Indian peacekeepers prevented more casualties in S Sudan: UN official

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/Seoul, Apr 26: A special train possibly belonging to North Korean leader Kim Jong Un was spotted this week at a resort town in the country, according to satellite images reviewed by a Washington-based North Korea monitoring project, amid conflicting reports about Mr. Kim's health and whereabouts.

The monitoring project, 38 North, said in its report on Saturday that the train was parked at the “leadership station” in Wonsan on April 21 and April 23. The station is reserved for the use of the Kim family, it said.

Though the group said it was probably Kim Jong Un's train, Reuters has not been able to confirm that independently, or whether he was in Wonsan.

“The train's presence does not prove the whereabouts of the North Korean leader or indicate anything about his health but it does lend weight to reports that Kim is staying at an elite area on the country's eastern coast,” the report said.

Speculation about Mr. Kim's health first arose due to his absence from the anniversary of the birthday of North Korea's founding father and Mr. Kim's grandfather, Kim Il Sung, on April 15.

North Korea's state media last reported on Mr. Kim's whereabouts when he presided over a meeting on April 11.

China has dispatched a team to North Korea including medical experts to advise on Kim Jong Un, according to three people familiar with the situation.

A third-generation hereditary leader who came to power after his father's death in 2011, Kim has no clear successor in a nuclear-armed country, which could present major international risk.

On Thursday, U.S. President Donald Trump downplayed reports that Mr. Kim was ill. “I think the report was incorrect,” Mr. Trump told reporters, but he declined to say if he had been in touch with North Korean officials.

Mr. Trump has met Mr. Kim three times in an attempt to persuade him to give up a nuclear weapons program that threatens the United States as well as its Asian neighbors. While talks have stalled, Mr. Trump has continued to hail Mr. Kim as a friend.

Reporting from inside North Korea is notoriously difficult because of tight controls on information.

A Trump administration official said continuing days of North Korean media silence on Mr. Kim's whereabouts had heightened concerns about his condition, and that information remained scant from a country U.S. intelligence has long regarded as a ”black box.”

The U.S. State Department did not immediately respond to questions about the situation on Saturday.

Daily NK, a Seoul-based website that reports on North Korea, cited one unnamed source in North Korea on Monday as saying that Kim had undergone medical treatment in the resort county of Hyangsan north of the capital Pyongyang.

It said that Mr. Kim was recovering after undergoing a cardiovascular procedure on April 12.

Since then, multiple South Korean media reports have cited unnamed sources this week saying that Mr. Kim might be staying in the Wonsan area.

On Friday, local news agency Newsis cited South Korean intelligence sources as reporting that a special train for Mr. Kim's use had been seen in Wonsan, while Mr. Kim's private plane remained in Pyongyang.

Newsis reported Mr. Kim may be sheltering from COVID-19, the respiratory disease caused by the novel coronavirus.

Mr. Kim, believed to be 36, has disappeared from coverage in North Korean state media before. In 2014, he vanished for more than a month and North Korean state TV later showed him walking with a limp.

Speculation about his health has been fanned by his heavy smoking, apparent weight gain since taking power and family history of cardiovascular problems.

Washington, Apr 8: President Donald Trump has threatened to put a "very powerful" hold on US' funding to the World Health Organization, accusing the UN agency of being "very China centric" and criticising it for having "missed the call" in its response to the coronavirus pandemic.

Trump slammed the global health agency for its early guidance aimed at countering the international spread of the coronavirus.

"We're going to put a hold on money spent to the WHO. We're going to put a very powerful hold on it and we're going to see. It's a great thing if it works. But when they call every shot wrong, that's no good," Trump told reporters at his daily White House news conference on Tuesday.

The Geneva-headquartered World Health Organization (WHO), receives vast amounts of money from the United States.

"We pay for a majority or the biggest portion of their money. They actually criticized and disagreed with my travel ban at the time I did it. They were wrong. They've been wrong about a lot of things. They had a lot of information early and they didn't want to - they're very - they seem to be very China centric," Trump said.

The president said his administration was going to look into the US funding to the WHO.

"We give a majority of the money that they get, and it's much more than the USD 58 million. USD 58 million is a small portion of what they've got over the years. Sometimes they get much more than that. Sometimes it's for programs that they're doing, and-it's much bigger numbers. If the programmes are good, that's great as far as we're concerned," he said.

"But we want to look into it, WHO, because they called it wrong. They (WHO) called it wrong. They missed the call. They could've called it months earlier. They would have known and they should have known and they probably did know. So, we'll be looking into that very carefully, and we're going to put a hold on money spent to the WHO," Trump said.

Meanwhile, Senator Jim Risch, chairman of Senate Foreign Relations Committee, called for an independent investigation into the WHO's handling of the COVID-19 response.

"The WHO has failed not only the American people, it has failed the world with its flagrant mishandling of the response to COVID-19," said Risch.

WHO Director general Tedros Adhanom Ghebreyesus' apparent unwillingness to hold the Chinese Communist Party to even the minimum standard of global health and transparency hindered the world's ability to blunt the spread of this pandemic, he said.

"It is completely unacceptable that the world's global health organization has become a political puppet of the Chinese government," he alleged, adding that "an independent investigation into the WHO's handling of the COVID-19 response is imperative."

The United States is the largest contributor to the WHO.

"Our valuable tax payer dollars should go towards investments to prevent the spread of disease, not to aid and abet cover-ups that cost lives and isolate portions of the world's population on political grounds, as has been the case with Taiwan," Senator Risch said.

A bipartisan group of nearly two dozen lawmakers announced Tuesday to introduce a resolution to defund the WHO until Ghebreyesus resigns and an international commission investigates the organisation's role in covering up the Chinese Communist Party's failed COVID-19 response.

"The WHO helped the Chinese Communist Party hide the threat of COVID-19 from the world and now more than 10,000 Americans are dead, a number that is expected to rise dramatically in the coming weeks," Congressman Guy Reschenthaler alleged.

"The United States is the largest contributor to WHO. It is not right that Americans' hard-earned tax dollars are being used to propagate China's lies and hide information that could have saved lives. This bill will hold the WHO accountable for their negligence and deceit," he asserted.

The United States' intelligence community has reported that the Chinese government hid the threat of COVID-19 and, as a result, made it difficult for the rest of the world to respond early, appropriately and aggressively, said Congressman Fred Keller.

"For reasons beyond understanding, the WHO acted as a silent partner in this effort instead of protecting the lives of millions across the world, including hundreds of thousands of American citizens. Our hard-earned tax dollars should not go to a global organization more concerned with not offending the Chinese government than providing accurate information and protecting innocent lives," Keller said.

Senator Marco Rubio accused the Chinese Communist Party of using WHO "to mislead the world."

"The organisation's leadership is either complicit or dangerously incompetent. I will work with the Trump Administration to ensure that WHO is independent and has not been compromised by the CCP before we continue our current funding, he added.

According to Johns Hopkins University, there are over 1.43 million confirmed coronavirus cases across the world and over 82,000 people have died due to the disease. The US has nearly 400,000 infections, the highest in the world.