Coronavirus COVID-19 - Global Health Pandemic #68

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Kawasaki-like syndrome found in adults as well as children.

Looks like it would. It kills anthrax for one thing. BBM:

"The researchers reported that virus tests at the Galveston National Laboratory found 99.8% of the novel SARS-CoV-2, the virus that causes COVID-19, was killed in a single pass through a filter made from commercially available nickel foam heated to 200 degrees Centigrade, or about 392 degrees Fahrenheit. It also killed 99.9% of the anthrax spores in testing at the national lab, which is run by the University of Texas Medical Branch."

ALSO: "This novel biodefense indoor air protection technology offers the first-in-line prevention against environmentally mediated transmission of airborne SARS-CoV-2 and will be on the forefront of technologies available to combat the current pandemic and any future airborne biothreats in indoor environments," Cheema said.

Hourani and Peel have called for a phased roll-out of the device, "beginning with high-priority venues, where essential workers are at elevated risk of exposure (particularly schools, hospitals and health care facilities, as well as public transit environs such as airplanes)."

That will both improve safety for frontline workers in essential industries and allow nonessential workers to return to public work spaces, they said."

I hope it will work as well as it sounds.

I hope that it's tested and the tests are published in various journals. Would also like to know the cost...and how they plan to scale up.
 
I was hospitalized a few years ago for 5 days. The bill was nearly $60,000 and I wasn't even in the ICU. I have no idea how our millions without insurance manage.

My son was hospitalized last year for 4 days in Naples FL. With insurance, his bill was $50,000. He only makes $55,000/yr but thank goodness he had decent coverage. He is still paying on it... $200/mo.
 
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NYTimes: 69 page internal CDC document deems schools fully reopening as the "highest risk" for spread of the coronavirus.

As Trump Demanded Schools Reopen, His Experts Warned of ‘Highest Risk’

...”the talking points say. “In addition, few plans include information regarding school closure in the event of positive tests in the school community.”

This is my biggest question. What will schools do when (certainly not “if”) a student or teacher has covid. Will the entire class quarantine for 14 days? Will the entire school quarantine? At the very least it isn't seem feasible for kids to hop in and out of school like that not to even mention the health risk many teachers face. I don’t think anyone argues that children need to be in school but I have a feeling that it just won’t work for most parts of the country.
 
My work is online, I am alone, and that’s not good. I had to put my cat and my dog down within the last 3 months, (unrelated natural causes). It is too hot to walk or garden for more than a few minutes. I am keeping it together but just barely.

You can chat over WS if you need to. I'm not online much, but if you see me and need to talk, please message me.
 
Of course we all knew it was just a matter of time before Dr. Fauci would be thrown under the bus.

Yep. I’m just going to repeat myself from an earlier post - that IMO, Dr Fauci has maintained his integrity throughout this nightmare. I know exactly who I would trust if given a choice between him and politicians.
 
I live in a smallish city in Texas, but my loved ones, including grown children are in a very large city a few hours away. It’s easy to take a look at the rapidly growing numbers and see that we need a hard lockdown before the hospitals are completely overrun, not after. We need it before the schools and daycares open, not after! I don’t know anyone who wants that, but as Taste123 said, sacrifices must be made in order to protect lives. MOO

My work is online, I am alone, and that’s not good. I had to put my cat and my dog down within the last 3 months, (unrelated natural causes). It is too hot to walk or garden for more than a few minutes. I am keeping it together but just barely.

I’m very grateful to be able to converse with everyone here at WS! I look forward to Trisha’s podcasts. It’s like having a few friends (and their pets),over in my living room.

I’m ready to bite the bullet with a complete lockdown because this has got to be stopped, the sooner, the better!

Keep posting TGIRecovered.:):):)
Among the many horrid numbers, we hear of successes.
As you state, 'lock downs' important when numbers are high.
Here, we are in a 'lock down', hoping for a speedy success story, all following the rules.
We have great leaders.

Hope, soon, you obtain another pet to love, during this sad time.
Good luck, and keep safe.
 
MIS-C: South Carolina identifies first cases of coronavirus-related inflammatory syndrome in children - CNN

“(CNN)Two children in South Carolina have been diagnosed with the coronavirus-related pediatric inflammatory syndrome, according to the state's Department of Health and Environmental Control.“

[...]

