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A New Coronavirus Threat to Children A New Coronavirus Threat to Children
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The coronavirus has largely spared children. Most confirmed to be infected have had only mild symptoms. But doctors in Europe and the United States have recently reported a troubling new phenomenon: Some children are becoming seriously ill with symptoms that can involve inflammation in the skin, eyes, blood vessels and heart.The coronavirus has largely spared children. Most confirmed to be infected have had only mild symptoms. But doctors in Europe and the United States have recently reported a troubling new phenomenon: Some children are becoming seriously ill with symptoms that can involve inflammation in the skin, eyes, blood vessels and heart.
The condition, which doctors are calling “pediatric multisystem inflammatory syndrome,” is so new that there are still many unanswered questions about how and why it affects children. Here’s a summary of what is and isn’t known so far.The condition, which doctors are calling “pediatric multisystem inflammatory syndrome,” is so new that there are still many unanswered questions about how and why it affects children. Here’s a summary of what is and isn’t known so far.
Symptoms can include fever, rash, reddish eyes, swollen lymph nodes and sharp abdominal pain. They do not usually include two common hallmarks of Covid-19: cough and shortness of breath.Symptoms can include fever, rash, reddish eyes, swollen lymph nodes and sharp abdominal pain. They do not usually include two common hallmarks of Covid-19: cough and shortness of breath.
The syndrome can bear some resemblance to a rare childhood illness called Kawasaki disease, but as doctors learn more, they are emphasizing that the two conditions are not the same.The syndrome can bear some resemblance to a rare childhood illness called Kawasaki disease, but as doctors learn more, they are emphasizing that the two conditions are not the same.
Both involve a surge of inflammation in the body and can have serious effects on the heart. But Dr. Steven Kernie, chief of pediatric critical care medicine at Columbia University and NewYork-Presbyterian Morgan Stanley Children’s Hospital, said the new syndrome appears to affect the heart differently. While Kawasaki disease can produce coronary aneurysms when left untreated, the new syndrome seems to mostly involve inflammation of coronary arteries and other blood vessels.Both involve a surge of inflammation in the body and can have serious effects on the heart. But Dr. Steven Kernie, chief of pediatric critical care medicine at Columbia University and NewYork-Presbyterian Morgan Stanley Children’s Hospital, said the new syndrome appears to affect the heart differently. While Kawasaki disease can produce coronary aneurysms when left untreated, the new syndrome seems to mostly involve inflammation of coronary arteries and other blood vessels.
And though shock is a rare complication of Kawasaki disease, the new syndrome has sent many of the children into a kind of toxic shock with very low blood pressure and an inability of the blood to effectively circulate oxygen and nutrients to the body’s organs, Dr. Kernie said.And though shock is a rare complication of Kawasaki disease, the new syndrome has sent many of the children into a kind of toxic shock with very low blood pressure and an inability of the blood to effectively circulate oxygen and nutrients to the body’s organs, Dr. Kernie said.
The coronavirus primarily affects adults by entering cells in their lungs and replicating, often causing respiratory failure. But this childhood syndrome “seems to be less a lung-specific disease,” Dr. Kernie said.The coronavirus primarily affects adults by entering cells in their lungs and replicating, often causing respiratory failure. But this childhood syndrome “seems to be less a lung-specific disease,” Dr. Kernie said.
While most of the hospitalized children with the syndrome need some additional oxygen, and a few have required ventilators, the effect on the lungs seems to be driven by an inflammatory response that affects many other parts of the body as well.While most of the hospitalized children with the syndrome need some additional oxygen, and a few have required ventilators, the effect on the lungs seems to be driven by an inflammatory response that affects many other parts of the body as well.
Three children in New York have died from it, Governor Andrew Cuomo reported on Saturday. Another death, of a 14-year-old boy in England was reported in, a study in the journal Lancet.Three children in New York have died from it, Governor Andrew Cuomo reported on Saturday. Another death, of a 14-year-old boy in England was reported in, a study in the journal Lancet.
