Obama approves reservists for Ebola fight, government under fire

October 17, 2014

Washington, Oct 17: President Barack Obama authorized calling up military reservists for the US fight against Ebola in west Africa on Thursday, as lawmakers criticized his administration's efforts to contain the disease at home.

ObamaObama's move came after lawmakers held a congressional hearing to probe the federal response to the virus. Amid criticism of perceived missteps by the administration, many House of Representatives members joined calls for a ban on travel from the hardest-hit West African countries: Liberia, Sierra Leone and Guinea.

Obama signed the executive order authorizing the use of US military reservists to support humanitarian aid efforts in those countries, highlighting the need to launch an all-out attack against the disease. The order did not specify how many personnel would be involved.

A congressional hearing on Thursday came as concerns about the virus in the United States intensified after two Texas nurses who cared for Liberian patient Thomas Eric Duncan contracted the virus.

After the hearing, the White House said Obama met with top administration officials handling the government's response to Ebola.

News that one of the nurses, Amber Vinson, traveled aboard a commercial airliner while running a slight fever ratcheted up public health concerns on Wednesday, prompting several schools in Ohio and Texas to close because people with ties to the schools shared the flight with Vinson.

The US National Institutes of Health (NIH) said it would take over the care of the first Texas nurse diagnosed with Ebola, Nina Pham, who contracted the virus while caring for Duncan, who later died.

Lawmakers focused questions and pointed criticism at the hearing on Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

"The administration did not act fast enough in responding in Texas," Democratic Representative Bruce Braley of Iowa told the hearing. "We need to look at all the options available to keep our families safe and move quickly and responsibly to make any necessary changes at airports."

Several Republicans said flights from west Africa, where the virus is widespread, should be stopped.

Ebola has killed nearly 4,500 people in West Africa, predominantly in Sierra Leone, Liberia and Guinea, since March. On Thursday, Sierra Leone's government said the virus had spread to the last healthy district in the country, killing at least two people.

The virus is spread through direct contact with bodily fluids from an infected person showing symptoms of Ebola.

Frieden argued, as he has before, that closing US borders would not work and would leave the country less able to track people with Ebola entering. Moreover, cutting flights to Africa would hit the US ability to stop the virus at its source, he said.

His comments came before it was announced that Obama had sent a letter to leaders of Congress saying an unspecified number of reservists would be used to help active-duty personnel in support of the US Ebola mission in West Africa. The vast majority of engineers, transport units, civil affairs personnel, military police and medical units are in the reserves or National Guard.

Frieden told the hearing, "I will tell you, as director of the CDC, one of the things I fear about Ebola is that it could spread more widely in Africa. If that were to happen, it could become a threat to our health system and the healthcare we give for a long time to come."

Frieden said he has spoken to the White House about the issue of dealing with people traveling with Ebola. Asked if the White House had ruled out a travel ban, the CDC chief did not answer directly, saying, "I can't speak for the White House."

However, Federal Aviation Administration chief Michael Huerta told reporters separately that the government was assessing whether to issue a travel ban "on a day-to-day basis."

Jamaica, meanwhile, imposed an immediate travel ban on Liberia, Guinea and Sierra Leone, the Caribbean island's government announced. Jamaica said the ban would apply to people traveling directly or indirectly, from or through those countries.

The South American country of Guyana said it had denied entry to citizens of those countries, as well as Nigeria, for the past five weeks.

Sick nurses leaving Texas

Pham, 26, was to be transferred late on Thursday from Dallas to an isolation unit at the NIH in Bethesda, Maryland outside Washington for treatment, the agency's director, Dr. Anthony Fauci, told lawmakers at Thursday's hearing.

"We will be supplying her with state-of-the-art care in our high-level containment facilities," said Fauci.

Dr. Daniel Varga, chief clinical officer and senior vice president of Texas Health Resources, which owns the hospital, told the hearing that mistakes were made in diagnosing Duncan and in giving inaccurate information to the public, and said he was "deeply sorry."

He also said there had been no Ebola training for staff before Duncan was admitted.

"It would be an understatement to say that the response to the first US-based patient with Ebola has been mismanaged, causing risk to scores of additional people," said Representative Diana DeGette, the top Democrat on the subcommittee holding Thursday's hearing.

At least two lawmakers have called for Frieden's resignation. Others, including Republican House Speaker John Boehner of Ohio, have joined in urging travel restrictions on the West African countries hardest hit by Ebola. The disease appeared in the United States last month.

Vinson was transferred to Emory University Hospital for treatment on Wednesday night.

In Ohio, where Vinson had visited family members, two schools in the Cleveland suburb of Solon were closed on Thursday because an employee may have traveled on the same plane as Vinson, though on a different flight.

Ohio's health department said the CDC was sending staff to help coordinate efforts to contain the spread of Ebola.

