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| 15 Children Are Hospitalized With Mysterious Illness Possibly Tied to Covid-19 | 15 Children Are Hospitalized With Mysterious Illness Possibly Tied to Covid-19 |
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| Fifteen children, many of whom had the coronavirus, have recently been hospitalized in New York City with a mysterious syndrome that doctors do not yet fully understand but that has also been reported in several European countries, health officials announced on Monday night. | Fifteen children, many of whom had the coronavirus, have recently been hospitalized in New York City with a mysterious syndrome that doctors do not yet fully understand but that has also been reported in several European countries, health officials announced on Monday night. |
| Many of the children, ages 2 to 15, have shown symptoms associated with toxic shock or Kawasaki disease, a rare illness in children that involves inflammation of the blood vessels, including coronary arteries, the city’s health department said. | Many of the children, ages 2 to 15, have shown symptoms associated with toxic shock or Kawasaki disease, a rare illness in children that involves inflammation of the blood vessels, including coronary arteries, the city’s health department said. |
| None of the New York City patients with the syndrome have died, according to a bulletin from the health department, which describes the illness as a “multisystem inflammatory syndrome potentially associated with Covid-19.” | None of the New York City patients with the syndrome have died, according to a bulletin from the health department, which describes the illness as a “multisystem inflammatory syndrome potentially associated with Covid-19.” |
| Reached late Monday night, the state health commissioner, Dr. Howard A. Zucker, said state officials were also investigating the unexplained syndrome. | Reached late Monday night, the state health commissioner, Dr. Howard A. Zucker, said state officials were also investigating the unexplained syndrome. |
| The syndrome has received growing attention in recent weeks as cases began appearing in European countries hit hard by the coronavirus. | The syndrome has received growing attention in recent weeks as cases began appearing in European countries hit hard by the coronavirus. |
| “There are some recent rare descriptions of children in some European countries that have had this inflammatory syndrome, which is similar to the Kawasaki syndrome, but it seems to be very rare,” Dr. Maria Van Kerkhove, a World Health Organization scientist, said at a news briefing last week. | “There are some recent rare descriptions of children in some European countries that have had this inflammatory syndrome, which is similar to the Kawasaki syndrome, but it seems to be very rare,” Dr. Maria Van Kerkhove, a World Health Organization scientist, said at a news briefing last week. |
| It was not immediately known whether children in other parts of the United States have come down with this illness. New York City has been the center of the pandemic. | It was not immediately known whether children in other parts of the United States have come down with this illness. New York City has been the center of the pandemic. |
| Covid-19, the disease caused by the coronavirus, tends to be much more dangerous for older people and those with underlying health conditions. Children are less likely to become seriously ill than adults. But some do. In New York City, six children have died of Covid-19, according to data from the health department. | Covid-19, the disease caused by the coronavirus, tends to be much more dangerous for older people and those with underlying health conditions. Children are less likely to become seriously ill than adults. But some do. In New York City, six children have died of Covid-19, according to data from the health department. |
| Reports of children sick with the unexplained syndrome in New York City have been circulating for several days, but Monday’s bulletin was the first time the city’s health authorities warned doctors to be on the lookout for patients who might have it. | Reports of children sick with the unexplained syndrome in New York City have been circulating for several days, but Monday’s bulletin was the first time the city’s health authorities warned doctors to be on the lookout for patients who might have it. |
| The bulletin said that most of the 15 children had a fever and many had a rash, vomiting or diarrhea. Since being hospitalized, five of them have needed a mechanical ventilator to help them breathe, and most of the 15 “required blood pressure support.” | The bulletin said that most of the 15 children had a fever and many had a rash, vomiting or diarrhea. Since being hospitalized, five of them have needed a mechanical ventilator to help them breathe, and most of the 15 “required blood pressure support.” |
| “The full spectrum of disease is not yet known,” the bulletin said. Of the 15 patients, most either tested positive for the coronavirus or were found, through antibody testing, to likely have been previously infected. | “The full spectrum of disease is not yet known,” the bulletin said. Of the 15 patients, most either tested positive for the coronavirus or were found, through antibody testing, to likely have been previously infected. |
| The city’s health commissioner, Dr. Oxiris Barbot, said in a statement: “Even though the relationship of this syndrome to Covid-19 is not yet defined, and not all of these cases have tested positive for Covid-19 by either DNA test or serology, the clinical nature of this virus is such that we are asking all providers to contact us immediately if they see patients who meet the criteria we’ve outlined.” | The city’s health commissioner, Dr. Oxiris Barbot, said in a statement: “Even though the relationship of this syndrome to Covid-19 is not yet defined, and not all of these cases have tested positive for Covid-19 by either DNA test or serology, the clinical nature of this virus is such that we are asking all providers to contact us immediately if they see patients who meet the criteria we’ve outlined.” |
