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Months after the outbreak of COVID-19 in Wuhan city of central China, families of those deceased, who contracted the contagious infection, stood in long queues at funeral homes demanding to receive the cremated ashes of their loved ones.

Now this has spurred questions about the actual tally of COVID-19 related casualties in Wuhan, in a renewed pressure on the Chinese government that is already struggling to control its containment narrative of the pandemic spread.

Chinese media outlet Caixin showed how trucks carrying 2,500 urns with the ashes of the deceased COVID-19 cases were being shipped in a funeral home last week. Another picture published revealed how 3,500 urns were stacked within these funeral homes. It is therefore unclear how many urns have been filled in.

According to media reports, workers at several funeral parlors declined to provide any details as to how many urns were waiting to be collected, saying they either did not know or were not authorised to share the number.

Some families said they had been forced to wait for several hours to pick up the ashes. The photos circulated as mass deaths from the virus spiked in cities across the west, including Milan, Madrid and New York, where hospitals were erecting tents to handle the overflow as global infections soar past 500,000, with 24,000 dead.

According to Chinese government figures, 2,535 people in Wuhan have died of the virus. The announcement that a lockdown in place since January would be lifted came after the country said its tally of new cases had hit zero and stepped up diplomatic outreach to other countries hard hit by the virus, sending some of them medical supplies.

But some in China have been skeptical of the accuracy of the official tally, particularly given Wuhan's overwhelmed medical system, authorities' attempts to cover up the outbreak in its initial stages, and multiple revisions to the way official cases are counted.

Residents on social media have demanded disciplinary action against top Wuhan officials.

Many people who died had Covid-19 symptoms, but weren't tested and excluded from the official case tally, Caixin said. There were also patients who died of other diseases due to a lack of proper treatment when hospitals were overwhelmed dealing with those who had the coronavirus.

There were 56,007 cremations in Wuhan in the fourth quarter of 2019, according to data from the city's civil affairs agency. The number of cremations was 1,583 higher than those in the fourth quarter of 2018 and 2,231 higher than the fourth quarter of 2017.

Two locals in Wuhan who have lost family members to the virus said online that they were informed they had to be accompanied by their employers or officials from neighborhood committees when picking up the urns, likely as a measure against public gatherings.

COVID-19 is affecting 199 countries and territories around the world. Over 664,000 coronavirus cases have been registered globally out of which 30,890 have succumbed to the infection.

Mar 6: UK stocks fell again on Friday as growing economic risks from the coronavirus outbreak shattered investor confidence, with Britain recording its first death from the pathogen.

A 1.5% fall for the FTSE 100 erased the blue-chip index's gains from earlier this week. Export-heavy companies have now lost over $230 billion in value since the epidemic sparked a worldwide rout last week.

The domestically focussed mid-cap index was down 1.9%.

Cruise operator Carnival dropped 4.2% to its lowest level since 2012, a day after its Grand Princess ocean liner was barred from returning to its home port of San Francisco on virus fears.

Britain said an older person with underlying health problems had succumbed to the flu-like virus on Thursday, while the number of infections jumped to 115.

In company news, drug maker AstraZeneca fell 1% after it said its treatment for a form of bladder cancer failed to meet the main goal of improving overall survival in patients in a late-stage study.

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."