1 00:00:04,280 --> 00:00:09,039 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's stay sixty one. 2 00:00:09,200 --> 00:00:13,960 Speaker 1: Since coronavirus was declared a global pandemic our main story. 3 00:00:14,720 --> 00:00:18,000 Speaker 1: For a long time, it seemed like the only reassuring 4 00:00:18,040 --> 00:00:21,599 Speaker 1: thing about the virus was that children were unlikely to 5 00:00:21,640 --> 00:00:25,960 Speaker 1: get very sick from it. That idea is being challenged, though, 6 00:00:26,360 --> 00:00:29,840 Speaker 1: as a new COVID nineteen related illness has begun to 7 00:00:29,880 --> 00:00:34,839 Speaker 1: appear in children around the world. But first, here's what 8 00:00:34,960 --> 00:00:50,839 Speaker 1: happened today. New York City, the epicenter of the outbreak 9 00:00:50,880 --> 00:00:54,440 Speaker 1: in the US, is likely to stay locked down into June. 10 00:00:55,440 --> 00:00:59,600 Speaker 1: That's according to its bare build Blasio. Some parts of 11 00:00:59,640 --> 00:01:03,400 Speaker 1: the eight will be able to reopen from Friday, but 12 00:01:03,480 --> 00:01:06,959 Speaker 1: the city hasn't made enough progress in cutting down on 13 00:01:07,040 --> 00:01:12,880 Speaker 1: new cases. That's even though hospital and intensive care admissions 14 00:01:12,920 --> 00:01:17,679 Speaker 1: are falling. Deblasio also said health officials will turn to 15 00:01:17,800 --> 00:01:22,240 Speaker 1: dozens of small, private, neighborhood medical practices to aid in testing, 16 00:01:22,720 --> 00:01:28,679 Speaker 1: contact tracing, and outpatient care around the country. A promising 17 00:01:28,720 --> 00:01:32,160 Speaker 1: new COVID nineteen drug may be hard to come by. 18 00:01:32,920 --> 00:01:36,759 Speaker 1: Gilead Sciences is donating vials of its COVID nineteen drug 19 00:01:36,880 --> 00:01:41,080 Speaker 1: ram desevere to countries around the world, but the US 20 00:01:41,440 --> 00:01:45,800 Speaker 1: will get less than half. Gilead is donating about enough 21 00:01:45,880 --> 00:01:50,280 Speaker 1: to treat seventy eight thousand hospitalized patients, according to the 22 00:01:50,320 --> 00:01:54,040 Speaker 1: Department of Health and Human Services, but more than three 23 00:01:54,120 --> 00:01:58,160 Speaker 1: hundred thousand patients in the US are eligible for emergency 24 00:01:58,200 --> 00:02:01,600 Speaker 1: access to the drug that won't be available through the 25 00:02:01,760 --> 00:02:07,400 Speaker 1: end of July. More data is showing the virus's disproportionate effects. 26 00:02:08,440 --> 00:02:11,720 Speaker 1: We know that Black Americans are dying at alarmingly high 27 00:02:11,840 --> 00:02:16,360 Speaker 1: rates of COVID nineteen, but a new Bloomberg News analysis 28 00:02:16,400 --> 00:02:20,640 Speaker 1: shows that majority black counties have triple the COVID nineteen 29 00:02:20,720 --> 00:02:24,880 Speaker 1: death rate of others. The larger a county's share of 30 00:02:24,919 --> 00:02:30,000 Speaker 1: Black residents, the worse the health outcomes get. In counties 31 00:02:30,000 --> 00:02:33,079 Speaker 1: where African Americans are a higher proportion of the population 32 00:02:33,240 --> 00:02:35,799 Speaker 1: than they are in the US, the death rate is 33 00:02:35,919 --> 00:02:40,519 Speaker 1: roughly double the national average. That's according to an analysis 34 00:02:40,520 --> 00:02:45,000 Speaker 1: of Johns Hopkins University and Census Bureau data. In majority 35 00:02:45,080 --> 00:02:50,480 Speaker 1: Black counties, deaths from coronavirus are more than triple. The 36 00:02:50,520 --> 00:02:54,480 Speaker 1: disparities have only grown as the death toll has climbed. 