US scraps $300 million in military aid to Pakistan

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."

Saint Martin's Island, Feb 12: At least 15 women and children drowned and more than 50 others were missing after a boat overloaded with Rohingya refugees sank off southern Bangladesh as it tried to reach Malaysia Tuesday, officials said.

Some 138 people -- mainly women and children -- were packed on a trawler barely 13 metres (40 feet) long, trying to cross the Bay of Bengal, a coast guard spokesman told news agency.

"It sank because of overloading. The boat was meant to carry maximum 50 people. The boat was also loaded with some cargo," another coast guard spokesman, Hamidul Islam, added.

Nearly one million Rohingya live in squalid camps near Bangladesh's border with Myanmar, many fleeing the neighbouring country after a 2017 brutal military crackdown.

With few opportunities for jobs and education in the camps, thousands have tried to reach other countries like Malaysia and Thailand by attempting the hazardous 2,000-kilometre journey.

In the latest incident, 71 people have been rescued including 46 women. Among the dead, 11 were women and the rest children.

Anwara Begum said two of her sons, aged six and seven, drowned in the tragedy.

"We were four of us in the boat... Another child (son, aged 10) is very sick," the 40-year-old told news agency.

Fishermen tipped off the coast guard after they saw survivors swimming and crying for help in the sea.

The boat's keel hit undersea coral in shallow water off Saint Martin's Island, Bangladesh's southernmost territory, before it sank, survivors said.

"We swam in the sea before boats came and rescued us," said survivor Mohammad Hossain, 20.

Coast guard commander Sohel Rana said three survivors, including a Bangladeshi, were detained over human trafficking allegations.

An estimated 25,000 Rohingya left Bangladesh and Myanmar on boats in 2015 trying to get to Thailand, Malaysia and Indonesia. Hundreds drowned when overloaded boats sank.

Begum said her family paid a Bangladeshi trafficker $450 per head to be taken to Malaysia.

"We're first taken to a hill where we stayed for five days. Then they used three small trawlers to take us to a large trawler, which sank," she said.

Shakirul Islam, a migration expert whose group works with Rohingya to raise awareness against trafficking, said desperation in the camps was making refugees want to leave.

"It was a tragedy waiting to happen," he said.

"They just want to get out, and fall victim to traffickers who are very active in the camps."

Islam said in the past two months dozens of Rohingya reported approaches from traffickers to his OKUP migration rights group.

"Human smuggling and trafficking in the Bay of Bengal is particularly difficult to address as it requires concerted effort from multiple states," the Bangladesh head of UN agency the International Organization for Migration, Giorgi Gigauri, told news agency.

"The gaps in coordination are easily exploited by criminal networks."

Since last year, Bangladeshi authorities have picked up over 500 Rohingya from rickety fishing trawlers or coastal villages as they waited to board boats.

Trafficking often increases during the November-March period when the sea is safest for the small trawlers used by traffickers.

Bangladesh and Myanmar signed a repatriation deal to send back some Rohingya to their homeland, but none have agreed to return because of safety fears.

The charity Save the Children called on Myanmar to "take all necessary steps to ensure the Rohingya community can return to their homes in a safe and dignified manner".

"The tragic drowning of women and children... should be a wake-up call for us all," the group's Athena Rayburn said in a statement.

London, Feb 19: UK Home Secretary Priti Patel today announced the launch of the Britain's new points-based visa system, aimed at attracting the "brightest and the best" from the world, including from India, and cutting down numbers of cheap, low-skilled workers coming to the country.

The new system will come into force from January 1, 2021 at the end of the transition period after the UK's exit from the European Union (EU) last month, which will formally end free movement of people within the economic bloc for the UK as a non-member.

The new post-Brexit system, which will apply equally to the EU and non-EU countries like India, is based on assigning points for specific skills, qualifications, salaries and professions, with visas only awarded to those who gain enough points.

"Today is a historic moment for the whole country. We're ending free movement, taking back control of our borders and delivering on the people's priorities by introducing a new UK points-based immigration system, which will bring overall migration numbers down," said Ms Patel, the senior-most Indian-origin Cabinet minister.

"We will attract the brightest and the best from around the globe, boosting the economy and our communities, and unleash this country's full potential," Ms Patel, in charge of the UK's visa and immigration system, said.

The UK Home Office said the new system is a direct response to the 2016 referendum in favour of Brexit, which was seen as a vote to end the country's reliance on cheap migrant labour and reduce overall levels of migration with tighter security.

"The new single global system will treat the EU and non-EU citizens equally. It will give top priority to those with the highest skills and the greatest talents, including scientists, engineers and academics," the Home Office said.

The Global Talent Scheme, a fast-track visa to be in operation from Friday, will also apply to the EU citizens from next year to allow highly-skilled scientists and researchers to come to the UK without a job offer.

Professor Alice Gast, President of Imperial College London, said: "British science is global. The new post-study work and Global Talent visas will help us to attract the world's brightest students and researchers, wherever they come from."

"From the race to develop a coronavirus vaccine to clean energy, British science's international collaborations drive innovation and excellence."

The government said the points threshold for the new system will be carefully set to attract the talent the UK needs. Skilled workers will need to meet a number of relevant criteria, including specific skills and the ability to speak English, to be able to work in the UK. All applicants will be required to have a job offer and, in line with the Migration Advisory Committee''s (MAC) recommendations, the minimum salary threshold will be set at 25,600 pounds - lower than the previous 30,000 pounds level for Tier 2 work visas.

The new points-based system will also expand the skills threshold for skilled workers.

Those looking to live and work in the UK will need to be qualified up to A-level or equivalent, rather than degree-level under the current system. This will provide greater flexibility and ensure UK business has access to a wide pool of skilled workers, the Home Office said.

In line with the British Prime Minister Boris Johnson's manifesto commitment in the December 2019 General Election, there will be no specific route for low-skilled workers.

"It is estimated 70 per cent of the existing EU workforce would not meet the requirements of the skilled worker route, which will help to bring overall numbers down in future," the Home Office said.

Student visa routes will also be points-based and be opened up to EU citizens from next year.

Those wishing to study in the UK will need to demonstrate that they have an offer from an approved educational institution, that they can support themselves financially and that they speak English.

To address the specific labour concerns of the agricultural sector reliant on seasonal workers from the EU, the Seasonal Workers Pilot will be expanded in time for the 2020 harvest from 2,500 to 10,000 places.

EU citizens and other non-visa nationals will not require a visa to enter the UK when visiting the UK for up to six months.

However, the use of national identity cards will be phased out for travel to the UK and the Home Office highlighted that as part of its post-Brexit offer, those EU citizens resident in the UK by December 31 2020 can still apply to settle in the UK through the EU Settlement Scheme until June 2021.