SharecloseShare pageCopy linkAbout sharingFor a fourth day in a row, India has set an unwelcome world record for the number of new coronavirus infections: a further 349,691 cases in the 24 hours to Sunday morning, with another 2,767 lives lost. The capital, Delhi, is one of the worst-hit areas. The BBC’s Vikas Pandey reports from a city whose hospitals are overwhelmed and whose citizens are in desperation. When Ashwin Mittal’s grandmother’s oxygen saturation level dropped a week ago, he started frantically looking for a hospital bed in Delhi. He called everybody he could, but every hospital refused.Her condition deteriorated further on Thursday and he took her to the emergency rooms of several hospitals, but every place was full. They accepted the fate that she was going to die without getting any treatment. But she was gasping for every breath and Ashwin just couldn’t bear it after a while. He took her in his car and went from one hospital to another for several hours until one in north Delhi agreed to take her in the emergency ward for “a few hours”. He was to continue looking for a bed.Ashwin, who has also tested positive for coronavirus, continued his search while battling a high fever and severe body aches. But he couldn’t find a bed, and the hospital continued to keep his grandmother in the emergency ward on compassionate grounds.Deaths climb as India reels from deadly Covid waveViral picture that defines India’s Covid distressWhy second Covid wave is devastating IndiaDoctors there said she needed an ICU and had a good chance of survival. A family friend told me that the hospital was planning to discharge her on Sunday as it was running out of oxygen.”The family is back to where they started and has accepted the fate. They know that if she survives, it will be because of a miracle, not because of any treatment,” the friend said.Miracles are what many families in Delhi are left to rely on. Most hospitals are full and many of them are refusing new admissions owing to the uncertainty over oxygen supply.Oxygen-equipped ambulances are in short supply and it’s becoming difficult for families to transport patients to hospitals even if they find a bed. image copyrightGetty ImagesIndia in crisisDelhi is extending its lockdown for a second weekIndian Prime Minister Narendra Modi has urged people to exercise caution and get vaccinated, saying ” this storm has shaken the nation” The Fortis Escorts Heart Institute, a private hospital in Delhi, said on Sunday it would not admit any more patients because of a shortage of oxygen At least 20 people died on Saturday at the Jaipur Golden Hospital in Delhi because of a lack of oxygenI know a few cases where patients have died because they did not get high-flow oxygen support. Every morning starts with frantic calls from friends, family and colleagues asking for a bed, oxygen cylinders or medicines. The number of people I am able to help is reducing every day as the doctors and officials who could earlier help are no longer available to speak on the phone. Helplines are not working and the vendors who could earlier help have run out of supplies.I go to bed with a sense of defeat every night, but then pick myself up and start in the morning again as more and more people call for help. I can understand their helplessness as I lost a cousin a few days ago in a top hospital in the city. He waited for 18 hours to get a ventilator but the hospital didn’t have any. That’s how Delhi is functioning at the moment. Friends are calling friends; social media is awash with desperate pleas for help.But it’s almost impossible to find a hospital bed here now. Oxygen cylinders and medicines are in short supply. On Saturday, Saroj Hospital and Batra Hospital told families to take their patients away as they were running out of oxygen. The city has been been reporting more than 24,000 cases daily in the past few days. The hospitals are completely overrun, and healthcare workers are exhausted. Some people I know are taking dangerous journeys with their critically ill relatives to other cities which are 300-500km (18-300 miles) away. Sivesh Rana’s brother was in a critical condition but he couldn’t find a bed in Delhi and decided to take him in an ambulance to a city in the neighbouring state of Haryana. But his condition worsened during the journey and the ambulance wasn’t equipped to deal with a critical patient. He died a few hours after arriving at the hospital.Dr A Fathahudeen, who is part of Kerala state’s Covid task force, says the crisis is unprecedented and doctors can’t do much if oxygen supply is not guaranteed.”You need high-pressure liquid oxygen for the smooth functioning of ventilators and bi-pap machines. When the pressure drops, the machines fail to deliver adequate oxygen into the lungs, and the consequences can be fatal,” he says.He adds that oxygen is one of the major treatments to stabilise the patient, allowing doctors time to assess them and plan a future course of treatment. image copyrightGetty ImagesDr Fathahudeen says urgent measures are needed as patients are dying without getting the treatment they require.”The Indian army is one of the finest in the world to build makeshift hospitals and ICU beds within a short span of time. They should be roped in,” he adds.The situation is not very different in other cities, including Pune, Nashik, Lucknow, Bhopal, Indore and Allahabad, as the second Covid wave devastates the country.India reported 349,000 cases on Friday – a record daily spike. It reported 2,767 deaths. But experts say the actual numbers are likely to be much higher.Getting tested has become very difficult in many cities as labs are overrun. As I earlier reported, many people are dying at home because they are not getting hospital beds or they are not being able to get tested for Covid. So, they don’t find a place as a Covid patient in the database managed by different states.Meanwhile, frantic calls continue – each one more heartbreaking than the last. How have you been affected by coronavirus in India? Tell us your story by emailing: haveyoursay@bbc.co.uk.Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:WhatsApp: +44 7756 165803Tweet: @BBC_HaveYourSayUpload your pictures/video hereOr fill out the form belowPlease read our terms & conditions and privacy policy

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On the first anniversary of the At Home section, zigzag through this puzzle to reveal the twist.This week is the one-year anniversary of the At Home section, and what better way to celebrate than with a puzzle containing a hidden picture? Solve the clues and reveal the twist, with a mini shout-out to the section’s basket-weaving activity from August.Write the answers to the 16 clues in the blank spaces on each strip. (We’ve filled in some letters to help.) Then cut and sort the strips into one of the four categories, based on your answers. Can you find what connects them? Words starting with B? Animals you’d find on a farm? We’ve given you a clue for each category.Once you’ve sorted your strips into categories, the A and B groups become the vertical “warp” for your weaving; the C and D groups are woven through them horizontally. They should be ordered alphabetically within their categories. Follow the diagram to weave the strips in an under-and-over pattern, with the lettered squares going under the vertical strips. The weaving will reveal the hidden picture.Robert VinluanStep 1Place the A and B groups vertically using alphabetical order within each group, starting from the left and alternating groups.Step 2 Start with the first strip alphabetically from the C group and weave it in, making sure the lettered squares go under the A strips. Slide the strip to the bottom.Step 3 Repeat with the first alphabetical strip from the D group, making sure it goes under the B strips. Keep weaving, alternating strips from the C and D groups until you have used all your strips.Step 4Congratulations! You’ve revealed the image! Now fold and tape the extra tabs to square the sides and save your artwork.A printable version of this activity is available for download here.

