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Her Heart Stopped for 6 Hours. Now She’s Ready to Go Back to Work.

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LONDON — Audrey Mash’s life was hanging in the balance. Her heart had stopped beating when she was caught in a snowstorm on a hike in the Spanish Pyrenees with her husband, and when she arrived at a Barcelona hospital she had no vital signs.

“I was trying to feel a pulse,” her husband, Rohan Schoeman, told the Catalan news Channel TV3. “I couldn’t feel a breath. I couldn’t feel a heartbeat.”

When Ms. Mash, a 34-year-old English-language teacher, arrived at the Vall d’Hebron Hospital last month, “she was blue and cold and she had no vital signs,” Dr. Eduard Argudo, who helped treat her, said in an interview on Friday.

But after she spent six hours in cardiac arrest, doctors managed to restart Ms. Mash’s heart and save her life with the aid of a highly specialized tool.

Ms. Mash’s experience will go down in the record books in Spain as the longest period of cardiac arrest in which the patient survived, the doctors said.

On Thursday, she appeared at a news conference in Barcelona and stood smiling while surrounded by the doctors and members of the rescue teams that had worked to save her life. She said she felt happy and grateful to be alive.

“I am the lucky one,” she said. “I’m the one who didn’t have to do anything.”

Ms. Mash, a Briton who lives in Barcelona, had gone on the hike in early November with her husband but when the snowstorm hit on the trail, they lost their way in the inclement weather and clung to each other, trying to shelter from the wind and cold.

Her body temperature dropped sharply, she developed severe hypothermia, and she ultimately went into cardiac arrest.

First, she began to “talk nonsense,” her husband told Channel TV3. Then, she had trouble moving. Later, she became unconscious.

By the time the emergency workers rescued the couple, Ms. Mash’s body temperature was 64 Fahrenheit. The average body temperature is 98.6 degrees Fahrenheit.

A helicopter rescue team airlifted her to the Vall d’Hebron, where a team of doctors mobilized to save her life.

Medical journals have long noted the cases of people who have emerged from yearslong comas. And medical studies of hypothermic cardiac arrests in Norway have explored the cases of patients who have survived after their core body temperature dropped to 56 degrees Fahrenheit and they spent nearly seven hours in that condition.

Ms. Mash’s hypothermic condition not only stopped her heart for six hours, but it also protected her brain and other organs from damage, the doctors said.

“If she had been in cardiac arrest for that long with a normal body temperature, she would have died,” Dr. Argudo said

Dr. Argudo, who had been called back to the hospital to attend to the unusual case after ending a 24-hour shift, said his team deployed a specialist tool that has never before used on a patient in hypothermic cardiac arrest in Spain: an extracorporeal membrane oxygenation machine, known as Ecmo.

The tool is more commonly used to treat infants with breathing or heart problems.

The machine takes blood from the patient, infuses it with oxygen and then reintroduces it to the body and circulates it around the bloodstream. It is more commonly used to treat infants with breathing or heart problems.

It also allows doctors to control the blood’s temperature, so they slowly increased it until Ms. Mash’s body temperature reached a point where they could use a defibrillator to shock her heart into beating normally again.

The medical team had prepared her husband for the possibility that she could experience brain damage when she woke up, but that was dispelled when she was taken off sedation two days after the rescue.

“We were really happy and surprised when she woke up and immediately asked, ‘What am I doing here?’ and ‘Who are you?’ ” Dr. Jordi Riera, the director of the Ecmo program at Vall d’Hebron Hospital, said in an interview on Friday.

But beating all expectations of a long period of healing, she has made a near-full recovery. Ms. Mash was discharged from the hospital 12 days after her rescue.

She plans to return to work on Wednesday, but before that she will try to go for a run this weekend, she said in a phone interview on Friday.

Ms. Mash remembers nothing about the traumatic experience. Her last memory before waking up in the intensive care unit is of heading off to hike with her husband.

