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COVID-19 Striking Far More Children Than Expected – SciTechDaily

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Cumulative number of confirmed COVID-19 pediatric intensive care patients United States (March 18-April 6). Credit: mvps.org

The number of children infected with the coronavirus is far more extensive than what is currently reported — a hidden detail that could vastly underestimate the demand on health care systems and pediatric intensive care units (PICUs).

A new study published in the Journal of Public Health Management and Practice from the University of South Florida (USF) and the Women’s Institute for Independent Social Enquiry (WiiSE), estimates that for each child who requires intensive care for COVID-19, there are 2,381 children infected with the virus. This calculation follows a report from the Chinese Center for Disease Control and Prevention regarding its clinical study of over 2,100 children in China with COVID-19.

Estimated Number of Children Infected With SARS-CoV-2

Cumulative estimated number of children infected with SARS-CoV-2 United States. (March 18-April 6). Credit: University of South Florida

According to the North American registry, Virtual PICU Systems, 74 children in the U.S. were admitted to PICUs between March 18 and April 6, signaling an additional 176,190 children were likely infected during this timeframe. Children younger than 2 accounted for 30 percent of the cases, 24 percent were ages 2 to 11 and 46 percent of the PICU cases were children between ages 12 and 17. Researchers say that if as many as 25 percent of the U.S. population becomes infected with the coronavirus before the end of 2020, 50,000 children with severe illness will need to be hospitalized, with 5,400 of them critically ill and requiring mechanical ventilation. Clinical reports indicate the average length of stay for pediatric COVID-19 is 14 days. According to a national survey aimed to evaluate the U.S. pediatric critical care capacity and published in “Critical Care Medicine,” there are approximately 5,100 PICU beds in the U.S.

“Although the risk of severe illness from COVID-19 is lower in pediatric cases than adults, hospitals should be prepared and have the proper equipment and staffing levels to deal with a potential influx of younger patients,” said author Jason Salemi, associate professor of epidemiology in the USF College of Public Health. “Government officials and policy makers should understand the likelihood of capacity challenges, which underscores the importance of effective mitigation strategies such as frequent and thorough handwashing and persisted social distancing measures.”

Projected Numbers of Children Hospitalization for COVID-19

Projected numbers of children aged 0 to 17 years in the United States who will require hospitalization for COVID-19 during 2020. Credit: University of South Florida

Pediatric coronavirus is highly complex, as many hospitals are prohibiting visitors in order to implement social distancing and quarantine protocols. A caretaker may also be infected, which would require logistical and infection control accommodations that place an additional strain on hospital resources. Upon hospital discharge, young children may be unable to independently comply with home infection control and self-isolation recommendations.

Researchers point out the infection rate will be much higher for children in low-income families with parents in blue-collar and service jobs, which preclude the option of working from home. There’s also an increased risk to children who live in urban public housing projects due to the close proximity of housing units and small communal recreation and commons areas.

The study’s authors recommend all state health departments and the CDC begin reporting confirmed COVID-19 cases in age-specific tables, using the standard 5-year age groups for health surveillance and make the data publicly available.

Reference: “COVID-19 in Children in the United States: Intensive Care Admissions, Estimated Total Infected, and Projected Numbers of Severe Pediatric Cases in 2020” by Elizabeth Barnett Pathak, PhD, MSPH; Jason L. Salemi, PhD, MPH; Natasha Sobers, PhD, MBBS, MPH, FRSPH; Janelle Menard, PhD, MPH and Ian R. Hambleton PhD, 10 April 2020, Journal of Public Health Management and Practice.
DOI: 10.1097/PHH.0000000000001190

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Trucker brings in another case of COVID-19 as two new cases emerge Friday – Winnipeg Sun

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Another case of COVID-19 in a truck driver, and one in a close household contact of that driver, were reported by public health officials on Friday.

The two new cases bring the province’s total to an even 300 since the outbreak began in early March. The cases are both from Winnipeg. One is in a man in his 30s and another in a man in his 20s.

Dr. Brent Roussin, Manitoba’s chief public health officer, said the trucker who tested positive had travelled outside of the province.

Other details were sparse, including if the driver had self-isolated or not.

“I don’t have a lot of details on that as of yet, the public health investigation is ongoing,” Roussin said.

