WEBVTT - New Fears About Kids Getting Sick 0:00:04.280 --> 0:00:09.039 Welcome to Prognosis. I'm Laura Carlson. It's stay sixty one. 0:00:09.200 --> 0:00:13.960 Since coronavirus was declared a global pandemic our main story. 0:00:14.720 --> 0:00:18.000 For a long time, it seemed like the only reassuring 0:00:18.040 --> 0:00:21.599 thing about the virus was that children were unlikely to 0:00:21.640 --> 0:00:25.960 get very sick from it. That idea is being challenged, though, 0:00:26.360 --> 0:00:29.840 as a new COVID nineteen related illness has begun to 0:00:29.880 --> 0:00:34.839 appear in children around the world. But first, here's what 0:00:34.960 --> 0:00:50.839 happened today. New York City, the epicenter of the outbreak 0:00:50.880 --> 0:00:54.440 in the US, is likely to stay locked down into June. 0:00:55.440 --> 0:00:59.600 That's according to its bare build Blasio. Some parts of 0:00:59.640 --> 0:01:03.400 the eight will be able to reopen from Friday, but 0:01:03.480 --> 0:01:06.959 the city hasn't made enough progress in cutting down on 0:01:07.040 --> 0:01:12.880 new cases. That's even though hospital and intensive care admissions 0:01:12.920 --> 0:01:17.679 are falling. Deblasio also said health officials will turn to 0:01:17.800 --> 0:01:22.240 dozens of small, private, neighborhood medical practices to aid in testing, 0:01:22.720 --> 0:01:28.679 contact tracing, and outpatient care around the country. A promising 0:01:28.720 --> 0:01:32.160 new COVID nineteen drug may be hard to come by. 0:01:32.920 --> 0:01:36.759 Gilead Sciences is donating vials of its COVID nineteen drug 0:01:36.880 --> 0:01:41.080 ram desevere to countries around the world, but the US 0:01:41.440 --> 0:01:45.800 will get less than half. Gilead is donating about enough 0:01:45.880 --> 0:01:50.280 to treat seventy eight thousand hospitalized patients, according to the 0:01:50.320 --> 0:01:54.040 Department of Health and Human Services, but more than three 0:01:54.120 --> 0:01:58.160 hundred thousand patients in the US are eligible for emergency 0:01:58.200 --> 0:02:01.600 access to the drug that won't be available through the 0:02:01.760 --> 0:02:07.400 end of July. More data is showing the virus's disproportionate effects. 0:02:08.440 --> 0:02:11.720 We know that Black Americans are dying at alarmingly high 0:02:11.840 --> 0:02:16.360 rates of COVID nineteen, but a new Bloomberg News analysis 0:02:16.400 --> 0:02:20.640 shows that majority black counties have triple the COVID nineteen 0:02:20.720 --> 0:02:24.880 death rate of others. The larger a county's share of 0:02:24.919 --> 0:02:30.000 Black residents, the worse the health outcomes get. In counties 0:02:30.000 --> 0:02:33.079 where African Americans are a higher proportion of the population 0:02:33.240 --> 0:02:35.799 than they are in the US, the death rate is 0:02:35.919 --> 0:02:40.519 roughly double the national average. That's according to an analysis 0:02:40.520 --> 0:02:45.000 of Johns Hopkins University and Census Bureau data. In majority 0:02:45.080 --> 0:02:50.480 Black counties, deaths from coronavirus are more than triple. The 0:02:50.520 --> 0:02:54.480 disparities have only grown as the death toll has climbed. 0:02:57.520 --> 0:03:02.200 In South Korea, confirmed cases of Good nineteen suddenly increased 0:03:02.240 --> 0:03:06.080 after a lull that has sparked fears of a potential 0:03:06.120 --> 0:03:10.640 second wave of infections. The latest surge is tied to 0:03:10.720 --> 0:03:14.600 a single infected twenty nine year old who visited nightclubs 0:03:14.600 --> 0:03:19.160 and Seoul. Since he did, at least fifty four cases 0:03:19.200 --> 0:03:21.840 have been traced to the clubs, according to the Korea 0:03:21.919 --> 0:03:27.120 Centers for Disease Control and Prevention. Authorities are estimating between 0:03:27.280 --> 0:03:30.040 six to seven thousand people could have been exposed to 0:03:30.040 --> 0:03:33.960 the virus from clubs between April nine and May six. 0:03:35.200 --> 0:03:38.920 Souls Mayor