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With over 200 possible cases, doctors warn reports of rare, coronavirus-linked child inflammatory illness likely to rise – ABC News

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Medical professionals in 20 states and Washington D.C. are investigating more than 200 confirmed or suspected cases of a mysterious illness thought to be linked to the coronavirus and affecting children, according to a new ABC News survey of hospital and state health officials across the country. And while the unexplained syndrome is believed to be extremely rare, experts said they expect the number to grow.

Experts said the inflammatory syndrome, recently named by the Centers for Disease Control and Prevention as Multisystem Inflammatory Syndrome in Children (MIS-C), resembles toxic shock syndrome and Kawasaki disease, itself a rare inflammatory disease typically affecting children under the age of five, and has the potential to be deadly. At least three children have died with the syndrome in New York, where at least an additional 119 cases are under investigation, according to the New York State Department of Health.

While the CDC says the group of symptoms is “associated with” COVID-19, exact cause remains a mystery.

Many kids, though not all, who experience symptoms of MIS-C — which include fever, rash, eye irritation, swollen lymph nodes and/or swelling of the hands and feet — either have been diagnosed with COVID-19 or tested positive for the antibodies, said health experts. And doctors say even those that have tested negative for antibodies could test positive later because of the lag in antibody development.

According to the CDC, It typically takes one to three weeks after someone becomes infected with the novel coronavirus for their body to make antibodies, and some people could take longer than that.

The illness is only a small percentage of the 1.5 million coronavirus cases in the U.S. Dr. Courtney Gidengil, a pediatric infectious disease physician and a policy researcher at the thinktank RAND, said the syndrome is incredibly rare, and parent’s should not panic.

But Gidengil warned the U.S. should expect to see the number of reported cases of the mystery illness rise.

“It seems like it takes four to six weeks for [MIS-C] to develop after infection, not due to the virus itself but rather the body’s response to the illness,” Gidengil said. “We probably will start to see it pop up more around the entire country.”

There is no current official tally of suspected incidents of the illness nationwide, but an ABC News survey of hospital and state health officials in all 50 states and Washington, D.C. found at least 220 confirmed or possible cases of the illness. The majority of possible cases have been reported in New York, but more than a dozen have also been reported in New Jersey and Michigan, and officials said they also saw potential cases in Massachusetts, Washington D.C., Connecticut, California, Utah, Delaware, Illinois, Kentucky, Louisiana, Ohio, Oregon, Pennsylvania, Washington State, Tennessee, Mississippi, Missouri, Georgia and Minnesota.

Some other states like Maryland and North Carolina have told ABC News they don’t have any confirmed cases but are monitoring for any suspected cases.

“I’ll wager that’s going to only go up and it’s going to be much more widespread than anyone thinks,” New York’s Cuomo said.

The CDC sent a warning Thursday to thousands of doctors to be on the lookout for the illness, which was previously known as pediatric multi-system inflammatory syndrome, or PMIS. Friday the government agency said that surveillance of the disease “is limited,” but “now that the case definition and [a health alert] are out, more info is likely to follow.”

Health departments across the country said they have already been on the lookout. Doctors in the U.K., Italy and Spain reported an increase in cases there last month.

The Michigan health department sent out an alert earlier this month to local health agencies and health care providers about the disease and a reminder to report suspected cases within 24 hours. To date, there are 17 suspected cases under review in the state, Michigan health department spokesperson Lynn Sutfin told ABC News. New Jersey, which has reported a total of 18 cases as of Wednesday, sent out their own alert earlier this month as well.

A doctor in Oregon told ABC News proper knowledge about the illness allowed an afflicted eighth grader to get treatment immediately, which ultimately helped save her.

“I’m very grateful because I could have been gone,” 14-year old Leah said in an interview with ABC . “I’m glad I got help right away.”

In California, the state has yet to declare the syndrome a reportable illness, but hospitals have been paying close attention as early as March. Dr. Jim Stein, chief medical officer at Children’s Hospital Los Angeles, said the illness is a sign that the impact of the novel coronavirus is extending to children in a way that “this is no longer considered necessarily less significant for children than it is for adults.”

The CDC alert said that “It is currently unknown if multisystem inflammatory syndrome is specific to children or if it also occurs in adults.”

But little is known about the illness’ connection to COVID-19.

Of the 16 children with inflammatory symptoms in California, 14 have been tested for coronavirus antibodies, Stein said. None of them had tested positive for the coronavirus detection at the time they were admitted to the hospital, but four of them tested positive later. Stein added that the 10 patients that tested negative could also develop antibodies later.

Dr. Andrew Pavia, who has been monitoring two suspected cases at the University of Utah Health Primary Children’s Hospital, said treatments given to patients with the toxic shock related symptoms could also interfere with antibody tests for COVID-19, further complicating the efforts to identify any link between the two.

Health experts are also going back to their current and past patients as they examine more patients and the case definition of the illness broadens from the classic Kawasaki disease, which could increase the number of cases brought forth.

“There’s just a lot to worry about with respect to kids,” Alker said. “We really need a national strategy we need our leaders to sort of thoughtfully consider and address this wide range of threats that children face right now to their health and development.”

