Pak says espionage charges against its official 'false'

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."

Washington, Jun 2: US President Donald Trump said that peaceful protests following the death of African-American man George Floyd in police custody were derailed by acts of domestic terrorism.

"These are not acts of peaceful protests, these are acts of domestic terror - the destruction of innocent life, and the spilling of innocent blood is an offence to humanity and a crime against God," Trump said during a press briefing on Monday.

Trump also added that the chaos is the work of professional agitators and provocateurs - anarchists and the far-left movement Antifa, among others - and put them on notice, vowing to enforce law and order.

He further said, "Those who threaten innocent life and property will be arrested, detained and prosecuted to the fullest extent of the law. I want the organizers of this terror to be on notice that you will face severe criminal penalties and lengthy sentences in jail. This includes Antifa and others who are leading instigators."

The US president also that he is invoking an 1807 law to mobilize the military around the country to "quickly solve the problem."

"I am also taking swift and decisive action to protect our capital Washington DC. As we speak, I am dispatching thousands and thousands of heavily armed soldier, military personnel and enforcement officers to stop the rioting," Trump said during a press briefing.

"I am mobilizing all available federal resources, civilian and military, to stop the rioting and looting, to end the destruction and arson. And to protect the rights of law-abiding Americans, including your Second Amendment rights," he added.

Trump said mayors and governors must establish an "overwhelming law enforcement presence until the violence has been quelled." If the city or state refuses to take the actions, Trump said he would deploy the US military.

Trump on Monday also said that all Americans are rightly 'sickened by the brutal death' of George Floyd and his administration is fully committed to providing justice to George and his family.

"All Americans were rightly sickened and revolted by the brutal death of George Floyd. My administration is fully committed, the justice will be fully served for George and his family and He will not have died in vain," Trump said.

"My first and highest duty as president is to defend and protect the great country and the American people. I have sworn an oath to uphold the laws of our nation and that is exactly what I will do," he added.

After the media address, Trump made a surprise visit to the damaged St Johns church near White House, walking through park violently cleared of protesters. He walked to the church across the street from the White House after tear gas was fired at protesters in the area.