37 00:02:57,520 --> 00:03:02,200 Speaker 1: In South Korea, confirmed cases of Good nineteen suddenly increased 38 00:03:02,240 --> 00:03:06,080 Speaker 1: after a lull that has sparked fears of a potential 39 00:03:06,120 --> 00:03:10,640 Speaker 1: second wave of infections. The latest surge is tied to 40 00:03:10,720 --> 00:03:14,600 Speaker 1: a single infected twenty nine year old who visited nightclubs 41 00:03:14,600 --> 00:03:19,160 Speaker 1: and Seoul. Since he did, at least fifty four cases 42 00:03:19,200 --> 00:03:21,840 Speaker 1: have been traced to the clubs, according to the Korea 43 00:03:21,919 --> 00:03:27,120 Speaker 1: Centers for Disease Control and Prevention. Authorities are estimating between 44 00:03:27,280 --> 00:03:30,040 Speaker 1: six to seven thousand people could have been exposed to 45 00:03:30,040 --> 00:03:33,960 Speaker 1: the virus from clubs between April nine and May six. 46 00:03:35,200 --> 00:03:38,920 Speaker 1: Souls Mayor has ordered all nightclubs and similar establishments in 47 00:03:38,960 --> 00:03:51,800 Speaker 1: the capital to close, and now our main story. Last week, 48 00:03:52,160 --> 00:03:54,640 Speaker 1: a five year old boy in New York died from 49 00:03:54,720 --> 00:03:59,800 Speaker 1: COVID nineteen related complications. Dozens of other children are becoming 50 00:04:00,000 --> 00:04:04,000 Speaker 1: sick with a similar cluster of symptoms. They mirror a 51 00:04:04,160 --> 00:04:09,080 Speaker 1: rare condition called Kawasaki disease. The rise of this new 52 00:04:09,120 --> 00:04:13,720 Speaker 1: threat to children opens up a terrifying possibility. Have we 53 00:04:13,840 --> 00:04:18,560 Speaker 1: been wrong about how the disease affects kids. The accepted 54 00:04:18,600 --> 00:04:22,000 Speaker 1: wisdom had been that children could transmit the virus but 55 00:04:22,160 --> 00:04:25,880 Speaker 1: not get sick from it. The new illness is throwing 56 00:04:25,920 --> 00:04:30,960 Speaker 1: that assumption into question. Jason Gale talked to the world's 57 00:04:31,160 --> 00:04:36,040 Speaker 1: leading expert on Kawasaki disease to help unpack what's going on. 58 00:04:41,360 --> 00:04:43,400 Speaker 1: You might have heard of a pox body. It's a 59 00:04:43,480 --> 00:04:47,680 Speaker 1: social gathering where children are deliberately exposed to an infectious disease, 60 00:04:48,120 --> 00:04:52,320 Speaker 1: like chicken pox. These parties were sometimes done before vaccines 61 00:04:52,320 --> 00:04:55,640 Speaker 1: were widely available to speed up immunity, in the belief 62 00:04:55,680 --> 00:04:59,520 Speaker 1: that some illnesses experienced as children would result in less 63 00:04:59,560 --> 00:05:03,240 Speaker 1: severe disease then if the infection occurred in adulthood. But 64 00:05:03,360 --> 00:05:07,080 Speaker 1: the practice has survived to modern times, usually hosted by 65 00:05:07,160 --> 00:05:10,680 Speaker 1: vaccination skeptics, and there are signs the spirit of the 66 00:05:10,680 --> 00:05:14,680 Speaker 1: Fox Party exists in our Washington State county, where people 67 00:05:14,760 --> 00:05:19,360 Speaker 1: allegedly called the coronavirus from such events. Washington State health 68 00:05:19,360 --> 00:05:23,279 Speaker 1: officials say that deliberately catching the pandemic virus can be 69 00:05:23,360 --> 00:05:27,560 Speaker 1: incredibly dangerous for obvious reasons. It puts people that increased 70 00:05:27,640 --> 00:05:31,520 Speaker 1: risk for hospitalization and even death. It may also lead 71 00:05:31,520 --> 00:05:34,440 Speaker 1: to an uptick in cases that will slow attempts to 72 00:05:34,480 --> 00:05:38,120 Speaker 1: lift physical distancing measures and revive the economy. And there's 73 00:05:38,120 --> 00:05:40,159 Speaker 1: still a lot we don't know about the virus that 74 00:05:40,279 --> 