Books make great educational resources to combat discrimination and xenophobia, and to foster activism.After a year with a marked increase in discrimination and harassment aimed at Asian-Americans across the country, the past few months have been particularly shocking, in both the frequency and violence of attacks. A powerful way to fight racism is education. Conversations about prejudice with your children starting at a young age go a long way toward building empathy and acceptance, and books can be a great tool for sending important messages. This list of 10 fiction, nonfiction and comic books will help kids of all backgrounds understand and combat this wave of anti-Asian hate and bullying, and provide more context to America’s history of discrimination.Children’s Books“My Footprints,” by Bao Phi; illustrated by Basia TranIn this snowy yet colorful picture book, little Thuy uses her imagination to recover from a bullying incident at school, with help from her two mothers. Ages 4 to 7.“My Name is Bilal,” by Asma Mobin-Uddin; illustrated by Barbara KiwakBilal tries to hide his Muslim identity at his new school while his sister, Ayesha, is harassed for wearing a head scarf. A book, persuades Bilal to embrace his faith publicly and gives him the courage to stand up to the school bully. Ages 6 to 9.“Inside Out & Back Again,” by Thanhha LaiThis novel in verse spends a year with 10-year-old Ha and her family as they flee war-torn Saigon and start a new life in Alabama. Ha weathers bullying from classmates for her appearance and limited English skills until she pushes back. Ages 9 to 12.“Count Me In,” by Varsha BajajKarina and Chris have been neighbors for years, yet their families have never spoken until Karina’s Indian-American grandfather volunteers to tutor Chris in math. When the grandfather is attacked by a stranger while walking, the students work together to heal and overcome the hate. Ages 9 to 12.“Fred Korematsu Speaks Up,” by Laura Atkins and Stan Yogi; illustrated by Yutaka HouletteThe story of the civil rights activist Fred Korematsu is told in poems chronicling his experiences of racism as a child and his long fight for justice. This biography includes passages about the country’s history of discrimination, the impact it had on Japanese-Americans and resources for young activists. Ages 9 to 12.Teenage Nonfiction Books“They Called Us Enemy,” by George Takei, Justin Eisinger and Steven Scott; illustrated by Harmony BeckerIn this graphic memoir, the “Star Trek” actor and activist George Takei recounts his harrowing childhood and his family’s traumatic experience being uprooted from Los Angeles and being taken to three World War II internment camps. Ages 12 and up.“From a Whisper to a Rallying Cry: The Killing of Vincent Chin and the Trial that Galvanized the Asian American Movement,” by Paula YooIn 1982, Vincent Chin was celebrating his bachelor party at a bar when an argument with two white men turned fatal. Chin’s death and the light criminal sentences his killers received incited national protests and a federal trial. Yoo’s comprehensive account sheds new light on the tragedy and its legacy. Ages 13 and up.Teenage Graphic Novels“Displacement,” by Kiku Hughes In this science-fiction story inspired by her family, the teenage Kiku Hughes time-travels to the 1940s and finds herself trapped in the same World War II internment camp as her grandmother. There, Kiku gets a life-altering history lesson. Ages 12 and up.“Superman Smashes the Klan,” by Gene Luen Yang, art by Gurihiru Based on a 1946 Superman radio series, two Metropolis teenagers experience racism and attacks from the Ku Klux Klan when their family moves from Chinatown to the suburbs. Ages 12 and up.“Flamer,” by Mike Curato Boy Scout summer camp is fraught with anxiety for the teenager Aiden Navarro when he is bullied for his Filipino heritage, while questioning his religion and sexuality. This graphic novel is a moving story about self-discovery and survival. Ages 14 and up.

