Dramatic reduction in H-1B filings by Indian companies, reports US daily

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."

Wellington, Jun 8: New Zealand lifted all domestic coronavirus restrictions on Monday after its final COVID-19 patient was given the all clear, with Prime Minister Jacinda Ardern revealing she danced around her living room when told about the milestone.

While strict border controls will remain in place, Ardern said restrictions such as social distancing and limits on public gatherings were no longer needed.

"We are confident we have eliminated transmission of the virus in New Zealand for now," she said in a televised address, saying Kiwis had "united in unprecedented ways to crush the virus".

The South Pacific nation, with a population of five million, has had 1,154 confirmed COVID-19 cases and 22 deaths.

There have been no new infections for 17 days and, until Monday, just one active case for more than a week.

Details of the final patient were not released for privacy reasons but it is believed to be a woman aged in her 50s who was linked to a cluster at an Auckland nursing home.

Ardern said the sacrifices made by New Zealanders, including a drastic seven-week lockdown that helped curb infection rates, had been rewarded now that there were no active cases in the country.

Asked about her reaction upon hearing the news, she replied: "I did a little dance" with baby daughter Neve.

"She was caught a little by surprise but she joined in, having absolutely no idea why I was dancing around the lounge."

New Zealand's move down to Level 1, the lowest rating on its four-tier virus response system, means nightclubs can operate without dance floor restrictions and theatres will reopen.

It also means sporting events can proceed with crowds in the stands, a change New Zealand Rugby (NZR) said offered its Super Rugby Aotearoa competition the opportunity to achieve a world first when it kicks off this weekend.

"We're incredibly proud, and grateful, to be the first professional sports competition in the world to be in a position to have our teams play in front of their fans again," NZR chief executive Mark Robinson said.

While many other sporting competitions around the globe have announced plans to restart, the vast majority will be played either with no crowds or with numbers severely restricted.

On a broader level, Ardern said easing restrictions would help New Zealand's economy.

"We now have a head start on economic recovery because at level one we become one of the most open, if not the most open, economies in the world," she said.

The prime minister said modelling showed the economy would operate at just 3.8 percent below normal at Level 1, compared with a 37 percent impairment at Level 4 lockdown.

Washington, Jun 12: US President Donald Trump is considering suspending a number of employment visas including the H-1B, most sought-after among Indian IT professionals, in view of the massive unemployment in America due to the coronavirus pandemic, according to a media report.

The proposed suspension could extend into the government’s new fiscal year beginning October 1, when many new visas are issued, The Wall Street Journal reported on Thursday, quoting unnamed administration officials.

“That could bar any new H-1B holder outside the country from coming to work until the suspension is lifted, though visa holders already in the country are unlikely to be affected,” the daily reported.

H-1B is the most coveted foreign work visas for technology professionals from India.

Such a decision by the Trump administration is likely to have an adverse impact on thousands of Indian IT professionals. Already a large number of Indians on the H-1B visas have lost their jobs and are headed back home during the coronavirus pandemic.

The White House, however, said that no final decision has been made and the administration is considering various proposals.

“The administration is currently evaluating a wide range of options, formulated by career experts, to protect American workers and job seekers especially disadvantaged and underserved citizens — but no decisions of any kind have been made,” White House spokesman Hogan Gidley said in a statement.

In addition to the H-1B visas, the suspension could apply to the H-2B visa for short-term seasonal workers, the J-1 visa for short-term workers including camp counselors and au pairs and the L-1 visa for internal company transfers, the financial daily reported.

Meanwhile, the US Chambers of Commerce CEO Thomas Donohue on Thursday wrote a letter to Trump, expressing concern over his reported move on temporary work visas.

“As the economy rebounds, American businesses will need assurances that they can meet all their workforce needs. To that end, it is crucial that they have access to talent both domestically and from around the world,” Donohue wrote in a letter to Trump.

According to The Hill newspaper, Donohue said that American businesses need L-1 visa holders, who have a work visa valid for a relatively short amount of time, for necessary expertise.

He noted the importance of H-1B visa holders, who have a work visa valid for multiple years, for various industries, including technology, accounting and manufacturers, the newspaper said.

“Policies that would, for example, impose wide-ranging bans on the entry of nonimmigrant workers or impose burdensome new regulatory requirements on businesses that employ foreign nationals would undermine that access to talent and in the process, undercut our economy’s ability to grow and create jobs,” Donohue added.