Muslim teacher asked to hang herself with headscarf in US

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."

Jul 1: Hong Kong police moved swiftly on Wednesday against protesters gearing up for the first rally since the introduction of sweeping security legislation, making their first arrest under it and warning of punishment for pro-independence material.

Beijing on Tuesday unveiled the details of the much-anticipated law after weeks of uncertainty, pushing China's freest city and one of the world's most glittering financial hubs onto a more authoritarian path.

As hundreds of protesters gathered downtown for an annual rally marking the 23rd anniversary of the former British colony's handover to China, riot police used pepper spray to arrest at least two people, while one metro station closed.

Police, who earlier banned the rally, cited the law for the first time in confronting protesters and they also made their first arrest under it - a man holding a flag advocating independence.

"You are displaying flags or banners/chanting slogans/or conducting yourselves with an intent such as secession or subversion, which may constitute offences under the ... national security law," police said in a message displayed on a purple banner.

The law will punish crimes of secession, subversion, terrorism and collusion with foreign forces with up to life in prison, heralding a more authoritarian era for the Asian financial hub.

China's parliament adopted it in response to months of pro-democracy protests last year triggered by fears that Beijing was stifling the city's freedoms, guaranteed by a "one country, two systems" formula agreed when it returned to Chinese rule.

Authorities in Beijing and Hong Kong have repeatedly said the legislation is aimed at a few "troublemakers" and will not affect rights and freedoms, nor investor interests.

But critics fear it will crush the freedoms that are seen as key to Hong Kong's success as a financial centre.

"With the release of the full detail of the law, it should be clear to those in any doubt that this is not the Hong Kong they grew up in," said Hasnain Malik, head of equity research, Tellimer in Dubai.

"The difference is that U.S. and China relations are far worse and this could be used as a pretext to impede the role of Hong Kong as a finance hub."

In Beijing, Zhang Xiaoming, executive deputy director of Beijing's Hong Kong and Macau Affairs Office, told reporters suspects arrested by Beijing's new security office in Hong Kong could be tried on the mainland.

He said the mainland's national security office abided by Chinese law and that Hong Kong's legal system could not be expected to implement the laws of the mainland. Article 55 of the law states that Beijing's national security office in Hong Kong could exercise jurisdiction over "complex" or "serious" cases.

Mainland security agencies will also be based in Hong Kong officially for the first time, with powers that go beyond city laws.

"The law is a birthday gift to (Hong Kong) and will show its precious value in the future," Zhang said, adding the law would not be applied retroactively.

On July 1 last year, hundreds of protesters stormed and vandalised the city's legislature to protest against a now-scrapped bill that would have allowed extraditions to mainland China.

Those protests evolved into calls for greater democracy, paralysing parts of the city and paving the way for Beijing's imposition of the law this week.

'INEVITABLE'

Speaking at a flag-raising ceremony to mark the handover anniversary, the city's Beijing-backed leader, Carrie Lam, said the law was the most important development since the city's return to Chinese rule.

"It is also an inevitable and prompt decision to restore stability," Lam said at the same harbour-front venue where 23 years ago the last colonial governor, Chris Patten, a staunch critic of the security law, tearfully handed back Hong Kong to Chinese rule.

Some pro-Beijing officials and political commentators say the law is aimed at sealing Hong Kong's "second return" to the motherland after the first failed to bring residents to heel.

Luo Huining, the head of Beijing's top representative office in Hong Kong, said at the ceremony the law was a "common aspiration" of Hong Kong citizens.

Critics denounced the lack of transparency surrounding the details of the legislation until it was unveiled. It came into force at 11 p.m. (1500 GMT) on Tuesday.

Some pro-democracy activists gave up membership of their groups just before the law came into force, though calling for the campaign for democracy to go on offshore.

"I saw this morning there are celebrations for Hong Kong's handover, but to me it is a funeral, a funeral for 'one country two systems'," said democracy lawmaker Kwok Ka-ki.

Feb 2: The Philippines on Sunday reported the first death from a new virus outside of China, where authorities delayed the opening of schools in the worst-hit province and tightened quarantine measures in a city that allow only one family member to venture out to buy supplies.

The Philippine Department of Health said a 44-year-old Chinese man from Wuhan was admitted on Jan. 25 after experiencing a fever, cough, and sore throat. He developed severe pneumonia, and in his last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise.”

The man’s 38-year-old female companion, also from Wuhan, also tested positive for the virus and remains in hospital isolation in Manila.

President Rodrigo Duterte approved a temporary ban on all travelers, except Filipinos, from China and its autonomous regions. The U.S., Japan, Singapore and Australia have imposed similar restrictions despite criticism from China and an assessment from the World Health Organization that they were unnecessarily hurting trade and travel.