Many job seekers don’t know where to look after the year we’ve just had. If you count yourself among this crowd, here’s how to get back into the market, even if you’re feeling rusty.Airlines are canceling flights because they don’t have enough pilots to fly them. Restaurants are posting open positions on their Instagram feeds. Even the local grocery store has a “hiring” sign out front. Welcome to spring 2021: After a year of being battered by the pandemic, the economy is finally showing signs of a strong, steady recovery, and jobs are popping up like crocuses. Employers added almost a million positions in March alone, according to the Labor Department.“Across our industry, everyone is prioritizing hiring,” said Kelly McCulloch, the chief people officer at Taco Bell, which held a nationwide “hiring party” by converting parking lots into drive-through job fairs last week. The company’s goal: To find 5,000 new employees in one day. “It’s definitely unprecedented,” she said.It’s not just food, travel and hospitality businesses that are desperate for workers. “The market for job candidates in the technology space is crazy right now,” said Randi Weitzman, a recruiter for Robert Half, an international human resources consulting firm. “There are more jobs than there are available candidates, and most candidates are receiving multiple competing offers.”But with this hiring frenzy comes a new conundrum: How can the still-staggering number of unemployed Americans (about 9.7 million, per the latest report from the Bureau of Labor Statistics, or more if you’re counting those who are underemployed) find their way to the right positions? Especially those people who have been out of the work force for months or even a full year?“It’s frustrating when we hear job candidates say they’ve been looking for work and can’t find it,” said Richard Wahlquist, president and chief executive of the American Staffing Association, an alliance of recruiters and staffing agencies that helps companies fill contract and permanent roles. “We’ve got more than seven million open jobs right now in America that businesses are having a hard time filling, and our members are having a hard time sourcing talent.”The main problem, Mr. Wahlquist said, is that many job seekers don’t know where to look — or how to market themselves, especially in this new era of online job postings and remote work. “A lot of people just aren’t good at finding employment,” he added. “Most of us don’t get taught how to do that by our parents, or in high school or college.” If you count yourself among this crowd, here’s how to bridge the disconnect and get back into the job market, even if you’re feeling rusty.Brush up on your digital communication skills.If you haven’t spent the past year in Zoom meetings, you didn’t exactly miss out, but you still need to be able to present yourself as savvy and professional onscreen. “A lot of interviews are virtual now, even if the job itself will be done in person,” Ms. Weitzman said. “People who’ve been out of the work force should practice setting up Zooms with their friends or family, so that they feel comfortable on video.”Even if you’ve had plenty of experience chatting with people on FaceTime, that’s not quite the same thing. “Ask for feedback on how your background looks, and know where to look in the camera or on the screen in order to come across as engaged,” Ms. Weitzman explained. “It takes practice to be able to shake off nerves when you’re going through the process.”Look online — and not just on LinkedIn.LinkedIn is by far the biggest job-searching tool, and you’ll want to make sure your profile is up-to-date and well tended. (Better yet, use the platform’s “Open to Work” feature, which displays a badge on your profile photo that indicates you are looking for a new job and makes it easier for potential employers to find you.) But it’s not the only place you should look; many employers are soliciting candidates on other social platforms, too, like Facebook and Instagram.“We’re constantly looking for new ways to market our jobs,” Ms. McCulloch said. “To do that, we have to meet candidates where they are — and many of them are on social channels.”That goes both ways. If you’re looking for work, it can be helpful to share that with your own online network. A friend or connection might be able to refer you to a job opening. “We fill a lot of positions through referrals from existing employees,” Ms. McCulloch said. (While you’re at it, tidy up your social media presence — potential employers might be put off by certain types of content.)Finally, don’t be scared of online networking events. Many offer useful services like résumé reviews and interview coaching.Talk to an employment agency, recruiter, or headhunter.Many job seekers think that they have to pay recruiters to find them jobs. But it’s actually the opposite — employers hire recruiters to find qualified candidates. And no matter what field you’re in, there’s probably a recruiter who’s looking to staff it right now, Mr. Wahlquist assured. “You can find one that represents people who do the kind of work that you’ve done, or what you’re looking to do, based on your skills,” he said. A Google search can provide names, while the American Staffing Association also has a directory online of employment firms that’s searchable by location, field and job type.Mr. Wahlquist recommends having initial conversations with recruiters, to give you a sense of what work they have done with people with backgrounds similar to yours. Feel free to ask the firm to help you identify exactly what your skill set is, and how to sell it.