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Washington, Jul 14: The United States has the biggest Covid-19 testing programme in the world, better than big countries like Russia, China, India and Brazil, President Donald Trump said on Monday, asserting that America has "just about the lowest mortality rate" due to the disease in the world.

"We have one of the lowest mortality rates anywhere," Trump said at a White House roundtable. More than 34 lakh Americans have tested positive for Covid-19 so far and over 1,37,000 have died due to the disease, both of which are the largest numbers among all the countries.

The huge number of positive cases, the president said, is due to the massive testing efforts undertaken by his administration, more extensive than any other country.

"We test more than anybody by far. And when you test, you create cases. So we have created cases. I can tell you that some countries, they test when somebody walks into a hospital sick or walks into maybe a doctor's office, but usually a hospital. That is the testing they do, so they do not have cases, whereas we have all these cases. So, it is a double-edged sword," he said.

At the same time, the United States has the lowest mortality rate or just about the lowest mortality rate due to the disease in the world, Trump added. "We are doing a great job. We are doing very well with vaccines and we are doing very, very well with therapeutics. I think we are going to have some very good information coming out soon," he said in response to a question.

"But we have the best and certainly, by far, the biggest testing programme anywhere in the world. If you tested China or Russia or any of the larger countries, if you just tested India, as an example, the way we test, you would see numbers that would be very surprising. Brazil too. You know, Brazil is going through a big problem, but they do not do testing like we do," Trump said.

"So we do the testing and by doing the testing, we have tremendous numbers of cases. As an example, we have done 45 million tests. If we did half that number, you would have half the cases probably -- around that number. If we did another half of that, you would have half the numbers. Everyone would be saying, 'Oh, we are doing so well on cases'," he added.

Responding to a question, Trump said what China did to the world should not be forgotten.

"I think what China has done to the world with what took place -- the China plague -- you can call it the China virus, you can call it whatever you want to call it. It has about 20 different names. What they did to the world should not be forgotten," he said.

The trade deal with China that was signed early this year remains intact, the president said. "It is intact, they (China) are buying. Whether they buy or not, that is up to them. They are buying," he said.

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."

Naypyitaw, Jul 2: A landslide at a jade mine in northern Myanmar has killed at least 113 people, officials say, warning the death toll is likely to rise further.

The incident took place early on Thursday in the jade-rich Hpakant area of Kachin state after a bout of heavy rainfall, the Myanmar Fire Services Department said on Facebook.

"The jade miners were smothered by a wave of mud," the statement said. "A total of 113 bodies have been found so far," it added, raising the death toll from at least 50.

Photos posted on the Facebook page showed a search and rescue team wading through a valley apparently flooded by the mudslide.

'No one could help them'

Maung Khaing, a 38-year-old miner from the area, said he saw a towering pile of waste that looked on the verge of collapse and was about to take a picture when people began shouting "run, run!"

"Within a minute, all the people at the bottom [of the hill] just disappeared," he told Reuters news agency by phone.

"I feel empty in my heart. I still have goosebumps ... There were people stuck in the mud shouting for help, but no one could help them."

Tar Lin Maung, a local official with the information ministry, said authorities had recovered more than 100 bodies.

"Other bodies are in the mud. The numbers are going to rise," he told Reuters.

Fatal landslides are common in the poorly regulated mines of Hpakant, the victims often from impoverished communities who risk their lives hunting the translucent green gemstone.

The government of Myanmar leader Aung San Suu Kyi pledged to clean up the industry when it took power in 2016, but activists say little has changed.

Official sales of jade in Myanmar were worth $750.4m in 2016-2017, according to data published by the government as part of the Extractive Industries Transparency Initiative.

But experts believe the true value of the industry, which mainly exports to China, is much larger.

Northern Myanmar's abundant natural resources - including jade, timber, gold and amber - have also helped finance both sides of a decades-long conflict between ethnic Kachin and the military.

The fight to control the mines and the revenues they bring frequently traps local civilians in the middle.