There is no good data on how many children have developed the syndrome, but it appears to be a small number so far. On May 8, Gov. Andrew M. Cuomo said there had been 73 reported cases in New York state and that the health department was investigating several child deaths as other possible cases. A handful of cases have been reported in other states, including Louisiana, Mississippi and California. There have been at least 50 cases reported in European countries, including Britain, France, Switzerland, Spain and Italy.There is no good data on how many children have developed the syndrome, but it appears to be a small number so far. On May 8, Gov. Andrew M. Cuomo said there had been 73 reported cases in New York state and that the health department was investigating several child deaths as other possible cases. A handful of cases have been reported in other states, including Louisiana, Mississippi and California. There have been at least 50 cases reported in European countries, including Britain, France, Switzerland, Spain and Italy.
Hospitals have seen cases in children of all ages, from infants to older teenagers.Hospitals have seen cases in children of all ages, from infants to older teenagers.
Dr. Katie Schafer, a general pediatrician who has a private practice in Birmingham, Michigan, a suburb of Detroit, said that because there were still many unknowns about the condition, parents of children who have symptoms should take them to pediatricians rather than assuming that a rash or fever or abdominal pain is only a sign of a typical childhood illness.Dr. Katie Schafer, a general pediatrician who has a private practice in Birmingham, Michigan, a suburb of Detroit, said that because there were still many unknowns about the condition, parents of children who have symptoms should take them to pediatricians rather than assuming that a rash or fever or abdominal pain is only a sign of a typical childhood illness.
“This is presenting very much like a common childhood illness, which it is not,” she said. “This is a novel diagnosis that doesn’t exactly have a name, doesn’t exactly have a timeline, doesn’t exactly have a protocol. We didn’t learn about this in medical school.”“This is presenting very much like a common childhood illness, which it is not,” she said. “This is a novel diagnosis that doesn’t exactly have a name, doesn’t exactly have a timeline, doesn’t exactly have a protocol. We didn’t learn about this in medical school.”
Many of the children who have become sick with the syndrome either tested positive for the coronavirus at the time of their symptoms, or had positive antibody tests suggesting they may have been infected weeks earlier. Dr. Schafer said it was possible that “this may be a post-infection condition and not necessarily part of the acute phase of Covid.”Many of the children who have become sick with the syndrome either tested positive for the coronavirus at the time of their symptoms, or had positive antibody tests suggesting they may have been infected weeks earlier. Dr. Schafer said it was possible that “this may be a post-infection condition and not necessarily part of the acute phase of Covid.”
Updated June 5, 2020Updated June 5, 2020
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.
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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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.
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.
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.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.
Treatments have included steroids, intravenous immunoglobulin, high-dose aspirin and antibiotics, as well as supportive oxygen through the nose, a mask or, in the most serious cases, a ventilator. Most children who are intubated can be removed from the ventilators within a few days, doctors said.Treatments have included steroids, intravenous immunoglobulin, high-dose aspirin and antibiotics, as well as supportive oxygen through the nose, a mask or, in the most serious cases, a ventilator. Most children who are intubated can be removed from the ventilators within a few days, doctors said.
It’s unclear. Children who have had serious effects on their hearts will need to be monitored by cardiologists in case there is residual heart damage. Others will undoubtedly need to be followed by their pediatricians to keep track of any lingering effects.It’s unclear. Children who have had serious effects on their hearts will need to be monitored by cardiologists in case there is residual heart damage. Others will undoubtedly need to be followed by their pediatricians to keep track of any lingering effects.
Children may be at greater risk for this syndrome because their immune systems are not fully developed, Dr. Kernie said. But there are no clues yet as to why some children get sick and not others. Many of the children have been previously healthy. And the syndrome doesn’t seem to run in families, but Dr. Kernie’s hospital and others are doing genetic testing to see if there is a predisposition or genetic reason one child becomes very sick while siblings seem unscathed.Children may be at greater risk for this syndrome because their immune systems are not fully developed, Dr. Kernie said. But there are no clues yet as to why some children get sick and not others. Many of the children have been previously healthy. And the syndrome doesn’t seem to run in families, but Dr. Kernie’s hospital and others are doing genetic testing to see if there is a predisposition or genetic reason one child becomes very sick while siblings seem unscathed.
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