Mysterious blood clots are COVID-19's latest lethal surprise

News Network
April 28, 2020

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."

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News Network
March 3,2020

Mar 3: Just hours after the ending of a week-long “reduction” in violence that was crucial for Donald Trump’s peace deal in Afghanistan, the Taliban struck again: On Monday, they killed three people and injured about a dozen at a football match in Khost province. This resumption of violence will not surprise anyone actually invested in peace for that troubled country. The point of the U.S.-Taliban deal was never peace. It was to try and cover up an ignominious exit for the U.S., driven by an election-bound president who feels no responsibility toward that country or to the broader region.

Seen from South Asia, every point we know about in the agreement is a concession by Trump to the Taliban. Most importantly, it completes a long-term effort by the U.S. to delegitimize the elected government in Kabul — and, by extension, Afghanistan’s constitution. Afghanistan’s president is already balking at releasing 5,000 Taliban prisoners before intra-Afghan talks can begin — a provision that his government did not approve.

One particularly cringe-worthy aspect: The agreement refers to the Taliban throughout  as “the Islamic Emirate of Afghanistan that is not recognized by the United States as a state and is known as the Taliban.” This unwieldy nomenclature validates the Taliban’s claim to be a government equivalent to the one in Kabul, just not the one recognised at the moment by the U.S. When read together with the second part of the agreement, which binds the U.S. to not “intervene in [Afghanistan’s] domestic affairs,” the point is obvious: The Taliban is not interested in peace, but in ensuring that support for its rivals is forbidden, and its path to Kabul is cleared.

All that the U.S. has effectively gotten in return is the Taliban’s assurance that it will not allow the soil of Afghanistan to be used against the “U.S. and its allies.” True, the U.S. under Trump has shown a disturbing willingness to trust solemn assurances from autocrats; but its apparent belief in promises made by a murderous theocratic movement is even more ridiculous. Especially as the Taliban made much the same promise to an Assistant Secretary of State about Osama bin Laden while he was in the country plotting 9/11.

Nobody in the region is pleased with this agreement except for the Taliban and their backers in the Pakistani military. India has consistently held that the legitimate government in Kabul must be the basic anchor of any peace plan. Ordinary Afghans, unsurprisingly, long for peace — but they are, by all accounts, deeply skeptical about how this deal will get them there. The brave activists of the Afghan Women’s Network are worried that intra-Afghan talks will take place without adequate representation of the country’s women — who have, after all, the most to lose from a return to Taliban rule.

But the Pakistani military establishment is not hiding its glee. One retired general tweeted: “Big victory for Afghan Taliban as historic accord signed… Forced Americans to negotiate an accord from the position of parity. Setback for India.” Pakistan’s army, the Taliban’s biggest backer, longs to re-install a friendly Islamist regime in Kabul — and it has correctly estimated that, after being abandoned by Trump, the Afghan government will have sharply reduced bargaining power in any intra-Afghan peace talks. A deal with the Taliban that fails also to include its backers in the Pakistani military is meaningless.

India, meanwhile, will not see this deal as a positive for regional peace or its relationship with the U.S. It comes barely a week after Trump’s India visit, which made it painfully clear that shared strategic concerns are the only thing keeping the countries together. New Delhi remembers that India is not, on paper, a U.S. “ally.” In that respect, an intensification of terrorism targeting India, as happened the last time the U.S. withdrew from the region, would not even be a violation of Trump’s agreement. One possible outcome: Over time the government in New Delhi, which has resolutely sought to keep its ties with Kabul primarily political, may have to step up security cooperation. Nobody knows where that would lead.

The irresponsible concessions made by the U.S. in this agreement will likely disrupt South Asia for years to come, and endanger its own relationship with India going forward. But worst of all, this deal abandons those in Afghanistan who, under the shadow of war, tried to develop, for the first time, institutions that work for all Afghans. No amount of sanctimony about “ending America’s longest war” should obscure the danger and immorality of this sort of exit.

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Agencies
February 23,2020

Wuhan, Feb 23: Ninety-seven more people died in China due to coronavirus, taking the death toll to 2,442, officials said on Sunday, as a team of WHO experts visited the worst-affected Wuhan city in Hubei province.