“People keep asking me how I feel it has changed me, but I do not have the memory,” she said in the interview. “I never considered the fact that I might die. But it is different for my husband and parents — they were in a very stressful situation.”

Born in Britain, she spent part of her childhood in South Africa, where she met her husband, and has also lived in China. The couple moved to Barcelona two years before the hiking rescue.

She is a keen hiker and tries to go to the mountains with her husband at least once a month, and has previously trekked in the Himalayas. Doctors said that her experience there might have helped her to survive, in addition to her young age and active lifestyle.

“There is very low levels of oxygen in the Himalayas, so her body was in some way prepared for this,” Dr. Riera said.

The hypothermia has left Ms. Mash with some mobility and sensitivity issues in her fingers, which means she cannot do up buttons on her own or put earrings in herself, she said, but she hopes that will improve.

She praised the 40 people involved in her rescue and medical treatment as “absolute heroes who should be in the limelight for this.”

While near-death experiences can prompt some people to reassess their priorities in life, she said that was not her style.

“There is nothing I am going to be changing about my life,” Ms. Mash said. “I like my life. I have good friends; I love my job and my husband. If anything, it has made me realize how much I do not want to lose that.”

The experience has also not deterred her from one of her favorite activities.

“I hope that in spring we will be able to start hiking again,” Ms. Mash said. “I don’t want this to take away that hobby from me.”

But she will steer clear of the mountains in winter.

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Fig leaf or first defence? Deploying flimsy masks against coronavirus

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While Asian commuters cover their noses and mouths with the blue-green paper-thin covers — and social media buzzes with mask emojis, rumours of stockpiles and shortages — the humble medical mask has become an essential weapon in the battle against an invisible enemy.

Cheap, mass-made and usually readily available at convenience stores, experts dispute the usefulness of masks as a tool to block transmission of the new SARS-like virus.

‘One-way defence’

While the basic, loose-fitting mask can help restrict the spread of cough droplets from infected people, they are a “one-way” defence and do not create an effective barrier to breathing in dangerous airborne microbes. 

“It is not one of the recommended barrier measures” for people who have not been contaminated, according to France’s health minister Agnes Buzyn. 

Satoshi Hiroi, a senior researcher at the Osaka Institute of Public Heath, said high-quality masks could be effective, referring to more expensive, tight-fitting respirators used to filter fine particulates of dust and pollution. 

“But as always, there is no 100% guarantee,” he said, adding, the science was still out on exactly how the virus — which has so far killed 106 people and infected more than 4 000 — is transmitted.

Act of self-defence

Still, on Bangkok’s streets many members of the public put faith in surgical masks on Tuesday 28 January, an act of self-defence in worrying times.

“I’m very concerned about the virus,” Tanyamon Jamophast, 28, told AFP.

“Everywhere I go [in addition to a mask], I also bring alcohol and gel sanitiser to clean my hands and avoid areas with Chinese tourists.”

Others wore heavier duty — and more effective — PM2.5 or 3M (N95) masks, in a city shrouded for weeks by damaging pollution. 

A total of 14 infections, all but one detected in Chinese visitors, have been reported in Thailand, a peak season destination for the tour groups from the mainland.

Sold out

For chemist Suphak Saphakkul that has led to the most intense panic-buying of medical items he has witnessed since the SARS epidemic in 2002/3.

“All our [mask] suppliers are out of stock. These masks are made in China and the country itself is out of stock,” he said.

“We know that it does not provide 100% protection, but it is better than nothing…and it can also reassure the public.”

Masking up

Even for those who have one, there is a proper method to masking up.

On Monday, the mayor of Wuhan, the epicentre of the outbreak, took an online battering after wearing his mask inside-out.

“You can inhale the virus if there is a gap between the mask and the face,” added Satoshi Hiroi of the Osaka Institute of Public Heath.

Meanwhile, the Hubei provincial governor was pilloried for not wearing a mask during a press conference — contravening an order to cover-up in public.

