Will have to take military way if India doesn't listen, warns China

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."

Washington, Jun 1: As protesters gathered outside the White House on Friday night in Washington DC, US President Donald Trump was briefly taken to the White House underground bunker, The New York Times reported citing a person having firsthand knowledge about the incident.

Trump was there for less than an hour before being brought upstairs. After hundreds of people surged towards the White House on Friday, Secret Service and the United States Park Police officers sought to block them.

Trump's team was surprised by the protests that were witnessed outside the White House on Friday night, according to the US daily. It is, however, unclear if Melania Trump and Barron Trump were also taken down with him.

in response to the continuing protests against the death of African-American man George Floyd in police custody.

National Guard members have been activated in 15 states and Washington, DC with another 2,000 prepared to activate if needed.

Demonstrators across the United States have been protesting since May 25, when George Floyd, a 46-year-old African-American man, died under the police custody in the city of Minneapolis.

Moscow, May 19: Russia confirmed 9,263 new coronavirus infections Tuesday, bringing the country’s official number of cases to 299,941.

On Sunday, the head of Russia's public health watchdog, Anna Popova, said the growth of new coronavirus cases in Russia is stabilizing.

Russia is the second most-affected country in terms of infections.

A record 115 people have died over the past 24 hours, bringing the total toll to 2,837 — a rate considerably lower than in many other countries hit hard by the pandemic.

Russia began easing nation-wide lockdown restrictions last week and announced the national football league would restart in late June.

Critics have cast doubt on Russia's low official mortality rate, accusing authorities of under-reporting in order to play down the scale of the crisis.

Russian health officials say one of the reasons the count is lower is that only deaths directly caused by the virus are being included.

Deputy Prime Minister Tatiana Golikova over the weekend denied manipulation of numbers, saying hospitals had a financial interest in identifying infections because they are allocated more money to treat coronavirus patients.

Authorities also say that since the virus came later to Russia, there was more time to prepare hospital beds and launch wide-scale testing to slow the spread.