| “And to parents,” she added, “if your child has symptoms like fever, rash, abdominal pain or vomiting, call your doctor right away.” | “And to parents,” she added, “if your child has symptoms like fever, rash, abdominal pain or vomiting, call your doctor right away.” |
| Conjunctivitis, or inflammation of the eye, and swollen lymph nodes are also symptoms of Kawasaki disease. | Conjunctivitis, or inflammation of the eye, and swollen lymph nodes are also symptoms of Kawasaki disease. |
| The health department identified the 15 patients by contacting hospital pediatric intensive care units across the city in recent days. “Only severe cases may have been recognized at this time,” the bulletin said. | The health department identified the 15 patients by contacting hospital pediatric intensive care units across the city in recent days. “Only severe cases may have been recognized at this time,” the bulletin said. |
| The 15 patients were all hospitalized on or after April 17. | The 15 patients were all hospitalized on or after April 17. |
| WNBC-TV previously reported that Mount Sinai Kravis Children’s Hospital had treated some patients believed to have this syndrome — and that some had developed heart problems and low blood pressure. | WNBC-TV previously reported that Mount Sinai Kravis Children’s Hospital had treated some patients believed to have this syndrome — and that some had developed heart problems and low blood pressure. |
| Dr. Zucker, the state health commissioner, was asked last week about reports of toxic shock in younger patients. He responded that officials were aware that the virus attacks different organs, including the lining of blood vessels, something some doctors believe may be contributing to blood clots in some coronavirus patients. | Dr. Zucker, the state health commissioner, was asked last week about reports of toxic shock in younger patients. He responded that officials were aware that the virus attacks different organs, including the lining of blood vessels, something some doctors believe may be contributing to blood clots in some coronavirus patients. |
| Updated June 22, 2020 | Updated June 22, 2020 |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| “What we have been seeing is that there are some children who may have an inflammation of those blood vessels, and are developing a toxic-shock-like syndrome,” he said, adding that he had spoken to number of hospital directors about a small number of cases. | |
| On Monday night, Dr. Zucker reiterated that state health officials were aware of multiple cases of this syndrome in New York City hospitals, and that he had spoken with medical providers statewide about it. | On Monday night, Dr. Zucker reiterated that state health officials were aware of multiple cases of this syndrome in New York City hospitals, and that he had spoken with medical providers statewide about it. |
| Dr. Zucker said the state health department was also looking at Kawasaki-like cases in children and adolescents in Europe, which were the subject of an international webinar last weekend. | Dr. Zucker said the state health department was also looking at Kawasaki-like cases in children and adolescents in Europe, which were the subject of an international webinar last weekend. |
| “So far, from what we understand, this is a rare complication in the pediatric population that they believe is related to Covid-19,” Dr. Zucker said, adding, “We are following it very closely.” | “So far, from what we understand, this is a rare complication in the pediatric population that they believe is related to Covid-19,” Dr. Zucker said, adding, “We are following it very closely.” |
| Pediatricians in several European countries, including Italy, Britain, France and Spain, have reported dozens of cases of children presenting these kind of symptoms. | Pediatricians in several European countries, including Italy, Britain, France and Spain, have reported dozens of cases of children presenting these kind of symptoms. |
| No deaths have been recorded, and although many of the children tested positive for the coronavirus, others didn’t. | No deaths have been recorded, and although many of the children tested positive for the coronavirus, others didn’t. |
| In Italy’s northern town of Bergamo, a hot spot for the outbreak, one hospital had 20 cases in April alone. In four Parisian hospitals, 20 children were hospitalized with inflammatory heart conditions, and in Britain, over a dozen children with such symptoms have required intensive care. | In Italy’s northern town of Bergamo, a hot spot for the outbreak, one hospital had 20 cases in April alone. In four Parisian hospitals, 20 children were hospitalized with inflammatory heart conditions, and in Britain, over a dozen children with such symptoms have required intensive care. |
| Spain has recorded a few dozen cases throughout the country, and Switzerland and Belgium have reported a handful. | Spain has recorded a few dozen cases throughout the country, and Switzerland and Belgium have reported a handful. |
| Pediatricians have urged families whose children have high fever, rashes or stomach pains to call doctors immediately. Some have said they were concerned that parents might not take their children to the hospitals because of the pandemic. | Pediatricians have urged families whose children have high fever, rashes or stomach pains to call doctors immediately. Some have said they were concerned that parents might not take their children to the hospitals because of the pandemic. |
| As those countries are weighing how to reopen schools, health experts said the small number of these unusual cases shouldn’t prevent the authorities from doing so. | As those countries are weighing how to reopen schools, health experts said the small number of these unusual cases shouldn’t prevent the authorities from doing so. |
| Jesse McKinley and Elian Peltier contributed reporting. | Jesse McKinley and Elian Peltier contributed reporting. |