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."

Washington, May 17: The overall number of global coronavirus cases has increased to over 4.6 million, while the death toll has surpassed 311,000, according to the Johns Hopkins University.

As of Sunday morning, the total number of cases stood at 4,634,068, while the death toll increased to 311,781, the University's Center for Systems Science and Engineering (CSSE) revealed in its latest update.

The US currently accounts for the world's highest number of cases and deaths at 1,467,796 and 88,754, respectively.

In terms of cases, Russia has the second highest number of infections at 272,043, followed by the UK (241,461), Brazil (233,142), Spain (230,698), Italy (224,760), France (179,630), Germany (175,752), Turkey (148,067) and Iran (118,392), the CSSE figures showed.

Meanwhile, the UK accounted for the second highest COVID-19 deaths worldwide at 34,546.

The other countries with over 10,000 deaths are Italy (31,763), Spain (27,563), France (27,532), and Brazil (15,662).

Feb 12: China on Wednesday reported another drop in the number of new cases of a viral infection and 97 more deaths, pushing the total dead past 1,100 as postal services worldwide said delivery was being affected by the cancellation of many flights to China.

The National Health Commission said 2,015 new cases had been reported over the last 24 hours, declining for a second day. The total number of cases in mainland China reached 44,653, although many experts say a large number of others infected have gone uncounted.

The additional deaths raised the mainland toll to 1,113. Two people have died elsewhere, one in Hong Kong and one in the Philippines.

In the port city of Tianjin, just southeast of Beijing, a cluster of cases has been traced to a department store in Baodi district. One-third of Tianjin’s 104 confirmed cases are in Baodi, the Xinhua state news agency reported.

A salesperson working in the store’s small home appliance section became the first individual in the cluster to be diagnosed on Jan. 31, Xinhua said. The store was already closed at that point, then disinfected on Feb. 1. Nevertheless, several more diagnoses soon followed.

The next to have their infections confirmed were also salespeople at the store. They had not visited Wuhan recently and, with the exception of one married couple, the patients worked in different sections of the store and did not know one another, according to Xinhua.

Japan’s Health Ministry said that 39 new cases have been confirmed on a cruise ship quarantined at Yokohama, bringing the total to 174 on the Diamond Princess.

The U.S. Postal Service said that it was “experiencing significant difficulties” in dispatching letters, parcels and express mail to China, including Hong Kong and Macau.

Both the U.S. and Singapore Post said in notes to their global counterparts that they are no longer accepting items destined for China, “until sufficient transport capacity becomes available.”

The Chinese mail service, China Post, said it was disinfecting postal offices, processing centers and vehicles to ensure the virus doesn’t spread via the mail and to protect staff.

It said the crisis is also impacting mail that transits China to other destinations including North Korea, Kazakhstan, Kyrgyzstan, Mongolia, Tajikistan, Turkmenistan, Uzbekistan and Vietnam.

The World Health Organization has named the disease caused by the virus as COVID-19, avoiding any animal or geographic designation to avoid stigmatization and to show the illness comes from a new coronavirus discovered in 2019.

The illness was first reported in December and connected to a food market in the central Chinese city of Wuhan, where the outbreak has largely been concentrated.

Zhong Nanshan, a leading Chinese epidemiologist, said that while the virus outbreak in China may peak this month, the situation at the center of the crisis remains more challenging.

“We still need more time of hard working in Wuhan,” he said, describing the isolation of infected patients there a priority.

“We have to stop more people from being infected,” he said. “The problem of human-to-human transmission has not yet been resolved.”

Without enough facilities to handle the number of cases, Wuhan has been building prefabricated hospitals and converting a gym and other large spaces to house patients and try to isolate them from others.

China’s official media reported Tuesday that the top health officials in Hubei province, of which Wuhan is the capital, have been relieved of their duties. No reasons were given, although the province’s initial response was deemed slow and ineffective. Speculation that higher-level officials could be sacked has simmered, but doing so could spark political infighting and be a tacit admission of responsibility.

The virus outbreak has become the latest political challenge for the party and its leader, Xi Jinping, who despite accruing more political power than any Chinese leader since Mao Zedong, has struggled to handle crises on multiple fronts. These include a sharply slowing domestic economy, the trade war with the U.S. and pushback on China’s increasingly aggressive foreign policies.

China is struggling to restart its economy after the annual Lunar New Year holiday was extended to try to curb the spread of the virus. About 60 million people are under virtual quarantine and many others are still working at home.

In Hong Kong, the diagnosis of four people living in an apartment building prompted worried comparisons with the deadly SARS pandemic of 17 years ago.

More than 100 people were evacuated from the building after a 62-year-old woman diagnosed with the virus was found living 10 floors directly below a man who was earlier confirmed with the virus.

Health officials called it a precautionary measure and sought to assuage fears of an epidemic, dismissing similarities to the SARS community outbreak at the Amoy Gardens housing estate in 2003.