By the end of Saturday, a total of 2,442 people had died of the disease and 76,936 confirmed cases of novel coronavirus infection had been reported in 31 provincial-level regions, China's National Health Commission (NHC) said in its daily update on Sunday.

Ninety-six deaths were reported from Hubei province and one from Guangdong province on Saturday besides 648 new confirmed cases of coronavirus infections, it said.

Hubei province, where the virus first emerged in December last, reported 630 new confirmed cases, taking the total confirmed cases in the hard-hit province to 64,084, state-run Xinhua news agency reported.

The NHC also said China's daily number of newly cured and discharged novel coronavirus patients has surpassed that of new confirmed infections for the fifth consecutive day, indicating that cases of infections are coming down.

Saturday saw 2,230 people walk out of hospital after recovery, much higher than the number of the same day's new confirmed infections, which was 648, Xinhua reported.

A total of 22,888 patients infected with the novel coronavirus had been discharged from hospital after recovery by the end of Saturday, NHC said.

Meanwhile, a team of public health experts from the World Health Organisation (WHO) visited Wuhan on Saturday to conduct a detailed probe about the virus which reportedly originated from a seafood market in the city in December last year.

The NHC said WHO experts along with their Chinese counterparts who formed a joint investigation team have held talks with the local health authority in Wuhan and visited relevant healthcare institutions.

The UN team comprises specialists from the United States, Germany, Japan, Nigeria, Russia, Singapore and South Korea, Hong-Kong based South China Morning Post reported.

The 12-member team, which arrived in China on Monday, was initially designated to visit only Beijing, Guangdong and Sichuan provinces, while the worst-affected Hubei province and its capital Wuhan were missing from the list.

However, the team was finally given permission to visit Wuhan by the Chinese government.

Besides controlling the spread of the virus, a major task for the WHO team along with their Chinese counterparts was to come up with standard medicine to cure the disease.

The NHC said on Saturday that the team had met top Chinese respiratory disease expert Zhong Nanshan in Guangdong, and visited the centre for disease control and prevention in Guangdong and the city of Shenzhen, and Sichuan.

The specialists also discussed quarantine measures, the wild animal trade and community prevention measures with their Chinese counterparts, it said.

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Agencies
August 7,2020

Washington, Aug 7: US President Donald Trump on Thursday (local time) signed executive orders halting all transactions with Chinese applications TikTok and WeChat within 45 days, citing national security concerns, further escalating the tensions between Beijing and Washington.

"WeChat, a messaging, social media, and electronic payment application owned by the Chinese company Tencent Holdings Ltd., reportedly has over one billion users worldwide, including users in the United States. Like TikTok, WeChat automatically captures vast swaths of information from its users. 

This data collection threatens to allow the Chinese Communist Party (CCP) access to Americans' personal and proprietary information," Trump said in a statement.

Citing reasons for the ban on WeChat, the US President said that the application captures the personal and proprietary information of Chinese nationals visiting the US, thereby providing the CCP a mechanism to keep tabs on the Chinese citizens who may be "enjoying the benefits of a free society for the first time in their lives".

"In March 2019, a researcher reportedly discovered a Chinese database containing billions of WeChat messages sent from users in not only China but also the United States, Taiwan, South Korea and Australia. WeChat, like TikTok, also reportedly censors content that the CCP deems politically sensitive and may also be used for disinformation campaigns that benefit the CCP. 

These risks have led other countries, including Australia and India, to begin restricting or banning the use of WeChat. The US must take aggressive action against the owner of WeChat to protect our national security," he added.

Earlier, Trump had issued an order banning TikTok as it "reportedly censors content that the CCP deems politically sensitive, such as content concerning protests in Hong Kong and China's treatment of Uighurs and other Muslim minorities. 

TikTok may also be used for disinformation campaigns that benefit the CCP."
US politicians have repeatedly criticised TikTok, owned by Beijing-based startup ByteDance, of being a threat to national security because of its ties to China.

The development comes as China and the US are at loggerheads on a variety of issues including Hong Kong national security law, the South China Sea, the novel coronavirus and trade.

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