Covid-19 Mortality, Crunching the Numbers, Children, The Jungle 1906 to 2020
The Jungle
The Jungle is a 1906 novel by the American journalist and novelist Upton Sinclair (1878–1968).[1] Sinclair wrote the novel to portray the harsh conditions and exploited lives of immigrants in the United States in Chicago and similar industrialized cities. His primary purpose in describing the meat industry and its working conditions was to advance socialism in the United States.[2] However, most readers were more concerned with several passages exposing health violations and unsanitary practices in the American meat packing industry during the early 20th century, which greatly contributed to a public outcry which led to reforms including the Meat Inspection Act. Sinclair famously said of the public reaction, "I aimed at the public's heart, and by accident I hit it in the stomach."
The book depicts working-class poverty, the lack of social supports, harsh and unpleasant living and working conditions, and a hopelessness among many workers. These elements are contrasted with the deeply rooted corruption of people in power. A review by the writer Jack London called it "the Uncle Tom's Cabin of wage slavery."[3]
Sinclair was considered a muckraker, or journalist who exposed corruption in government and business.[4] In 1904, Sinclair had spent seven weeks gathering information while working incognito in the meatpacking plants of the Chicago stockyards for the socialist newspaper Appeal to Reason. He first published the novel in serial form in 1905 in the newspaper, and it was published as a book by Doubleday in 1906.
Meatpacking industry hits grim milestone of 10,000 coronavirus cases linked to plants
Sky Chadde and Kyle Bagenstose
USA TODAY
Subject: [Docket No. FSIS–2016–0017] RIN 0583–AD62 Modernization of Swine Slaughter Inspection
DEPARTMENT OF AGRICULTURE
Food Safety and Inspection Service
9 CFR Parts 301, 309, and 310
[Docket No. FSIS–2016–0017] RIN 0583–AD62 Modernization of Swine Slaughter Inspection
AGENCY: Food Safety and Inspection Service, USDA. ACTION: Final rule.
FSIS is establishing NSIS to improve the effectiveness of market hog slaughter inspection; make better use of the Agency’s resources; and remove unnecessary regulatory obstacles to industry innovation by revoking maximum line speeds and allowing establishments flexibility to reconfigure evisceration lines...
WEDNESDAY, APRIL 29, 2020
President Donald J. Trump signed an Executive Order to keep meat and poultry processing facilities open during the COVID-19 national emergency
The new rule will end limits on how fast slaughterhouses can kill pigs. It will also shift responsibility for removing defective meat during the slaughtering process from government inspectors to plant workers. The USDA will still inspect live pigs and the final pork products.
As line speeds increase, meatpacking workers are in ever more danger Don't expect the Trump administration to improve conditions in this already brutal industry. Matt McConnell Opinion contributor
WEDNESDAY, SEPTEMBER 18, 2019
USDA Modernizes Swine Slaughter Inspection for the First Time in Over 50 Years and TSE Prion Risk Factors
SATURDAY, APRIL 18, 2020
Coronavirus at Smithfield pork plant: The untold story of America's biggest outbreak
MONDAY, APRIL 27, 2020
Noem releases finalized CDC report pertaining to Smithfield Foods
WHAT ABOUT THOSE POOR EMPLOYEES ???
***> However, plant management reported that there were approximately 40 different languages spoken by employees in the plant and that English, Spanish, Kunama, Swahili, Nepali, Tigrinya, Amharic, French, Oromo, and Vietnamese are the top 10 languages. We were also unable to obtain information about the workstations of confirmed positive cases.