has ordered all nightclubs and similar establishments in 0:03:38.960 --> 0:03:51.800 the capital to close, and now our main story. Last week, 0:03:52.160 --> 0:03:54.640 a five year old boy in New York died from 0:03:54.720 --> 0:03:59.800 COVID nineteen related complications. Dozens of other children are becoming 0:04:00.000 --> 0:04:04.000 sick with a similar cluster of symptoms. They mirror a 0:04:04.160 --> 0:04:09.080 rare condition called Kawasaki disease. The rise of this new 0:04:09.120 --> 0:04:13.720 threat to children opens up a terrifying possibility. Have we 0:04:13.840 --> 0:04:18.560 been wrong about how the disease affects kids. The accepted 0:04:18.600 --> 0:04:22.000 wisdom had been that children could transmit the virus but 0:04:22.160 --> 0:04:25.880 not get sick from it. The new illness is throwing 0:04:25.920 --> 0:04:30.960 that assumption into question. Jason Gale talked to the world's 0:04:31.160 --> 0:04:36.040 leading expert on Kawasaki disease to help unpack what's going on. 0:04:41.360 --> 0:04:43.400 You might have heard of a pox body. It's a 0:04:43.480 --> 0:04:47.680 social gathering where children are deliberately exposed to an infectious disease, 0:04:48.120 --> 0:04:52.320 like chicken pox. These parties were sometimes done before vaccines 0:04:52.320 --> 0:04:55.640 were widely available to speed up immunity, in the belief 0:04:55.680 --> 0:04:59.520 that some illnesses experienced as children would result in less 0:04:59.560 --> 0:05:03.240 severe disease then if the infection occurred in adulthood. But 0:05:03.360 --> 0:05:07.080 the practice has survived to modern times, usually hosted by 0:05:07.160 --> 0:05:10.680 vaccination skeptics, and there are signs the spirit of the 0:05:10.680 --> 0:05:14.680 Fox Party exists in our Washington State county, where people 0:05:14.760 --> 0:05:19.360 allegedly called the coronavirus from such events. Washington State health 0:05:19.360 --> 0:05:23.279 officials say that deliberately catching the pandemic virus can be 0:05:23.360 --> 0:05:27.560 incredibly dangerous for obvious reasons. It puts people that increased 0:05:27.640 --> 0:05:31.520 risk for hospitalization and even death. It may also lead 0:05:31.520 --> 0:05:34.440 to an uptick in cases that will slow attempts to 0:05:34.480 --> 0:05:38.120 lift physical distancing measures and revive the economy. And there's 0:05:38.120 --> 0:05:40.159 still a lot we don't know about the virus that 0:05:40.279 --> 0:05:49.000 causes COVID nineteen, including any long term health effects. COVID 0:05:49.080 --> 0:05:53.000 nineteen seems to occur less frequently among children and they 0:05:53.240 --> 0:05:56.479 rarely get severely sick from it, but the risk for 0:05:56.560 --> 0:06:00.359 children isn't zero. In fact, in Europe and now in 0:06:00.360 --> 0:06:03.560 the United States, critically ill kids have been ending up 0:06:03.560 --> 0:06:07.480 in intensive care units with shock like symptoms. It's yet 0:06:07.520 --> 0:06:11.200 another mysterious dimension of a disease we only heard about 0:06:11.200 --> 0:06:15.120 four months ago. Stephen Powers is National Medical Director for 0:06:15.160 --> 0:06:19.160 England in the National Health Service. He told reporters recently 0:06:19.560 --> 0:06:24.640 that these uncommon life threatening symptoms resemble Kawazarkie disease, a 0:06:24.800 --> 0:06:28.160 rare childhood illness. We have become aware in the last 0:06:28.160 --> 0:06:32.720 few days of reports of severe illness in children which 0:06:32.800 --> 0:06:36.240 might be a Kawasaki like disease. So Kawasaki disease is 0:06:36.279 --> 0:06:40.400 a very rare inflammatory condition that occurs in children. The 0:06:40.880 --> 0:06:45.640 cause is not often known. Kawazarkie disease is characterized by 0:06:45.800 --> 0:06:49.760 inflammation of blood vessels throughout the body. It's the leading 0:06:49.800 --> 0:06:53.520 cause of acquired heart disease in American children, but with 0:06:53.600 --> 0:06:56.960 effective treatment, only a small percentage of patients is left 0:06:57.000 --> 0:07:00.919 with lasting coronary uttery damage. On Wednesday last week in 0:07:00.960 --> 0:07:04.360 the lance at Medical Journal, Doctors in England describes an 0:07:04.440 --> 0:07:08.760 unprecedented cluster of eight children with something resembling the condition. 