We continue to see more and more young people, especially those under 20, contracting and spreading COVID-19, and we know MIS-C is a threat to our youngest South Carolinians," State Epidemiologist Dr. Linda Bell said in a news release. "MIS-C is a serious health complication linked to COVID-19 and is all the more reason why we must stop the spread of this virus."“

—-


Multisystem Inflammatory Syndrome Found In Rappahannock District
July 10
The Rappahannock Area Health District confirmed its first case of COVID-19-related multisystem inflammatory syndrome in children.
“This represents the seventh case of MIS-C in Virginia, and there have been no MIS-C related deaths reported so far in the state. Cases of MIS-C in Virginia are reported on the Virginia Department of Health website. This case will be added to the data, which is updated daily.“

—-


MIS-C: Tip of the Iceberg for Kids' COVID Inflammation?
Surveillance data affirm profile of the syndrome, but there may be more to it

June 30

“”Overall, a consistent clinical picture is emerging," said Michael Levin, PhD, of Imperial College London, in an accompanying editorial.

These larger cohorts mostly confirm prior findings on the the affected age range (median 8-10 years, but range from infants to late teens), predominance of Hispanic/black children affected, presenting symptoms (GI symptoms are frequent), and that cardiac involvement is common, noted Kevin Friedman, MD, of Boston Children's Hospital and a member of the American Heart Association's Young Hearts Council and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee.

However, Levin drew attention to the issue of case definitions.

The U.K. definition of "pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2" (PIMS) released in April was followed by a narrower definition released in May by the CDC and WHO for MIS-C.

These "hastily developed case definitions based on the most severe cases" might miss less serious cases, Levin noted. For example, the CDC and WHO definitions require evidence of SARS-CoV-2 infection or exposure, which "is problematic, since asymptomatic infections are common and antibody testing is neither universally available nor reliable."

Children meeting MIS-C diagnostic criteria could represent the "tip of the iceberg," Levin wrote.”



WS Thread for MIS-C:
Multisystem inflammatory syndrome in children (MIS-C and COVID-19)
 
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Hey Snoods ... pet adoptions and fostering are way, way, way up here in Australia. So many people bringing a new family member into their homes now that covid has changed our lives. Lots of places have closed applications as they have no pets left to be fostered or adopted!
Oh my gosh that’s AMAZING! You have no idea how much that lifts my spirits. Just another reason why I love Aussies so much!
Thank you for taking the time to let me know. :)
 
Interesting study showing a community case spread from a family gathering and also how contact tracing helps show spread...

That gathering ended up infecting at least 41 people in 9 separate families and at 8 different workplaces.

https://www.charlotteobserver.com/news/coronavirus/article244147427.html

"Two families who attended the party & later tested positive for the coronavirus returned to work afterward, infecting at least 9 of their co-workers, the contact tracing map shows. Those co-workers subsequently infected their parents, kids & spouses.”

And a little graphic to illustrate.
Screen%20Shot%202020-07-10%20at%203.54.59%20PM.png
 
Bringing forward some information and posts from the MIS-C thread, as we move forward in our discussions about schools opening, etc.:

“What is MIS-C?
Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. We do not yet know what causes MIS-C. However, many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.”

Multisystem Inflammatory Syndrome in Children (MIS-C)

“MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care.“

Coronavirus Disease 2019 (COVID-19)

Kawasaki Syndrome | CDC

“CDC is investigating reports of multisystem inflammatory syndrome in children (MIS-C)associated with coronavirus disease 2019 (COVID-19), which may present with Kawasaki disease-like features. Please visit the CDC MIS-C website for information for healthcare providers, parents, and to find out what CDC is doing to respond to MIS-C.

Kawasaki disease (KD), also known as Kawasaki syndrome, is an acute febrile illness of unknown cause that primarily affects children younger than 5 years of age. The disease was first described in Japan by Tomisaku Kawasaki in 1967, and the first cases outside of Japan were reported in Hawaii in 1976. Clinical signs include fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips, and throat.“

“What to do if you think your child is sick with MIS-C
Contact your child’s doctor, nurse, or clinic right away if your child is showing symptoms of MIS-C:

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Bloodshot eyes
  • Feeling extra tired
Be aware that not all children will have all the same symptoms.