Date: April 22, 2020
From: Michael Grant, CDC National Institute for Occupational Safety and Health Colin Basler, CDC National Center for Emerging Zoonotic Infectious Diseases Jesica Jacobs, CDC Laboratory Leadership Service Officer Erin Kennedy, CDC Center for Global Health John Osburn, South Dakota Department of Health Jonathan Steinberg, CDC Epidemic Intelligence Officer, South Dakota Department of Health Suzanne Tomasi, CDC National Institute for Occupational Safety and Health
To: Joshua Clayton, South Dakota Department of Health Copy: Russ Dokken, Smithfield Foods Scott Reed, Smithfield Foods Mark Wiggs, Smithfield Foods B.J. Motley, President, UFCW Local 304A Union
Subject: Strategies to reduce COVID-19 transmission at the Smithfield Foods Sioux Falls Pork Plant
Background
The South Dakota Department of Health requested an Epi Aid for assistance in developing strategies to help reduce SARS-CoV-2 infections among Smithfield Foods Sioux Falls pork processing plant employees. SARS-CoV-2 is the virus that causes coronavirus disease 2019 (COVID-19). A team from the Centers for Disease Control and Prevention (CDC) traveled to Sioux Falls, South Dakota for an Epi Aid on April 14, 2020. The CDC team included veterinary epidemiologists, an Epidemic Intelligence Service Officer, an industrial hygienist, and a Laboratory Leadership Service Officer. One component of this effort was to visit the Smithfield Foods pork processing plant to evaluate existing health and safety controls and provide recommendations for improvement. This memorandum provides observations and recommendations based on our visits to the plant on April 16 and 17, 2020 and conversations with plant management and the United Food and Commercial Workers Union (UFCW) local president. The recommendations in this memorandum are steps that Smithfield Foods may want to consider implementing to address the conditions we identified at the plant. These recommendations are discretionary and not required or mandated by CDC.
No harvesting or further production work were taking place in the plant while we were on site. The first case among employees was detected on March 24, 2020. Smithfield Foods announced that the process to halt production began on April 11, 2020. The plant informed us that all processing activities were Page 2 of 15 completed on April 14, 2020 and that the plant would be shut down indefinitely while Smithfield Foods continued extensive sanitation and modification efforts in the plant. The few employees we observed in the plant during our walkthroughs were performing maintenance and distribution center tasks. We toured the plant and observed workstations from the pens where the swine are delivered through the distribution center, where product is shipped out of the plant. We also observed the route that employees take from the parking lots through the symptom screening tents and into the facility. Additionally, we observed administrative areas, the occupational health clinic and quarantine room, and the common areas (e.g., break rooms, cafeterias, locker rooms) shared by employees.
Our team was unable to identify important demographic information about this workforce, limiting our ability to understand the diversity of the employees. However, plant management reported that there were approximately 40 different languages spoken by employees in the plant and that English, Spanish, Kunama, Swahili, Nepali, Tigrinya, Amharic, French, Oromo, and Vietnamese are the top 10 languages. We were also unable to obtain information about the workstations of confirmed positive cases. This type of information could provide a better understanding of what workplace factors may have contributed to the spread of COVID-19 among employees. Key demographic and workstation information was requested from the company to help answer some of these questions in the future. Additional recommendations and findings may be provided upon receipt of demographic and workstation information.
Observations and Discussion
Employee Screening
snip...
Business
USDA Inspector Reportedly Dies Amid Meat-Plant Viral Outbreaks
By Deena Shanker and Lydia Mulvany
April 23, 2020, 2:14 PM CDT
Agency reported death during a call, two participants say Another inspector died in March, a union official says
An inspector from the U.S. Department of Agriculture has died after apparently contracting Covid-19, according to information the federal agency provided Thursday during a phone call with consumer groups.
The USDA didn’t immediately respond to requests for comment. Two participants on the call corroborated that the death was disclosed on the call.
“If USDA had acted more quickly to ensure worker safety, they could have prevented the disease from spreading across the meat industry as it has,” says Sarah Sorscher of the Center for Science in the Public Interest, who was on the call. “Instead, we have massive shutdowns and worker deaths. All that delay and lack of action is going to make it much harder to bring these outbreaks under control.”
As meat processing plants become hotbeds of virus outbreaks, inspectors are finding themselves at higher risk and increasingly getting sick themselves. There are about 6,500 inspectors across the country working for the USDA’s Food Safety and Inspection Service. One hundred have tested positive for the virus.
Paula Schelling, the acting national joint council chairwoman of food-inspector locals for the American Federation of Government Employees, who wasn’t on the agency call, said she also heard of the death on Thursday. She said that the worker was in Chicago and his wife is now in intensive care. Another inspector died in New York in March, she said.
“It makes my heart sad,” she said.
Testimony of Dr. Tom Frieden, President and Chief Executive Officer of Resolve to Save Lives, an initiative of Vital Strategies
Good morning, Chairwoman DeLauro, Ranking Member Cole, and distinguished Members of the Subcommittee. Thank you for the opportunity to testify today. I’m Dr. Tom Frieden. I was CDC Director from 2009 to 2017 and New York City Health Commissioner from 2002 until my appointment to lead the CDC. I received my MD and MPH degrees from Columbia University in my home town of New York City, with advanced training in internal medicine, infectious disease, public health, and epidemiology. I am President and CEO of Resolve to Save Lives, an initiative of the global public health organization Vital Strategies, and Senior Fellow for Global Health at the Council on Foreign Relations. Resolve to Save Lives partners with countries to prevent 100 million deaths from heart disease and stroke and make the world safer from epidemics.
