Death toll in China’s coronavirus jumps to 425, confirmed cases soar to over 20,000

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, Apr 15: Wearing masks and gloves, South Korean voters cast their ballots on Wednesday to elect 300 parliamentary lawmakers amid the coronavirus outbreak.

Voting kicked off at 6 am (local time) and was to run until 6 pm (local time) at 14,330 polling stations across the country, according to the National Election Commission (NEC). The number of eligible voters is 44 million, according to Yonhap news agency.

The once-in-four-years legislative election is widely seen as a referendum on President Moon Jae-in, whose five-year term will end in mid-2022, as well as a test of the country's fight against COVID-19 under the leadership of Moon, The Strait Times reported.

South Korea has received international praise for its massive testing capability and other innovative measures, such as drive-through testing and high-tech contact tracing.

Experts, therefore, expect the ruling Democratic Party (DP) to extend its lead in Parliament, given that the government's handling of the virus outbreak is viewed positively both at home and abroad, as per The Strait Times.

At least 10,564 people in the country have been infected by coronavirus, which has claimed 222 lives. About 2,800 patients are undergoing treatment.

The number of new cases has fallen from a high of 813 on February 29 to below 50 for six days in a row as an intensive social distancing campaign that started on March 21 remained in place.

Several surveys cited by the newspaper also showed that voters consider the pandemic as the biggest factor in their decision. A recent poll showed that 72.6 per cent of respondents rated the government's response to the outbreak as positive.

The NEC has said that public safety at polling stations will be a priority to prevent any possible spread of the virus.

All 14,330 polling stations and 251 counting stations will be disinfected on polling day, the NEC was quoted.

Voters will undergo temperature screening and those registering temperatures of 37.5 degrees Celsius or higher or display respiratory symptoms will have to exercise their franchise at a separate booth.

Tuesday was the last of 13 days of campaigning, which saw most candidates reducing their ground activities and face-to-face encounters with voters. Instead, the candidates boosted their online presence with videos and social media engagements in a bid to win votes, according to The Strait Times.

In addition, the government has also decided to temporarily lift quarantine rules to permit self-isolators to vote in the elections. Some 50,000 people in self-isolation who have no symptoms and expressed a willingness to vote will be allowed to cast ballots after the regular voting ends in the evening.

London, Jun 4: Meghan, Britain's Duchess of Sussex, has spoken about events following the death of George Floyd saying she was sorry that children had to grow up in a world where racism still existed and that current events in the United States were "devastating".

"I know you know that black lives matter," Meghan said in a video she recorded for students graduating from her old high school in Los Angeles which was aired on Wednesday.

The death of Floyd has become the latest flashpoint for long-simmering rage over police brutality against African Americans and led to nationwide protests, some violent, with curfews imposed in some cities to quell the disorder.

"For the past couple of weeks I've been planning on saying a few words to you for your graduation and as we've all seen over the last week what is happening in our country, and in our state and in our home town of LA is absolutely devastating," said Meghan, whose mother is African American and father is white.

"First thing I want to say to you is that I'm sorry, I'm so sorry that you have to grow up in a world where this is still present," she said in her message to the girls at the Immaculate Heart High School.

The duchess, a former US actress and wife of Queen Elizabeth's grandson Prince Harry, said she wanted to say "the right thing" and was nervous her words would be "picked apart".

"The only wrong thing to say is to say nothing. Because George Floyd's life mattered, and Breonna Taylor's life mattered, and Philando Castile's life mattered and Tamir Rice's life mattered and so did so many other people whose names we know, and whose names we do not know," she said.

Britain's royal family by tradition does not comment on political issues. However, Meghan and Harry stepped down from their official royal roles at the end of March and are now living in Los Angeles with their baby son Archie.

In her message, the 38-year-old reflected on her own memories of the 1992 LA riots.

"Those memories don't go away and I can't imagine that at 17 or 18 years old, which is how old you are now, that you would have to have a different version of that same type of experience," she said.

"That's something you should have an understanding of, but an understanding of as a history lesson not as your reality. So I'm sorry that in a way we have not gotten the world to the place you deserve it to be."