Pakistan court allows Indian woman to return home

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."

Apr 12: India and other South Asian countries are likely to record their worst growth performance in four decades this year due to the coronavirus outbreak, the World Bank said on Sunday.

The South Asian region, comprising eight countries, is likely to show economic growth of 1.8 per cent to 2.8 per cent this year, the World Bank said in its South Asia Economic Focus report, well down from the 6.3 per cent it projected six months ago.

India's economy, the region's biggest, is expected to grow 1.5 per cent to 2.8 per cent in the fiscal year that started on April 1. The World Bank has estimated it will grow 4.8 per cent to 5 per cent in the fiscal year that ended on March 31.

"The green shoots of a rebound that were observable at the end of 2019 have been overtaken by the negative impacts of the global crisis," the World Bank report said.

Other than India, the World Bank forecast that Sri Lanka, Nepal, Bhutan and Bangladesh will also see sharp falls in economic growth.

Three other countries - Pakistan, Afghanistan and the Maldives - are expected to fall into recession, the World Bank said in the report, which was based on country-level data available as of April 7.

Measures taken to counter the coronavirus have disrupted supply chains across South Asia, which has recorded more than 13,000 cases so far - still lower than many parts of the world.

India's lockdown of 1.3 billion people has also left millions out of work, disrupted big and small businesses and forced an exodus of migrant workers from the cities to their homes in villages.

In the event of prolonged and broad national lockdowns, the report warned of a worst-case scenario in which the entire region would experience an economic contraction this year.

To minimize short-term economic pain, the Bank called for countries in the region to announce more fiscal and monetary steps to support unemployed migrant workers, as well as debt relief for businesses and individuals.

India has so far unveiled a $23 billion economic plan to offer direct cash transfers to millions of poor people hit by its lockdown. In neighbouring Pakistan, the government has announced a $6 billion plan to support the economy.

"The priority for all South Asian governments is to contain the virus spread and protect their people, especially the poorest who face considerable worse health and economic outcomes," said senior World Bank official Hartwig Schafer.

Ramallah, Jul 2: Several world countries renew a call for Israel to halt contentious plans to annex parts of the occupied Palestinian territory after the regime delayed the implementation of the land garb bid in the face of a series of stumbling blocks, including internal rifts, global criticisms and the US’s failure to give Tel Aviv the go-ahead for the move.

Israel's ruling coalition, led by Prime Minister Benjamin Netanyahu, had announced July 1 as the date to begin moving forward with the plan to impose Tel Aviv’s “sovereignty” over about a third of the West Bank, including settlements and the fertile Jordan Valley.

Without clarifications, the regime, however, failed to launch the scheme on the set date amid widening differences between Netanyahu and his coalition partner, minister of military affairs Benny Gantz.

Meanwhile, there are signs that the administration of US President Donald Trump, a staunch Israel supporter, has cooled its backing for the Israeli move amid what is believed to be troubles at home and fears that it might hurt the president’s chances of re-election besides international pressure.

On Wednesday, Netanyahu's office said in a statement that he would continue to discuss a possible West bank annexation with the US administration.

“In the coming days there will be additional discussions,” the statement said.

Labor, Social Affairs and Social Services Minister Ofir Akunis said the Israel would annex portions of the West Bank in July but only after the US president issued a declaration on the matter.

The annexation “will only happen after a declaration by Trump,” he told Israeli Army Radio.

Trump had already given Tel Aviv the green light for the land grab in his self-proclaimed “deal of the century,” which was unveiled in January with the aim of re-drawing the Middle East map.

However, the Trump administration has so far refrained from offering official support for the annexation sought by Netanyahu and his right-wing allies.

Unlike the US, several countries, including some of Israel’s allies, have expressed their opposition to Israel’s planned push to consolidate its occupation of Palestine.

Germany passes anti-annexation resolution

On Wednesday, the German parliament approved a resolution calling on the government to dissuade Israel from annexing the West Bank.

The motion, which was brought in the German legislature by the three parties in Chancellor Angela Merkel's coalition, was approved without opposing votes. 

Berlin should use its “special relations and contacts [with Tel Aviv] to express to the Israeli government our concerns and our urgent demand to refrain from an annexation of parts of the West Bank and from the continued expansion of settlements, both of which contradict international law,” read the resolution.

Speaking at the parliamentary debate before the vote, German Foreign Minister Heiko Maas said, “We reject unilateral changes of borders, and we won’t recognize them.”

He also stressed that peace “cannot be achieved through unilateral steps but only through serious negotiations.”

France warns of consequences

Similarly, French Foreign Minister, Jean-Yves Le Drian warned that any Israeli annexation would be a violation of international law and would bring about consequences.

“Annexation of Palestinian territories, whatever the perimeters, would seriously throw into question the parameters to resolve the conflict,” he told a parliamentary hearing. 

The top diplomat added, “An annexation decision could not be left without consequences and we are examining different options at a national level and also in coordination with our main European partners.”

Australia raises concerns

Additionally, Australian Foreign Minister Marise Payne voiced worries about the Israeli scheme, saying she had directly expressed this view to Israeli Foreign Minister Gabi Ashkenazi.

“We are following with concern possible moves towards the unilateral annexation or change in status of territory on the West Bank,” she said in a statement.

“The focus needs to be on a return to direct and genuine negotiations between Israel and the Palestinians for a durable and resilient peace arrangement, as soon as possible,” Payne added.

Vatican summons US, Israeli envoys

Meanwhile, the Vatican announced on Wednesday that it had summoned the American and Israeli ambassadors to protest Israel’s annexation bid.

In separate meetings, Vatican Secretary of State Cardinal Pietro Parolin told Israeli Ambassador Oren David and US Ambassador Callista Gingrich of concerns “regarding possible unilateral actions that may further jeopardize the search for peace between Israelis and Palestinians, as well as the delicate situation in the Middle East,”

“As already declared … the Holy See reiterates that ... Israel and the State of Palestine have the right to exist and to live in peace and security, within internationally recognized borders,” the Vatican said in a statement.

“It thus appeals to the parties to do everything possible to reopen the process of direct negotiation, on the basis of the relevant Resolutions of the United Nations,” it added.

Amnesty urges firm action

Amnesty International called on the international community to take firm action against Israel’s annexation plan and its “law of the jungle” mentality.

“Members of the international community must enforce international law and restate that annexation of any part of the occupied West Bank is null and void,” said Saleh Higazi, deputy regional director for Amnesty Middle East and North Africa.

“They must also work to immediately stop the construction or expansion of illegal Israeli settlements and related infrastructure in the Occupied Palestinian Territories as a first step towards removing Israeli civilians living in such settlements,” he added.

Palestinians mark ‘Day of Rage'

Also on Wednesday, Palestinians held “Day of Rage” rallies both in the West Bank and the Gaza Strip against the Israeli expansionism.

In Gaza city, several thousand protesters gathered, some brandishing Palestinian national flags and placards condemning Trump.

Some demonstrators carried signs in English reading, “We Can’t Breathe Since 1948” and “Palestinian Lives Matter,” in reference to the American Black Lives Matter movement.

“The occupation has killed us and killed our children and deprived us of a good life. May God grant the Resistance victory,” a protester told the al-Aqsa TV.

“The resistance must be revived,” Gaza protester Rafeeq Inaiah told media persons. “Israel is afraid of force.”

Similar demonstrations also took place in the West Bank cities of Ramallah and Jericho.