In the next few minutes, I will provide a perspective, based on 30 years fighting epidemics – including leading the CDC’s response to Ebola – of where we are and what we need to do, together, to protect Americans. I’ll also propose a new approach to bring stability and security to our efforts to keep Americans safer from epidemics. The bottom line is that our war against COVID-19 will be long and difficult, and, until we have a vaccine, we must have a comprehensive strategy and use data to drive our policies and programs in order to save lives and restore the economy. We must also adopt a new strategy to make sure nothing like this ever happens again if it can possibly be prevented.
Snip...
Sadly, just projecting from the number of people already infected and being infected now, the virus will have killed at least 100,000 people in the U.S. within a month.
Second, as bad as this has been so far, we’re just at the beginning. Until we have an effective vaccine, unless something unexpected happens, our viral enemy will be with us for many months or years. No one can predict with certainty how this new virus will behave in warmer weather and what will happen in the coming months in this country and around the world. There is no magic bullet. Not travel restrictions. Not staying at home. Not testing. Not Remdesivir. All of those can help, but until and unless we have a safe and effective vaccine, there’s no single weapon that will deliver a knock-out punch.
Sadly, just projecting from the number of people already infected and being infected now, the virus will have killed at least 100, 000 people in the U.S. within a month,
Covid-19 Mortality, Crunching the Numbers
https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries
Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient
Coronaviruses have been implicated in nosocomial outbreaks1 with environmental contamination as a route of transmission.2 Similarly, nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported.3 However, the mode of transmission and extent of environmental contamination are unknown.
Methods | From January 24 to February 4, 2020, 3 patients at the dedicated SARS-CoV-2 outbreak center in Singapore in airborne infection isolation rooms (12 air exchanges per hour)with anterooms and bathrooms had surface environmental samples taken at 26 sites. Personal protective equipment (PPE) samples from study physicians exiting the patient rooms also were collected. Sterile premoistened swabs were used.
Air sampling was done on 2 days using SKC Universal pumps (with 37-mm filter cassettes and 0.3-μm polytetrafluoroethylene filters for 4 hours at 5 L/min) in the room and anteroom and a Sartorius MD8 microbiological sampler (with gelatin membrane filter for 15 minutes at 6 m3 /h) outside the room (eFigure in the Supplement).
Specific real-time reverse transcriptase–polymerase chain reaction (RT-PCR) targetingRNA-dependentRNApolymeraseand E genes4was used to detect the presence of SARS-CoV-2 (see detailed methods in the eAppendix in the Supplement). Cycle threshold values, ie, number of cycles required for the fluorescent signal tocross the threshold inRT-PCR,quantified viral load, with lower values indicating higher viral load.
Sampleswere collected on 5 days over a 2-week period. One patient’s room was sampled before routine cleaning and 2 patients’ rooms after routine cleaning. Twice-daily cleaning of high-touch areas was done using 5000 ppm of sodium dichloroisocyanurate. The floor was cleaned daily using 1000 ppm of sodium dichloroisocyanurate.
Clinical data (symptoms, day of illness, and RT-PCR results) and timing of cleaning were collected and correlated with sampling results. Percentage positivity was calculated for rooms with positive environmental swabs. Institutional review board approval and written informed consent were obtained as part of a larger multicenter study.
Results | Patient A’s room was sampled on days 4 and 10 of illness while the patient was still symptomatic, after routine cleaning. All samples were negative. Patient B was symptomatic on day 8 and asymptomatic on day 11 of illness; samples taken on these 2 days after routine cleaning were negative (Table 1).
Patient C, whose samples were collected before routine cleaning, had positive results, with 13 (87%) of 15 room sites (including air outlet fans) and 3 (60%) of 5 toilet sites (toilet bowl, sink, and door handle) returning positive results (Table 2). Anteroom and corridor samples were negative. Patient C had upper respiratory tract involvement with no pneumonia and had 2 positive stool samples for SARS-CoV-2 on RT-PCR despite not having diarrhea. Patient C had greater viral shedding, with a cycle threshold value of 25.69 in nasopharyngeal samples compared with 31.31 and 35.33 in patients A and B (Table 1).