Regular handwashing with soap, alcohol rubs and avoiding touching one’s face, as well as crowded places, are endorsed by the World Health Organisation as effective personal hygiene habits against infection.  

The advice has not stopped a run on the shelves, stockpiling or price hikes for medical masks, from Cambodia to Tokyo and Hubei to Hong Kong, where queues stretched outside the remaining retailers with stocks.

In Bangkok, it is a case of better safe than sorry.

“I just want to be as careful as I can,” said 50-year-old commuter Apinya Sukprasitchai.

By Sophie Deviller / Montira Rungjirajittranon © Agence France-Presse

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Coronavirus Live Updates: More Than 4,000 Infected as Death Toll Surpasses 100

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The outbreak of a mysterious new virus is rapidly spreading, the Chinese authorities said on Tuesday, as the official account of known cases jumped nearly 60 percent overnight and the death toll exceeded 100 for the first time.

◆ China said on Tuesday that 106 people had died from the coronavirus that is believed to have originated in the central city of Wuhan and which is spreading across the country. The previous death toll on Monday was 81.

◆ The number of confirmed cases increased from 2,835 on Monday to 4,515 on Tuesday, according to the National Health Commission. The youngest confirmed case is a 9-month-old girl in Beijing.

◆ Most of the cases have been confirmed in the central Chinese province of Hubei, the epicenter of the outbreak, where several cities, including Wuhan, have been placed under a veritable lockdown. Of the total cases, 2,714 are in Hubei.

◆ Thailand has reported 14 cases of infection; Hong Kong has eight; the United States, Taiwan, Australia and Macau have five each; Singapore, Japan, South Korea and Malaysia each have reported four; France has three; Canada and Vietnam have two; and Nepal, Cambodia and Germany each have one. There have been no deaths outside China.

The sudden outbreak is straining China’s already overworked and underfunded health care system.

In major cities like Beijing and Shanghai, many people have to stand in line in the wee hours of the morning to secure appointments with doctors. When they do get an appointment, patients get only a couple of minutes with a doctor. During flu season, residents set up camp overnight with blankets in hospital corridors.

China does not have a functioning primary care system, so most people flock to hospitals. On an ordinary day, doctors are frustrated and exhausted as they see as many as 200 patients.

Those weaknesses are most pronounced in the poorer areas of China — like Wuhan, the epicenter of the coronavirus. Panicked residents of the city are heading to the hospitals if they have any sign of a cold or cough. Videos circulating on Chinese social media show doctors straining to handle the enormous workload and hospital corridors loaded with patients, some of whom appear to be dead.

Despite having dealt with the SARS coronavirus nearly two decades ago, many Chinese hospitals in smaller cities are not fully prepared to deal with a major outbreak like the current virus. Wuhan hospitals have posted messages online urgently appealing for medical equipment. The situation is even more desperate in poorer, rural areas nearby.

Last week, eight hospitals in Hubei Province — where Wuhan is situated and where most of the cases have appeared — put out a call for N95 masks, goggles, surgical masks and surgical gowns. In the absence of proper equipment, some medical workers have resorted to cutting plastic folders to jury-rig goggles.

With medical facilities in short supply, the local government has also pledged to build a new 1,000-bed hospital in 10 days, and vowed that another new 1,300-bed hospital would be ready by the middle of next month. It is taking a page out of the government’s playbook during SARS, when it built a new hospital in Beijing in just a week.

Health officials in the United States issued new guidance for travelers on Monday, recommending that they avoid all nonessential trips to China.

The warning, from the Centers for Disease Control and Prevention, warned that transportation in and out of Hubei Province, the center of the outbreak, is restricted and that there is “limited access to adequate medical care in affected areas.”

International health officials counseled travelers in China to avoid contact with sick people, animal markets and uncooked meats, and to talk to their health care provider and wash hands frequently.