“Most of us have learned things over the course of our careers that don’t logically fall out of our fingers onto a résumé,” Mr. Wahlquist said. “An employment professional will go through your education, training and job history to get a full picture of your hard and human skill sets, with an eye on what’s needed today by employers.”Broaden your horizons.The transition to, and acceptance of, remote work has enabled employers to cast a wider net when they search for talent — and so should you, in looking for jobs.“Many employers are open to hiring remote workers, but often in the same time zone,” Ms. Weitzman said. “That means if you live on the East Coast, you’ll have multiple options in New York, Boston, Philadelphia, Connecticut.” Sure, this means you’re competing with a bigger pool of candidates, but it also gives you more chances to find the right fit.This could also be a good time to make a career transition. “You might want to be more flexible and think about switching fields,” Mr. Wahlquist said. “Take those skills that you’ve developed and try to find something that is even better, or more sustainable long term.”Meanwhile, consider taking a relevant training course, especially if you’ve been unemployed. “If you’re not working, I would 100-percent recommend to sign up for some training, because it shows initiative and a vested interest in updating and expanding your skill set,” Ms. Weitzman said. Be honest about why you’re unemployed.If you’ve been out of a job for a while, either for lack of opportunities or because you were busy shepherding children through Zoom school, that’s OK. “Everybody knows what happened this past year,” Mr. Wahlquist said. “Most people have a big free pass for a gap in their work history during the pandemic.”Still, you should be prepared to explain — succinctly — what happened and what you’ve been doing since. “Even if your past job loss wasn’t entirely due to Covid, most employers want to start a relationship with transparency,” he said.And, potential employers will want to check up on your references. Expect that they’ll want to talk to your former supervisors for the past five years, or past couple of jobs. “Take this time to go back to those people and be direct,” Mr. Wahlquist. “You can ask, ‘Will you be willing to give a reference, and able to give me a good reference?’” A question that your former supervisor might be asked is if he or she would rehire you. “And if the answer is no, then why?”Consider a temporary role.Some people enjoy contract work. But many others prefer the security of a long-term role, especially one that offers benefits like health insurance, retirement plans, and paid sick leave or vacation time. What a lot of people don’t realize is how useful temp work can be for landing a permanent position.“We see a lot of this in a recovering economy: Employers put people on temp-to-hire assignments,” Mr. Wahlquist said. “Essentially, it reduces a lot of the risk of hiring somebody, both for the job seeker and for the employer. You can see if your personality fits with your colleagues, and how you align in terms of mission values.” If it isn’t a slam dunk, you can both move on. But if it is, then your foot is in the door.At the very least, contract work puts something on your résumé. “It gets you experience, gets you exposure and gets you more references,” Ms. Weitzman said. “Sometimes a client falls in love with a contractor and says, ‘I can’t live without them, so I’m going to offer them a full-time job.’ It’s a great step for anyone to get back into the work force.”

SharecloseShare pageCopy linkAbout sharingAt least 23 people have been killed in a fire at a hospital treating coronavirus patients in the capital of Iraq, Baghdad.Dozens of others were injured in the blaze, which erupted at the Ibn Khatib hospital on Saturday night.Reports say an accident had caused an oxygen tank to explode, sparking the blaze.Videos on social media show firefighters scrambling to extinguish the flames as people flee the building.Iraq’s Prime Minister Mustafa al-Kadhimi called for an immediate investigation into the causes of what he called a “tragic accident”.image copyrightReutersThe head of Iraq’s Civil Defence, Major General Kadhim Bohan, told state media the fire broke out in the hospital’s intensive-care unit, on a floor “designated for pulmonary resuscitation”.So far, emergency crew had rescued 90 out of 120 patients and relatives, state news agency INA quoted him as saying.About “30 patients were in the intensive care unit”, which was reserved for the most severe cases of Covid-19 in Baghdad, a hospital source told the AFP news agency.The injured and patients who weren’t hurt have been taken by ambulance to other hospitals nearby.The fire caused many of the oxygen tanks designated to support the #COVID19 patients in the hospital to explode. #Baghdad so far dozens of victims have been reported. pic.twitter.com/OAC8Jt3jq3— Steven Nabil (@thestevennabil) April 24, 2021
The BBC is not responsible for the content of external sites.View original tweet on TwitterIraq’s Civil Defence said the fire was under control by the early hours of Sunday morning.Baghdad Governor Mohammed Jaber echoed the prime minister’s call for an urgent investigation to determine if anyone should be “brought to justice” for negligence.In a statement, the government’s human rights commission said the incident was “a crime against patients exhausted by Covid-19”.image copyrightGetty ImagesIraq’s hospitals have been pushed to the limit during the coronavirus pandemic, adding to the strains wrought by years of war, neglect and corruption.Coronavirus infections have been rising steeply since February in Iraq, and passed one million cases in total this week.The health ministry has recorded a total of 1,025,288 cases of the disease and 15,217 deaths since the pandemic began.The country launched its vaccination campaign last month, and has received nearly 650,000 doses, most of which have come from Covax, a global programme for sharing jabs.