“And unfortunately there’s just no sign that exists right now,” Alker added.

With new illness, questions about summer camps, schools re-opening

The sudden rise in critically ill children, albeit extremely small nationwide, has only further ignited the debate surrounding reopening, especially when it comes to schools.

Most states have decided that school openings will occur on a local level, and for nearly the entire country that decision still hangs in the balance. But the start of summer camps and summer programs is just around the corner, and many states have already moved to allow them to go on. States including Georgia, Tennessee, and Connecticut all have possible cases of MIS-C they have been monitoring in their state but have said summer camps may reopen with various forms of social distancing in place.

Dr. Anthony Fauci, the nation’s top infectious disease expert, repeatedly warned lawmakers during a hearing on Tuesday about opening schools and businesses too soon, which he said could cause further outbreaks.

“We don’t know everything about this virus and we really better be very careful particularly when it comes to children,” Dr. Fauci warned.

But some lawmakers have been quick to dismiss the warnings, eagerly pushing to open schools in the fall, which are seen as a major indicator of the country being officially opened.

Sen. Rand Paul, R- Kentucky, pushed back on Fauci’s calls for cautiousness and said it would be a “huge mistake” not to let kids return to school sooner. President Trump also told reporters Wednesday that he was “surprised” by Fauci’s comments. He said it was “not an acceptable answer.”

“I think that we have to open our schools,” Trump said in an interview on Wednesday. “Young people are very little affected by this. We have to get the schools open.”

In Connecticut, where Gov. Ned Lamont and hospitals have recently confirmed that at least five children in the state are being monitored and treated for the new syndrome, the state’s Office of Early Childhood announced this week that summer camps, with the exception of overnight camps, can open on June 29 with specific guidance in place, including a requirement to get a permission to host a group more than 30 as well as other social distancing measures. When schools can reopen there remains a question, as Education Commissioner Miquel Cardona said this week that the school reopening plan will depend on infection trends and that they will need to be flexible.

Georgia Gov. Kemp has implemented a similar measure. Summer camps were permitted to begin operating this week, as long as they follow 32 mandatory criteria that his team developed in absence of the CDC’s guidance. Overnight camps are prohibited. Kemp’s office did not respond to a request for comment about how the new illnesses in the state would impact his decisions about schools moving forward.

In most other states, some summer camps are opening up while some other camps are choosing to remain closed amid state governments’ lack of state-wide directives.

In Maryland, Montgomery County this week went ahead and cancelled all summer camps in the county as it awaits for state health department’s guidance for camps. Guidance on summer camps is pending in Michigan and Massachusetts as well, while Missouri has left it to counties and cities to decide on the fate of summer camps.

In Utah, the Girl Scouts of Utah has extended the cancellation of “in-person meetings for troops and services of units” until June 30, but YMCA of Northern Utah is moving ahead with its camps while adhering to CDC social distancing guidelines. Schools remain closed through the end of the academic year.

An ‘additional risk to consider’

Early concerns about re-opening schools had more to do with the possibility of children potentially transmitting the coronavirus to their teachers, parents or elderly grandparents, who have shown to be much more susceptible to COVID-19’s more serious effects.

Pavia said that the new “scary illness” affecting kids, while very rare, has only added to the difficult safety calculations.

“I think it’s one more factor to put into the very complex decision making about letting kids go back to school in the fall or the summer camps,” Pavia said. “We know that overall they’re likelihood of getting severe respiratory disease is very low. We think that MIS-C is a rare but very serious complication, and you know how it’s hard to make decisions about rare but serious events.”

“I think for schools, it’s just an additional risk to consider,” Pavis added. “I still think that for deciding whether to open schools, the bigger concern is what role children may play in prolonging the epidemic and infecting older people. That’s likely to be a much larger impact in terms of numbers. Psychologically, this may have a bigger role.”

In the meantime, health experts are urgently trying to get the word out about the disease so parents can know identify and get their children medical attention as soon as possible.

“Parents: know the signs of Pediatric Multi-Symptom Inflammatory Syndrome to protect your child,” New York City blasted out in its text-message notification system on Friday.

“This is truly disturbing,” Gov. Cuomo said of the illness at a press conference this week. “We raise it because it’s something parents should be aware of.”

ABC News’ Katherine Faulders and Allie Pecorin contributed to this report.

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City asking people to wear masks on buses, but not mandatory – GuelphToday

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As the city prepares to allow more riders on Guelph Transit buses, it is asking riders to wear a non-medical mask or face covering.

They are not mandatory.

Free 30-minute Guelph Transit service will continue for the rest of June but the city says thta with more businesses reopening and more people heading back to work, Guelph Transit is preparing to resume fare collection and regular schedules later in the summer.

In a news release Friday morning, the city said the request is based advice from Wellington-Dufferin-Guelph Public Health.

“According to health officials, wearing a homemade face covering/non-medical mask is not a substitute for physical distancing and hand washing. Wearing a mask has not been proven to protect the person wearing it, but it can help protect others around you,” the release said.

