As US reopens, COVID-19 cases hit new high; Trump administration downplays

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 9: The defacement of Mahatma Gandhi's statue by unknown miscreants was a "disgrace", US President Donald Trump has said, days after it was vandalised with graffiti and spray painting during the nationwide protests against the custodial killing of African-American George Floyd.

The statue, which is across the road from the Indian Embassy, was vandalised on the intervening night of June 2 and 3, prompting the Indian embassy to register a complaint with the local law enforcement agencies.

The incident happened during the week of nationwide protests against the custodial killing of Floyd in Minneapolis on May 25.

"It was a disgrace," Trump made the brief comment at the White House on Monday when asked about the incident.

The Indian Embassy here has taken up the matter with the US Department of State for early investigation into the matter, as also with the Metropolitan Police and National Park Service.

It is working with the US Department of State, Metropolitan Police and National Park Service for expeditious restoration of the statue at the park.

The US president and First Lady Melania Trump, during their visit to India in February, had spent considerable time at the Gandhi Ashram in Ahmedabad. Prime Minister Narendra Modi had personally given them a tour of the historic place.

"The First Lady and I have just had a pleasure of visiting Mahatma Gandhi's Ashram, a few miles from here, where he launched the famous Salt March," Trump had said during his address at the Namaste Trump rally at the Motera Stadium in Ahmedabad on February 24. A day later, Trump and the first lady also laid a wreath at Raj Ghat in New Delhi.

Pictures of Trump and the first lady with Gandhi's spinning wheel during their visit to the Sabarmati Ashram in Ahmedabad are seen hanging on the walls of the White House.

Last week, top US lawmakers and the Trump Campaign condemned the vandalisation of the statue.

"Very disappointing," tweeted Kimberly Guilfoyle, advisor to Donald J Trump for President Inc. and National Chair of the Trump Victory Finance Committees.

North Carolina Senator Tom Tillis said, "It's disgraceful to see the defacing of the Gandhi statue" in Washington DC.

"Gandhi was a pioneer of peaceful protesting, demonstrating the great change it can bring. Rioting, looting and vandalising do not bring us together, he said.

Senator Marco Rubio said, "more evidence that violent radicals and run of the mill crazies have hijacked legitimate protests to create anarchy or for their own purposes."

Protests against the custodial killing of Floyd turned violent in the US and prestigious monuments were damaged. In Washington DC, protestors burnt a historic church and damaged monuments like the Lincoln Memorial.

US Ambassador to India Ken Juster apologised for the incident.

"So sorry to see the desecration of the Gandhi statue in Wash, DC. Please accept our sincere apologies," he said.

"Appalled as well by the horrific death of George Floyd and the awful violence and vandalism. We stand against prejudice & discrimination of any type. We will recover and be better," he said in a tweet last week.

One of the few statues of a foreign leader on a federal land in Washington DC, the statue of Gandhi was dedicated by former prime minister Atal Bihari Vajpayee in the presence of the then US president Bill Clinton on September 16, 2000, during his state visit to the US.

Jul 1: Hong Kong police moved swiftly on Wednesday against protesters gearing up for the first rally since the introduction of sweeping security legislation, making their first arrest under it and warning of punishment for pro-independence material.

Beijing on Tuesday unveiled the details of the much-anticipated law after weeks of uncertainty, pushing China's freest city and one of the world's most glittering financial hubs onto a more authoritarian path.

As hundreds of protesters gathered downtown for an annual rally marking the 23rd anniversary of the former British colony's handover to China, riot police used pepper spray to arrest at least two people, while one metro station closed.

Police, who earlier banned the rally, cited the law for the first time in confronting protesters and they also made their first arrest under it - a man holding a flag advocating independence.

"You are displaying flags or banners/chanting slogans/or conducting yourselves with an intent such as secession or subversion, which may constitute offences under the ... national security law," police said in a message displayed on a purple banner.

The law will punish crimes of secession, subversion, terrorism and collusion with foreign forces with up to life in prison, heralding a more authoritarian era for the Asian financial hub.

China's parliament adopted it in response to months of pro-democracy protests last year triggered by fears that Beijing was stifling the city's freedoms, guaranteed by a "one country, two systems" formula agreed when it returned to Chinese rule.

Authorities in Beijing and Hong Kong have repeatedly said the legislation is aimed at a few "troublemakers" and will not affect rights and freedoms, nor investor interests.

But critics fear it will crush the freedoms that are seen as key to Hong Kong's success as a financial centre.

"With the release of the full detail of the law, it should be clear to those in any doubt that this is not the Hong Kong they grew up in," said Hasnain Malik, head of equity research, Tellimer in Dubai.

"The difference is that U.S. and China relations are far worse and this could be used as a pretext to impede the role of Hong Kong as a finance hub."

In Beijing, Zhang Xiaoming, executive deputy director of Beijing's Hong Kong and Macau Affairs Office, told reporters suspects arrested by Beijing's new security office in Hong Kong could be tried on the mainland.

He said the mainland's national security office abided by Chinese law and that Hong Kong's legal system could not be expected to implement the laws of the mainland. Article 55 of the law states that Beijing's national security office in Hong Kong could exercise jurisdiction over "complex" or "serious" cases.

Mainland security agencies will also be based in Hong Kong officially for the first time, with powers that go beyond city laws.

"The law is a birthday gift to (Hong Kong) and will show its precious value in the future," Zhang said, adding the law would not be applied retroactively.

On July 1 last year, hundreds of protesters stormed and vandalised the city's legislature to protest against a now-scrapped bill that would have allowed extraditions to mainland China.

Those protests evolved into calls for greater democracy, paralysing parts of the city and paving the way for Beijing's imposition of the law this week.

'INEVITABLE'

Speaking at a flag-raising ceremony to mark the handover anniversary, the city's Beijing-backed leader, Carrie Lam, said the law was the most important development since the city's return to Chinese rule.

"It is also an inevitable and prompt decision to restore stability," Lam said at the same harbour-front venue where 23 years ago the last colonial governor, Chris Patten, a staunch critic of the security law, tearfully handed back Hong Kong to Chinese rule.

Some pro-Beijing officials and political commentators say the law is aimed at sealing Hong Kong's "second return" to the motherland after the first failed to bring residents to heel.

Luo Huining, the head of Beijing's top representative office in Hong Kong, said at the ceremony the law was a "common aspiration" of Hong Kong citizens.

Critics denounced the lack of transparency surrounding the details of the legislation until it was unveiled. It came into force at 11 p.m. (1500 GMT) on Tuesday.

Some pro-democracy activists gave up membership of their groups just before the law came into force, though calling for the campaign for democracy to go on offshore.

"I saw this morning there are celebrations for Hong Kong's handover, but to me it is a funeral, a funeral for 'one country two systems'," said democracy lawmaker Kwok Ka-ki.