U.S. experts weigh the risks for younger women and cases of a rare blood-clotting disorder, and lift the pause in giving the one-shot vaccine.Use of the one-shot Johnson & Johnson Covid vaccine will resume within days, but with a warning added to its label about the risk for a rare blood-clotting disorder that has occurred among young women, the Food and Drug Administration said on Friday.Concerns about the disorder had led to a pause in the use of the vaccine that began 10 days earlier. The F.D.A. decided against limiting the vaccine’s use by age or gender, although some European countries have imposed such restrictions on a vaccine made by AstraZeneca because of a similar clotting disorder. Federal health officials said information about the disorder would be provided at vaccination sites. Dr. Peter Marks, the F.D.A.’s top vaccine regulator, predicted that the vaccine could be deployed again by Saturday morning.The Johnson & Johnson suspension came after officials learned that six women had developed a severe disorder that led to blood clots in their brains within about two weeks of receiving the vaccine. One died. The pause was widely considered a blow to national and global vaccination efforts and removed an effective vaccine that many states and countries had counted on to deploy in hard-to-reach places. Unlike the vaccines made by Pfizer-BioNTech and Moderna, Johnson & Johnson’s vaccine requires only one shot and is easier to store and distribute because it does not require extremely cold temperatures. At the advisory panel meeting about the blood-clotting issue on Friday, the C.D.C. reported that it had identified a total of 15 cases, including three deaths. But the risk is considered extremely small — nearly eight million Americans have received the Johnson & Johnson vaccine — and the panel ultimately decided that the vaccine’s benefits far outweighed its risks. It also concluded that failing to use it would lead to more deaths than the clotting disorder might cause.The panel voted 10 to 4 to resume using the vaccine with the warning label. Some who voted “no” wanted a more prominent warning about the risk to younger women and the availability of other Covid vaccines that do not appear to pose the same risk. Lifting the pause will allow many states to restart giving the one-dose shot to college students and hard-to-reach populations like rural Americans, migrants and the homebound elderly. Their access had been hampered by the suspension, which left roughly 10 million doses sitting on shelves.In Wisconsin, where one-third of the population is fully vaccinated, officials said they intended to begin using their Johnson & Johnson doses as soon as possible. “We have also heard from a number of vaccinators who say that there are lots of people who don’t like needles,” said Julie Willems Van Dijk, the deputy secretary of the state health department. “They just want to get the vaccine that requires them to have one shot versus two shots.”Dr. Rochelle P. Walensky, the C.D.C. director, said governors had expressed intense interest in resuming use of the shot.“They wondered why we had paused and they were anxious to have this back, have an opportunity for a single-dose vaccine, for a one-and-done possibility,” she said.About 135.8 million people in the United States have received at least one shot of a coronavirus vaccine since the rollout began. But since last week, average daily doses have fallen by almost 13 percent, from a peak of 3.38 million daily doses, on average, to about 2.95 million, on average. It is the first time since early April that providers have given fewer than three million shots a day, on average.It is difficult to say exactly what is driving the decrease. Even before the use of the Johnson & Johnson vaccine was paused, shipments of it had dipped because of a factory error that had ruined millions of doses.Larry Bergner, the administrator for the health department in Newton County, Mo., population 58,000, said demand had been falling before the pause. He was concerned that the federal government’s decision had made hesitancy about the vaccine in the area worse.“Some tell me that they had planned on getting vaccinated until J.&J. was halted,” Mr. Bergner said. “Now, they say they are going to hold off until they feel confident that all vaccines are safe.”The county had distributed fliers and made phone calls to businesses, churches and other community groups to drum up interest for a vaccination clinic on Wednesday, but only 14 people showed up. It was actually about double what Mr. Bergner had expected, he said, though the health department could have handled about 100 shots.Dr. Walensky said the federal government planned to emphasize the vaccine’s safety to Americans who might be hesitant to take it after the pause.“We have to do extraordinary outreach to clinicians, as we have been doing this past week,” she said. “We already have plans to start that on Monday, to public health officials. And then we have to do extraordinary outreach to patients, to meet people where they’re at, to educate them.”She said the C.D.C. had talked to health providers for young women, including the American College of Obstetricians and Gynecologists. The pause and investigation into the rare disorder, she added, should give the public confidence in the system used to monitor vaccine safety.Registration for the Johnson & Johnson vaccine at the Charlotte Maxeke Johannesburg Academic Hospital in South Africa last month. Shots will resume there next week, officials announced Thursday.João Silva/The New York TimesEuropean Union regulators earlier this week did not recommend the kind of age restrictions for the Johnson & Johnson shots that some countries have imposed on the AstraZeneca vaccine. Johnson & Johnson did agree to include a warning of risks for the blood clots. Several European countries have since resumed use of the Johnson & Johnson vaccine, as has South Africa. Up until just hours before the pause was recommended by American officials, regulators had planned for a revision to the F.D.A.’s emergency use authorization similar to the one formalized Friday, with warnings about the blood clots. But top health officials decided in a meeting on April 12 that the government should call for a pause while federal authorities and the C.D.C.’s expert panel investigated a possible link between the clots and the vaccine. They feared a number of cases of the disorder had not been identified and wanted to allow more time for those who had just received the vaccine to reach the point at which the rare clotting typically appears. “As we did this intensive scientific evaluation over recent days, I think we became more and more confident about the decision that was made today,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said on Friday.In the C.D.C. panel analysis, women between 30 and 39 appear to be at greatest risk, with 11.8 cases per million doses given. Among women 18 to 49, there have been seven cases per million doses. The condition, which