Iranian Vice President infected with coronavirus, toll rises to 26

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."

Beijing, Feb 9: After making sure everyone's face mask is on and sanitizer is to hand, the Qiao family heads out to Jingshan Park, a former royal sanctuary beside the Forbidden City in China's capital Beijing.

Snow has fallen for a second day, a rare event in the city of 21.5 million that would normally bring hundreds of thousands of people out to take photos and play. But the streets are empty and the parks are so quiet the only sound is of birds chirping.

It's not just Beijing. Shanghai, China's financial hub, and other cities in the world's most populous nation have turned into ghost towns after the government extended a holiday and asked residents not to go out because of the coronavirus.

"We know the situation of the coronavirus is severe. But the epicentre is far away, so we think it should be fine here ... It's a God-given chance to enjoy this family moment with snow and without work," said Mr Qiao, who has an 11-year-old daughter.

The epidemic has killed 722 people and infected nearly 32,000 in China as of February 8. More than three-quarters of the cases are in the central Hubei province where the virus originated - more than 1,000 km (620 miles) from Beijing.

Only a few people are brave enough to come out. A security guard at Jingshan Park said there were less than a third of the number of tourists than usual, even with the rare snowfall.

Even at one of the best spots for snapping photos of snowy Beijing just outside the Forbidden City, there's barely a crowd, while the usual tour buses and groups of people speaking different dialects are nowhere to be seen.

"Last year when it snowed, I took a few hours off work to come down here to take a picture and the crowd was several layers deep," said a man in his 30s who gave his surname as Yang. "But this year, I am not at all worried about finding a space to take a photo. The virus is keeping people indoors."

Security guards along Wangfujing street, a popular pedestrianised shopping area in downtown Beijing, said it was normally so crowded during the holiday period that it was hard to move around.

"Look at it now, there are more security guards and street cleaners than tourists!" said one of the guards.

Businesses, including shops, bars and restaurants, have been severely hit by the epidemic as the government has banned mass gatherings and even group meals in an effort to curb the spread of the coronavirus.

"You would have to wait outside for a table on a normal day," said a waitress at a restaurant with more than 50 tables. Just five were taken at the peak lunch hour.

Only a handful of the more than 100 restaurants along Beijing's famous food street, Guijie, were open, and the remaining outlets were wondering how long they can hold out.

Washington, Apr 8: President Donald Trump has threatened to put a "very powerful" hold on US' funding to the World Health Organization, accusing the UN agency of being "very China centric" and criticising it for having "missed the call" in its response to the coronavirus pandemic.

Trump slammed the global health agency for its early guidance aimed at countering the international spread of the coronavirus.

"We're going to put a hold on money spent to the WHO. We're going to put a very powerful hold on it and we're going to see. It's a great thing if it works. But when they call every shot wrong, that's no good," Trump told reporters at his daily White House news conference on Tuesday.

The Geneva-headquartered World Health Organization (WHO), receives vast amounts of money from the United States.

"We pay for a majority or the biggest portion of their money. They actually criticized and disagreed with my travel ban at the time I did it. They were wrong. They've been wrong about a lot of things. They had a lot of information early and they didn't want to - they're very - they seem to be very China centric," Trump said.

The president said his administration was going to look into the US funding to the WHO.

"We give a majority of the money that they get, and it's much more than the USD 58 million. USD 58 million is a small portion of what they've got over the years. Sometimes they get much more than that. Sometimes it's for programs that they're doing, and-it's much bigger numbers. If the programmes are good, that's great as far as we're concerned," he said.

"But we want to look into it, WHO, because they called it wrong. They (WHO) called it wrong. They missed the call. They could've called it months earlier. They would have known and they should have known and they probably did know. So, we'll be looking into that very carefully, and we're going to put a hold on money spent to the WHO," Trump said.

Meanwhile, Senator Jim Risch, chairman of Senate Foreign Relations Committee, called for an independent investigation into the WHO's handling of the COVID-19 response.

"The WHO has failed not only the American people, it has failed the world with its flagrant mishandling of the response to COVID-19," said Risch.

WHO Director general Tedros Adhanom Ghebreyesus' apparent unwillingness to hold the Chinese Communist Party to even the minimum standard of global health and transparency hindered the world's ability to blunt the spread of this pandemic, he said.

"It is completely unacceptable that the world's global health organization has become a political puppet of the Chinese government," he alleged, adding that "an independent investigation into the WHO's handling of the COVID-19 response is imperative."

The United States is the largest contributor to the WHO.

"Our valuable tax payer dollars should go towards investments to prevent the spread of disease, not to aid and abet cover-ups that cost lives and isolate portions of the world's population on political grounds, as has been the case with Taiwan," Senator Risch said.

A bipartisan group of nearly two dozen lawmakers announced Tuesday to introduce a resolution to defund the WHO until Ghebreyesus resigns and an international commission investigates the organisation's role in covering up the Chinese Communist Party's failed COVID-19 response.

"The WHO helped the Chinese Communist Party hide the threat of COVID-19 from the world and now more than 10,000 Americans are dead, a number that is expected to rise dramatically in the coming weeks," Congressman Guy Reschenthaler alleged.

"The United States is the largest contributor to WHO. It is not right that Americans' hard-earned tax dollars are being used to propagate China's lies and hide information that could have saved lives. This bill will hold the WHO accountable for their negligence and deceit," he asserted.

The United States' intelligence community has reported that the Chinese government hid the threat of COVID-19 and, as a result, made it difficult for the rest of the world to respond early, appropriately and aggressively, said Congressman Fred Keller.

"For reasons beyond understanding, the WHO acted as a silent partner in this effort instead of protecting the lives of millions across the world, including hundreds of thousands of American citizens. Our hard-earned tax dollars should not go to a global organization more concerned with not offending the Chinese government than providing accurate information and protecting innocent lives," Keller said.

Senator Marco Rubio accused the Chinese Communist Party of using WHO "to mislead the world."

"The organisation's leadership is either complicit or dangerously incompetent. I will work with the Trump Administration to ensure that WHO is independent and has not been compromised by the CCP before we continue our current funding, he added.

According to Johns Hopkins University, there are over 1.43 million confirmed coronavirus cases across the world and over 82,000 people have died due to the disease. The US has nearly 400,000 infections, the highest in the world.