Odds favour Thunberg for Peace Prize; experts sceptical

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."

May 18: Risk managers expect a prolonged global recession as a result of the coronavirus pandemic, a report by the World Economic Forum showed on Tuesday.

Two-thirds of the 347 respondents to the survey - carried out in response to the outbreak - put a lengthy contraction in the global economy top of their list of concerns for the next 18 months.

Half of risk managers expected bankruptcies and industry consolidation, the failure of industries to recover and high levels of unemployment, particularly among the young.

“The crisis has devastated lives and livelihoods. It has triggered an economic crisis with far-reaching implications and revealed the inadequacies of the past," said Saadia Zahidi, managing director of the World Economic Forum.

Environmental goals risk being discarded as a result of the pandemic, the report said, but governments should try to carve out a "green recovery".

"We now have a unique opportunity to use this crisis to do things differently and build back better economies that are more sustainable, resilient and inclusive," Zahidi said.

The report was compiled by the World Economic Forum’s Global Risks Advisory Board together with Marsh & McLennan Companies Inc and Zurich Insurance Group.

Risk managers were surveyed between April 1 and 13.

Washington, Mar 26: Indian-American hoteliers have come forward to rescue the stranded Indian students in the US following implementation of lockdown measures in the country in response to the rapidly-spreading coronavirus pandemic, offering them free accommodation and free meals.

With the students scrambling for a roof over their heads after being asked to vacate their hostels and India banning international flights for a week from March 22 due to the coronavirus pandemic, more than 6,000 rooms in nearly 700 hotels were offered to them by Wednesday following a call from the Indian Embassy.

The Indian Embassy have been running a round-the-clock helpline since last week for the students in the US, who number over 2,50,000.

Most of these hotels offered are in and around universities and colleges, but the hotel owners from across the country have come up in large numbers to the call given by community leaders, who have roped in Asian American Hotel Owners Association (AAHOA) for the purpose.

India's Ambassador to the US Taranjit Singh Sandhu said in a tweet, "It is heartening to see that Indian; Indian-American and other hotel owners are coming forward to help people with accommodation in these testing times. Together we can overcome the fight against COVID19!"

"The Indian community has come together to help the student and many hotel owners have offered their rooms free of cost to them. Many of them are also offering free meals to these students," Chicago-based community leader Nirav Patel told PTI.

Indian-American hotelier couple K K Mehta and Chandra Mehta have offered more than 100 rooms to Indian students at their two prime properties each near the Times Square and Barclays Center in New York City, said Jaipur Foot USA chairman Prem Bhandari on behalf of the hotels.

The Indian Consulate in New York had contacted them about this 10 days ago, he said.

"These students are the future of both India and the United States. All the top Indian-American CEOs, scientists and doctors came to this country as a student. It's our moral duty to help them with our resources," Bhandari said.

Regional director of AAHOA Upper Midwest Kalpesh Joshi said they had created a master list of the availability hotel rooms, which was being constantly updated.

Free accommodation would be allocated in coordination with the Indian Embassy and its consulates, he said.

"The Indian Embassy and its consulates are working tirelessly to get these students rooms," he added.

Joshi has also sent out a video message to his hotelier colleagues: "Because of the coronavirus outbreak, our Indian students in the US are out of shelter. Let's work together. As a hotelier, I would like to request all my hotelier friends to come forward... let's provide some rooms to the students."

Boston-based Computer Society of India (North America) has collaborated with AAHOA to help students and Indian IT professionals searching for emergency accommodation due to the COVID-19 lockdown.

Anyone who is having financial hardship will be given hotel accommodation either free of cost or the rates will not be more than USD 50, said the Computer Society of India (North America).

Minesh Patel, the chairman of Virginia Asian American Store Association, said between Richmond, Norfolk, and Virginia Beach, Indian-American hotel owners can help in arranging accommodation for over 500 Indian students.

Florida-based Vipul Patel, the national president of Asian American Store Owners Association, said support for the Indian students have been pouring in from the Indian-American hoteliers.

"I have not come across any hotel owner who said no to us," Patel said.

Rooms would be allocated to students on the recommendation of the Indian Embassy and its consulates in Houston, Chicago, Atlanta, San Francisco and New York.

The Indian Consulate in New York was the first to take a lead in this regard. It has worked with Hammock Worldwide Hotels and Resorts to provide temporary accommodation for the students at a flat rate of USD 50 per night.

Joshi said that initially there was a suggestion to charge a convenience fee of USD 20-25 per day from the students.

"But when a few of them offered free rooms and free meals, everyone agreed to it," he said.

According to Johns Hopkins University coronavirus tracker, the number of deaths caused by the novel coronavirus in the US rose to 1,031 with 68,572 confirmed cases. The US has the third highest number of confirmed cases behind China and Italy.