US tells India it is mulling caps on H-1B visas to deter data rules says sources

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."

Six months since the new coronavirus outbreak, the pandemic is still far from over, the World Health Organization said Monday, warning that "the worst is yet to come".

Reaching the half-year milestone just as the death toll surpassed 500,000 and the number of confirmed infections topped 10 million, the WHO said it was a moment to recommit to the fight to save lives.

"Six months ago, none of us could have imagined how our world -- and our lives -- would be thrown into turmoil by this new virus," WHO chief Tedros Adhanom Ghebreyesus told a virtual briefing.

"We all want this to be over. We all want to get on with our lives. But the hard reality is this is not even close to being over.

"Although many countries have made some progress, globally the pandemic is actually speeding up.

"We're all in this together, and we're all in this for the long haul.

"We will need even greater stores of resilience, patience, humility and generosity in the months ahead.

"We have already lost so much -- but we cannot lose hope."

Tedros also said that the pandemic had brought out the best and worst humanity, citing acts of kindness and solidarity, but also misinformation and the politicisation of the virus.

In an atmosphere of global political division and fractures on a national level, "the worst is yet to come. I'm sorry to say that," he said.

"With this kind of environment and condition, we fear the worst."

Washington, Jun 27: Facebook has said that it will flag all "newsworthy" posts from politicians that break its rules, including those from President Donald Trump.

Separately, Facebook's stock dropped more than 8 per cent, erasing roughly USD 50 billion from its market valuation, after the European company behind brands such as Ben & Jerry's and Dove announced it would boycott Facebook ads through the end of the year over the amount of hate speech and divisive rhetoric on its platform.

Later in the day, Coca-Cola also announced it joined the boycott for at least 30 days.

CEO Mark Zuckerberg had previously refused to take action against Trump posts suggesting that mail-in ballots will lead to voter fraud, saying that people deserved to hear unfiltered statements from political leaders.

Twitter, by contrast, slapped a "get the facts" label on them.

Until Friday, Trump's posts with identical wording to those labelled on Twitter remained untouched on Facebook, sparking criticism from Trump's opponents as well as current and former Facebook employees.

Now, Facebook is all but certain to face off with the president the next time he posts something the company deems to be violating its rules.

"The policies we're implementing today are designed to address the reality of the challenges our country is facing and how they're showing up across our community," Zuckerberg wrote on his Facebook page announcing the changes.

Zuckerberg said the social network is taking additional steps to counter election-related misinformation.

In particular, the social network will begin adding new labels to all posts about voting that will direct users to authoritative information from state and local election officials.

Facebook is also banning false claims intended to discourage voting, such as stories about federal agents checking legal status at polling places.

The company also said it is increasing its enforcement capacity to remove false claims about local polling conditions in the 72 hours before the US election.

Ethan Zuckerman, director of the Massachusetts Institute of Technology's Center for Civic Media, said the changes are a "reminder of how powerful Facebook may be in terms of spreading disinformation during the upcoming election".

He said the voting labels will depend on how good Facebook's artificial intelligence is at identifying posts to label.

"If every post that mentions voting links, people will start ignoring those links. If they're targeted to posts that say things like 'Police will be checking warrants and unpaid traffic tickets at polls' a classic voter suppression disinfo tactic and clearly mark posts as disinfo, they might be useful," he said.

But Zuckerman noted that Facebook "has a history of trying hard not to alienate right-leaning users, and given how tightly President Trump has aligned himself with voter-suppressing misinfo, it seems likely that Facebook will err on the side of non-intrusive and ignorable labels, which would minimize impact of the campaign."

Earlier in the day, shares of Facebook and Twitter dropped sharply after consumer-product maker Unilever announced a new ad boycott on Facebook, Twitter and Instagram through at least the end of the year.

The European company said it took the move to protest the amount of hate speech online.

Unilever said the polarised atmosphere in the United States ahead of November's presidential election placed responsibility on brands to act.

In addition to the decline in Facebook shares, Twitter ended the day more than 7 per cent lower.

Unilever, which is based in the Netherlands and Britain, joins a raft of other advertisers pulling back from online platforms.

Facebook in particular has been the target of an escalating movement to withhold advertising dollars to pressure it to do more to prevent racist and violent content from being shared on its platform.

"We have decided that starting now through at least the end of the year, we will not run brand advertising in social media newsfeed platforms Facebook, Instagram and Twitter in the U.S.," Unilever said.

"Continuing to advertise on these platforms at this time would not add value to people and society."

Facebook did not immediately respond to a request for comment. On Thursday, Verizon joined others in the Facebook boycott.

Unilever "has enough influence to persuade other brand advertisers to follow its lead," said eMarketer analyst Nicole Perrin.

She noted that Unilever pulled back spending "for longer, on more platforms (including Twitter) and for more expansive reasons" in particular, by citing problems with "divisiveness" as well as hate speech.

Sarah Personette, vice president of global client solutions at Twitter, said the company's "mission is to serve the public conversation and ensure Twitter is a place where people can make human connections, seek and receive authentic and credible information, and express themselves freely and safely."

She added that Twitter is "respectful of our partners' decisions and will continue to work and communicate closely with them during this time."