Seek emergency care right away if your child is showing any of these emergency warning signs of MIS-C or other concerning signs:

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain
How doctors will care for your child
Doctors may do certain tests to look for inflammation or other signs of disease. These tests might include:

  • Blood tests
  • Chest x-ray
  • Heart ultrasound (echocardiogram)
  • Abdominal ultrasound
Doctors may provide supportive care for symptoms (medicine and/or fluids to make your child feel better) and may use various medicines to treat inflammation. Most children who become ill with MIS-C will need to be treated in the hospital. Some will need to be treated in the pediatric intensive care unit (ICU).

Parents or caregivers who have concerns about their child’s health, including concerns about COVID-19 or MIS-C, should call a pediatrician or other healthcare provider immediately. Healthcare providers can follow CDC recommendations to keep children and their parents or caregivers safe if an in-person visit is needed.

What we don’t know about MIS-C
CDC is still learning about MIS-C and how it affects children, so we don’t know why some children have gotten sick with MIS-C and others have not. We also do not know if children with certain health conditions are more likely to get MIS-C. These are among the many questions CDC is working to try to understand.

All CDC recommendations are based on the best data and science available at the time, and we will update them as we learn more.

How to protect your child from COVID-19
Based on what we know now about MIS-C, the best way you can protect your child is by taking everyday actions to prevent your child and the entire household from getting the virus that causes COVID-19.“

Coronavirus Disease 2019 (COVID-19)

Mayo Clinic:
COVID-19 linked to inflammatory syndrome in children

“Multisystem inflammatory syndrome in children (MIS-C) and COVID-19
Learn the signs and symptoms of a rare, serious condition called multisystem inflammatory syndrome in children (MIS-C) that's linked to COVID-19, the new coronavirus disease.

Though children of all ages can become sick with coronavirus disease 2019 (COVID-19), most kids who are infected typically don't become as sick as adults do. Some children who have an active infection with the virus that causes COVID-19 might not show any signs or symptoms at all.


Still, you may have heard about a serious inflammatory syndrome in children, including some teenagers, that appears to be linked to COVID-19. It's called multisystem inflammatory syndrome in children (MIS-C). This syndrome is rare, and most children who have it eventually get better with medical care. But some kids rapidly get worse, to the point where their lives are at risk.

Much remains to be learned about this new and emerging inflammatory syndrome, and the cause is not known yet. But if your child shows any signs or symptoms, get help fast. Here's what you need to know.


What is multisystem inflammatory syndrome in children (MIS-C)?
Multisystem inflammatory syndrome in children (MIS-C) is a serious condition in which some parts of the body — such as the heart, blood vessels, kidneys, digestive system, brain, skin or eyes — become inflamed. Inflammation typically includes swelling, often with redness and pain.


Many, but not all, children with MIS-C test negative for a current infection with the virus that causes COVID-19. Yet evidence indicates that many of these children were infected with the COVID-19 virus in the past, as shown by positive antibody test results.

An antibody test with a positive result means that the child's immune system developed blood proteins (antibodies) that fought the COVID-19 virus. Sometime this blood test is the only indication that the child was ever infected — meaning the child may have fought the infection without ever having shown signs or symptoms of COVID-19. Still, some children with MIS-C are currently infected with the virus, usually confirmed by detection of the virus on a swab taken from the back of the nose or throat.

MIS-C shares some of the same signs and symptoms as another condition called Kawasaki disease. Kawasaki disease mainly affects children under 5 years of age. It causes inflammation in the walls of blood vessels, particularly those that supply blood to the heart muscle (coronary arteries). Researchers are working to figure out if the two conditions are related or not.


What are the signs and symptoms of MIS-C?
Signs and symptoms of multisystem inflammatory syndrome in children include those below, though not all children have the same symptoms:

  • Fever that lasts 24 hours or longer
  • Vomiting
  • Diarrhea
  • Pain in the stomach
  • Skin rash
  • Red eyes
  • Redness or swelling of the lips and tongue
  • Feeling unusually tired
  • Redness or swelling of the hands or feet

Emergency warning signs of MIS-Cinclude:

  • Inability to wake up or stay awake
  • Difficulty breathing
  • Chest pain or pressure that doesn't go away
  • New confusion
  • Bluish lips or face
  • Severe stomach pain

What should you do if you think your child has MIS-C?
If your child shows any of the emergency warning signs listed above — or is severely sick with other signs and symptoms — get care immediately. Take your child to the nearest emergency department or call 911 or your local emergency number.

