Coronavirus Chronicles — No More Pencils, No More Books?

What are the chances that America’s children can return to classrooms any time soon? A glance at some recently published facts and figures might give an indication. As the daily new case totals go up and up, writers Robinson Meyer and Alexis C. Madrigal frame these eloquent phrases:

A new and brutal stage now menaces the Sun Belt states, whose residents face a nearly unbroken chain of outbreaks stretching from South Carolina to California. Across the South and large parts of the West, cases are soaring, hospitalizations are spiking, and a greater portion of tests are coming back positive.

Statistics can be served up in myriad frames, so let’s take something easy to visualize: sick people in medical settings, hooked up to machines, surrounded by masked figures intent on sticking needles into them. On May 30, 34,650 COVID-19 patients were in American hospital beds. The number went down almost to a slim 27,000 and then right back up again. On June 30, it was 34,830. In other words, the number of people sick enough to be hospitalized bounced right back up to where it was a month ago.

On June 25, there were 41,000 new cases. In other words, the day’s new-case total was higher than the number of already-occupied beds. Perhaps the enormity of that figure doesn’t register on the consciousness, so writer Umair Haque says it in a couple of other ways:

America makes up just 4 percent of the world’s population — but it has 26% of the globe’s Coronavirus caseload. America had 25% of the world’s Coronavirus cases today — and that number’s rising — and yet it has less than 5% of the world’s population.

This point (framed by The Atlantic‘s Meyer and Madrigal) is very important:

It can take up to 14 days for someone to show symptoms; it can take another two weeks for that person to appear in the data as a confirmed case. This means that […] virus statistics tell you what was happening in a community two to three weeks ago.

A daycare center is in many ways similar to a school, and the situation in Texas day-care centers is not encouraging. Reese Oxner reported,

As of Tuesday, there were 950 reported positive cases of COVID-19 — 307 children and 643 staff members — at 668 child care locations. Statewide, 12,207 licensed child care operations are open, and total reported coronavirus cases have risen from 59 cases in mid-May to 576 on June 23.

“Guidance” from the federal government is a take-it-or-leave-it proposition, and many states have declined to take it at any stage. But just for the record, the Centers for Disease Control recommends that daycare facilities keep their young charges six feet apart. That’s only one child at a time in the sandbox! Considering that the main mission of preschool education is to teach sharing, cooperation, and togetherness, this sounds like a tall order.

The American Academy of Pediatrics is not a government body but a professional organization, and its opinion is that three feet of distance is plenty, in light of the observation that “the relative impact of physical distancing among children is likely small based on current evidence and certainly difficult to implement.” In any case, the AAP feels that the educational advantage of physical presence in school outweighs the health risks, which is a bold position.

In quite a few locales, the concept of “reopening” society is a joke because Americans have exercised their right to selfishly do as they please all along. At the end of June, national expert Dr. Anthony Fauci announced that the new cases per day number would only get worse.

Your responses and feedback are welcome!

Source: “A Devastating New Stage of the Pandemic,” TheAtlantic.com, 06/25/20
Source: “US Historical Data,” CovidTracking.com, undated
Source: “How Bad is America’s Coronavirus Explosion? Much Worse Than You Think,” Eand.co, 06/26/20
Source: “More than 300 children in Texas day cares have caught COVID-19, and the numbers are rising,” TexasTribune.org, 07/01/20
Source: “Dr. Anthony Fauci says U.S. coronavirus outbreak is ‘going to be very disturbing,’ could top 100,000 new cases a day,” CNBC.com, 06/30/20
Image by loco steve/CC BY 2.0

Coronavirus Chronicles — Have Kids Been In On It All Along?

Evidence seems to be piling up to indicate that children have never been safe from the novel coronavirus. The previous Childhood Obesity News post mentioned some untoward deaths among the child population. This was way back, before the disease was acknowledged to be present in the United States.

For LATimes.com, Paige St. John and Annette Choi described how, in a handful of California counties, medical examiners remembered fatalities that were sketchy somehow. Here and there, a kid would have “mysterious inflammatory symptoms” and an illness that followed some kind of bizarre course. The Shasta County forensic pathologist would like infectious disease workups for a couple of children who died during the winter.

There were, between December and March, some weird adult cases including a man in Orange County who was an organ donor — which may or may not be a successful transmission route for the virus. A man died in Los Angeles, late in January, whose brother has repeatedly asked the medical examiner that the body be tested for COVID-19. The California Department of Public Health has been requested to take another look at several tragedies that might have been the first, undetected introduction of the virus.

The roadblock

Only the Centers for Disease Control can tell for sure, and their testing process requires competently preserved tissue from the questionable patient, which is not always available. One county had discarded samples from anyone who died before March 1, not suspecting that they might come in handy. The journalists note,

It was well into March before most California coroners and medical examiners began to routinely test decedents who fell under their jurisdiction for COVID-19, using now-familiar nasal swab tests that must be done within days of death.

