Obama approves reservists for Ebola fight, government under fire

October 17, 2014

Washington, Oct 17: President Barack Obama authorized calling up military reservists for the US fight against Ebola in west Africa on Thursday, as lawmakers criticized his administration's efforts to contain the disease at home.

ObamaObama's move came after lawmakers held a congressional hearing to probe the federal response to the virus. Amid criticism of perceived missteps by the administration, many House of Representatives members joined calls for a ban on travel from the hardest-hit West African countries: Liberia, Sierra Leone and Guinea.

Obama signed the executive order authorizing the use of US military reservists to support humanitarian aid efforts in those countries, highlighting the need to launch an all-out attack against the disease. The order did not specify how many personnel would be involved.

A congressional hearing on Thursday came as concerns about the virus in the United States intensified after two Texas nurses who cared for Liberian patient Thomas Eric Duncan contracted the virus.

After the hearing, the White House said Obama met with top administration officials handling the government's response to Ebola.

News that one of the nurses, Amber Vinson, traveled aboard a commercial airliner while running a slight fever ratcheted up public health concerns on Wednesday, prompting several schools in Ohio and Texas to close because people with ties to the schools shared the flight with Vinson.

The US National Institutes of Health (NIH) said it would take over the care of the first Texas nurse diagnosed with Ebola, Nina Pham, who contracted the virus while caring for Duncan, who later died.

Lawmakers focused questions and pointed criticism at the hearing on Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

"The administration did not act fast enough in responding in Texas," Democratic Representative Bruce Braley of Iowa told the hearing. "We need to look at all the options available to keep our families safe and move quickly and responsibly to make any necessary changes at airports."

Several Republicans said flights from west Africa, where the virus is widespread, should be stopped.

Ebola has killed nearly 4,500 people in West Africa, predominantly in Sierra Leone, Liberia and Guinea, since March. On Thursday, Sierra Leone's government said the virus had spread to the last healthy district in the country, killing at least two people.

The virus is spread through direct contact with bodily fluids from an infected person showing symptoms of Ebola.

Frieden argued, as he has before, that closing US borders would not work and would leave the country less able to track people with Ebola entering. Moreover, cutting flights to Africa would hit the US ability to stop the virus at its source, he said.

His comments came before it was announced that Obama had sent a letter to leaders of Congress saying an unspecified number of reservists would be used to help active-duty personnel in support of the US Ebola mission in West Africa. The vast majority of engineers, transport units, civil affairs personnel, military police and medical units are in the reserves or National Guard.

Frieden told the hearing, "I will tell you, as director of the CDC, one of the things I fear about Ebola is that it could spread more widely in Africa. If that were to happen, it could become a threat to our health system and the healthcare we give for a long time to come."

Frieden said he has spoken to the White House about the issue of dealing with people traveling with Ebola. Asked if the White House had ruled out a travel ban, the CDC chief did not answer directly, saying, "I can't speak for the White House."

However, Federal Aviation Administration chief Michael Huerta told reporters separately that the government was assessing whether to issue a travel ban "on a day-to-day basis."

Jamaica, meanwhile, imposed an immediate travel ban on Liberia, Guinea and Sierra Leone, the Caribbean island's government announced. Jamaica said the ban would apply to people traveling directly or indirectly, from or through those countries.

The South American country of Guyana said it had denied entry to citizens of those countries, as well as Nigeria, for the past five weeks.

Sick nurses leaving Texas

Pham, 26, was to be transferred late on Thursday from Dallas to an isolation unit at the NIH in Bethesda, Maryland outside Washington for treatment, the agency's director, Dr. Anthony Fauci, told lawmakers at Thursday's hearing.

"We will be supplying her with state-of-the-art care in our high-level containment facilities," said Fauci.

Dr. Daniel Varga, chief clinical officer and senior vice president of Texas Health Resources, which owns the hospital, told the hearing that mistakes were made in diagnosing Duncan and in giving inaccurate information to the public, and said he was "deeply sorry."

He also said there had been no Ebola training for staff before Duncan was admitted.

"It would be an understatement to say that the response to the first US-based patient with Ebola has been mismanaged, causing risk to scores of additional people," said Representative Diana DeGette, the top Democrat on the subcommittee holding Thursday's hearing.

At least two lawmakers have called for Frieden's resignation. Others, including Republican House Speaker John Boehner of Ohio, have joined in urging travel restrictions on the West African countries hardest hit by Ebola. The disease appeared in the United States last month.

Vinson was transferred to Emory University Hospital for treatment on Wednesday night.

