Pakistan must prosecute top LeT operatives along with its leader Hafiz Saeed, says US

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."

Scientists predict the world may have a COVID-19 vaccine within one year or even a few months earlier, said the Director-General of the World Health Organisation even as he underlined the importance of global cooperation to develop, manufacture and distribute vaccines.

However, making the vaccine available and distributing it to all will be a challenge and requires political will, Tedros Adhanom Ghebreyesus said on Thursday during a meeting with the European Parliament's Committee for Environment, Public Health and Food Safety.

One option would be to give the vaccine only to those that are most vulnerable to the virus.

There are currently over 100 COVID-19 vaccine candidates in various stages of development.

Adhanom Ghebreyesus said the pandemic has highlighted the importance of global solidarity and that health should not be seen as a cost but an investment.

He added that all countries in the world must strengthen primary health care and crisis preparedness and stressed the need for EU leadership globally.

While the Director-General said the situation in the EU has improved significantly, he underlined that COVID-19 is very much still circulating globally, with more than four million new cases in the last month.

Many Members of European Parliament said that the global community must cooperate including in developing, manufacturing and distributing vaccines against COVID-19 and asked when a safe vaccine could be available.

Several Members of European Parliament underlined the importance of the WHO but also said it has made mistakes in its response to the pandemic.

The Director-General admitted everyone makes mistakes and informed the members that an independent panel will evaluate the WHO response to the pandemic to learn from any mistakes made.

It will start its work soon, he said.

Jun 10: Indian-origin California Senator Kamala Harris has joined former vice president and 2020 Democratic presidential nominee Joe Biden to raise USD 3.5 million for the upcoming November elections.

Tuesday's fundraiser is the second-largest single event haul so far for the Biden campaign, which raised USD 4 million at one event earlier this month.

Harris' presence during the virtual mega fund raiser assumes significance as the Democratic Party leaders consider her to be one of the front-runners to be the nominee for vice president. The 55-year-old lawyer-politician was once considered to be a strong opponent of Biden in the 2020 Democratic primaries.

Introducing Harris to the 1,400 supporters present at the event, Biden underlined the history-breaking nature of her past electoral wins.

"For much of her career, she was the only person in the room who looked like she did," he said.

At the start of the campaign last year, Harris was very critical of Biden. She later endorsed him, months after she decided to withdraw herself from the race to the White House.

During the fundraiser, Harris was effusive in her praise for Biden.

Referring to Biden's meeting with George Floyd's family, she said, "He (Biden)is someone who whether one on one or speaking to the nation always has a sense of how people are experiencing this world, and what their needs are...This moment in the history of our country really represents an extraordinary exercise in contrast."

"On the other hand, we have a Donald Trump who had the gall to dispatch the US military to clear the streets so that he could prance down and then, like a prop, hold up the bible for a photo op," Harris said.

The death of African-American Floyd during police confinement in Minneapolis on May 25 has resulted in widespread protests not only in the US but across the world.

"There are so many contrasts between Joe Biden and Donald Trump that really point to the choice that we as Americans have today," Harris said.

California Lt Governor Eleni Kounalakis also joined the fund raiser.

In his remarks, Biden, 77, said the US is reeling in anguish and anger over the brutal killing of Floyd or the systemic racism that still infects every part of the society. "Harris knows better than anybody," he said.

"At the same time, we're facing the worst economic disaster since the Great Depression. American history is not a fairy tale with a guaranteed ending, a happy ending. This is a battle for the soul of the country.

"It's been a constant tug of war between the American ideal that we all are created equal -- and the harsh reality that racism has long torn us apart...I'm going to ask every American to look where we are now and to think, is this who we are? Is this who we want to be?" Biden asked.

Participating in the questions and answers session, Harris said America has still not fully embraced, acknowledged or addressed its history of racism and its current history of racism.

"One can think of this moment as an inflection moment, and it will require bold action and it will require immediate action...This stresses the importance and the immediacy and the urgency of electing Joe Biden," she said.

Replying to a question, Biden said, "Did you see today where the President of the United States while George Floyd was being buried, was condemning the older man who was knocked down with his head bleeding and everyone walking by. Did you see that? I mean, my lord. What have we become if we abide by this? So much we can do and must do."

Harris said the election is going to be rough and tumble.

"There are very powerful forces that thrive off of the hate and division that Donald Trump has been sowing. This is not going to be easy. And we have about just a few months to get this thing done," she said.