If your child isn't severely ill but shows other signs or symptoms of MIS-C, contact your child's doctor right away for advice. Doctors may want to do some tests — such as blood tests, or imaging tests of the chest, heart or abdomen — to check for areas of inflammation and other signs of MIS-C.



How is MIS-C treated?
Most children with MIS-C need to be treated in a hospital, and some will need treatment in a pediatric intensive care unit. Treatment usually involves different types of therapies that target the immune system and reduce inflammation. Depending on your child's symptoms and condition, he or she may receive anti-inflammatory drugs and other medications to reduce inflammation in the affected vital organs, such as the heart or kidneys, and protect them from permanent damage.


MIS-C is not contagious, but there's a chance that your child could have an active infection with the COVID-19 virus or another type of contagious infection. So the hospital will use infection control measures while caring for your child.”

“How to help prevent your child from getting MIS-C
The best way to help prevent your child from getting MIS-C is to take action to avoid exposure to the COVID-19 virus and teach your child how to do the same. Follow the guidelines of the U.S. Centers for Disease Control and Prevention:


  • Keep hands clean. Wash hands often with soap and water for at least 20 seconds. If soap and water aren't available, use a hand sanitizer that contains at least 60% alcohol.
  • Avoid people who are sick. In particular, avoid people who are coughing, sneezing or showing other signs and symptoms that indicate they might be sick and contagious.
  • Practice social distancing. This means that you and your child should stay at least 6 feet (2 meters) from other people when outside of your home.
  • Wear cloth face masks in public settings. When it's difficult to practice social distancing, both you and your child — if he or she is age 2 years or older — should wear face masks that cover the nose and mouth.
  • Clean and disinfect high-touch surfaces every day. This includes areas of your home such as doorknobs, light switches, remotes, handles, countertops, tables, chairs, desks, keyboards, faucets, sinks and toilets.
  • Wash clothing and other items as needed. Follow manufacturers' instructions, using the warmest appropriate water setting on your washing machine. Remember to include washable plush toys.
You can be assured that experts continue to collect and analyze data about MIS-Cto learn more about this complex condition and its possible causes, and to improve diagnosis, treatment and outcomes for children.”“

Mayo Clinic
COVID-19 linked to inflammatory syndrome in children

MIS-C: South Carolina identifies first cases of coronavirus-related inflammatory syndrome in children - CNN

“Experts are still learning about MIS-C and trying to determine why some children experience it while others do not.
But two recent studies -- both published last month in the New England Journal of Medicine -- show MIS-C can cause serious symptoms and is potentially fatal. They showed that 80% of patients with MIS-C required treatment in intensive care.
In one report, CDC researchers analyzed 186 cases from 26 states between March 15 and May 20.
Patients were hospitalized for a median of seven days and 20% required ventilation to help them breathe. Four patients, or 2%, died. The median age of patients was 8 years old. Just 7% of patients were under a year old, most of the rest were between a year old and 14, and 16% were ages 15 to 20.
The second report, by the New York State Department of Health, examined 99 children with suspected or confirmed MIS-C who were hospitalized between March 1 and May 20. In that study, the median hospital stay was six days.“

Two South Carolina children diagnosed with MIS-C: health condition linked to COVID-19, DHEC says

“The Department of Health and Environmental Control says both children are under the age of 10. One is from the Midlands region, and one is from the PeeDee region.

“We continue to see more and more young people, especially those under 20, contracting and spreading COVID-19, and we know MIS-C is a threat to our youngest South Carolinians,” said Dr. Linda Bell, State Epidemiologist. “MIS-C is a serious health complication linked to COVID-19 and is all the more reason why we must stop the spread of this virus. Anyone and everyone is susceptible to COVID-19 as well as additional health risks associated with it, which is why all of us must stop the virus by wearing a mask and stay six feet away from others. These simple actions are how we protect ourselves and others, including our children.”

