Pak gives nod to Saudi Arabia for establishing oil refinery in port city of Gwadar

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."

Beijing, Feb 6: The number of confirmed fatalities from China's coronavirus outbreak rose to at least 560, after authorities in hardest-hit Hubei province reported 70 new deaths on February 6.

In its daily update, the health commission in Hubei also confirmed the number of confirmed infections in the outbreak has reached 28,018 nationwide with 3,694 new cases reported.

The epidemic, which has spiralled into a global health emergency, is believed to have emerged in December from a market that sold wild game in Hubei's capital Wuhan.

Hu Lishan, an official in Wuhan, warned Wednesday that despite building a hospital from scratch and converting public buildings to accommodate thousands of extra patients, there was still a "severe" lack of beds in the region.

There was also a shortage of "equipment and materials," he told reporters, adding that officials were looking to convert other hotels and schools in the city into treatment centres.

Authorities in several other cities in China have placed restrictions on the number of people allowed to leave their homes.

Global concerns have also risen about the virus, with cases confirmed in more than 20 countries.

New York, Apr 5: New York State, the epicentre of the coronavirus pandemic in the US, continued to record the highest count of daily deaths from COVID-19 as a staggering number of 630 people died in a 24-hour period and Governor Andrew Cuomo said the outbreak in the state could peak in about seven days.

The state had recorded the highest single increase in the number of deaths from novel coronavirus in a single day between April 2 and 3 when 562 people had died, one person dying from the viral infection almost every two-and-a-half minutes.

In the 24 hours since April 4, the death toll grew to 630, "all-time increase" up to a total of 3,565, up from 2,935 on Friday morning, Cuomo said.

The daily death toll in New York continues to grow at record numbers as the state remains the most impacted in the US from coronavirus.

Coronavirus cases in New York State now stand at 113,704, out of the country's total number of 312,146. New Jersey, the second most impacted state in the US, has about 30,000 COVID-19 cases.

New York City alone has 63,306 coronavirus patients, up from 57,169 the previous 24 hours, and 2,624 deaths.

Cuomo said the apex in the state, the point where the number of infections on a daily basis hits the high point, is still about 4-8 days away.

"We have been talking about hitting that apex, the high point of the curve. I call it the battle of the mountaintop. That's going to be the number one point of engagement of the enemy," he said.

"But our reading of the projections is we're somewhere in the seven-day range, four, five, six seven, eight day range. Nobody can give you a specific number, which makes it very frustrating to plan when they can't give you a specific number or a specific date, but we're in that range," Cuomo said.

"We are not yet at the apex. Part of me would like to be at the apex and just let's do it. But there's part of me that says it's good that we're not at the apex because we're not yet ready for the apex either, still working on the capacity of the (healthcare) system," the governor said.

Cuomo has expressed anger over the short supply of essential medical equipment for healthcare professionals to help them deal with the surge in coronavirus cases across the state and the country.

He said personal protective equipment (PPE) such as masks, gowns and face shields are in short supply in New York as they are across the country and there is need for companies to make these materials.

"It is unbelievable to me that in the New York State, in the United States of America, we can't make these materials and that we are all shopping China to try to get these materials and we're all competing against each other," he had said earlier.

Cuomo said on Saturday that the state has 85,000 volunteers, including 22,000 from outside the state, and he will also be signing an executive order to allow medical students who were slated to graduate to begin practising, supplementing the state's healthcare professional capacity.

On ventilators, he said the state had ordered 17,000 but there was not enough supply in the federal stockpile to meet this growing demand across the state.    

"China is remarkably the repository for all of these orders - ventilators, PPE, it all goes back to China, which long term we have to figure out why we wound up in this situation where we don't have the manufacturing capacity in this country," he said, adding, "New York has been shopping in China."

The Chinese government helped facilitate a donation of 1,000 ventilators that will arrive at the JFK Airport in the city, he said, as he thanked the Chinese government, Alibaba head Jack Ma, the Jack Ma Foundation, Alibaba co-founder co-founder Joe Tsai and China's Consul General Huang Ping.
In addition, the state of Oregon would deliver 140 ventilators to New York.    

Cuomo has signed an executive order allowing the state to redistribute ventilators and personal protective equipment from hospitals, private sector companies and institutions that don't currently need them and redeploy the equipment to other hospitals with the highest need.
Those institutions will either get their ventilator back or they will be reimbursed and paid for their ventilator so they can buy a new ventilator.
The 2,500-bed facility at the Javits Convention Centre, which was supposed to be used for non-COVID patients, will now be used as COVID-positive facility.

"The federal government will staff that and the federal government with equip that. That is a big deal because that 2,500-bed facility will relieve a lot of pressure on the downstate system as a significant number of beds and that facility has to make that transition quickly and that's what we're focused on," Cuomo said.

Cuomo emphasised that he wants the pandemic to end as soon as possible as it is taking an unprecedented strain on life.

"I want this to be all over. It's only gone on for 30 days since our first case. It feels like an entire lifetime. I think we all feel the same. This stresses this country, this state, in a way that nothing else has frankly, in my lifetime. It stresses us on every level.

The economy is stressed, the social fabric is stressed, the social systems are stressed, transportation is stressed," he said.