Seema Verma confirmed by Senate for top health post in Trump admin

March 14, 2017

Washington, Mar 14: The US Senate has confirmed Indian-American Seema Verma for a top health care position in the Trump administration and she was set to play a key role in the government's bid to "repeal and replace" Obamacare.

seemaverma

Verma, who has been described by the White House as the "unquestionably qualified" first generation Indian-American, was confirmed by the Senate by a vote of 55-43.

She is likely to play a key role in the health care reform of US President Donald Trump, who has made it a priority to repeal and replace the affordable healthcare of his predecessor Barack Obama.

The second Indian-American in the Trump Administration to be confirmed by the Senate, Verma would head the USD 1 trillion Centers of Medicare and Medicaid Services that provides health services to 130 million people.

US Ambassador to the United Nations Nikki Haley was the first Indian-American Cabinet rank official to serve in any presidential administration. The Senate vote on Verma's confirmation was mostly on party lines.

A health policy consultant, she is known as the architect of health care reforms in several states, including Indiana. Senate Majority Leader Mitch McConnell said Verma is extremely qualified with a health policy background and a record of success.

"She is committed to protecting Medicare and modernising Medicaid so the programmes deliver the best results for those who need it. She also understands the challenges that Obamacare has created for families," he said.

"Ms Verma's knowledge and leadership abilities will serve the American people well at CMS, an agency that touches the lives of millions every day. She will play an important role as we work to repeal and replace Obamacare, and put in place health care reforms that work for the American people," said Senator Richard Burr, Chairman of the Senate Select Committee on Intelligence.

However, Democratic Senator Kamala Harris, the first Indian American Senator voted against Verma. "I voted no on Seema Verma to head Medicare and Medicaid. I disagree with her ideas to cap and cut Medicaid and her views on maternity coverage," Harris said.

In a speech on the Senate floor, Senate Finance Committee Chairman Orrin Hatch said Verma is especially qualified to lead CMS and modernise its programmes to increase the effectiveness of healthcare delivery.

"She brings the experience and, importantly, bipartisan solutions that can and should unite people across the political spectrum in addressing some of the greatest challenges in our healthcare system. I urge all of my colleagues to join me in supporting Ms. Verma's nomination to this important position," he said.

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Agencies
July 1,2020

The ILO has warned that if another Covid-19 wave hits in the second half of 2020, there would be global working-hour loss of 11.9 percent - equivalent to the loss of 340 million full-time jobs.

According to the 5th edition of International Labour Organisation (ILO) Monitor: Covid-19 and the world of work, the recovery in the global labour market for the rest of the year will be uncertain and incomplete.

The report said that there was a 14 percent drop in global working hours during the second quarter of 2020, equivalent to the loss of 400 million full-time jobs.

The number of working hours lost across the world in the first half of 2020 was significantly worse than previously estimated. The highly uncertain recovery in the second half of the year will not be enough to go back to pre-pandemic levels even in the best scenario, the agency warned.

The baseline model – which assumes a rebound in economic activity in line with existing forecasts, the lifting of workplace restrictions and a recovery in consumption and investment – projects a decrease in working hours of 4.9 percent (equivalent to 140 million full-time jobs) compared to last quarter of 2019.

It says that in the pessimistic scenario, the situation in the second half of 2020 would remain almost as challenging as in the second quarter.

“Even if one assumes better-tailored policy responses – thanks to the lessons learned throughout the first half of the year – there would still be a global working-hour loss of 11.9 per cent at the end of 2020, or 340 million full-time jobs, relative to the fourth quarter of 2019,” it said.

The pessimistic scenario assumes a second pandemic wave and the return of restrictions that would significantly slow recovery. The optimistic scenario assumes that workers’ activities resume quickly, significantly boosting aggregate demand and job creation. With this exceptionally fast recovery, the global loss of working hours would fall to 1.2 per cent (34 million full-time jobs).

The agency said that under the three possible scenarios for recovery in the next six months, “none” sees the global job situation in better shape than it was before lockdown measures began.

“This is why we talk of an uncertain but incomplete recovery even in the best of scenarios for the second half of this year. So there is not going to be a simple or quick recovery,” ILO Director-General Guy Ryder said.