The first reports of this syndrome came from the United Kingdom in late April. Cases in the United States were first reported in New York City in early May.“

Multisystem Inflammatory Syndrome Found In Rappahannock District
July 10
The Rappahannock Area Health District confirmed its first case of COVID-19-related multisystem inflammatory syndrome in children.
“This represents the seventh case of MIS-C in Virginia, and there have been no MIS-C related deaths reported so far in the state. Cases of MIS-C in Virginia are reported on the Virginia Department of Health website. This case will be added to the data, which is updated daily.“

New England Journal of Medicine
https://www.nejm.org/doi/full/10.1056/NEJMoa2021680
Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
List of authors.
  • Leora R. Feldstein, Ph.D.,
  • Erica B. Rose, Ph.D.,
  • Steven M. Horwitz, M.D.,
  • Jennifer P. Collins, M.D.,
  • for the Overcoming COVID-19 Investigators, and the CDC COVID-19 Res

    BACKGROUND

    Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome.

    METHODS
    We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms.

    RESULTS
    We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki’s disease–like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%).

    CONCLUSIONS
    Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.)”

    Full Report at link

Multisystem Inflammatory Syndrome in Children (MIS-C) | Boston Children's Hospital

“MIS-C has varied symptoms that affect several organs and systems in the body. Many children have symptoms resembling toxic shock syndrome or Kawasaki disease, in which blood vessels, including the coronary arteries, enlarge or form aneurysms. Some children have signs of excessive blood clotting, gastrointestinal symptoms, kidney injury, neurologic symptoms, or heart inflammation with impaired heart function. These symptoms can occur in different combinations.

While Boston Children’s Hospital and other medical centers are still actively collecting data on MIS-C, it seems so far to be rare, and most children recover with careful observation and treatment. To date, some children with this syndrome have needed to be hospitalized, but only a very small percentage have passed away.”

[...]

“Some researchers suspect that MIS-C is caused by a delayed immune response to the coronavirus that somehow goes into overdrive, causing inflammation that damages organs. It’s also possible that the antibodies children make to the virus are creating the immune reaction. Since only a small number of children develop MIS-C, it is possible that there are genetic factors that make some children susceptible.“

-more at link

Worrisome details noted in kids with COVID inflammatory syndrome
June 29

“Today the New England Journal of Medicine published two studies spotlighting the serious manifestations of COVID-19–related multisystem inflammatory syndrome in children (MIS-C), the first involving 186 kids in 26 states and the second involving 99 patients in New York.“


MIS-C: Tip of the Iceberg for Kids' COVID Inflammation?
Surveillance data affirm profile of the syndrome, but there may be more to it

June 30

“”Overall, a consistent clinical picture is emerging," said Michael Levin, PhD, of Imperial College London, in an accompanying editorial.

These larger cohorts mostly confirm prior findings on the the affected age range (median 8-10 years, but range from infants to late teens), predominance of Hispanic/black children affected, presenting symptoms (GI symptoms are frequent), and that cardiac involvement is common, noted Kevin Friedman, MD, of Boston Children's Hospital and a member of the American Heart Association's Young Hearts Council and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee.

However, Levin drew attention to the issue of case definitions.

The U.K. definition of "pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2" (PIMS) released in April was followed by a narrower definition released in May by the CDC and WHO for MIS-C.

These "hastily developed case definitions based on the most severe cases" might miss less serious cases, Levin noted. For example, the CDC and WHO definitions require evidence of SARS-CoV-2 infection or exposure, which "is problematic, since asymptomatic infections are common and antibody testing is neither universally available nor reliable."

Children meeting MIS-C diagnostic criteria could represent the "tip of the iceberg," Levin wrote.”

Childhood Multisystem Inflammatory Syndrome — A New Challenge in the Pandemic
  • Michael Levin, F.Med.Sci., Ph.D.
June 29, 2020
DOI: 10.1056/NEJMe2023158

New England Journal of Medicine

“The recognition and description of new diseases often resemble the parable of the blind men and the elephant, with each declaring that the part of the beast they have touched fully defines it. As the coronavirus disease 2019 (Covid-19) pandemic has evolved, case reports have appeared describing children with unusual febrile illnesses that have features of Kawasaki’s disease,1 toxic shock syndrome,2 acute abdominal conditions, and encephalopathy, along with other reports of children with fever, elevated inflammatory markers, and multisystem involvement.3-5 It is now apparent that these reports were describing different clinical presentations of a new childhood inflammatory disorder.