the C.D.C. is calling thrombosis with thrombocytopenic syndrome, causes severe blood clots and also a tendency to bleed at the same time, because of abnormally low levels of platelets, a blood component involved in clotting.The disorder is “rare but clinically serious,” Dr. Tom Shimabukuro, the deputy director of the C.D.C.’s immunization safety office, said at the meeting.Additional potential cases, including some in men, are being reviewed. There was also a case in a 25-year-old man who participated in a clinical trial of the vaccine.The patients’ symptoms closely resemble a rare syndrome that can be caused by heparin, a widely used blood thinner, Dr. Michael Streiff, a hematologist at Johns Hopkins University, told the panel. Heparin, typically used to treat blood clots, should not be given to these patients, he said.Symptoms include severe headaches, abdominal pain, leg pain or shortness of breath. Those problems generally do not set in before about six days after the vaccination. Once the symptoms occur, treatment should begin as soon as possible, because it can worsen rapidly, researchers say. Dr. Marks, the F.D.A. regulator, said the agency was recommending blood thinners other than heparin, and a blood product called intravenous immune globulin, which can help ease the immune reaction causing the problem.“That appears to reverse this process,” he said.Officials warned that women under 50 have an increased risk of a rare but serious blood-clotting disorder, and “may choose” to receive a different vaccine instead.Mario Tama/Getty ImagesResearchers suspect that in these rare cases, the vaccine causes an intense reaction by the patient’s immune system, which churns out antibodies that activate platelets, a blood component needed for clotting. Why this occurs in some people, many of them younger women, is not known, and experts say that they have so far been unable to identify traits or underlying conditions that may make some people susceptible. Top U.S. health officials have stressed that finding the small number of cases of a rare disorder, and pausing use of the vaccine, indicated that safeguards were in place to assess risks and to raise awareness among doctors and hospitals about the unusual symptoms.“This pause was essential to our ability to inform the public,” Dr. José R. Romero, chairman of the expert panel, the Advisory Committee on Immunization Practices, said on Friday.But some public health experts have expressed concerns that the government’s actions would fuel vaccine hesitancy just when the Biden administration is heavily pushing to have all adults immunized by the summer.The impact of the Johnson & Johnson vaccine on vaccine hesitancy is still evolving. A poll released this week from Ipsos/Axios found that the pause itself boosted confidence in federal vaccine monitors, with 81 percent saying that the C.D.C. and the F.D.A. acted appropriately. The sentiment was unusually bipartisan, with 87 percent of Republicans and 91 percent of Democrats sharing that view.Measuring the impact of the Johnson & Johnson pause is rather tricky because as Liz Hamel, vice president of public opinion and research survey at the Kaiser Family Foundation, said, “You don’t know what the trajectory of the vaccine uptake would have been in the absence of this pause.”The biggest challenge ahead, she noted, will be the creation of vaccine-confidence messages that resonate, especially in light of the setback with Johnson & Johnson. “We don’t know whether it has increased hesitancy among women in particular,” she said.Rob Barss, a paramedic, talked with Romeo Porier before administering a Johnson & Johnson shot, part of a mobile vaccine distribution program in Leominster, Mass.Cj Gunther/EPA, via ShutterstockBenjamin Mueller, Matina Stevis-Gridneff, Julie Bosman, Jan Hoffman, Carl Zimmer and Emily Anthes contributed reporting.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesUS health regulators have lifted an 11-day pause on the Johnson & Johnson (J&J) Covid-19 jab, but will add a warning label about the potential for extremely rare blood clots.A Centers for Disease Control and Prevention (CDC) panel earlier approved restarting US rollout of the shot. Fifteen vaccine recipients suffered from a dangerous blood clot out of nearly eight million given the jab. This week, Europe’s drug regulator also ended restrictions on the J&J vaccine. European regulators this month also linked similar, highly unusual blood clots to the AstraZeneca Covid-19 shot, but found the benefits of the drug outweighed any risks.On Friday afternoon, the CDC and Food and Drug Administration swiftly followed the recommendation of the CDC advisory panel after it voted 10-4 to continue rolling out the vaccine for people 18 years of age and older in line with its original authorisation.The decision means at least 10 million doses of the J&J vaccine, shipped from the company’s factory in the Netherlands, can be deployed across the US immediately. The health officials on Friday identified nine more cases of the blood clots, adding to six cases already identified since regulators first approved the jab as safe and effective in February.All were women, most under the age of 50. Three died and seven remain in hospital.About a dozen of the cases affected women aged 30-39. Seven of the women were obese, two had high blood pressure, and two were using oral contraceptives, according to health officials. CDC officials who presented the data on Friday said a few cases of blood clots in men were being reviewed, too.Covid map: Where are cases the highest?Covid vaccine: Pfizer v Oxford AstraZeneca v ModernaThe officials also said it was important for women be told about the potential risks of the vaccine so they could decide whether to seek alternatives.Dr Sarah Long, of Drexel University College of Medicine, was among the panel members who voted against the proposal because she thought it did not go far enough in warning women. “This is an age group that is most at risk [of the blood clot] that is getting vaccine predominantly to save other peoples’ lives and morbidity, not their own,” she told AP new agency. “And I think we have a responsibility to be certain that they know this.”Symptoms can arise within three weeks of vaccination and include acute headaches, shortness of breath, and leg and abdominal pain. US health officials are warning doctors that heparin, a common treatment for blood clots, can worsen the vaccine-linked condition.The US paused use of the single-dose shot earlier this month over a few reports of blood clotting in the brain post-vaccine among US women. Following the advice, all federal sites in the US stopped using the vaccine. It was not the first setback for J&J in its US coronavirus vaccine rollout. Last month, the ingredients for up to 15 million doses of the pharmaceutical giant’s vaccine were ruined at a Baltimore facility.Federal inspectors this week identified a series of problems at the Emergent BioSolutions plant, including cleanliness and safety issues.