0:07:09.520 --> 0:07:12.960 One patient, a fourteen year old, needed life support but 0:07:13.040 --> 0:07:16.280 tragically died from a stroke. New York has had at 0:07:16.320 --> 0:07:20.200 least seventy three similar pediatric patients, three of them fatal. 0:07:20.800 --> 0:07:28.440 France and Italy have had cases too. This is something 0:07:28.480 --> 0:07:34.400 that is appearing in cities around the globe now that 0:07:34.480 --> 0:07:38.040 have been heavily impacted by COVID nineteen disease in the 0:07:38.080 --> 0:07:43.000 adult population. That's Professor Jane Burns. She's one of the 0:07:43.000 --> 0:07:46.480 world's top experts on camazaki disease and leads a research 0:07:46.520 --> 0:07:50.040 center dedicated to studying it at the University of California, 0:07:50.120 --> 0:07:54.600 San Diego. She's seen thousands of cases over thirty five years, 0:07:55.240 --> 0:07:58.720 and the Rady Children's Hospital where she works treats eighty 0:07:58.840 --> 0:08:03.400 to newcow psychi disease patients each year. Jane has yet 0:08:03.440 --> 0:08:06.240 to see any of these COVID nineteen related cases, but 0:08:06.320 --> 0:08:10.040 has been following the research closely, so we're getting a 0:08:10.080 --> 0:08:16.160 picture that this is something that occurs in probably genetically 0:08:16.240 --> 0:08:24.680 susceptible children as a reaction that involves previous exposure to 0:08:24.880 --> 0:08:29.400 the stars COVID two virus, and now we're seeing cases 0:08:29.440 --> 0:08:33.720 in the United States. Jane says these aren't COVID nineteen patients, 0:08:33.880 --> 0:08:37.240 but a majority have the virus or antibodies to the infection. 0:08:38.080 --> 0:08:41.760 While the cases share some signs and symptoms of Kawasaki disease, 0:08:42.200 --> 0:08:45.000 the ones that have been described during the pandemic have 0:08:45.160 --> 0:08:48.400 some additional features, so it's not certain that what they 0:08:48.440 --> 0:08:53.320 have is Kawazaki. The diseases usually diagnosed and susceptible children 0:08:53.600 --> 0:08:56.360 by the time they start school. The average age of 0:08:56.440 --> 0:09:00.160 the patients in England was about nine. I have not 0:09:00.320 --> 0:09:04.680 seen a case, so let's be clear. But um, the 0:09:04.960 --> 0:09:08.719 descriptions are more than half of them coming in with 0:09:08.800 --> 0:09:16.240 gastro intestinal symptoms, so vomiting, abdominal pain, diarrhea. Everybody has fever, 0:09:16.559 --> 0:09:23.560 so all these presentations are are significant persistent high fever. Also, 0:09:23.880 --> 0:09:26.600 six of the eight children in England were described as 0:09:26.640 --> 0:09:31.120 being of Afro Caribbean descent and five are boys. Jane 0:09:31.160 --> 0:09:34.800 says one in every sixty children in Japan gets Kwazoki disease, 0:09:35.240 --> 0:09:39.000 but no atypical cases have been seen there during the pandemic. 0:09:39.720 --> 0:09:42.960 Even still, she says, there may be genetic, racial, and 0:09:43.120 --> 0:09:47.040 social disparities at play and these need to be properly investigated. 0:09:47.760 --> 0:09:51.400 The shock syndrome that these pediatric patients experience is also 0:09:51.760 --> 0:09:54.960 more severe than what's seen in Kawasaki disease or KAD 0:09:55.160 --> 0:10:02.600 for short, and they have certain clinical differences in the 0:10:02.720 --> 0:10:05.199 nature of the shock, the way the heart is behaving. 0:10:05.840 --> 0:10:11.240 But the interesting hypothesis that this raises is that Kawasaki 0:10:11.320 --> 0:10:16.119 disease may be a syndrome that can actually be triggered 0:10:16.880 --> 0:10:22.880 in children of different genetic backgrounds by different environmental triggers. 