Reporting was contributed by Chris Buckley, Russell Goldman, Elaine Yu, Raymond Zhong, Austin Ramzy, Sui-Lee Wee, Joseph Goldstein, Jeffrey E. Singer, Peter S. Goodman and Roni Caryn Rabin. Jin Wu, Zoe Mou, Albee Zhang, Amber Wang, Yiwei Wang and Claire Fu contributed research.

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Mahikeng woman arrested for cop’s murder, residents heard screams

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A woman has been arrested for the murder of an off-duty police constable in Mahikeng in the North West after the two allegedly became embroiled in an argument.

It is alleged that residents alerted police in the early hours of Tuesday when they heard screams coming from a house in the Rhodes Park area.

“Members of the SAPS (SA Police Service) reacted swiftly to the crime scene and upon arrival, they found a 29-year-old police constable lying in a pool of blood. The member was rushed to hospital but sadly, died on arrival.

“At the scene, eyewitnesses pointed out a 33-year-old woman as the alleged murderer. The woman was then arrested,” police spokesperson Colonel Athlenda Mathe said.

The woman allegedly had an argument with the constable, preliminary investigations revealed.

She is expected to appear in the Mmabatho Magistrate’s Court on Thursday and cannot be identified until then.

National police commissioner General Khehla Sitole has welcomed the arrest.

“We cannot overemphasise the important role of our communities in working together with our members to detect, prevent and investigate crime. We will continue to urge people in South Africa to join their local community police forums with a view of ensuring that together, we put an end to criminality. We, once again, applaud the brave men and women who continue to work with us in sharing information on crimes,” Sitole said.

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How to reduce your tax bill without resorting to a tax revolt

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Economists and analysts are warning South African taxpayers to prepare themselves for a barrage of tax hikes come April 2020, as government scurries to find some way to plug the country’s growing tax gap.

It has become evident in recent years that the country’s tax collector, SARS, is struggling to meet targets for revenue collection, with government’s spending budget only getting bigger.

With tax collection falling short, and government bailouts to SOEs expanding (on top of an overwhelming wage bill), economists have warned that taxpayers will likely have to fork out more in 2020 and beyond, in the form of more taxes.

Some taxes on the cards include adjusted tax brackets for income tax; higher fuel levies and sin taxes; and even a possible VAT hike to 16%, which would be the second such hike after the tax was raised to 15% in 2018.

News of possible tax hikes comes as government keeps throwing billions of rands at failed SOEs and reports of nepotism and corruption persist in government departments, has again spurred talk of a tax revolt among taxpayers.

However, while tax protest via a revolt might seem attractive, dodging taxes is illegal – and analysts have previously noted that the route would be ineffective in South Africa, where such action would likely fail without the support of corporations.

What can be done

According to Stephen Hartzenberg, head of Product Development at 10X Investments, there are other options available to taxpayers before heading into the murky waters of a tax revolt – namely using every legal channel available to you to minimise the tax you pay at the end of the month.

“There is no doubt that people are angry about money wasted on dysfunctional state-owned enterprises and lost to corruption, and for good reason. In such circumstances, it seems perfectly reasonable for people to ask why they should render unto Caesar more than is absolutely necessary,” he said.

“As much as the idea of fighting back may sound righteous – given a belief that the situation seems to call for stern punitive action against the powers that be – but quiet diplomacy can be extremely effective too. The bottom line is: Make sure you have maxed out on tax incentives before considering tax evasion or a tax revolt.”

Hartzenberg said that taxpayers instead have a number of legal (and moral) tools at their disposal, including:

  • Contributions to a medical aid (and if you have major medical expenses above a certain threshold);
  • Donations to certain charities;
  • Investments in tax-free savings accounts;
  • Retirement fund contributions.

Retirement funds

Hartzenberg said that contributing to a retirement fund will reduce your take-home pay, but it is effectively moving your earnings (plus the tax you would have paid on them) to a different column on your personal balance sheet.

Importantly, you will get all the tax you have paid on these rands refunded when you file your return the following year, he said.