Unwilling to be flooded with California’s equivalents of cold case files, the CDC is very choosy about what it takes on. Apparently, the institution will not even consider accepting a case unless the decedent looks good on paper, fulfilling certain symptomological requirements.

The problem is, we now know that a lot of people have COVID-19 who never show a symptom, and some of them appear to die from other causes. Some California officials are apathetic about the issue, believing that investigation of last fall’s deaths can do nothing to aid the present situation.

Up in King County, Washington, home of Seattle, the Medical Examiner’s office sees death as a good enough reason to order up a test, and follows a liberal nasal swab policy. County officials work with funeral homes to find testable cases whose data can add to the body of knowledge and perhaps save other lives. If they can find old blood samples, they will definitely test them for antibodies.

In New York City, the story of a boy illustrates a frightening point about transmission — sometimes, nobody knows how it happened. How does a 14-year-old get heart failure?

After cleaning out his locker at Monsignor McClancy High School on March 18 to continue school online at home, he only left the apartment once, they said, to help his mother wash clothes in their high-rise building’s laundry room. His parents and 22-year-old sister also avoided going out and the tests they have had turned up negative.

But Jack almost died from Multisystem Inflammatory Syndrome, which now appears to be the aftermath of unrecognized COVID-19 that comes back to take another swipe at its victim. Nobody knows how he got sick in the first place, and there could be unexplained child fatalities all over the country with equally mysterious origins, that have been ignored.

Your responses and feedback are welcome!

Source: “Mysterious deaths of infants, children raise questions about how early coronavirus hit California,” LATimes.com, 06/21/20
Source: “‘Straight-Up Fire’ in His Veins: Teen Battles New Covid Syndrome,” NYTimes.com, 05/17/20
Image by MFer Photography/CC BY-ND 2.0

Coronavirus Chronicles — Transmission and Testing

We have seen how devastating the coronavirus can be for children, especially if they are obese. It can leave kids needing heart and lung transplants. We don’t want them to catch it, or to pass it on to others. But what is really known about transmission? Backing up a step, what is actually known about the identification and diagnosis of this potentially deadly disease?

Currently, there is a lot of discussion about how COVID-19 is transmitted, and to make any sense of it, knowing something about the two kinds of testing is helpful. One kind determines if the person has an active case, and another seeks to learn whether they ever had it.

William F. Marshall, III, M.D., of the prestigious Mayo Clinic points out, significantly, that no test is 100% accurate. For instance, there is such a thing as a false-negative result, which means a person tests negative when actually they are infected with COVID-19.

Two tests define whether a person is in active disease mode. The familiar swab up the nose uses the PCR (polymerase chain reaction) technique to detect the genetic material of the virus. Dr. Marshall says,

Molecular tests are considered very accurate when properly performed by a health care professional, but the rapid test appears to miss some cases.

The antigen test uses a nasal or throat swab and detects proteins that belong to the virus. It is more practical than PCR for mass testing, but not as dependable. Dr. Marshall says, “A positive antigen test result is considered very accurate, but there’s an increased chance of false negative results.”

From the army base at Fort Benning, GA, comes a disheartening anecdote about testing. Out of a batch of 640 new recruits who arrived for basic training, 636 tested negative. The four individuals with positive results were removed. Just over a week later, 142 of the previously negative troops now tested positive.

Did the patient ever have COVID-19?

Antibody testing uses blood to learn if a person had developed antibodies against the disease, and it comes with a couple of huge caveats:

If you have testing too early in the course of infection, when the immune response is still building up in your body, the test may not detect antibodies… [T]he World Health Organization cautions that there’s a lack of evidence on whether having antibodies means you’re protected against reinfection… The level of immunity and how long immunity lasts are not yet known.

Even if a person indubitably had coronavirus, and is full of antibodies, there is no consensus on whether the antibodies will stick around and prove useful.

A big surprise

We thought we knew that children are not very susceptible to COVID-19. As it turns out, that conclusion might need to be re-examined, in the light of deaths that were treated as routine, or at least as not justifiably troubling, in the days before Americans heard of the disease. There is new information every day about every aspect of it, and a very disturbing article was published just two days ago.

February 6, 2020, was when a death was first identified as being caused by the coronavirus. California’s Governor Gavin Newsom asked for a retrospective look at deaths in the weeks previous to that date, and things became interesting.

(To be continued…)

Your responses and feedback are welcome!

Source: “How do COVID-19 antibody tests differ from diagnostic tests?,” MayoClinic.org, undated
Source: “8 days after quarantine and testing negative, 142 Fort Benning soldiers test positive for COVID-19,” ConnectingVets.radio.com, 06/01/20
Source: “Mysterious deaths of infants, children raise questions about how early coronavirus hit California,” LATimes.com, 06/21/20
Image by Megan Mason/CC BY 2.0