0:10:24.400 --> 0:10:32.439 So there's an interesting question that perhaps stars Cove two 0:10:32.600 --> 0:10:39.959 virus is one of many other agents or just things 0:10:40.080 --> 0:10:44.160 in the environment that can trigger this syndrome in children 0:10:44.600 --> 0:10:50.600 who perhaps have a slightly different genetic susceptibility. And these 0:10:50.679 --> 0:10:53.800 children who are now presenting with the shock syndrome, and 0:10:54.280 --> 0:10:57.520 the children who are getting the typical KD in these 0:10:57.520 --> 0:11:02.680 same communities, maybe the these our children who were never 0:11:02.760 --> 0:11:07.199 going to get Kawasaki disease in their life until they 0:11:07.240 --> 0:11:13.560 came across this virus that's been unleashed onto the world. 0:11:13.880 --> 0:11:18.520 Jane says, probably about one children worldwide have been diagnosed 0:11:18.559 --> 0:11:22.199 with the syndrome during the pandemic. That compares with some 0:11:22.360 --> 0:11:27.360 four million COVID nineteen cases. What's really intriguing to me 0:11:27.600 --> 0:11:31.640 as a Kawasaki disease researcher is that at the same 0:11:31.679 --> 0:11:37.079 time these desperately ill children are being seen, there has 0:11:37.200 --> 0:11:42.120 been a dramatic uptick in the same communities of children 0:11:42.200 --> 0:11:46.680 with typical Kawasaki disease. Whatever it is behind the syndrome 0:11:46.800 --> 0:11:51.280 that's sometimes leading to desperate cardiovasculate collapse, the effect that 0:11:51.400 --> 0:11:55.760 children are responding to the same treatment used for Kawasaki disease, 0:11:56.480 --> 0:11:59.559 Jane says patients can usually be cued in a matter 0:11:59.559 --> 0:12:03.360 of day with the infusions of a blood based therapy 0:12:03.400 --> 0:12:06.280 called immunoglobulin, but they need to get it within their 0:12:06.280 --> 0:12:09.520 first week of illness. The other good news is that 0:12:09.559 --> 0:12:14.120 the disease is relatively easy to diagnose. Parents can easily 0:12:14.160 --> 0:12:16.640 make the diagnosis. You don't have to have to have 0:12:16.720 --> 0:12:22.400 gone to medical school. It's fever, bloodshot eyes, red lips 0:12:22.400 --> 0:12:27.000 and tongue, swollen hands and feet, and red palms and solos, 0:12:27.760 --> 0:12:32.480 and so it should be empowering to parents that they 0:12:32.520 --> 0:12:37.520 can recognize this disease and and ask for blood testing 0:12:38.000 --> 0:12:42.560 to support the diagnosis by looking for inflammation whatever it 0:12:42.679 --> 0:12:45.600 is that's causing this new life threatening illness and children. 0:12:46.000 --> 0:12:48.920 There's some solace in knowing that it's rare and that 0:12:49.040 --> 0:12:52.680 it can be easily treated. It's a reminder, though, that 0:12:52.840 --> 0:12:55.679 we still have a lot to learn about the coronavirus 0:12:55.800 --> 0:13:06.360 and to reject any invitation to a virus potty. That 0:13:06.640 --> 0:13:10.400 was Bloomberg's Jason Gail, and that's our show today. For 0:13:10.520 --> 0:13:13.400 coverage of the outbreak from one and twenty bureaus around 0:13:13.440 --> 0:13:19.079 the world, visit bloomberg dot com slash coronavirus and if 0:13:19.080 --> 0:13:21.680 you like the show, please leave us a review and 0:13:21.720 --> 0:13:25.640 a rating on Apple Podcasts or Spotify. It's the best 0:13:25.679 --> 0:13:30.240 way to help more listeners find our global reporting. The 0:13:30.320 --> 0:13:34.480 Prognosis Daily edition is hosted by Me Laura Carlson. The 0:13:34.520 --> 0:13:38.600 show was produced by Me Topher Foreheads, Jordan Gospore and 0:13:38.800 --> 0:13:43.559 Magnus Henrikson. Today's main story was reported by Jason Gail. 0:13:44.600 --> 0:13:49.240 Original music by Leo Sidrin. Our editors are Francesca Levi 0:13:49.559 --> 0:13:53.960 and Rick Shine. Francesco Levi is Bloomberg's head of podcasts, 0:13:54.520 --> 0:13:55.360 Thanks for listening.