Last week, two cases in truck drivers that had travelled into the U.S. for work were also reported.

Roussin said no new measures are going to be implemented in terms of testing truck drivers or requiring them to self-isolate upon return from international or domestic travel.

Currently, all truck drivers can access asymptomatic testing, but Roussin said they cannot disrupt supply chains into the province.

The province’s active caseload jumped to nine with the two new cases as no new recoveries were announced. There have been 284 total recoveries thus far.

The death toll in Manitoba remains at seven, and no one is in hospital at the moment.

The Cadham Provincial Laboratory processed 671 tests on Thursday, bringing the running total since early February to 47,372.

Meanwhile, changes to the hours of operation at community testing sites in Brandon, Portage la Prairie, Steinbach and Winkler, as well as at Thunderbird House in Winnipeg, come into effect this weekend.

Due to low patient volumes, these sites are now closed on Sundays.

KNOWLEDGE, ROAD TESTS RESUME

Manitoba Public Insurance is resuming knowledge tests for all licence classes and road test bookings for Class 1 licences effective immediately, a release said on Friday.

Customers are encouraged to book Class 5 and 6 knowledge tests online. For those who cannot book online, MPI is allowing customers who phone their Autopac agent to perform certain critical transactions over the phone or by email.

For Class 1 road tests, drivers will be required to provide and wear their own mask, be screened prior to the test and sanitize all touchpoints in their vehicle.

Knowledge test customers will be asked to arrive on-site 15 minutes prior to their appointment.

sbilleck@postmedia.com

Twitter: @scottbilleck

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Ripples from coronavirus research scandal rocks global scientific community – RFI English

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Issued on: 06/06/2020 – 12:02Modified: 06/06/2020 – 12:02

The first research scandal of the coronavirus pandemic has created unnecessary distraction around the politically divisive drug hydroxychloroquine, scientists say.

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This as questions swirl around the tiny health care company at the center of the affair.

 On Thursday, most of the authors of major studies that appeared in The Lancet and the New England Journal of Medicine (NEJM) retracted their work.

The issued apologies, saying they could no longer vouch for their data after the firm that supplied it — Chicago-based Surgisphere — refused to be audited.

 At any other time the matter might have led to hang-wringing within academia, but it has taken on a new dimension as the world grapples with a virus that has claimed some 400,000 lives.

Lancet paper

 Of particular interest was the paper in The Lancet that claimed to have analyzed the records of 96,032 patients admitted to 671 hospitals across six continents, finding that hydroxychloroquine showed no benefit and even increased the risk of death.

Its withdrawal is seen as a boost to backers of the decades-old anti-malarial drug, who include US President Donald Trump and his Brazilian counterpart Jair Bolsonaro.

 “It’s very politicized — there is a group, probably not particularly small, who have learned to mistrust science and scientists, and this just feeds into that narrative,” Gabe Kelen, a professor of emergency medicine at Johns Hopkins University, told French new agency AFP.

This is despite the fact that even without The Lancet paper, evidence has been building against hydroxychloroquine’s use against COVID-19.

 On Friday, results from a fourth randomized controlled trial — carefully designed human experiments considered the most robust form of clinical investigation — showed it had no impact against the virus.

Mystery company

 The Lancet, which first published in 1823, is one of the world’s most trusted medical journals.

   As a  result, the hydroxychloroquine paper had an outsized impact: the World Health Organization, Britain and France all suspended ongoing clinical trials.

 But things soon began unravelling after researchers noticed numerous red flags, from the huge number of patients involved to the unusual level of detail about the doses they had received.

 Both The Lancet and the equally prestigious NEJM, which had published a paper on whether blood thinners elevated the risk of COVID-19 that relied on the same company, issued expressions of concern — before the authors themselves pulled both papers.

 Role of Surgisphere

 Surgisphere, founded in 2007 by vascular surgeon Sapan Desai, had refused to share data with third-party reviewers, saying it would violate privacy agreements with hospitals.

 However, when science news site The Scientist began reaching out to hospitals throughout the US to ask whether they had participated, it found none.

Surgisphere’s internet profile has also raised numerous questions. Only a handful of employees could be found on LinkedIn, and most have now deactivated their accounts.