A quadruple amputee, he was a relentless defender on the United States’ wheelchair rugby team, which won a gold medal at the 2008 Paralympics in Beijing.Nick Springer, who became a Paralympic gold medalist in wheelchair rugby at Beijing in 2008, only nine years after contracting meningococcal meningitis, which caused the partial amputations of his arms and legs, died on April 14 in Chandler, Ariz., a suburb of Phoenix. He was 35.His father, Gary, said that Springer, who lived in Phoenix, died in a friend’s pool after finishing a lap. A cause of death has not yet been determined, but he had been seeing a cardiologist for an arrhythmia.Wheelchair rugby — also known as “Murderball,” which was the title of a 2005 documentary about the sport — suited Springer’s love of rough-and-tumble action. He had played hockey from age 5 or 6, hoping to become a New York Ranger.In 2000, a year after losing parts of his arms and his legs above the knees, he turned to sled hockey while still in rehabilitation. He later took up wheelchair rugby, an often violent sport that contains elements of traditional rugby, basketball and handball.“A lot of people look at me like I’m fragile,” Springer told The New York Times in 2003. “Sports gives me a chance to get out there and bang myself up.”After Springer tried wheelchair rugby for the first time in 2003, “He rolled off the court with an ear-to-ear grin, saying, ‘Dad, I think I can be really good at this,’” said Gary Springer, who drove Nick from their home in Croton-on-Hudson, N.Y., in Westchester County, to Hackensack, N.J., where he practiced, and to tournaments where he competed with a team from the Eastern Paralyzed Veterans Association (now the United States Spinal Association).He excelled quickly: He joined the development squad of USA Wheelchair Rugby, the sport’s governing body, in the spring of 2005, and made the U.S. national team the next year, when it won the gold medal at the world championships. In 2008, the team won the Canada Cup and the gold medal over Australia at the Paralympics in Beijing.“He was a great defender — probably for a long period of time the best defender in the world,” said Scott Hogsett, a friend and a teammate of Springer’s on the 2008 team. “He’s the main reason we won the gold; he defended one of the best players in the world” — the Australian wheelchair rugby star Ryley Batt — and shut him down.”But the victory in China came amid sadness. Springer’s mother, Nancy (Ford) Springer, was dying of cancer while her husband and their daughter, Olivia, were at the Paralympics.When she first learned she had cancer, in January 2008, Springer had offered to stop playing wheelchair rugby and move home.“She looked me in the eye and said, ‘It would crush me if you don’t go to the Olympics,’” he said, recalling her conversation to The Journal News, a newspaper based in White Plains, N.Y., in 2008. “And she said, ‘The one thing you have to promise is that you won’t let this keep you from winning the gold medal.’”Ms. Springer was in a coma, surrounded by friends and family watching the gold medal game on a laptop and hearing the announcer refer to her son as “Nick the Tank.” She died the next day, before her son, husband and daughter got home.The gold medal, Springer said, was how he would remember her.“It’s my mother’s medal,” he told The Journal News.Springer playing sled hockey in 2003. “A lot of people look at me like I’m fragile,” he said. “Sports gives me a chance to get out there and bang myself up.”Dith Pran/The New York TimesNicholas Bowen Springer was born on June 9, 1985, in Manhattan and grew up in Brooklyn and Croton-on-Hudson. His father is an entertainment publicist, and his mother taught deaf children and was one of several founders of the National Meningitis Association.Springer had hockey on his mind in August 1999. He had just completed two weeks of goaltender camp near Toronto — he was going to play the position on his high school’s junior varsity team that fall — and was attending sleepaway camp in western Massachusetts.After a three-day, 30-mile hike, he began feeling flulike symptoms, which continued to worsen over the next 16 hours. Purple blotches appeared on his abdomen, indicating blood clots. All were symptoms of meningococcal meningitis, a bacterial infection that causes swelling of the protective membranes that cover the brain and spinal cord.Up to one in five people who survive meningitis may suffer amputations, deafness, and brain and kidney damage; 10 to 15 percent die, even with rapid treatment, according to the National Meningitis Association.Springer was sent to a hospital in Pittsfield, Mass., then was quickly airlifted to another in Springfield, where his organs began to fail and his blood pressure fell to almost zero. He was given a 10 percent chance of survival.He was transferred to a hospital in Manhattan, where, while he was in a medically induced coma that would last eight weeks, he underwent the amputations.After awakening, according to the 2003 New York Times article, he told his father: “Dad, I don’t think I have any fingers. I think I know about my legs, too.” Mr. Springer recalled: “My wife and I looked at each other and said, ‘This is our new normal.’ Because Nick is alive. He’s still Nick.”Springer declined to wear prosthetics or use an electric wheelchair. And he played wheelchair rugby relentlessly.“At a very high level, it can be really violent, and that’s what people like about it,” his friend Scott Hogsett said. “Who doesn’t want to watch two people crash in wheelchairs as hard as you can?”Springer was named the 2009 athlete of the year by the United States Quad Rugby Association, which oversees a league of local teams like the ones he played for in Sarasota, Fla., and in Phoenix, where Hogsett was a teammate. He was also on the 2010 world championship team and the 2012 Paralympic team that won a bronze medal.“Nick was just ferocious,” Joe Delagrave, a teammate on the 2012 Paralympic team, said. “We met in 2009 and he got me playing at a high level. He was phenomenal at mentoring people and loving them.”In addition to his father, Springer is survived by his sister, Olivia McCall, and his father’s partner, Elizabeth Cier.Springer, who graduated from Eckerd College in St. Petersburg in 2010 with a bachelor’s degree in communications, had been an advocate for vaccine awareness. He began speaking at colleges and community organizations and to health professionals in 2005 on behalf of the meningitis association and Novartis, which made a vaccine. In 2015, he began speaking exclusively to health workers after Novartis sold most of its vaccine business to GlaxoSmithKline.“He talked,” his father said, “about before he got sick, getting sick, and how his parents didn’t know there was a vaccination that could have prevented it.”