00:05:49,000 Speaker 1: causes COVID nineteen, including any long term health effects. COVID 75 00:05:49,080 --> 00:05:53,000 Speaker 1: nineteen seems to occur less frequently among children and they 76 00:05:53,240 --> 00:05:56,479 Speaker 1: rarely get severely sick from it, but the risk for 77 00:05:56,560 --> 00:06:00,359 Speaker 1: children isn't zero. In fact, in Europe and now in 78 00:06:00,360 --> 00:06:03,560 Speaker 1: the United States, critically ill kids have been ending up 79 00:06:03,560 --> 00:06:07,480 Speaker 1: in intensive care units with shock like symptoms. It's yet 80 00:06:07,520 --> 00:06:11,200 Speaker 1: another mysterious dimension of a disease we only heard about 81 00:06:11,200 --> 00:06:15,120 Speaker 1: four months ago. Stephen Powers is National Medical Director for 82 00:06:15,160 --> 00:06:19,160 Speaker 1: England in the National Health Service. He told reporters recently 83 00:06:19,560 --> 00:06:24,640 Speaker 1: that these uncommon life threatening symptoms resemble Kawazarkie disease, a 84 00:06:24,800 --> 00:06:28,160 Speaker 1: rare childhood illness. We have become aware in the last 85 00:06:28,160 --> 00:06:32,720 Speaker 1: few days of reports of severe illness in children which 86 00:06:32,800 --> 00:06:36,240 Speaker 1: might be a Kawasaki like disease. So Kawasaki disease is 87 00:06:36,279 --> 00:06:40,400 Speaker 1: a very rare inflammatory condition that occurs in children. The 88 00:06:40,880 --> 00:06:45,640 Speaker 1: cause is not often known. Kawazarkie disease is characterized by 89 00:06:45,800 --> 00:06:49,760 Speaker 1: inflammation of blood vessels throughout the body. It's the leading 90 00:06:49,800 --> 00:06:53,520 Speaker 1: cause of acquired heart disease in American children, but with 91 00:06:53,600 --> 00:06:56,960 Speaker 1: effective treatment, only a small percentage of patients is left 92 00:06:57,000 --> 00:07:00,919 Speaker 1: with lasting coronary uttery damage. On Wednesday last week in 93 00:07:00,960 --> 00:07:04,360 Speaker 1: the lance at Medical Journal, Doctors in England describes an 94 00:07:04,440 --> 00:07:08,760 Speaker 1: unprecedented cluster of eight children with something resembling the condition. 95 00:07:09,520 --> 00:07:12,960 Speaker 1: One patient, a fourteen year old, needed life support but 96 00:07:13,040 --> 00:07:16,280 Speaker 1: tragically died from a stroke. New York has had at 97 00:07:16,320 --> 00:07:20,200 Speaker 1: least seventy three similar pediatric patients, three of them fatal. 98 00:07:20,800 --> 00:07:28,440 Speaker 1: France and Italy have had cases too. This is something 99 00:07:28,480 --> 00:07:34,400 Speaker 1: that is appearing in cities around the globe now that 100 00:07:34,480 --> 00:07:38,040 Speaker 1: have been heavily impacted by COVID nineteen disease in the 101 00:07:38,080 --> 00:07:43,000 Speaker 1: adult population. That's Professor Jane Burns. She's one of the 102 00:07:43,000 --> 00:07:46,480 Speaker 1: world's top experts on camazaki disease and leads a research 103 00:07:46,520 --> 00:07:50,040 Speaker 1: center dedicated to studying it at the University of California, 104 00:07:50,120 --> 00:07:54,600 Speaker 1: San Diego. She's seen thousands of cases over thirty five years, 105 00:07:55,240 --> 00:07:58,720 Speaker 1: and the Rady Children's Hospital where she works treats eighty 106 00:07:58,840 --> 00:08:03,400 Speaker 1: to newcow psychi disease patients each year. Jane has yet 107 00:08:03,440 --> 00:08:06,240 Speaker 1: to see any of these COVID nineteen related cases, but 108 00:08:06,320 --> 00:08:10,040 Speaker 1: has been following the research closely, so we're getting a 109 00:08:10,080 --> 00:08:16,160 Speaker 1: picture that this is something that occurs in probably genetically 110 00:08:16,240 --> 00:08:24,680 Speaker 1: susceptible children as a reaction that involves previous exposure to 111 00:08:24,880 --> 00:08:29,400 Speaker 1: the stars COVID two virus, and now we're seeing cases 112 00:08:29,440 --> 00:08:33,720 Speaker 1: in the United States. Jane says these aren't COVID nineteen patients, 113 00:08:33,880 --> 00:08:37,240 Speaker 1: but a majority have the virus or antibodies to the infection. 