In Ohio, where Vinson had visited family members, two schools in the Cleveland suburb of Solon were closed on Thursday because an employee may have traveled on the same plane as Vinson, though on a different flight.

Ohio's health department said the CDC was sending staff to help coordinate efforts to contain the spread of Ebola.

Frontier Airlines said it had placed six crew members on paid leave for 21 days "out of an abundance of caution."

Back in Texas, the Belton school district in central Texas said three schools were closed on Thursday because two students were on the same flight as the nurse.

Frieden has said it was unlikely passengers who flew with Vinson were infected because the nurse had not vomited or bled on the flight, but he said she should not have boarded the plane.

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News Network
April 28,2020

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."

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Agencies
January 4,2020

Tel Aviv, Jan 4: Israeli Prime Minister Benjamin Netanyahu on Friday came out in the support of Trump administration for carrying out the strike near Baghdad's international airport which led to the killing of Iran's elite IRGC Qassem Soleimani, saying that "The US has the right of self-defence."

"Just as Israel has the right of self-defence, the United States has exactly the same right. Qassem Soleimani is responsible for the death of American citizens and many other innocent people. He was planning more such attacks," PM Benjamin Netanyahu wrote on Twitter.

In another tweet, Netanyahu also credited US President Donald Trump for acting decisively in the operation of Iraq that led to the killing of Qassem Soleimani -- a US-designated terrorist, along with six others.

"President Donald Trump deserves all the credit for acting swiftly, forcefully and decisively. Israel stands with the United States in its just struggle for peace, security and self-defence," he added.

Meanwhile, Iran on Friday vowed to take a "vigorous revenge" over the killing of General Qassem Soleimani, the head of Iran's elite IRGC.

The US had accused Soleimani of orchestrating several attacks on coalition bases in Iraq including the December 27 attack in which American and Iraqi personnel were killed. 

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Agencies
July 21,2020

Washington, Jul 21: Democrat Joe Biden urged Muslim Americans on Monday to join him in the fight to defeat President Donald Trump as he addressed an online summit hosted by the advocacy organisation Emgage Action to mobilise Muslim voters ahead of the presidential election.

I want to earn your vote not just because he's not worthy of being president, the presumptive presidential nominee told participants.

I want to work in partnership with you, make sure your voices are included in the decision-making process as we work to rebuild our nation.

Biden also reiterated a pledge to overturn a Trump administration ban on travelers from several predominantly Muslim countries, calling it vile.

Wa'el Alzayat, CEO of Emgage Action, said by email that the organisation was seeking to maximise Muslim American turnout in key battleground states.

In Michigan alone one of the states where the organisation has chapters and where Trump won in 2016 by fewer than 11,000 votes he said he believed there are more than 150,000 registered Muslim voters.

Several prominent Muslim American elected officials endorsed Biden for president in a letter organised by Emgage Action ahead of the summit.

Among those who signed the letter are Minnesota Rep. Ilhan Omar, Minnesota Attorney General Keith Ellison and Indiana Rep. Andre Carson, all Democrats.

Omar, one of the first Muslim women elected to Congress, served as a high-profile surrogate for Bernie Sanders before he exited the presidential race in April making her support for Biden potentially helpful as the former vice president seeks to mobilise Muslim voters this fall.

Muslim American voices matter to our communities, to our country, Biden said.

But we all know that your voice hasn't always gotten recognised or represented.

Emgage Action has titled the event Million Muslim Votes, underscoring its emphasis on boosting Muslim turnout in November.

Joe Biden's presence serves not only to galvanise Muslim Americans to cast their ballots, but to usher in an era of engaging with Muslim American communities under a Biden administration, Alzayat said by email before the summit.

The pro-Biden letter from Muslim American elected officials decried a number of Trump's domestic and international policies, including his administration's travel ban and his pullout from the Iran nuclear deal.

A Biden administration will move the nation forward on many of the issues we care about, the letter said, citing racial justice, affordable health care, climate change and immigration.

The Muslim American officials also praised Biden's agenda for their communities.

Among other goals, Biden has vowed to rescind the travel ban affecting Muslims on Day One if he's elected.

In his address, he pledged to include Muslim American voices in his administration, if elected, and to speak out against human rights abuses against Muslim minorities around the world.

I'll continue to champion the rights of Palestinians and Israelis to have a state of their own as I have for decades, each of them a state of their own, he said.

Other state- and local-level Muslim American officials signing onto the pro-Biden letter hail from several states, including Michigan.

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