Indian-origin loses job for posting torn Singapore flag

New Delhi, Jul 22: With a spike of 37,724 cases and 648 deaths reported in the last 24 hours, the total number of COVID-19 cases in India stands at 11,92,915, according to the Union Ministry of Health and Family Welfare.

The total number of cases includes 4,11,133 active cases, 7,53,050 cured/discharged/migrated and 28,732 deaths, the Health Ministry informed.

Maharashtra remains the worst affected state with 3,27,031 cases and 12,276 deaths.
The second worst-hit state, Tamil Nadu has reported 1,80,643 COVID-19 cases so far while Delhi has reported 1,25,096 cases, according to the Ministry.

Other states that have witnessed a higher number of COVID-19 positive cases include, Andhra Pradesh with 58,668 cases, Karnataka with 71,069 while Telangana has reported 47,705 COVID-19 positive cases.

Meanwhile, as per the information provided by the Indian Council of Medical Research (ICMR), the total number of samples tested up to July 21 is 1,47,24, 546 including 3,43,243 samples tested yesterday.

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."

Jakarta, Mar 15: Indonesia's transport minister is in intensive care after testing positive for the novel coronavirus, an official has said, as schools and tourist attractions were ordered to close over the health threat.

Transportation Minister Budi Karya Sumadi was receiving treatment at an army hospital in Jakarta, State Secretary Pratikno said on Saturday.

A hospital spokesman said Sumadi was encountering difficulty breathing but that his condition was improving.

Pratikno said Sumadi was involved in virus mitigation efforts, particularly the evacuation of Indonesians from epicenters of the outbreak, and that President Joko Widodo had called for tests to be carried out on other ministers.

Cases of the virus in Indonesia, the world's fourth most populous country, have jumped from zero two weeks ago to 96, with five deaths, according to government spokesperson Achmad Yurianto.

He also said the virus has spread outside Greater Jakarta to Bandung in West Java, Solo in Central Java, Manado in North Sulawesi, Pontianak in West Kalimantan, as well as holiday havens Yogyakarta and Bali.

Following the increase, the government on Saturday established a task force on COVID-19 mitigation.

Jakarta's Governor Anies Baswedan announced that schools would close for two weeks starting Monday, and ordered the closure of city-owned tourist attractions, such as Ragunan Zoo and Ancol beach.

He emphasized that Jakarta would not be locked down but urged people "to be responsible" and called for social distancing when possible.

Similarly, the administration of Solo, Central Java, Friday announced that schools and tourist attractions would close after a coronavirus patient died in the region.

The World Health Organization has said it is particularly concerned about high-risk nations with weaker health systems, which who may lack the facilities to identify cases.

A day after declaring the coronavirus outbreak to be pandemic this week, WHO chief Tedros Adhanom Ghebreyesus called Indonesia's president Widodo and both agreed to "scale up cooperation."