114 00:08:38,080 --> 00:08:41,760 Speaker 1: While the cases share some signs and symptoms of Kawasaki disease, 115 00:08:42,200 --> 00:08:45,000 Speaker 1: the ones that have been described during the pandemic have 116 00:08:45,160 --> 00:08:48,400 Speaker 1: some additional features, so it's not certain that what they 117 00:08:48,440 --> 00:08:53,320 Speaker 1: have is Kawazaki. The diseases usually diagnosed and susceptible children 118 00:08:53,600 --> 00:08:56,360 Speaker 1: by the time they start school. The average age of 119 00:08:56,440 --> 00:09:00,160 Speaker 1: the patients in England was about nine. I have not 120 00:09:00,320 --> 00:09:04,680 Speaker 1: seen a case, so let's be clear. But um, the 121 00:09:04,960 --> 00:09:08,719 Speaker 1: descriptions are more than half of them coming in with 122 00:09:08,800 --> 00:09:16,240 Speaker 1: gastro intestinal symptoms, so vomiting, abdominal pain, diarrhea. Everybody has fever, 123 00:09:16,559 --> 00:09:23,560 Speaker 1: so all these presentations are are significant persistent high fever. Also, 124 00:09:23,880 --> 00:09:26,600 Speaker 1: six of the eight children in England were described as 125 00:09:26,640 --> 00:09:31,120 Speaker 1: being of Afro Caribbean descent and five are boys. Jane 126 00:09:31,160 --> 00:09:34,800 Speaker 1: says one in every sixty children in Japan gets Kwazoki disease, 127 00:09:35,240 --> 00:09:39,000 Speaker 1: but no atypical cases have been seen there during the pandemic. 128 00:09:39,720 --> 00:09:42,960 Speaker 1: Even still, she says, there may be genetic, racial, and 129 00:09:43,120 --> 00:09:47,040 Speaker 1: social disparities at play and these need to be properly investigated. 130 00:09:47,760 --> 00:09:51,400 Speaker 1: The shock syndrome that these pediatric patients experience is also 131 00:09:51,760 --> 00:09:54,960 Speaker 1: more severe than what's seen in Kawasaki disease or KAD 132 00:09:55,160 --> 00:10:02,600 Speaker 1: for short, and they have certain clinical differences in the 133 00:10:02,720 --> 00:10:05,199 Speaker 1: nature of the shock, the way the heart is behaving. 134 00:10:05,840 --> 00:10:11,240 Speaker 1: But the interesting hypothesis that this raises is that Kawasaki 135 00:10:11,320 --> 00:10:16,119 Speaker 1: disease may be a syndrome that can actually be triggered 136 00:10:16,880 --> 00:10:22,880 Speaker 1: in children of different genetic backgrounds by different environmental triggers. 137 00:10:24,400 --> 00:10:32,439 Speaker 1: So there's an interesting question that perhaps stars Cove two 138 00:10:32,600 --> 00:10:39,959 Speaker 1: virus is one of many other agents or just things 139 00:10:40,080 --> 00:10:44,160 Speaker 1: in the environment that can trigger this syndrome in children 140 00:10:44,600 --> 00:10:50,600 Speaker 1: who perhaps have a slightly different genetic susceptibility. And these 141 00:10:50,679 --> 00:10:53,800 Speaker 1: children who are now presenting with the shock syndrome, and 142 00:10:54,280 --> 00:10:57,520 Speaker 1: the children who are getting the typical KD in these 143 00:10:57,520 --> 00:11:02,680 Speaker 1: same communities, maybe the these our children who were never 144 00:11:02,760 --> 00:11:07,199 Speaker 1: going to get Kawasaki disease in their life until they 145 00:11:07,240 --> 00:11:13,560 Speaker 1: came across this virus that's been unleashed onto the world. 