 According to the Guardian newspaper, its employees included an adult model and until last week the contact page on its website redirected to a WordPress template for a cryptocurrency website, leaving it unclear how hospitals could have reached out to them.

   Meanwhile Desai, who according to court records has three outstanding medical malpractice suits against him, has written extensively in the past on research misconduct.

   “The most serious cause of fraud in medical publishing is manufactured data that authors use to support high impact conclusions,” he said in a 2013 paper.

  

  

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COVID-19 research scandal: Unwanted diversion during pandemic – Egypt Independent

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June 6, 2020
10:04 am


The first research scandal of the coronavirus pandemic has created unnecessary distraction around the politically divisive drug hydroxychloroquine, scientists say, as questions swirl around the tiny health care company at the center of the affair.

On Thursday, most of the authors of major studies that appeared in The Lancet and the New England Journal of Medicine (NEJM) retracted their work and issued apologies, saying they could no longer vouch for their data after the firm that supplied it — Chicago-based Surgisphere — refused to be audited.

At any other time the matter might have led to hang-wringing within academia, but it has taken on a new dimension as the world grapples with a virus that has claimed some 400,000 lives.

Of particular interest was the paper in The Lancet that claimed to have analyzed the records of 96,032 patients admitted to 671 hospitals across six continents, finding that hydroxychloroquine showed no benefit and even increased the risk of death.

Its withdrawal is seen as a boost to backers of the decades-old anti-malarial drug, who include US President Donald Trump and his Brazilian counterpart Jair Bolsonaro.

“It’s very politicized — there is a group, probably not particularly small, who have learned to mistrust science and scientists, and this just feeds into that narrative,” Gabe Kelen, a professor of emergency medicine at Johns Hopkins University, told AFP.

This is despite the fact that even without The Lancet paper, evidence has been building against hydroxychloroquine’s use against COVID-19.

On Friday, results from a fourth randomized controlled trial — carefully designed human experiments considered the most robust form of clinical investigation — showed it had no impact against the virus.

– Mystery company –

The Lancet, which first published in 1823, is one of the world’s most trusted medical journals.

As a result, the hydroxychloroquine paper had an outsized impact: the World Health Organization, Britain and France all suspended ongoing clinical trials.

But things soon began unravelling after researchers noticed numerous red flags, from the huge number of patients involved to the unusual level of detail about the doses they had received.

Both The Lancet and the equally prestigious NEJM, which had published a paper on whether blood thinners elevated the risk of COVID-19 that relied on the same company, issued expressions of concern — before the authors themselves pulled both papers.

Surgisphere, founded in 2007 by vascular surgeon Sapan Desai, had refused to share data with third-party reviewers, saying it would violate privacy agreements with hospitals.

However, when science news site The Scientist began reaching out to hospitals throughout the US to ask whether they had participated, it found none.

Surgisphere’s internet profile has also raised numerous questions. Only a handful of employees could be found on LinkedIn, and most have now deactivated their accounts.

According to the Guardian newspaper, its employees included an adult model and until last week the contact page on its website redirected to a WordPress template for a cryptocurrency website, leaving it unclear how hospitals could have reached out to them.

Meanwhile Desai, who according to court records has three outstanding medical malpractice suits against him, has written extensively in the past on research misconduct.

“The most serious cause of fraud in medical publishing is manufactured data that authors use to support high impact conclusions,” he said in a 2013 paper.

– Systemic issues –

For Ivan Oransky, who founded Retraction Watch in 2010, the affair is far from surprising, serving instead to highlight systemic issues in science publishing and the way science is reported to the public.

“No one took a hard look at the data,” said Oransky. “But we’ve known about these issues for literally decades.”

Policymakers should get away from the idea of using the results of a single study to inform their decisions, he added, as was the case for the WHO — and the media has a responsibility to place papers in context instead of hyping them up.

The problem also stems from the fact that even leading journals rely too heavily on an honor system, but “you never know when a catastrophe is going to happen, if you’re not willing to put into place some reasonable safeguards,” added Oransky.

As to the future, the current episode is unlikely to serve as a wake-up call, he said. If one journal increases its diligence, more blockbuster papers will start appearing in its competitors.

Image: AFP/File / GEORGE FREY A pharmacy tech holds a tablet of hydroxychloroquine


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