“How much you get back depends on your tax bracket. If you earn R20,000 per month, you fall into the marginal tax bracket of 26%, which means for every extra rand you earn, 26 cents goes to the state.

“The good news is that this is the rate at which your refund will be returned for retirement contributions. In this example, a R10,000 investment in a retirement fund will result in a R2,600 refund from Sars. In other words, your R10,000 investment cost you only R7,400. That’s a whopping return on investment by any measure.”

Hartzenberg said that there are limits, but they are fairly high.

“You can deduct total contributions to a pension, provident or retirement annuity fund up to 27.5% of your taxable income. The overall limit is R350,000 per annum. In our example, the maximum deduction would be R66,000 (27.5% x R20,000 pm).

“Any excess contributions above the limit can be rolled over to the next tax year and deducted then,” he said.


Read: South Africa’s ‘shock’ medical aid changes explained

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Bulls Tongan centre Tuitavake finally arrives in Pretoria

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The Bulls weren’t able to give new signing Nafi Tuitavake a run in their Superhero Sunday warm-up match against the Lions, but the display impressed the former Crusaders centre.

The Tongan outside back’s arrival in the country was delayed due to a work permit issue, but he has since arrived and is eager to get into the mix for the Bulls.

Tuitavake prepared to compete for a place in exciting Bulls team

Cornal Hendricks scored the match-winning try against the Lions playing in Tuitavake’s favoured outside centre position, but his performance was far from faultless. Hendricks spilt two passes in try-scoring situations during the pre-season friendly.

Watch: Highlights of the Bulls 40-35 win over the Lions

Tuitavake hasn’t seen any action since a broken arm ended his Rugby World Cup in Japan. The Tonga centre was released by Northampton Saints at the end of the 2018/19 season English Premiership season.

“I watched the boys play against the Lions (on Superhero Sunday), and there’s definitely some good talent in the team … and I certainly want to be a part of it,” Tuitavake said at his unveiling.

Tongan surprised by SA franchise’s offer

Tuitavake was surprised by the Blue Bulls offer, but he is relishing the prospect of playing for the South African franchise.

“I was at home recovering when my agent asked if I’d be interested in joining the Bulls. I was surprised and didn’t really expect anything to come of it, but then I got an offer, and things happened very quickly after that,” explained Tuitavake at Loftus on Monday.

“It’s all good so far. Everyone’s been very welcoming, and I’m pleased to be here. I just need to adjust to the high altitude and the (hot) sun.

“But this is a great opportunity for me, to be part of a great team. Not too many foreigners come out this way for Super Rugby, but I’m looking forward to the challenge.”

Bulls new signing a versatile outside back

Tuitavake said that he is open to playing both in the outside centre berth vacated by Japan-bound Springbok Jesse Kriel or out on the wing.

“I’m comfortable at 13 and on the wing. I suppose I’ve got some experience, having also played in Europe and in Super Rugby before. I hope I can pay back the team for the confidence they’ve shown in me, but yes, it won’t be easy to fill the shoes vacated by Jesse,” Tuitavake told gathered media.

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Motsepe apologises for Africa-Trump utterances – SABC News

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South African business tycoon Patrice Motsepe has apologised for his recent remarks in which he told US President Donald Trump that Africa loves him.The comments were made at a private dinner hosted by Trump during the World Economic Forum (WEF) in Davos, Switzerland, last week.

Social media erupted in a debate after a video of the tycoon making the remarks went viral.  While most users disagreed with Motsepe, others seemed indifferent.

In a statement, Motsepe says his remarks were partly aimed at encouraging discussions between the Trump Administration and African political and business leaders. He says this was particularly in the context of the increasing feedback from US leaders that South Africa and some African countries are anti-American.

The businessman says Africa and America share the same values and it is in the interest of the continent to build mutually beneficial socio-political and trade ties between the economies and countries. Motsepe concurs with sentiments shared by some social media users that he had no right to speak on their behalf.

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