146 00:11:13,880 --> 00:11:18,520 Speaker 1: Jane says, probably about one children worldwide have been diagnosed 147 00:11:18,559 --> 00:11:22,199 Speaker 1: with the syndrome during the pandemic. That compares with some 148 00:11:22,360 --> 00:11:27,360 Speaker 1: four million COVID nineteen cases. What's really intriguing to me 149 00:11:27,600 --> 00:11:31,640 Speaker 1: as a Kawasaki disease researcher is that at the same 150 00:11:31,679 --> 00:11:37,079 Speaker 1: time these desperately ill children are being seen, there has 151 00:11:37,200 --> 00:11:42,120 Speaker 1: been a dramatic uptick in the same communities of children 152 00:11:42,200 --> 00:11:46,680 Speaker 1: with typical Kawasaki disease. Whatever it is behind the syndrome 153 00:11:46,800 --> 00:11:51,280 Speaker 1: that's sometimes leading to desperate cardiovasculate collapse, the effect that 154 00:11:51,400 --> 00:11:55,760 Speaker 1: children are responding to the same treatment used for Kawasaki disease, 155 00:11:56,480 --> 00:11:59,559 Speaker 1: Jane says patients can usually be cued in a matter 156 00:11:59,559 --> 00:12:03,360 Speaker 1: of day with the infusions of a blood based therapy 157 00:12:03,400 --> 00:12:06,280 Speaker 1: called immunoglobulin, but they need to get it within their 158 00:12:06,280 --> 00:12:09,520 Speaker 1: first week of illness. The other good news is that 159 00:12:09,559 --> 00:12:14,120 Speaker 1: the disease is relatively easy to diagnose. Parents can easily 160 00:12:14,160 --> 00:12:16,640 Speaker 1: make the diagnosis. You don't have to have to have 161 00:12:16,720 --> 00:12:22,400 Speaker 1: gone to medical school. It's fever, bloodshot eyes, red lips 162 00:12:22,400 --> 00:12:27,000 Speaker 1: and tongue, swollen hands and feet, and red palms and solos, 163 00:12:27,760 --> 00:12:32,480 Speaker 1: and so it should be empowering to parents that they 164 00:12:32,520 --> 00:12:37,520 Speaker 1: can recognize this disease and and ask for blood testing 165 00:12:38,000 --> 00:12:42,560 Speaker 1: to support the diagnosis by looking for inflammation whatever it 166 00:12:42,679 --> 00:12:45,600 Speaker 1: is that's causing this new life threatening illness and children. 167 00:12:46,000 --> 00:12:48,920 Speaker 1: There's some solace in knowing that it's rare and that 168 00:12:49,040 --> 00:12:52,680 Speaker 1: it can be easily treated. It's a reminder, though, that 169 00:12:52,840 --> 00:12:55,679 Speaker 1: we still have a lot to learn about the coronavirus 170 00:12:55,800 --> 00:13:06,360 Speaker 1: and to reject any invitation to a virus potty. That 171 00:13:06,640 --> 00:13:10,400 Speaker 1: was Bloomberg's Jason Gail, and that's our show today. For 172 00:13:10,520 --> 00:13:13,400 Speaker 1: coverage of the outbreak from one and twenty bureaus around 173 00:13:13,440 --> 00:13:19,079 Speaker 1: the world, visit bloomberg dot com slash coronavirus and if 174 00:13:19,080 --> 00:13:21,680 Speaker 1: you like the show, please leave us a review and 175 00:13:21,720 --> 00:13:25,640 Speaker 1: a rating on Apple Podcasts or Spotify. It's the best 176 00:13:25,679 --> 00:13:30,240 Speaker 1: way to help more listeners find our global reporting. The 177 00:13:30,320 --> 00:13:34,480 Speaker 1: Prognosis Daily edition is hosted by Me Laura Carlson. The 178 00:13:34,520 --> 00:13:38,600 Speaker 1: show was produced by Me Topher Foreheads, Jordan Gospore and 179 00:13:38,800 --> 00:13:43,559 Speaker 1: Magnus Henrikson. Today's main story was reported by Jason Gail. 180 00:13:44,600 --> 00:13:49,240 Speaker 1: Original music by Leo Sidrin. Our editors are Francesca Levi 181 00:13:49,559 --> 00:13:53,960 Speaker 1: and Rick Shine. Francesco Levi is Bloomberg's head of podcasts, 182 00:13:54,520 --> 00:13:55,360 Speaker 1: Thanks for listening.