The new figures reflect the worsening situation in many regions over the past weeks, especially in developing economies. Regionally, working time losses for the second quarter were: Americas (18.3 percent), Europe and Central Asia (13.9 percent), Asia and the Pacific (13.5 percent), Arab States (13.2 percent), and Africa (12.1 percent).

The vast majority of the world’s workers (93 per cent) continue to live in countries with some sort of workplace closures, with the Americas experiencing the greatest restrictions.

During the first quarter of the year, an estimated 5.4 percent of global working hours (equivalent to 155 million full-time jobs) were lost relative to the fourth quarter of 2019. Working- hour losses for the second quarter of 2020 relative to the last quarter of 2019 are estimated to reach 14 per cent worldwide (equivalent to 400 million full-time jobs), with the largest reduction (18.3 per cent) occurring in the Americas.

The ILO Monitor also found that women workers have been disproportionately affected by the pandemic, creating a risk that some of the modest progress on gender equality made in recent decades will be lost, and that work-related gender inequality will be exacerbated.

The severe impact of Covid-19 on women workers relates to their over-representation in some of the economic sectors worst affected by the crisis, such as accommodation, food, sales and manufacturing.

Globally, almost 510 million or 40 percent of all employed women work in the four most affected sectors, compared to 36.6 percent of men, it said.

The report said that women also dominate in the domestic work and health and social care work sectors, where they are at greater risk of losing their income and of infection and transmission and are also less likely to have social protection.

The pre-pandemic unequal distribution of unpaid care work has also worsened during the crisis, exacerbated by the closure of schools and care services.

Even as countries have adopted policy measures with unprecedented speed and scope, the ILO Monitor highlights some key challenges ahead, including finding the right balance and sequencing of health, economic and social and policy interventions to produce optimal sustainable labour market outcomes; implementing and sustaining policy interventions at the necessary scale when resources are likely to be increasingly constrained and protecting and promoting the conditions of vulnerable, disadvantaged and hard-hit groups to make labour markets fairer and more equitable.

“The decisions we adopt now will echo in the years to come and beyond 2030. Although countries are at different stages of the pandemic and a lot has been done, we need to redouble our efforts if we want to come out of this crisis in a better shape than when it started,” Ryder said. 

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Agencies
April 21,2020

Washington D.C., April 21: North Korea's leader, Kim Jong Un, is in grave danger following a surgery this month, according to a US intelligence official with direct knowledge.

Kim recently missed the celebration of his grandfather's birthday on April 15, which raised speculation about his well-being. He had been seen four days before that at a government meeting, according to intelligence reports cited by CNN.

The National Security Council and Office of the Director of National Intelligence have however declined to comment on the matter.

CNN has also reached out to the CIA and the State Department for comment and sought comment from the South Koreans.

Kim's absences from official state media often spark speculation and rumors about his health. North Korea has no free press and is often a black hole when it comes to the country's leadership. Analysts are heavily reliant on scanning state media dispatches and watching propaganda videos for any semblance of a clue.

Kim last appeared in North Korean state media on April 11. April 15 -- North Korea's most important holiday, the anniversary of the birth of the country's founding father, Kim Il Sung -- came and went without any official mention of Kim Jong Un's movements.

Experts are unsure of what to make of Kim's absence from any festivities celebrating his grandfather. When North Korean leaders have not shown up to these important celebrations in the past, it has portended major developments. But it has also turned out to be nothing.

"There have been a number of recent rumours about Kim's health (smoking, heart, and brain). If Kim is hospitalized, it would explain why he wasn't present on the important April 15th celebrations," said Bruce Klingner, a senior research fellow at the Heritage Foundation and former CIA deputy division chief for North Korea. "But, over the years, there have been a number of false health rumors about Kim Jong-un or his father. We'll have to wait and see."

Kim Jong Il's absence from a parade celebrating North Korea's 60th anniversary in 2008 was followed by rumblings that he was in poor health. It was later revealed he had a stroke, after which his health continued to decline until his death in 2011.

Kim Jong Un disappeared from the public eye for more than a month in 2014, which also prompted speculation about his health. He returned sporting a cane, and days later South Korean intelligence said that he had a cyst removed from his ankle.

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News Network
April 28,2020

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."

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