Joe Biden names Indian-American Medha Raj as digital chief of staff

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."

Wuhan, Feb 16: The death toll from China's coronavirus epidemic has climbed to 1,665 after 142 more people died, mostly in the worst-hit Hubei Province, and the confirmed cases jumped to 68,500, officials said on Sunday, as top WHO experts scramble to assist Beijing contain the virus spread.

China's National Health Commission confirmed 2,009 new cases across the country.

Hubei and its provincial capital Wuhan, where the virus first emerged in December, reported 1,843 of the new cases. The latest report brought the total confirmed cases in Hubei to 56,249 cases.

Of the new deaths, 139 were in Hubei, two in Sichuan, and one in Hunan, the state-run Xinhua news agency reported.

The number of new cases, however, appears to have started dropping and a top Chinese health official has said efforts to control the outbreak have reached the “most crucial stage".

The report said 9,419 infected patients had been discharged from hospital after recovery so far.

The coronavirus has posed a severe threat to the medical staff as more than 1,700 Chinese health officials have been infected by the virus while treating the patients and six of them have died.

Experts from the World Health Organisation are expected in Beijing on Sunday to join Chinese health authorities in containing the virus, which has spread to several other countries forcing them to temporarily stop tourist arrivals from China.

The health commission said a joint mission with WHO experts will pay field visits to China's three provincial-level regions to learn the effectiveness of the epidemic control measures.

One task of the mission will be to come up with standard medicine to cure the disease, according to the health commission.

Several antiviral drugs are under clinical trials and Chinese researchers have narrowed down their focus to a few existing drugs, including Chloroquine Phosphate, Favipiravir and Remdesivir, said Zhang Xinmin, director of the China National Centre for Biotechnology Development.

Experts have asked people to frequently wash hands and face, and wear masks.

Authorities have begun quarantining large quantity of bank notes and coins in the affected areas and sanitising them with UV light before releasing them back into circulation to stop the virus from spreading.

Singapore, Jul 11: Singapore Prime Minister Lee Hsien Loong has secured a “clear mandate” with his ruling People’s Action Party (PAP) winning 83 of the 93 contested parliamentary seats in the general election held amidst the Covid-19 pandemic, with the Opposition gaining ground by winning a record 10 seats.

The ruling party, in power since independence in 1965, secured 61.24 percent of the total votes cast in the election, down from 69.9 percent in 2015. About 2.6 million Singaporeans voted on Friday.

“We have a clear mandate, but the percentage of the popular vote is not as high as I had hoped for,” 68-year old Lee told a PAP’s post-results press conference on Saturday morning.

The opposition Workers’ Party secured 10 seats and defeated a team in the Group Representation Constituency of Sengkang led by former Minister in the Prime Minister’s Office Ng Chee Meng who is also the Secretary-General of the power National Trades Union Congress (NTUC).

The Prime Minister assured it is “only right” that Workers’ Party’s Indian-origin secretary-general Pritam Singh be “formally designated” as the Leader of the Opposition, and that he will be provided with “appropriate staff support and resources to perform his duties”.

Lee took the results in “these circumstances” as an “endorsement” of the party’s policies and plans as he had called the elections amidst Covid-19 pandemic.

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“We’ll take this forward and work with Singapore to realise those plans and solve the problems which we have,” Channel News Asia quoted the premier as saying.

Lee, who leads the PAP as secretary-general, said, “Singaporeans understand what’s at stake and why we must come together to uphold our national interests.”

He pledged to use this mandate “responsibly” to deal with the Covid-19 situation and economic downturn, to take Singapore “safely through the crisis and beyond”.

“The results reflect the pain and uncertainty that Singaporeans feel in this crisis, the loss of income, the anxiety about jobs, the disruption caused by the circuit breaker and the safe distancing restrictions,” he said.

This was not a “feel-good” election, said Lee, Singapore’s third prime minister who faces the city state’s worst recession with the economy projected to shrink between 7 and 4 per cent.

Lee acknowledged that the result also showed a “clear desire” for a diversity of voices in Parliament.

“Singaporeans want the PAP to form the government, but they, and especially the younger voters, also want to see more opposition presence in parliament,” he noted.

Lee added that he looks forward to the participation and contribution of the Opposition in parliament.

Singh, whose Workers’ Party team retained Aljunied Group Representation Constituency (GRC), will have 10 elected MPs now, up from six previously. His fellow member also retained the Hougang single-member constituency seat.

“Whether it works out… and whether it’s seen as a strengthening of Singapore will depend not only on what the PAP does but also on what the Opposition does because the Opposition now has 10 MPs elected from constituencies,” said Lee.

He assured that the ruling party will listen to Singaporeans and do its best to address their concerns, and “try to win” their support, whether or not they voted for the PAP.

When asked by the media if the party had lost the youth vote, he noted that different generations have different life experiences, and the young have significantly different life aspirations and priorities compared to the older generations.

“That’ll have to be reflected in our political process and in the government’s policies because, in the end, the government’s policies must be to achieve the aspirations of every generation of Singaporeans,” Lee said, assuring Singaporeans.

He hoped that the new generations of Singaporeans “look critically, but with an open mind” at what previous generations have done, “examine what’s relevant and what continues to make sense to them in a new environment” and “learn from these experiences hard-won by their parents and grandparents”.

This is so that they do not have to “learn them all over again and pay a high price which has already been paid”.

Lee added that he was, naturally, disappointed at the loss of the newly formed Sengkang GRC, which the Workers’ Party won with 52.13 percent of the valid votes.

“Ng Chee Meng and his team -- Lam Pin Min, Amrin Amin and Raymond Lye -- always knew it was going to be a tough fight,” he said.

“They gave it their all, but Sengkang voters have spoken, and we respect their decision.”

Lee described it as a “major loss to my team” and to the fourth-generation leaders, especially as Ng is the secretary-general of the Labour Movement, the NTUC.

Singh, 43, told a press conference following the results that his team would “continue to endeavour for good outcomes on the ground” and to represent voters “faithfully in parliament”.

“Today’s results are positive, but we have to hit the ground running. We should not get over our head with the results. There’s much work to do. And I can assure you this Workers’ Party team is committed to serve Singapore,” he stressed.

The PAP contested all 93 seats and the Workers’ Party 21 seats. Nine other political parties also contested the elections.

A total of 192 candidates contested for seats through 17 Group Representation Constituencies (GRCs).