and the crash of a MAX in Ethiopia in March killed a total of 346 people.

To70 said the aviation industry spent significant effort in 2019 "focusing on so-called 'future threats' such as drones." But the MAX crashes "are a reminder that we need to retain our focus on the basics that make civil aviation so safe: well-designed and well-built aircraft flown by fully informed and well-trained crews."

The Aviation Safety Network said on Wednesday that, despite the MAX crash, 2019 "was one of the safest years ever for commercial aviation." The 157 people killed in March on Ethiopian Airlines Flight 302 accounted for more than half of all deaths last year worldwide in passenger airline crashes.

Over the last two decades, aviation deaths around the world have been falling dramatically even as travel has increased. As recently as 2005, there were 1,015 deaths aboard commercial passenger flights worldwide, the Aviation Safety Network said.

Last week, 12 people were killed when a Fokker 100 operated by Kazakh carrier Bek Air crashed near Almaty after takeoff. In May, a Russian Sukhoi Superjet 100 aircraft caught fire as it made an emergency landing at Moscow’s Sheremetyevo airport, killing 41 people.

The figures do not include accidents involving military flights, training flights, private flights, cargo operations and helicopters.