Only 1 PPE swab, from the surface of a shoe front, was positive. All other PPE swabs were negative. All air samples were negative.
Discussion | There was extensive environmental contamination by 1 SARS-CoV-2 patient with mild upper respiratory tract involvement. Toilet bowl and sink samples were positive, suggesting that viral shedding in stool5 could be a potential route of transmission. Postcleaning samples were negative, suggesting that current decontamination measures are sufficient.
Air samples were negative despite the extent of environmental contamination. Swabs taken from the air exhaust outlets tested positive, suggesting that small virus-laden droplets may be displaced by airflows and deposited on equipment such as vents.ThepositivePPE samplewasunsurprising because shoe covers are not part of PPE recommendations. The risk of transmission from contaminated footwear is likely low, as evidenced by negative results in the anteroom and clean corridor.
This study has several limitations. First, viral culture was not done to demonstrate viability. Second, due to operational limitations during an outbreak, methodology was inconsistent and sample size was small. Third, the volume of air sampled represents only a small fraction of total volume, and air exchanges in the room would have diluted the presence of SARS-CoV-2 in the air. Further studies are required to confirm these preliminary results.
Significant environmental contamination by patients with SARS-CoV-2 through respiratory droplets and fecal shedding suggests the environment as a potential medium of transmission and supports the need for strict adherence to environmental and hand hygiene.
Coronavirus can survive long exposure to high temperature, a threat to lab staff around world: paper
The new coronavirus can survive long exposure to high temperatures, according to an experiment by a team of French scientists.
Professor Remi Charrel and colleagues at the Aix-Marseille University in southern France heated the virus that causes Covid-19 to 60 degrees Celsius (140 Fahrenheit) for an hour and found that some strains were still able to replicate.
The scientists had to bring the temperature to almost boiling point to kill the virus completely, according to their non-peer-reviewed paper released on bioRxiv.org on Saturday. The results have implications for the safety of lab technicians working with the virus.
"Immunity passports" in the context of COVID-19
Scientific Brief
24 April 2020
WHO has published guidance on adjusting public health and social measures for the next phase of the COVID-19 response.1 Some governments have suggested that the detection of antibodies to the SARS-CoV-2, the virus that causes COVID-19, could serve as the basis for an “immunity passport” or “risk-free certificate” that would enable individuals to travel or to return to work assuming that they are protected against re-infection. There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.
The measurement of antibodies specific to COVID-19
The development of immunity to a pathogen through natural infection is a multi-step process that typically takes place over 1-2 weeks. The body responds to a viral infection immediately with a non-specific innate response in which macrophages, neutrophils, and dendritic cells slow the progress of virus and may even prevent it from causing symptoms. This non-specific response is followed by an adaptive response where the body makes antibodies that specifically bind to the virus. These antibodies are proteins called immunoglobulins. The body also makes T-cells that recognize and eliminate other cells infected with the virus. This is called cellular immunity. This combined adaptive response may clear the virus from the body, and if the response is strong enough, may prevent progression to severe illness or re-infection by the same virus. This process is often measured by the presence of antibodies in blood.
WHO continues to review the evidence on antibody responses to SARS-CoV-2 infection.2-17 Most of these studies show that people who have recovered from infection have antibodies to the virus. However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans.
Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their accuracy and reliability. Inaccurate immunodiagnostic tests may falsely categorize people in two ways. The first is that they may falsely label people who have been infected as negative, and the second is that people who have not been infected are falsely labelled as positive. Both errors have serious consequences and will affect control efforts. These tests also need to accurately distinguish between past infections from SARS-CoV-2 and those caused by the known set of six human coronaviruses. Four of these viruses cause the common cold and circulate widely. The remaining two are the viruses that cause Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome. People infected by any one of these viruses may produce antibodies that cross-react with antibodies produced in response to infection with SARS-CoV-2.
Many countries are now testing for SARS-CoV-2 antibodies at the population level or in specific groups, such as health workers, close contacts of known cases, or within households.21 WHO supports these studies, as they are critical for understanding the extent of – and risk factors associated with – infection. These studies will provide data on the percentage of people with detectable COVID-19 antibodies, but most are not designed to determine whether those people are immune to secondary infections.
Other considerations
At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an “immunity passport” or “risk-free certificate.” People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission. As new evidence becomes available, WHO will update this scientific brief.
