Virus infections top 600,000 worldwide, long fight ahead

News Network
March 28, 2020

Berlin, Mar 28: The number of confirmed coronavirus infections worldwide topped 600,000 on Saturday as new cases stacked up quickly in Europe and the United States and officials dug in for a long fight against the pandemic.

The latest landmark came only two days after the world passed half a million infections, according to a tally by John Hopkins University, showing that much work remains to be done to slow the spread of the virus. It showed more than 602,000 cases and a total of over 27,000 deaths.

While the U.S. now leads the world in reported infections — with more than 104,000 cases — five countries exceed its roughly 1,700 deaths: Italy, Spain, China, Iran and France.

“We cannot completely prevent infections at this stage, but we can and must in the immediate future achieve fewer new infections per day, a slower spread,” German Chancellor Angela Merkel, who is in quarantine at home after her doctor tested positive for the virus, told her compatriots in an audio message. “That will decide whether our health system can stand up to the virus.”

The virus already has put health systems in Italy, Spain and France under extreme strain. Lockdowns of varying severity have been introduced across Europe. Merkel's chief of staff, Helge Braun, said that Germany — where authorities closed nonessential shops and banned gatherings of more than two in public — won't relax its restrictions before April 20.

As the epicenter has shifted westward, the situation has calmed in China, where some restrictions on people's lives have now been lifted. Six subway lines restored limited service in Wuhan, where the virus first emerged in December, after the city had its official coronavirus risk evaluation downgraded from high to medium on Friday. Five districts of the city of 11 million people had other restrictions on travel loosened after their risk factor was downgraded to low.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. But for others, especially older adults and people with existing health problems, the virus can cause more severe illness, including pneumonia, and lead to death.

More than 130,000 people have recovered, according to Johns Hopkins' tally.

In one way or another, the effects of the COVID-19 outbreak have been felt by the powerful and the poor alike.

On Friday, British Prime Minister Boris Johnson became the first leader of a major country to test positive for the virus. He said he would continue to work from self-quarantine.

Countries are still scrambling bring home some citizens stranded abroad by border closures and a near-shutdown of flights. On Saturday, 174 foreign tourists and four Nepali nationals on the foothills of Mount Everest were flown out days after being stranded on the only airstrip serving the world's highest mountain.

In neighboring India, authorities sent a fleet of buses to the outskirts of the capital to meet an exodus of migrant workers desperately trying to reach their home villages during the world's largest lockdown.

Thousands of people, mostly young male day laborers but also families, had fled their New Delhi homes after Prime Minister Narendra Modi announced a 21-day lockdown that began on Wednesday and effectively put millions of Indians who live off daily earnings out of work.

In a possibly hopeful sign, the U.S. Food and Drug Administration cleared a new rapid test from Abbott Laboratories, which the company says can detect the coronavirus in about 5 minutes. Medical device maker Abbott announced the emergency clearance of its cartridge-based test Friday night, saying the test delivers a negative result in 13 minutes when the virus is not detected.

While New York remained the worst-hit city in the U.S., Americans braced for worsening conditions elsewhere, with worrisome infection numbers being reported in New Orleans, Chicago and Detroit.

New Orleans’ sprawling Ernest N. Morial Convention Center, along the Mississippi River, was being converted into a massive hospital as officials prepared for thousands more patients than they could accommodate.

In New York, where there are more than 44,000 cases statewide, the number of people hospitalized with COVID-19 passed 6,000 on Friday, double what it had been three days earlier.

Gov. Andrew Cuomo called for 4,000 more temporary beds across New York City, where the Jacob K. Javits Convention Center has already been converted into a hospital.

The struggle to defeat the virus will take “weeks and weeks and weeks,” Cuomo told members of the National Guard working at the Javits Center.

President Donald Trump invoked the Defense Production Act on Friday, ordering General Motors to begin manufacturing ventilators. Trump had previously rejected Cuomo's pleas for tens of thousands more of the machines and the governor's calls to implement the Korean War-era production law.

Trump signed a $2.2 trillion stimulus package, after the House approved the sweeping measure by voice vote. Lawmakers in both parties lined up behind the law to send checks to millions of Americans, boost unemployment benefits, help businesses and toss a life preserver to an overwhelmed health care system.