A case definition for the emerging disorder was published in late April 2020,5 after U.K. pediatricians alerted the National Health Service to an unusual inflammatory illness, termed “pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),” or PIMS-TS.6 Similar cases were rapidly reported from many other countries.3,4 The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) subsequently published their own differing definitions of the disorder, which they named multisystem inflammatory syndrome in children (MIS-C).”

Studies find nearly 300 kids with inflammatory condition tied to Covid-19
June 29

“The studies, published in the New England Journal of Medicine, describe children who develop severe inflammation affecting multiple organ systems after having had Covid-19, sometimes between two and four weeks after the infection. The majority of the children were previously healthy.

In one of the studies, led by researchers at Boston Children’s Hospital, 80% of the children who developed the condition required intensive care, 20% required mechanical ventilation, and four children, or 2%, died. In the second study, from researchers from New York state, a similar percentage of 99 children who developed the syndrome required ICU care and two children died. In both studies, many of the children developed cardiovascular and clotting problems and many had gastrointestinal symptoms. A high proportion also had skin rashes.

“Ours were really sick kids,” said Adrienne Randolph, an ICU physician at Boston Children’s Hospital and senior author on one of the papers, which was based on reports from 26 states.”

New York State Department of Health Announces Study on Multisystem Inflammatory Syndrome in Children
Study Focused on Patients' Demographics, Underlying Conditions, Symptoms, and Health Outcomes
Study Links Syndrome to COVID-19


“ALBANY, N.Y. (June 29, 2020) - The New York State Department of Health today announced that the Department has led a study on multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, which was published today in the New England Journal of Medicine. The Department collaborated with the University at Albany School of Public Health and the federal Centers for Disease Control and Prevention (CDC) to complete the study.

The study describes 99 cases of MIS-C and concludes the emergence of the condition in New York State followed widespread COVID-19 transmission and often is associated with cardiac dysfunction.

"This landmark study links COVID-19 and MIS-C and will help healthcare professionals throughout the country diagnose this condition in their patients," said Commissioner of the New York State Department of Health Dr. Howard Zucker. "From the very beginning, New York State has led the nation on investigations into MIS-C, and I commend our team of public health scientists for their excellent work expanding our knowledge and understanding of the SARS-CoV-2 virus."

"This investigation into a new and serious condition among children with COVID-19 is a true model of state, federal, and academic collaboration in the midst of a public health emergency", said Dr. Eli Rosenberg, Associate Professor of Epidemiology at the University at Albany School of Public Health. "Each team brought invaluable and complementary expertise to the table to rapidly produce findings that will benefit other communities confronting this disease."”

“Manish Patel, from the Centers for Disease Control and Prevention’s Covid-19 response team, said the message to parents is they should be on the lookout for fever and rash in children who have recently had Covid-19.

“I think being a little vigilant is important,” said Patel, who is an author on Randolph’s paper. “Fever, rash and I think especially in the setting of areas where you have a lot of coronavirus infections, SARS-CoV-2 infections — have a lower threshold for seeking care, I would say.”

On the whole, children appear to contract SARS-CoV-2 less often than adults and have a milder course of disease when they do.

But in late April, doctors in London alerted the world to the possibility that some children who had Covid-19 appeared to go on to develop something that looked like Kawasaki’s disease, an inflammatory condition that can attack the heart. KD, as it is called, is generally seen in children under the age of 5. Shortly thereafter, doctors in New York began to report cases as well.“

Studies find nearly 300 kids with inflammatory condition tied to Covid-19
JUNE 29, 2020

New England Journal of Medicine
Multisystem Inflammatory Syndrome in Children in New York State

Elizabeth M. Dufort, M.D., Emilia H. Koumans, M.D., M.P.H., Eric J. Chow, M.D., M.P.H., Elizabeth M. Rosenthal, M.P.H., for the New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team*
June 29, 2020

“Abstract
BACKGROUND

A multisystem inflammatory syndrome in children (MIS-C) is associated with coronavirus disease 2019. The New York State Department of Health (NYSDOH) established active, statewide surveillance to describe hospitalized patients with the syndrome.