Frontier Airlines said it had placed six crew members on paid leave for 21 days "out of an abundance of caution."

Back in Texas, the Belton school district in central Texas said three schools were closed on Thursday because two students were on the same flight as the nurse.

Frieden has said it was unlikely passengers who flew with Vinson were infected because the nurse had not vomited or bled on the flight, but he said she should not have boarded the plane.

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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
May 8,2020

Washington, May 8: Four top Republican senators have urged US President Donald Trump to suspend all-new guest worker visas for 60 days and some of its categories, including the H-1B visa, for at least the next year or until unemployment figures return to normal levels in the country.

The unemployment figures in the US have reached an all-time high due to the coronavirus pandemic. The letter has been signed by Senators Ted Cruz, Tom Cotton, Chuck Grassley and Josh Hawley.

"As you know, more than 33 million Americans have filed for unemployment coverage just since mid-March, and approximately one-fifth of the American workforce is currently out of work. This is a stunning difference compared with the historically-low nationwide unemployment rate of just 3.5 per cent in February this year," they said in their letter to the president on Thursday.

The letter, dated May 7, specifically calls for suspension of all non-immigrant guest worker visas for the next 60 days, followed by a continued suspension of certain categories of new non-immigrant guest worker visas for a year or until the national unemployment figures return to normal levels.

"To protect unemployed Americans in the early stages of economic recovery, we urge you to suspend all non-immigrant guest worker visas for the next 60 days," the senators said.

Exceptions to this suspension should be rare, limited to time-sensitive industries such as agriculture and issued only on a case-by-case basis, when the employers can demonstrate that they have been unable to find Americans to take the jobs, the senators wrote.

After 60 days, the senators urged Trump to continue to suspend new non-immigrant guest workers for a year or until the national unemployment figures return to normal levels, whichever comes first.

"That suspension should, at a minimum, include H-2B visas (non-agricultural seasonal workers), H-1B visas (specialty occupation workers) and the Optional Practical Training (OPT) program (extension of foreign student visas after graduation). We also urge you to suspend the EB-5 immigrant visa program, effective immediately," the lawmakers wrote.

The H-1B work visa for foreign technology professionals is highly popular among Indians and a large number of Indians also opt for the EB-5 investors visa.

The senators argued that there is no reason why unemployed Americans and recent college graduates should have to compete in such a limited job market against an influx of additional H-1B workers, most of whom work in business, technology or STEM fields.

"Temporarily suspending the issuance of new H-1B visas would also protect the hundreds of thousands of H-1B workers and their families already working in the United States -- workers who could otherwise be subject to deportation if they are laid off for more than 60 days," they said.

"Of course, appropriate exceptions could also be crafted to the H-1B program suspension to allow for doctors, nurses and other healthcare professionals who wish to come to the United States to assist in combating the coronavirus pandemic," the senators wrote.

Additionally, the United States ought to suspend its Optional Practical Training (OPT) programme, which allows foreign students in the country to extend their stay after graduation for one to three years to get "experience in the field" by taking jobs here, they wrote.

In 2019, more than 223,000 former foreign students had their OPT applications approved or extended. While the merits of such a programme are subject to debate, there is certainly no reason to allow foreign students to stay for three additional years just to take jobs that would otherwise go to unemployed Americans as the country's economy recovers, the lawmakers said.

The senators also urged Trump to remove the EB-5 visa from the exemptions in his Presidential Proclamation issued on April 22, at least until real reforms are adopted.

The EB-5 programme has long been plagued by scandal and fraud, and criticised as effectively functioning as a pay-for-citizenship scheme in many cases. There is no reason that the programme should receive preferential treatment as opposed to other green card programmes for employment-based immigrants, the lawmakers said.

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Agencies
February 20,2020

Tokyo, Feb 20: One more Indian on board the cruise ship Diamond Princess quarantined off the coast of Japan was tested positive for novel coronavirus, the Indian Embassy in Tokyo said on Wednesday, adding that all seven Indian nationals infected with the virus have been shifted to hospitals in Japan for treatment.

"1 Indian crew who tested positive for #COVID19 among 88 new cases yesterday on #DiamondPrincess taken to hospital for treatment. Indians receiving treatment responding well. From today, the disembarkation of passengers only started, likely to continue till 21 Feb," the embassy tweeted.

"As of 2100 JST, altogether 7 Indian nationals (crew members on board #DiamondPrincess) are receiving treatment in hospitals in Japan, after testing positive for #COVID19 over last few days. Their health conditions are improving. 
@MEAIndia," the following tweet read.

A total of 138 Indians, including 132 crew and 6 passengers, were among the 3,711 people on board the luxury cruise ship which was quarantine off Japan on February 5 after it emerged that a former passenger had tested positive for the virus.

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