'Missing AirAsia plane maybe at the bottom of the sea'

Aboard Air Force One, Jan 6: US President Donald Trump threatened sanctions against Baghdad on Sunday after Iraq's parliament called on US troops to leave the country, and the president said if troops did leave, Baghdad would have to pay Washington for the cost of the air base there.

"We have a very extraordinarily expensive air base that's there. It cost billions of dollars to build, long before my time. We're not leaving unless they pay us back for it," Trump told reporters on Air Force One.

Trump said that if Iraq asked US forces to leave and it was not done on a friendly basis, "we will charge them sanctions like they've never seen before ever. It'll make Iranian sanctions look somewhat tame."

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, May 1:The novel coronavirus, that has killed over 230,000 people globally so far and has shattered economies, emerged from a virology lab in the Wuhan city of China, US President Donald Trump claimed Thursday with a high degree of confidence.

"Yes, I have. Yes, I have," Trump told reporters at the East Room of the White House when asked if he has seen anything at this point that gives him a high degree of confidence that the Wuhan Institute of Virology is where the virus originated.

The president, however, refuse to provide any details, except for saying that investigations are on and it would be out soon.

Asked what gave him a high degree of confidence that the virus originated from the Wuhan Institute of Virology, he said, "I can't tell you that. I'm not allowed to tell you that."

The president, however, did not hold his Chinese counterpart Xi Jinping responsible for this. "I don't want to say that, I don't want to say that, but certainly it could have been stopped. It came out of China and it could have been stopped and I wish they had stopped it and so does the whole world wish they had stopped it."

Reiterating that this is something that could have been contained at Wuhan ground zero, he said that China could have contained it. "They were either unable to, or they chose not to. And the world has suffered greatly."

One of two things happened, he reasoned. "They either didn't do it and you know they couldn't do it from a competent standpoint or they let it spread and I would say probably it got out of control."

"But there's another case that how come they stopped all of the planes and all of the traffic from going into China, but they didn't stop the planes and the traffic from coming into the United States and from coming into all over Europe," he said, citing the example of Italy, the hardest-hit European country.

"This country (the US) is very lucky and I'm very lucky that I put the ban on China, as you know, very early on. In January, we put the ban on China and that was a very early day. That wasn't a late day, that was an early day. Then, we later put the ban on in Europe," he said.

Before holding them accountable, Trump said he wants to find out what happened. "I think we'll be able to get a very good -- a very powerful definition of exactly what happened. We're working on it strongly now and I think it's going to be very powerful," he said.

"But they could have stopped it. They are a very brilliant nation, scientifically and otherwise. It got loose, let's say, and they could have capped it. They could have stopped it, but they didn't. And they stopped the planes from going to China, but they didn't stop them from going to the rest of the world. What was that all about?” he asked.

"We should have the answer to that in the not-too-distant future and that will determine a lot how I feel about China," Trump said.

When asked if President Xi misled him, Trump said, "Something happened. I don't say misleading or not. I'll let you know that. I mean, I'll be able to give you that answer at some point in the hopefully not-too-distant future."

The entire world has suffered as a result of this, he said.

"We have had tremendous death and tremendous sorrow, sadness, and nobody's ever seen anything like it. So, have most of the countries of the world. They've suffered tremendously. It's something that is going to have to be dealt with. We'll have to see," said the president.