Myanmar military plane with 116 people on board goes missing

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."

United Nations, Apr 2: The global economy could shrink by up to one per cent in 2020 due to the coronavirus pandemic, a reversal from the previous forecast of 2.5 per cent growth, the UN has said, warning that it may contract even further if restrictions on the economic activities are extended without adequate fiscal responses.

The analysis by the UN Department of Economic and Social Affairs (DESA) said the COVID-19 pandemic is disrupting global supply chains and international trade. With nearly 100 countries closing national borders during the past month, the movement of people and tourism flows have come to a screeching halt.

"Millions of workers in these countries are facing the bleak prospect of losing their jobs. Governments are considering and rolling out large stimulus packages to avert a sharp downturn of their economies which could potentially plunge the global economy into a deep recession. In the worst-case scenario, the world economy could contract by 0.9 per cent in 2020," the DESA said, adding that the world economy had contracted by 1.7 per cent during the global financial crisis in 2009.

It added that the contraction could be even higher if governments fail to provide income support and help boost consumer spending.

The analysis noted that before the outbreak of the COVID-19, world output was expected to expand at a modest pace of 2.5 per cent in 2020, as reported in the World Economic Situation and Prospects 2020.

Taking into account rapidly changing economic conditions, the UN DESA's World Economic Forecasting Model has estimated best and worst-case scenarios for global growth in 2020.

In the best-case scenario with moderate declines in private consumption, investment and exports and offsetting increases in government spending in the G-7 countries and China global growth would fall to 1.2 per cent in 2020.

"In the worst-case scenario, the global output would contract by 0.9 per cent instead of growing by 2.5 per cent in 2020," it said, adding that the scenario is based on demand-side shocks of different magnitudes to China, Japan, South Korea, the US and the EU, as well as an oil price decline of 50 per cent against our baseline of USD 61 per barrel.

The severity of the economic impact will largely depend on two factors - the duration of restrictions on the movement of people and economic activities in major economies; and the actual size and efficacy of fiscal responses to the crisis.

A well-designed fiscal stimulus package, prioritising health spending to contain the spread of the virus and providing income support to households most affected by the pandemic would help to minimise the likelihood of a deep economic recession, it said.

According to the forecast, lockdowns in Europe and North America are hitting the service sector hard, particularly industries that involve physical interactions such as retail trade, leisure and hospitality, recreation and transportation services. Collectively, such industries account for more than a quarter of all jobs in these economies.

The DESA said as businesses lose revenue, unemployment is likely to increase sharply, transforming a supply-side shock to a wider demand-side shock for the economy.

Against this backdrop, the UN-DESA is joining a chorus of voices across the UN system calling for well-designed fiscal stimulus packages which prioritize health spending and support households most affected by the pandemic.

Urgent and bold policy measures are needed, not only to contain the pandemic and save lives, but also to protect the most vulnerable in our societies from economic ruin and to sustain economic growth and financial stability, Under-Secretary-General for Economic and Social Affairs Liu Zhenmin said.

The analysis also warns that the adverse effects of prolonged economic restrictions in developed economies will soon spill over to developing countries via trade and investment channels.

A sharp decline in consumer spending in the European Union and the United States will reduce imports of consumer goods from developing countries.

Developing countries, particularly those dependent on tourism and commodity exports, face heightened economic risks. Global manufacturing production could contract significantly, and the plummeting number of travellers is likely to hurt the tourism sector in small island developing States, which employs millions of low-skilled workers, it said.

Meanwhile, the decline in commodity-related revenues and a reversal of capital flows are increasing the likelihood of debt distress for many nations. Governments may be forced to curtail public expenditure at a time when they need to ramp up spending to contain the pandemic and support consumption and investment.

UN Chief Economist and Assistant Secretary-General for Economic Development Elliot Harris said the collective goal must be a resilient recovery which puts the planet back on a sustainable track. We must not lose sight how it is affecting the most vulnerable population and what that means for sustainable development, he said.

The alarms raised by UN-DESA echo another report, released on March 31, in which UN experts issued a broad appeal for a large-scale, coordinated, comprehensive multilateral response amounting to at least 10 per cent of global gross domestic product (GDP).

