Trump's likely pick for Ambassador knows a lot about India

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."

Huawei will be completely removed from the UK's 5G networks by the end of 2027, the UK government announced on Tuesday after a review by the country's National Cyber Security Centre (NCSC) on the impact of US sanctions against the Chinese telecommunications giant.

In the lead up to this complete removal of all Huawei kit from UK networks, there will be a total ban on the purchase of any new 5G kit after December 31, 2020.

The decision was taken at a meeting of the UK's National Security Council (NSC) chaired by Prime Minister Boris Johnson, in response to new US sanctions against the telecom major imposed in May which removed the firm's access to products which have been built based on US semiconductor technology.

5G will be transformative for our country, but only if we have confidence in the security and resilience of the infrastructure it is built upon, said Oliver Dowden, UK Secretary of State for Digital, Culture, Media and Sport (DCMS).

Following US sanctions against Huawei and updated technical advice from our cyber experts, the government has decided it necessary to ban Huawei from our 5G networks. No new kit is to be added from January 2021, and UK 5G networks will be Huawei free by the end of 2027. This decisive move provides the industry with the clarity and certainty it needs to get on with delivering 5G across the UK, he said.

The minister, who laid out the details of the UK's ban on Huawei in the House of Commons, said the government will now seek to legislate with a new Telecoms Security Bill to put in place the powers necessary to implement the tough new telecoms security framework.

By the time of the next election (2024) we will have implemented in law an irreversible path for the complete removal of Huawei equipment from our 5G networks, said Dowden.

The new law will give the government the national security powers to impose these new controls on high risk vendors and create extensive security duties on network operators to drive up standards, DCMS said.

Technical experts at the NCSC reviewed the consequences of the US sanctions and concluded that Huawei will need to do a major reconfiguration of its supply chain as it will no longer have access to the technology on which it currently relies and there are no alternatives which we have sufficient confidence in.

They found the new restrictions make it impossible to continue to guarantee the security of Huawei equipment in the future.

After a ban on the purchase of new Huawei kit for 5G from next year, the aim is to completely remove the Chinese vendor's influence on 5G networks across the UK by the end of 2027.

The DCMS said Tuesday's decision takes into account the UK's specific national circumstances and how the risks from these sanctions are manifested in the country.

The existing restrictions on Huawei in sensitive and critical parts of the network remain in place, it highlighted.

The DCMS said the US action also affects Huawei products used in the UK's full fibre broadband networks. However, the UK has managed Huawei's presence in the UK's fixed access networks since 2005 and we also need to avoid a situation where broadband operators are reliant on a single supplier for their equipment.

As a result, following security advice from experts, DCMS is advising full fibre operators to transition away from purchasing new Huawei equipment. A technical consultation will determine the transition timetable, but it is expect this period to last no longer than two years.

The government said its new approach strikes the right balance by recognising full fibre's established presence and supporting the connections that the public relies on, while fully addressing the security concerns.

It stressed that its new policy in relation to high risk vendors has not been designed around one company, one country or one threat but as an enduring and flexible policy that will enable the UK to manage the risks to the network, now and in the future.

Beijing, Mar 24:  China reported 78 new confirmed cases, including 74 imported infections, while the death toll from the novel coronavirus increased to 3,277 after seven more fatalities were confirmed from the COVID-19, health officials said on Tuesday.

The overall confirmed cases on the Chinese mainland have reached 81,171 by the end of Monday. This included 3,277 people who died of the disease, 4,735 patients who were still being treated and 73,159 patients discharged after recovery, the National Health Commission (NHC) said on Tuesday.

The NHC said, 78 new confirmed COVID-19 cases were reported on the Chinese mainland on Monday, of which 74 were imported from abroad taking the number of overseas cases to 427.

Also on Monday, seven deaths and 35 new suspected cases were reported on the mainland with all the deaths in Hubei Province.

The total COVID-19 cases in Beijing climbed to 522 with eight deaths prompting local governments of Beijing as well as Shanghai to announce that all overseas arrivals will be subjected to nucleic acid tests to ensure proper detection.

Of the 74 newly imported cases, 31 were reported in Beijing, 14 in Guangdong, nine in Shanghai, five in Fujian, four in Tianjin, three in Jiangsu, two in Zhejiang and Sichuan respectively, and one in Shanxi, Liaoning, Shandong and Chongqing respectively, the NHC said.

Beijing is already diverting all international flights to different cities where the passengers will be quarantined for 14 days before arriving in the city.

The NHC said 132 people were still suspected of being infected with the virus.

Coronavirus epicentre Wuhan has reported one confirmed case after a gap of five days prompting officials to begin to ease restrictions.

Wuhan also reported seven new deaths, bringing the total number of deaths in the city and Hubei province for which Wuhan is the capital to 3,160.

The province also saw 444 patients discharged from hospital after recovery on Monday. Among the 4,200 patients being treated in hospital, 1,203 were still in severe condition and another 336 in critical condition, the local health commission said.

By the end of Monday, 356 confirmed cases, including four deaths have been reported in Hong Kong, which has restricted the entry of foreigners into the city. Also a total of 25 confirmed cases were reported in Macao and 195 in Taiwan including two deaths, state-run Xinhua news agency reporrted.

After days of decline in coronavirus cases, China on Monday said that COVID-19 has effectively been "stemmed" in the country and it started easing severe restrictions imposed on Wuhan's 11 million people who were under lockdown since January 23.

The authorities began relaxing restrictions in Wuhan as it reported no new case for the fifth consecutive day on Monday.

Significantly, the Central Leading Group (CLP), headed by Premier Li Keqiang which is coordinating efforts to contain the virus since January 23, said the virus has been curtailed in the country as well as in Wuhan.

"The meeting noted that the spread of the virus nationwide, particularly in the epicentre of Wuhan, has been effectively stemmed," an official statement said on Monday.

The meeting, however, warned that the risks for sporadic infections and localised outbreaks have not gone away. With the pandemic rampaging across the world, the situation remains complex and challenging.

"Wuhan city and Hubei province should stay focused on medical treatment and community-level containment as the two key priorities. They should continue to treat the severe cases, promptly admit new cases, and advance epidemiological investigations," the meeting said.

In Wuhan, officials said people are allowed to go back to work while restrictions on the public transport are gradually being eased.

The Hubei province and its capital Wuhan with over 56 million people were under lockdown since January 23. The vicious virus broke out in city, reportedly at a live animal market in December last year and became virulent inflicting thousands of people in the city and province catching the government off guard.

As the country saw a surge in imported infections, the Chinese government announced that all international flights scheduled to arrive in Beijing will be redirected to airports in 12 other Chinese cities from Monday.

International passengers flying to Beijing will instead land at airports in 12 cities including Shanghai, Tianjin, Nanjing and Shenyang as their first points of entry, the Civil Aviation Administration of China (CAAC) said in a statement.

On Monday, China said international travellers should "think twice" about choosing Beijing for flight transfer in view of the restrictions.

Starting from Monday, all international flights scheduled to arrive in Beijing will be redirected to airports in 12 other Chinese cities, Liu Haitao, an official with China's National Immigration Administration said.

Passengers would go through entry procedures and quarantine measures at the designated cities' airports before they continue their flights to Beijing, Liu said, urging travellers to reserve enough time for their next flights to make sure that they do not miss their outbound flights.