Dr. John Brooks of the U.S. Centers for Disease Control and Prevention warned Americans remained “in the acceleration phase” of the pandemic and that all corners of the country were at risk.

"There is no geographic part of the United States that is spared from this," he said.

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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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News Network
May 3,2020

London, May 3: The British government had a contingency plan for prime minister Boris Johnson’s death as his condition deteriorated while he battled COVID-19 last month in intensive care, Johnson said in an interview with The Sun newspaper.

Johnson returned to work on Monday, a month after testing positive for COVID-19. Johnson, 55, spent 10 days in isolation in Downing Street from late March, but was then was taken to London’s St Thomas’ Hospital where he received oxygen treatment and spent three nights in intensive care.

“They had a strategy to deal with a ‘death of Stalin’-type scenario,” Johnson, 55, was quoted as saying by The Sun. “It was a tough old moment, I won’t deny it.”

After Johnson was discharged, St Thomas’ said it was glad to have cared for the prime minister, but the hospital has given no details about the gravity of his illness beyond stating that he was treated in intensive care.

Johnson and his fiancée, Carrie Symonds, on Saturday announced the name of their newly born son as Wilfred Lawrie Nicholas, partly as a tribute to two of the intensive care doctors who they said had saved Johnson’s life.

“The doctors had all sorts of arrangements for what to do if things went badly wrong,” Johnson said of his COVID-19 battle. “The bloody indicators kept going in the wrong direction.”

He said doctors discussed invasive ventilation.

“The bad moment came when it was 50-50 whether they were going to have to put a tube down my windpipe,” he said. “That was when it got a bit . . . they were starting to think about how to handle it presentationally.”

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News Network
July 1,2020

Melbourne, July 1: Authorities will lock down around 300,000 people in suburbs north of Melbourne for a month from late on Wednesday to contain the risk of infection after two weeks of double-digit rises in new coronavirus cases in Australia's second-most populous state.

Australia has fared better than many countries in the pandemic, with around 7,830 cases and 104 deaths, but the recent surge has stoked fears of a second wave of COVID-19, echoing concerns expressed in other countries.

Globally, coronavirus cases exceeded 10 million on Sunday, a major milestone in the spread of a disease that has killed more than half a million people in seven months.

From midnight, more than 30 suburbs in Australia's second-biggest city will return to stage three restrictions, the third-strictest level in curbs to control the pandemic. That means residents will be confined to home except for grocery shopping, health appointments, work or caregiving, and exercise.

The restrictions will be accompanied by a testing blitz that authorities hope will extend to half the population of the area affected, and for which borders will be patrolled, authorities said. The measures come as curbs ease across the rest of the state of Victoria, with restaurants, gyms and cinemas reopening in recent weeks.

Victoria recorded 73 fresh cases on Tuesday from 20,682 tests, following an increase of 75 cases on Monday. State premier Daniel Andrews warned on Wednesday that the return of broader restrictions across city remained a possibility.

"If we all stick together these next four weeks, we can regain control of that community transmission ... across metropolitan Melbourne," Andrews said at a briefing. "Ultimately if I didn't shut down those postcodes I'd be shutting down all postcodes. We want to avoid that."

Victoria's spike in cases has been linked to staff members at hotels housing returned travellers for which quarantine protocols were not strictly followed. Victorian state authorities have announced an investigation into the matter.

Some other Australian states and territories are preparing to open borders, but applying limits and quarantine measures to citizens of Victoria as the school holiday season gets under way.

South Australia, the country's fifth most populous state, has had just three new cases in the past month. But citing the spike in coronavirus infections, on Tuesday it cancelled its scheduled reopening to other parts of the nation.

New South Wales (NSW), Australia's most populous state, has stopped short of closing its borders to all Victorians, but those holidaying from hotspot areas - not permitted under NSW rules - can be handed a fine of A$11,000 ($7,596) or jailed if they are detected, state authorities said.

The delays reopening internal borders cast doubts over a federal plan to set up "travel bubble" with neighbouring New Zealand that would allow movement between the two countries.

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