Malaysian plane may have turned back before disappearing

Seoul/South Korea, Apr 27: North Korean leader Kim Jong Un is "alive and well", a top security adviser to the South's President Moon Jae-in said, downplaying rumours over Kim's health following his absence from a key anniversary.
"Our government position is firm," said Moon's special adviser on national security Moon Chung-in, in an interview with CNN on Sunday. "Kim Jong Un is alive and well."

The adviser said that Kim had been staying in Wonsan -- a resort town in the country's east -- since April 13, adding: "No suspicious movements have so far been detected."

Conjecture about Kim's health has grown since his conspicuous absence from the April 15 celebrations for the birthday of his grandfather Kim Il Sung, the North's founder -- the most important day in the country's political calendar.

Kim has not made a public appearance since presiding over a Workers' Party politburo meeting on April 11, and the following day state media reported him inspecting fighter jets at an air defence unit.

North Korean leader Kim Jong Un was not gravely ill, two South Korean government sources said on Tuesday, following reports he had undergone a cardiovascular procedure and was now in "grave danger."

His absence unleashed a series of unconfirmed media reports over his condition, which officials in Seoul previously poured cold water on.

"We have nothing to confirm and no special movement has been detected inside North Korea as of now," the South's presidential office said in a statement last week.

South Korea's unification minister Kim Yeon-chul reiterated Monday that remained the case, adding the "confident" conclusion was drawn from "a complex process of intelligence gathering and assessment".

'Grave danger'

Daily NK, an online media outlet run mostly by North Korean defectors, has reported Kim was undergoing treatment after a cardiovascular procedure earlier this month.

Citing an unidentified source inside the country, it said Kim, who is in his mid-30s, had needed urgent treatment due to heavy smoking, obesity and fatigue.

Soon afterwards, CNN reported that Washington was "monitoring intelligence" that Kim was in "grave danger" after undergoing surgery, quoting what it said was an anonymous US official.

US President Donald Trump on Thursday rejected reports that Kim was ailing but declined to state when he was last in touch with him.

On Monday, the official Rodong Sinmun newspaper reported that Kim had sent a message of thanks to workers on the giant Wonsan Kalma coastal tourism project.

It was the latest in a series of reports in recent days of statements issued or actions taken in Kim's name, although none has carried any pictures of him.

Satellite images reviewed by 38North, a US-based think tank, showed a train probably belonging to Kim at a station in Wonsan last week.

It cautioned that the train's presence did not "indicate anything about his health" but did "lend weight" to reports he was staying on the country's eastern coast.

Reporting from inside the isolated North is notoriously difficult, especially regarding anything to do with its leadership, which is among its most closely guarded secrets.

Previous absences from the public eye on Kim's part have prompted speculation about his health.

In 2014 he dropped out of sight for nearly six weeks before reappearing with a cane. Days later, the South's spy agency said he had undergone surgery to remove a cyst from his ankle.

Washington, Apr 28: US President while addressing a news conference on coronavirus pandemic said his administration has launched "very serious investigations" into China's response to the novel coronavirus.

"And we are not happy with China, we are not happy with that whole situation, because we believe it could have been stopped at the source," he said. "It could have been stopped quickly and it wouldn't have spread all over the world," the BBC reported.

Trump has been critical of China as the pandemic has progressed and has frequently touted his decision to close the US borders to China in an effort to curb the outbreak. Some health experts have said the effort bought time for the US to prepare, but the Trump administration has been accused of squandering the opportunity.

"Nobody except one country can be held accountable for what happened," Trump said.

"Nobody's blaming anybody here, we're looking at a group of people that should've stopped it at the source."

The US will never forget those who were "sacrificed for a reason of incompetence or something else other than incompetence," he added.

"They" - referring to China - "could've protected the whole world - not just us - the whole world," he said.

At the starting of the conference Trump said COVID-19 cases are declining or stablising across the country.

"In all cases getting better," he said. "Really a horrible situation that we've been confronted with, but they're moving along."

He added there's a "hunger" to get back to work.

"Ensuring the health of our economy is vital to ensuring the health of our nation - these goals work in tandem."

The president has suggested an unnamed individual "a long time ago" could have stopped the "unnecessary death[s]" due to COVID-19.

"There has been so much unnecessary death in this country," he said.

"It could've been stopped and it could've been stopped short, but somebody a long time ago, it seems, decided not to do it that way and the whole world is suffering because of it."

He did not say who he was referencing and gave no other details.

Trump was asked if he has considered delaying the November presidential election.

"I never even thought of changing the date of the election," he answered. "Why would I do that? November 3rd. That's a good number."

Trump called the suggestion "made up propaganda" and said that "sleepy Joe" Biden - his presumptive Democratic rival - was likely unaware his campaign had put the statement out.

Former Vice-President Joe Biden said at a virtual fundraiser last week that he thought Trump would "try to kick back the election somehow".

The president has frequently levelled insults at his Democratic opponent by questioning the former vice-president's mental fortitude.

"I look forward to that election," Trump said.

The president responded to a question criticising Health Secretary Alex Azar's early downplaying of the disease by saying it was "unfair". He claimed Democrats did the same, including Speaker of the House of Representatives Nancy Pelosi.

"I was very fortunate through luck or whatever that we closed the border, we put a ban on China," he said.

"But I could tell you that Nancy Pelosi was dancing in the streets in Chinatown. She wanted to go, let's go out and party. That was late in February."

Back in February, Pelosi had encouraged people to visit San Francisco's Chinatown to help struggling businesses. She did not propose any parties, as the president suggested.

The city issued a stay-at-home order in March.

A reporter asked: If an American president loses more Americans over the course of six weeks than died during the entirety of the Vietnam war, does he deserve to be reelected?

Trump took the question in stride.

"So, yeah, we've lost a lot of people but if you look at what original projections were, 2.2 million, we're probably heading to 60,000 - 70,000," he said.

"It's far too many - one person is too many for this. I think we've made a lot of really good decisions," he added. "The big decision was closing the border, doing the ban on people coming in from China."

He also brings up the "unbelievable" job his administration did with ventilators.

"I think we've done a great job. And I will say this - one person is too many."

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."