The death toll in China climbed by 45 to 304 and the number of cases by 2,590 to 14,380, according to the National Health Commission, well above the number of those infected in in the 2002-03 outbreak of SARS, or severe acute respiratory syndrome, which broke out in southern China and spread worldwide.

Meanwhile, six officials in the city of Huanggang, neighboring the epicenter of Wuhan in Hubei province, have been fired over “poor performance” in handling the outbreak, the official Xinhua News Agency reported.

It cited the mayor as saying the city’s “capabilities to treat the patients remained inadequate and there is a severe shortage in medical supplies such as protective suits and medical masks.”

After Huanggang, the trading center of Wenzhou in coastal Zhejiang province also confined people to homes, allowing only one family member to venture out every other day to buy necessary supplies.

With the outbreak showing little sign of abating, authorities in Hubei and elsewhere have extended the Lunar New Year holiday, due to end this week, well into February. The annual travel crunch of millions of people returning from their hometowns to the cities is thought to pose a major threat of secondary infection at a time when authorities are encouraging people to avoid public gatherings.

All Hubei schools will postpone the opening of the new semester until further notice and students from elsewhere who visited over the holiday will also be excused from classes.

Far away on China’s southeast coast, the manufacturing hub of Wenzhou put off the opening of government offices until Feb. 9, private businesses until Feb. 17 and schools until March 1.

With nearly 10 million people, Wenzhou has reported 241 confirmed cases of the virus, one of the highest levels outside Hubei. Similar measures have been announced in the provinces and cities of Heilongjiang, Shandong, Guizhou, Hebei and Hunan, while the major cities of Shanghai and Beijing were on indefinite leave pending developments.

Despite imposing drastic travel restrictions at home, China has chafed at those imposed by foreign governments, criticizing Washington’s order barring entry to most non-citizens who visited China in the past two weeks. Apart from dinging China’s international reputation, such steps could worsen a domestic economy already growing at its lowest rate in decades.

The crisis is the latest to confront Chinese leader Xi Jinping, who has been beset by months of anti-government protests in the semi-autonomous Chinese city of Hong Kong, the reelection of Taiwan’s pro-independence president and criticism over human rights violations in the traditionally Muslim northwestern territory of Xinjiang. Economically, Xi faces lagging demand and dramatically slower growth at home while the tariff war with the U.S. remains largely unresolved.

Among a growing number of airlines suspending flights to mainland China was Qatar Airways. The Doha-based carrier said on its website that its flights would stop Monday. It blamed “significant operational challenges caused by entry restrictions imposed by a number of countries” for the suspension of flights.

Oman also halted flights to China, as did Saudi Arabia’s flagship national carrier, Saudia.

Saudi Arabia’s state-run TV reported that 10 Saudi students were evacuated from Wuhan on a special flight. It said the students would be screened upon arrival, but did not say whether they would be quarantined for 14 days.

This weekend, South Korea and India flew hundreds of their citizens out of Wuhan. They went into a two-week quarantine.

On Sunday, South Korea reported three more cases for a total of 15. They include an evacuee, a Chinese relative of a man who tested positive and a man who returned from Wuhan. India reported a second case, also in southern Kerala state.

South Korea also barred foreigners who have stayed or traveled to Hubei province within the last 14 days from entering the country.

Indonesia flew back 241 nationals from Wuhan on Sunday and quarantined them on the remote Natuna Islands for two weeks. Several hundred residents protested the move, with one saying, “This is not because we do not have a sense of solidarity with fellow nationals. But because we fear they could infect us with the deadly virus from China.”

A Turkish military transport plane carrying 42 people arrived in Ankara from Wutan Saturday night. The 32 Turkish, six Azerbaijani, three Georgian nationals and an Albanian will remain under observation for 14 days, together with 20 personnel who participated in the evacuation, Health Minister Fahrettin Koca said.

Vietnam counted its seventh case, a Vietnamese-American man who had a two-hour layover in Wuhan on his way from the U.S. to Ho Chi Minh City.

The virus’ rapid spread in two months prompted the WHO on Thursday to declare it a global emergency.

That declaration “flipped the switch” from a cautious attitude to recommending governments prepare for the possibility the virus might spread, said the WHO representative in Beijing, Gauden Galea. Most cases reported so far have been people who visited China or their family members.

WHO said it was especially concerned that some cases abroad involved human-to-human transmission.

“Countries need to get ready for possible importation in order to identify cases as early as possible and in order to be ready for a domestic outbreak control, if that happens,” Galea told The Associated Press.

Both the new virus and SARS are from the coronavirus family, which also includes those that cause the common cold.

The death rate in China is falling, but the number of confirmed cases will keep growing because thousands of specimens from suspected cases have yet to be tested, Galea said.

“The case fatality ratio is settling out at a much lower level than we were reporting three, now four, weeks ago,” he said.

Although scientists expect to see limited transmission of the virus between people with family or other close contact, they are concerned about cases of infection spreading to people who might have less exposure.