World records 1 million new coronavirus cases in just 100 hours

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."

Seoul, Jun 16: North Korea blew up an inter-Korean liaison office on its side of the border on Tuesday, the South's Unification Ministry said, after days of increasingly virulent rhetoric from Pyongyang.

"North Korea blows up Kaesong Liaison Office at 14:49," the ministry, which handles inter-Korean relations, said in a one-line alert sent to reporters.

The statement came minutes after an explosion was heard and smoke seen rising from the long-shuttered joint industrial zone in Kaesong where the liaison office was located, Yonhap news agency reported citing unspecified sources.

Its destruction came after Kim Yo Jong, the powerful sister of North Korean leader Kim Jong Un, said at the weekend: "Before long, a tragic scene of the useless north-south joint liaison office completely collapsed would be seen."

Since early June, North Korea has issued a series of vitriolic condemnations of the South over activists sending anti-Pyongyang leaflets over the border -- something defectors do on a regular basis.

Last week it announced it was severing all official communication links with South Korea.

The leaflets -- usually attached to hot air balloons or floated in bottles -- criticise North Korean leader Kim Jong Un for human rights abuses and his nuclear ambitions.

Analysts say Pyongyang may be seeking to manufacture a crisis to increase pressure on Seoul while nuclear negotiations with Washington are at a standstill.

Earlier Tuesday, North Korea's army said it was "fully ready" to take action against the South, included re-entering areas that had been demilitarised under an inter-Korean agreement.

"North Korea is frustrated that the South has failed to offer an alternative plan to revive the US-North talks, let alone create a right atmosphere for the revival," said Cheong Seong-chang, a director of the Sejong Institute's Center for North Korean Studies.

"It has concluded the South has failed as a mediator in the process."

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.