“As the buses get busy again, physical distancing may not always be possible. We’re asking riders to wear a non-medical mask or face covering to help prevent the spread of COVID-19,” says Robin Gerus, general manager of Guelph Transit.

Guelph Transit is encouraging face coverings, not requiring them.

“It’s becoming more common to wear a mask on public transit in other cities, but it’s new for Guelph. Some riders may not be aware of or understand the latest guidelines from health officials. Some may not have resources to purchase or make a mask, or they may have a medical reason for not wearing one,” added Gerus. Everyone is welcome to use Guelph Transit, and we’re asking people to protect and respect each other as ridership increases.”

Since March, Guelph Transit made the following adjustments to slow the spread of COVID-19:

  • free 30-minute service allows passengers to avoid using the farebox and board from the rear door
  • plastic barrier between the driver and passengers
  • hand sanitizing stations and cleaning supplies for drivers
  • no more than 10 people per bus
  • blocked several seats to encourage physical distancing between passengers

To prevent the spread of COVID-19, the City and Guelph Transit encourage riders to continue following the latest advice from Wellington-Dufferin-Guelph Public Health:

  • wash your hands regularly or use hand sanitizer
  • stay at least two metres away from people you don’t live with
  • when you can’t maintain physical distancing, wear a non-medical mask or face covering

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WHO resumes hydroxychloroquine trial on Covid-19 patients – ITIJ

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On May 25, WHO suspended the trial of the drug, which is usually used to treat malaria patients, after a study published in medical journal The Lancet found that Covid-19 hospitalised patients treated with hydroxychloroquine had a higher risk of death, as well as an increased frequency of irregular heartbeats, than those who weren’t treated with it. 

However, WHO officials have since asserted that there is no evidence that the drug reduces the mortality in these patients, and the study has since been retracted over data concerns. 

“The executive group received this recommendation and endorsed the continuation of all arms of solidarity trial including hydroxychloroquine,” said WHO Director-General Tedros Adhanom Ghebreyesus during a press conference 3 June, adding that WHO planned to continue to monitor the safety of the therapeutics being tested in trials involving over 3,500 patients spanning over 35 countries. 

“WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity,” Ghebreyesus said. 

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'Truly sorry': Scientists pull panned Lancet study of Trump-touted drug – National Post

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NEW YORK/LONDON — An influential study that found hydroxychloroquine increased the risk of death in COVID-19 patients has been withdrawn a week after it led to major trials being halted, adding to confusion about a malaria drug championed by U.S. President Donald Trump.

The Lancet medical journal pulled the study after three of its authors retracted it, citing concerns about the quality and veracity of data in it. The World Health Organization (WHO) will resume its hydroxychloroquine trials after pausing them in the wake of the study. Dozens of other trials have resumed or are in process.

The three authors said Surgisphere, the company that provided the data, would not transfer the dataset for an independent review and they “can no longer vouch for the veracity of the primary data sources.”

The fourth author of the study, Dr. Sapan Desai, chief executive of Surgisphere, declined to comment on the retraction.

The Lancet said it “takes issues of scientific integrity extremely seriously” adding: “There are many outstanding questions about Surgisphere and the data that were allegedly included in this study.”

Another study in the New England Journal of Medicine (NEJM) that used Surgisphere data and shared the same lead author, Harvard Medical School Professor Mandeep Mehra, was retracted for the same reason.

The Lancet said reviews of Surgisphere’s research collaborations were urgently needed.

The race to understand and treat the new coronavirus causing the COVID-19 pandemic has accelerated the pace of research and peer-reviewed scientific journals are go-to sources of information for doctors, policymakers and lay people alike.

Chris Chambers, a professor of psychology and an expert at the UK Center for Open Science, said The Lancet and the NEJM – which he described as “ostensibly two of the world’s most prestigious medical journals” – should investigate how the studies got through peer review and editorial checks.

“The failure to resolve such basic concerns about the data” raises “serious questions about the standard of editing” and about the process of peer review, he said.

The Lancet did not immediately respond to a Reuters request for comment. The NEJM could not immediately be reached for comment.

UNANSWERED QUESTIONS

The observational study published in The Lancet on May 22 said it looked at 96,000 hospitalized COVID-19 patients, some treated with the decades-old malaria drug. It claimed that those treated with hydroxychloroquine or the related chloroquine had higher risk of death and heart rhythm problems than patients who were not given the medicines.

“I did not do enough to ensure that the data source was appropriate for this use,” the study’s lead author, Professor Mehra, said in a statement. “For that, and for all the disruptions – both directly and indirectly – I am truly sorry.”

Many scientists voiced concern about the study, which had already been corrected last week because some location data was wrong. Nearly 150 doctors signed an open letter to The Lancet calling the article’s conclusions into question and asking to make public the peer review comments that preceded publication.

Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine said the retraction decision was “correct” but still left unanswered the question about whether hydroxychloroquine is effective in COVID-19.

“It remains the case that the results from randomized trials are necessary to draw reliable conclusions,” he said. (Reporting by Michael Erman, Peter Henderson, Kate Kelland and Josephine Mason Editing by Leslie Adler, Tom Brown, Giles Elgood and Carmel Crimmins)

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