According to estimates by the Johns Hopkins University, confirmed coronavirus cases across the world now stand at over 932,600 and over 42,000 deaths.

Beijing, Feb 24: The lockdown of Guo Jing's neighbourhood in Wuhan -- the city at the heart of China's new coronavirus epidemic -- came suddenly and without warning.

Unable to go out, the 29-year-old is now sealed inside her compound where she has to depend on online group-buying services to get food.

"Living for at least another month isn't an issue," Guo told news agency, explaining that she had her own stash of pickled vegetables and salted eggs.

But what scares her most is the lack of control -- first, the entire city was sealed off, and then residents were limited to exiting their compound once every three days.

Now even that has been taken away.

Guo is among some 11 million residents in Wuhan, a city in central Hubei province that has been under effective quarantine since January 23 as Chinese authorities race to contain the epidemic.

Since then, its people have faced a number of tightening controls over daily life as the death toll from the virus swelled to over 2,500 in China alone.

But the new rules this month barring residents from leaving their neighbourhoods are the most restrictive yet -- and for some, threaten their livelihoods.

"I still don't know where to buy things once we've finished eating what we have at home," said Pan Hongsheng, who lives with his wife and two children.

Some neighbourhoods have organised group-buying services, where supermarkets deliver orders in bulk.

But in Pan's community, "no one cares".

"The three-year-old doesn't even have any milk powder left," Pan told news agency, adding that he has been unable to send medicine to his in-laws -- both in their eighties -- as they live in a different area.

"I feel like a refugee."

The "closed management of neighbourhoods is bound to bring some inconvenience to the lives of the people", Qian Yuankun, vice secretary of Hubei's Communist Party committee, said at a press briefing last week.

Authorities on Monday allowed healthy non-residents of the city to leave if they never had contact with patients, but restrictions remained on those who live in Wuhan.

Demand for group-buying food delivery services has rocketed with the new restrictions, with supermarkets and neighbourhood committees scrambling to fill orders.

Most group-buying services operate through Chinese messaging app WeChat, which has ad-hoc chat groups for meat, vegetables, milk -- even "hot dry noodles", a famous Wuhan dish.

More sophisticated shops and compounds have their own mini-app inside WeChat, where residents can choose packages priced by weight before orders are sent in bulk to grocery stores.

In Guo's neighbourhood, for instance, a 6.5-kilogramme (14.3-pound) set of five vegetables, including potatoes and baby cabbage, costs 50 yuan ($7.11).

"You have no way to choose what you like to eat," Guo said. "You cannot have personal preferences anymore."

The group-buying model is also more difficult for smaller communities to adopt, as supermarkets have minimum order requirements for delivery.

"To be honest, there's nothing we can do," said Yang Nan, manager of Lao Cun Zhang supermarket, which requires a minimum of 30 orders.

"We only have four cars," she said, explaining that the store did not have the staff to handle smaller orders.

Another supermarket told AFP it capped its daily delivery load to 1,000 orders per day.

"Hiring staff is difficult," said Wang Xiuwen, who works at the store's logistics division, adding that they are wary about hiring too many outsiders for fear of infection.

Closing off communities has split the city into silos, with different neighbourhoods rolling out controls of varying intensity.

In some compounds, residents have easier access to food -- albeit a smaller selection than normal -- and one woman said her family pays delivery drivers to run grocery errands.

Her compound has not been sealed off either, the 24-year-old told AFP under condition of anonymity, though they are limited to one person leaving at a time.

Some districts have implemented their own rules, such as prohibiting supermarkets from selling to individuals, forcing neighbourhoods to buy in bulk or not at all.

"In the neighbourhood where I live, the reality is really terrible," said David Dai, who is based on the outskirts of Wuhan.

Though his apartment complex has organised group-buying, Dai said residents were unhappy with price and quality.

"A lot of tomatoes, a lot of onions -- they were already rotten," he told , estimating over a third of the food had to be thrown away.

His family must "totally depend" on themselves, added the 49-year-old, who has resorted to saving and drying turnip skins to add nutrients to future meals.

The uncertainty of not knowing when the controls will be lifted is also frustrating, said Ma Chen, a man in his 30s who lives alone.

"I have no way of knowing how much (food) I should buy."