A panel of advisers to the Centers for Disease Control and Prevention on Friday voted to recommend lifting the pause on the Johnson & Johnson Covid-19 vaccine for all adults and adding a label about an exceedingly uncommon, but potentially dangerous, blood clotting disorder.The vote came after a C.D.C. scientist presented nine new confirmed cases of the disorder, bringing the total to 15. All the cases have been in women, and 13 have been in women between 18 and 49 years old.Federal health officials are expected to respond quickly and formally recommend that states lift the pause.Administration of the vaccine ground to a halt last week after reports emerged of a rare blood clotting disorder in six women who had received the vaccine. The disorder combines blood clots, often in the brain, and a low level of platelets, blood cells that typically promote clotting.“This pause was essential to our ability to inform the public,” Dr. José R. Romero, the chair of the advisory panel, said at the meeting.The overall risk of developing the clotting disorder is extremely low. Women between 30 and 39 appear to be at greatest risk, with 11.8 cases per million doses given. There have been 7 cases per million doses among women between 18 and 49.Three women have died from the rare clots and seven remain hospitalized, four of whom are in the intensive care unit, a C.D.C. scientist said at Friday’s meeting.“These cases are not just numbers to any of us, and we take them very seriously,” Dr. Joanne Waldstreicher, the chief medical officer of Johnson & Johnson, said at the meeting. “These are people.”The company supported adding a warning label to the vaccine, and has agreed upon language for a potential label with the F.D.A., she said. The label she presented notes that “most cases” of the clotting disorder have occurred in women between 18 and 49 years old.Nearly 8 million doses of the Johnson & Johnson vaccine have now been administered. Among men and women who are 50 or over, there has been less than one case per million doses.The clotting disorder is “rare but clinically serious,” Dr. Tom Shimabukuro, the deputy director of the C.D.C.’s immunization safety office, said at the meeting.Roughly 10 million doses or more of the Johnson & Johnson vaccine, produced at the company’s factory in the Netherlands, are sitting on shelves across the United States and could be deployed immediately.The vaccine has immense potential benefits for the population. If vaccinations resume for all adults, 26 to 45 cases of the clotting disorder would be expected over the next six months, according to a model presented by Dr. Sara Oliver, a C.D.C. scientist. However, 600 to 1,400 fewer Covid-19 related deaths would be expected over the same time period.The vaccine, which is easy to store and requires just one shot, is also especially well-suited for use in hard-to-reach populations, including people who are homebound, homeless, or incarcerated.Additional potential cases of the clotting disorder, including some in men, are currently being reviewed. The C.D.C. scientist also mentioned one case that developed in a 25-year-old man who participated in a clinical trial of the vaccine.Twelve of the 15 women in the confirmed cases developed blood clots in the brain. Many also had clots elsewhere. Initial symptoms, which include headaches, typically begin six or more days after vaccination, Dr. Shimabukuro said. As the disorder develops, it can cause more severe headaches, nausea and vomiting, abdominal pain, weakness on one side of the body, speech difficulties, loss of consciousness and seizures.Dr. Shimabukuro noted that seven of the women were obese, two had hypothyroidism, two had high blood pressure, and two were using oral contraceptives. It is not yet clear whether any of these factors might increase the risk of developing the clotting disorder after vaccination.The patients’ symptoms closely resemble a rare syndrome that can be caused by heparin, a widely used blood thinner, Dr. Michael Streiff, a hematologist at Johns Hopkins University, told the panel. Heparin, which might typically be used to treat blood clots, should not be used to treat these patients, he said.Doctors should consider the rare clotting disorder in patients who present with blood clots and low levels of platelets within three weeks of receiving the Johnson & Johnson vaccine, Dr. Streiff said.“Recognition that this syndrome exists is helping to improve outcomes,” he said.The meeting comes as the federal government is also investigating problems at a Baltimore factory that was slated to help satisfy the country’s vaccine demand. Emergent BioSolutions, the plant’s operator, has produced tens of millions of doses of Johnson & Johnson’s vaccine, but they cannot be distributed until regulators certify the plant.After Emergent had to discard up to 15 million possibly contaminated doses of the vaccine last month, federal regulators conducted an inspection that found a series of problems, including the risk that other batches could have been contaminated.

India’s deadly second wave is continuing to set world records for its daily total of coronavirus cases.In the past 24 hours, more than 330,000 were recorded and thousands more have died. The country’s hospitals are reporting dangerously low oxygen levels and no empty beds.The BBC’s India correspondent Yogita Limaye went to one of the hospitals in Delhi.Read more: India Covid crisis: Hospitals buckle under record surge