METHODS
Hospitals in New York State reported cases of Kawasaki’s disease, toxic shock syndrome, myocarditis, and potential MIS-C in hospitalized patients younger than 21 years of age and sent medical records to the NYSDOH. We carried out descriptive analyses that summarized the clinical presentation, complications, and outcomes of patients who met the NYSDOH case definition for MIS-C between March 1 and May 10, 2020.

RESULTS
As of May 10, 2020, a total of 191 potential cases were reported to the NYSDOH. Of 95 patients with confirmed MIS-C (laboratory-confirmed acute or recent severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] infection) and 4 with suspected MIS-C (met clinical and epidemiologic criteria), 53 (54%) were male; 31 of 78 (40%) were black, and 31 of 85 (36%) were Hispanic. A total of 31 patients (31%) were 0 to 5 years of age, 42 (42%) were 6 to 12 years of age, and 26 (26%) were 13 to 20 years of age. All presented with subjective fever or chills; 97% had tachycardia, 80% had gastrointestinal symptoms, 60% had rash, 56% had conjunctival injection, and 27% had mucosal changes. Elevated levels of C-reactive protein, d-dimer, and troponin were found in 100%, 91%, and 71% of the patients, respectively; 62% received vasopressor support, 53% had evidence of myocarditis, 80% were admitted to an intensive care unit, and 2 died. The median length of hospital stay was 6 days.

CONCLUSIONS
The emergence of multisystem inflammatory syndrome in children in New York State coincided with widespread SARS-CoV-2 transmission; this hyperinflammatory syndrome with dermatologic, mucocutaneous, and gastrointestinal manifestations was associated with cardiac dysfunction.”

Full report at link:
https://www.nejm.org/doi/full/10.1056/NEJMoa2021756
 
...”the talking points say. “In addition, few plans include information regarding school closure in the event of positive tests in the school community.”

This is my biggest question. What will schools do when (certainly not “if”) a student or teacher has covid. Will the entire class quarantine for 14 days? Will the entire school quarantine? At the very least it isn't seem feasible for kids to hop in and out of school like that not to even mention the health risk many teachers face. I don’t think anyone argues that children need to be in school but I have a feeling that it just won’t work for most parts of the country.

I've asked that repeatedly and I see it ignored over and over again in public discussions in my area. In fact there was outrage that a football player for a local highschool team tested positive and now the whole team had to quarantine. People were saying how stupid it was and that the schools would just have to be shut down if they had to
quarantine everyone exposed to someone who tested positive.

Yes, exactly. That's what happens. So while these yokels were arguing we should stay open and quarantine no one exposed I think it's clear that can't work for more than a matter of weeks. So how come the people with big darn salaries and pensions for handling these schools can't even pretend to try and answer HOW schools can and should be run??? I mean this is their job like it or not. I am daily blown away by the level of denial I see. But I expect people whose jobs require addressing this to address it. This is insane. You can't wish a virus and pandemic away and or pretend no student will get sick so you don't need to plan what to do.

And I know other humans are capable of this. I have a friend who is a teacher in Canada and their schools have exact and specific plans laid out for how to handle all of this. How is it our country is somehow special in the level of stupidity displayed at every bureaucratic level?
 
...”the talking points say. “In addition, few plans include information regarding school closure in the event of positive tests in the school community.”

This is my biggest question. What will schools do when (certainly not “if”) a student or teacher has covid. Will the entire class quarantine for 14 days? Will the entire school quarantine? At the very least it isn't seem feasible for kids to hop in and out of school like that not to even mention the health risk many teachers face. I don’t think anyone argues that children need to be in school but I have a feeling that it just won’t work for most parts of the country.
Here in Fl. parents in my county of Central Fl.
told me NO MASKS in grades K-5, no required
social distancing.
I'm taking bets on how long til these schools
have to completely close down due to being
blanketed with the virus.
It's the poorer children going back to public schools according to parents, because it's cheaper than day care.
Where parents don't need to work, they're keeping kids home for virtual classes or regular home schooling.
Seems like a plan set up to fail, IMO.
 
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