Saudi Arabia, US condemn fresh terror attack in Kashmir

Paris, Jul 20: Two coronavirus vaccine candidates have proven safe for humans and produced strong immune reactions among patients involved in separate clinical trials, doctors said on Monday.

The first trial among more than 1,000 adults in Britain found that the vaccine induced "strong antibody and T cell immune responses" against the novel coronavirus.

A separate trial in China involving more than 500 people showed most had developed widespread antibody immune response.

The studies, published in The Lancet medical journal, constitute a major step on the road towards a COVID-19 vaccine that is effective and safe for widespread use.

The authors of the studies said that they encountered few adverse side-effects from the vaccine candidates.

However, they cautioned that more research was needed, particularly among older adults, who are disproportionately at risk of dying of COVID-19.

Co-author Sarah Gilbert from the University of Oxford said the results "hold promise".

"If our vaccine is effective, it is a promising option as these types of vaccine can be manufactured at large scale."

New Delhi, May 24: New rules for domestic travel during the lockdown were released by the government today, including advising passengers to download the Aarogya Setu application on their mobile devices and asking states to ensure thermal screening at departure point of airports, railway stations and bus terminals. The guidelines were shared by Civil Aviation Minister Hardeep Singh Puri, who also shared new rules for international travel.

The minister had recently said that international flight operations may start by mid-June or end-July if the COVID-19 virus "behaves in a predictable manner".

"Prescribed clinical protocol will be followed in case any domestic or international traveller shows symptoms of COVID-19. States can also develop their own protocol for quarantine and isolation as per their own assessment," Mr Puri said.

The guidelines come a day before the resumption of air travel after nearly two-months hiatus following lockdown to prevent the spread of coronavirus.

The Indian Railways has also issued a list of 100 pairs of trains that it will operate from June 1, putting in operation popular trains such as Durontos, Sampark Krantis, Jan Shatabdis and Poorva Express.

Dos and Don'ts shall be provided along with tickets to travellers by agencies concerned, said the Health Ministry's guidelines for domestic travel (air/train/inter-state bus travel).

Latest guidelines on domestic & international travel have been issued by @MoHFW_INDIA.

I hope travellers strictly follow these self-regulatory norms & strengthen India's hands in this fight against COVID19. Remember, each one of us is a soldier against the pandemic.@MoCA_GoIpic.twitter.com/xVbTG1K44n

— Hardeep Singh Puri (@HardeepSPuri) May 24, 2020
Travellers shall give 14-day quarantine undertaking before boarding

The states and Union Territories shall ensure that all passengers undergo thermal screening at the point of departure and only asymptomatic passengers are allowed to board the flight, train or bus. Asymptomatic passengers, however, will be permitted to travel after they give an undertaking to self-monitor for 14 days, the ministry said.

Those having moderate or severe symptoms will be admitted to dedicated COVID health facilities and managed accordingly, the guidelines said.

Those having mild symptoms will be given the option of home isolation or isolated in the COVID Care Centre (both public and private facilities) as appropriate and tested as per ICMR protocol, they said.

"If positive, they will continue in COVID Care Centre and will be managed as per clinical protocol. If negative, the passenger may be allowed to go home, isolate himself/herself and self-monitor his/her health for further 7 days," the health ministry said.

In case, any symptoms develop they shall inform the district surveillance officer or the state or the national call centre (1075), it said.

Use of face covers, following respiratory hygine during travel

During boarding and travel, all passengers shall use face covers or masks and will also follow hand hygiene, respiratory hygiene and maintain environmental hygiene, the ministry said in its guidelines.

At airports, railway stations and bus terminals, required measures to ensure social distancing shall be taken, the guidelines said.

Airports, railway stations and bus terminals to be regularly sanitised

Airports, railway stations and bus terminals should be regularly sanitised or disinfected and the availability of soaps and sanitisers shall be ensured, the health ministry said.

The ministry said that states can also develop their own protocol with regards to quarantine and isolation as per their assessment.

Guidelines for International Travel

The guidelines for international travel include mandatory undertaking for quarrantine for 14 days. "Only for exceptional and compelling reasons such as cases of human distress, pregnancy, death in family, serious illness and parent(s) accompanied by children below 10 yrs, as assessed by the receiving states, home quarantine may be permitted for international travellers for 14 days," the Civil Aviation minister said.

Asymptomatic travelers will be allowed to board flight/ship

At the time of boarding the flight or ship, only asymptomatic travellers will be allowed to board after thermal screening, the health ministry said.. Passengers arriving through land borders will also have to undergo the same procedure, it said.

"Self-declaration form in duplicate shall be filled by the person in the flight/ship and a copy of the same will be given to Health and immigration officials present at the airport/seaport/landport. The form will be made available through the Aarogya Setu app," the new order said.

Passengers found to be symtomatic during screening shall be immediately isolated and taken to medical facility as per health protocol. "These passengers will be kept under institutional quarrantine for a minimum period of 7 days and should undergo necessary tests as per ICMR protocol," the guidelines said.

Sanitisation and disinfection must inside flights

Authorities must take adequate measures to such as environmental sanitation and disinfection at the airports as well as within the flights, the guideline said.Suitable announcement about COVID-19 including precautionary measures to be followed shall be made at airports/ports, it added.

While on board flight, ships, passengers and crew required precautions such as wearing of masks, environmental hygiene, respiratory hygiene, hand hygiene, the ministry said.

This morning, India registered the biggest-single day jump in the number of coronavirus cases as 6,767 new patients were reported in the last 24 hours. This is the third consecutive day that India has reported more than 6,000 COVID-19 cases with a record number of new patients each day. The county has officially logged 1,31,868 cases, 3,867 deaths linked to the highly infectious illness since the pandemic began. Of these, 147 patients died in the last 24 hours. The global number of novel coronavirus cases has passed 5.25 million with more than 339,000 deaths. Since the outbreak first emerged in China in December, 5,260,970 cases have been recorded across 196 countries and territories, with 339,758 deaths attributed to the virus.

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."