Quake sows panic in Papua New Guinea, tsunami threat passes

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, Jan 9: The U.S. and Iran stepped back from the brink of possible war Wednesday as President Donald Trump signaled he would not retaliate militarily for Iran's missile strikes on Iraqi bases housing U.S. troops. No one was harmed in the strikes, but U.S. forces in the region remained on high alert.

Speaking from the White House, Trump seemed intent on deescalating the crisis, which spiralled after he authorized the assassination of Iran's top general, Qassem Soleimani. Iran responded overnight by firing more than a dozen missiles at two installations in Iraq, its most direct assault on America since the 1979 seizure of the U.S. Embassy in Tehran.

Trump's takeaway was that “Iran appears to be standing down, which is a good thing for all parties concerned and a very good thing for the world.”

The region remained on edge, however, and American troops including a quick-reaction force dispatched over the weekend were on high alert. Hours after Trump spoke, an ‘incoming’ siren went off in Baghdad's Green Zone after what seemed to be small rockets “impacted” the diplomatic area, a Western official said. There were no reports of casualties.

Iran's Supreme Leader Ayatollah Ali Khamenei said the overnight strike was not necessarily the totality of Iran's response. “Last night they received a slap,” Khamenei said. “These military actions are not sufficient (for revenge). What is important is that the corrupt presence of America in this region comes to an end.”

The strikes had pushed Tehran and Washington perilously close to all-out conflict and left the world waiting to see whether the American president would respond with more military force. Trump, in his nine-minute, televised address, spoke of a robust U.S. military with missiles that are “big, powerful, accurate, lethal and fast.'' But then he added: “We do not want to use it."

Iran for days had been promising to respond forcefully to Soleimani's killing, but its limited strike on two bases--one in the northern Iraqi city of Irbil and the other at Ain al-Asad in western Iraq--appeared to signal that it too was uninterested in a wider clash with the U.S. Foreign minister Mohammad Javad Zarif tweeted that the country had “concluded proportionate measures in self-defence.”

Trump said the U.S. was “ready to embrace peace with all who seek it.” That marked a sharp change in tone from his warning a day earlier that “if Iran does anything that they shouldn't be doing, they're going to be suffering the consequences, and very strongly.”

Trump opened his remarks at the White House by reiterating his promise that “Iran will never be allowed to have a nuclear weapon.” Iran had announced in the wake of Soleimani's killing that it would no longer comply with any of the limits on uranium enrichment in the 2015 nuclear deal crafted to keep it from building a nuclear device.

The president, who had earlier pulled the U.S. out of the deal, seized on the moment of calm to call for negotiations toward a new agreement that would do more to limit Iran's ballistic missile programmes and constrain regional proxy campaigns like those led by Soleimani.

Trump spoke of new sanctions on Iran, but it was not immediately clear what those would be.

Washington, Jul 15: The Trump administration has agreed to rescind its July 6 rule, which temporarily barred international students from staying in the United States unless they attend at least one in-person course, a federal district court judge said on Tuesday.

The U-turn by the Trump administration comes following a nationwide outrage against its July 6 order and a series of lawsuits filed by a large number of educational institutions, led by the prestigious Harvard University and Massachusetts Institute of Technology (MIT), seeking a permanent injunctive relief to bar the Department of Homeland Security (DHS) and the US Immigration and Customs Enforcement (ICE) from enforcing the federal guidelines barring international students attending colleges and universities offering only online courses from staying in the country.

As many as 17 US states and the District of Columbia, along with top American IT companies such as Google, Facebook and Microsoft, joined MIT and Harvard in the US District Court in Massachusetts against the DHS and the ICE in seeking an injunction to stop the entire rule from going into effect.

"I have been informed by the parties that they have come to a resolution. They will return to the status quo," Judge Allison Burroughs, the federal district judge in Boston, said in a surprise statement at the top of the hearing on the lawsuit.

The announcement comes as a big relief to international students, including those from India. In the 2018-2019 academic year, there were over 10 lakh international students in the US. According to a recent report of the Student and Exchange Visitor Program (SEVP), 1,94,556 Indian students were enrolled in various academic institutions in the US in January.

Judge Burroughs said the policy would apply nationwide.

"Both the policy directive and the frequently asked questions would not be enforced anyplace," she said, referring to the agreement between the US government and MIT and Harvard.

Congressman Brad Scneider said this is a great win for international students, colleges and common sense.

"The Administration needs to give us a plan to tackle our public health crisis - it can't be recklessly creating rules one day and rescinding them the next," he said in a tweet.

Last week, more than 136 Congressmen and 30 senators wrote to the Trump administration to rescind its order on international students.

"This is a major victory for the students, organisers and institutions of higher education in the #MA7 and all across the country that stood up and fought back against this racist and xenophobic rule," said Congresswoman Ayanna Pressley.

"Taking online classes shouldn't force international students out of our country," Congressman Mikie Sherrill said in a tweet.

In its July 6 notice, the ICE had said all student visa holders, whose university curricula were only offered online, "must depart the country or take other measures, such as transferring to a school with in-person instruction to remain in lawful status".

"If not, they may face immigration consequences, including but not limited to the initiation of removal proceedings," it had said.

In their lawsuit, the 17 states and the District of Columbia said for many international students, remote learning in the countries and communities they come from would impede their studies or be simply impossible.

The lawsuit alleged that the new rule imposes a significant economic harm by precluding thousands of international students from coming to and residing in the US and finding employment in fields such as science, technology, biotechnology, healthcare, business and finance, and education, and contributing to the overall economy.

In a separate filing, companies like Google, Facebook and Microsoft, along with the US Chamber of Commerce and other IT advocacy groups, asserted that the July 6 ICE directive will disrupt their recruiting plans, making it impossible to bring on board international students that businesses, including the amici, had planned to hire, and disturb the recruiting process on which the firms have relied on to identify and train their future employees.

The July 6 directive will make it impossible for a large number of international students to participate in the CPT and OPT programmes. The US will "nonsensically be sending...these graduates away to work for our global competitors and compete against us...instead of capitalising on the investment in their education here in the US", they said.