References
SNIP...SEE;
COVID-19 AND CHILDREN
Published Online May 6, 2020 https://doi.org/10.1016/ S0140-6736(20)31094-1
Hyperinflammatory shock in children during COVID-19 pandemic
South Thames Retrieval Service in London, UK, provides paediatric intensive care support and retrieval to 2 million children in South East England. During a period of 10 days in mid-April, 2020, we noted an unprecedented cluster of eight children with hyperinflammatory shock, showing features similar to atypical Kawasaki disease, Kawasaki disease shock syndrome,1 or toxic shock syndrome (typical number is one or two children per week). This case cluster formed the basis of a national alert. All children were previously fit and well. Six of the children were of AfroCaribbean descent, and five of the children were boys. All children except one were well above the 75th centile for weight. Four children had known family exposure to coronavirus disease 2019 (COVID-19). Demographics, clinical findings, imaging findings, treatment, and outcome for this cluster of eight children are shown in the table.
Clinical presentations were similar, with unrelenting fever (38–40°C), variable rash, conjunctivitis, peripheral oedema, and generalised extremity pain with significant gastrointestinal symptoms. All progressed to warm, vasoplegic shock, refractory to volume resuscitation and eventually requiring noradrenaline and milrinone for haemodynamic support. Most of the children had no significant respiratory involvement, although seven of the children required mechanical ventilation for cardiovascular stabilisation. Other notable features (besides persistent fever and rash) included development of small pleural, pericardial, and ascitic effusions, suggestive of a diffuse inflammatory process.
All children tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on bronchoalveolar lavage or nasopharyngeal aspirates. Despite being critically unwell, with laboratory evidence of infection or inflammation3 including elevated concentrations of C-reactive protein, procalcitonin, ferritin, triglycerides, and D-dimers, no pathological organism was identified in seven of the children. Adenovirus and enterovirus were isolated in one child.
Baseline electrocardiograms were non-specific; however, a common echocardiographic finding was echobright coronary vessels (appendix), which progressed to giant coronary aneurysm in one patient within a week of discharge from paediatric intensive care (appendix). One child developed arrhythmia with refractory shock, requiring extracorporeal life support, and died from a large cerebrovascular infarct. The myocardial involvement2 in this syndrome is evidenced by very elevated cardiac enzymes during the course of illness.
All children were given intravenous immunoglobulin (2 g/kg) in the first 24 h, and antibiotic cover including ceftriaxone and clindamycin. Subsequently, six children have been given 50 mg/kg aspirin. All of the children were discharged from PICU after 4–6 days. Since discharge, two of the children have tested positive for SARSCoV-2 (including the child who died, in whom SARS-CoV-2 was detected post mortem). All children are receiving ongoing surveillance for coronary abnormalities.
We suggest that this clinical picture represents a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection manifesting as a hyperinflammatory syndrome with multiorgan involvement similar to Kawasaki disease shock syndrome. The multifaceted nature of the disease course underlines the need for multispecialty input (intensive care, cardiology, infectious diseases, immunology, and rheumatology).
The intention of this Correspondence is to bring this subset of children to the attention of the wider paediatric community and to optimise early recognition and management. As this Correspondence goes to press, 1 week after the initial submission, the Evelina London Children’s Hospital paediatric intensive care unit has managed more than 20 children with similar clinical presentation, the first ten of whom tested positive for antibody (including the original eight children in the cohort described above).
We declare no competing interests.
*Shelley Riphagen, Xabier Gomez, Carmen Gonzalez-Martinez, Nick Wilkinson, Paraskevi Theocharis shelley.riphagen@gstt.nhs.uk
South Thames Retrieval Service for Children, Evelina London Children’s Hospital Paediatric Intensive Care Unit, London SE1 7EH, UK (SR, XG); and Evelina London Children’s Hospital, London, UK (CG-M, NW, PT)
2 New York Boys Die Of Multi-System Inflammatory Syndrome Affecting Children Amid Coronavirus Pandemic
May 8, 2020 at 11:41 pmFiled Under:Coronavirus, COVID-19, Health, Jessica Layton, Local TV, multi-symptom inflammatory syndrome, New York, Tony Aiello, Valhalla, Westchester County
VALHALLA, N.Y. (CBSNewYork) — A Westchester County boy has died after coming down with an illness affecting dozens of children in New York State.
The 7-year-old boy died late last week at Maria Fareri Children’s Hospital in Valhalla. Dr. Michael Gewitz said he suffered neurological complications from what is now called pediatric multi-system inflammatory syndrome.
Health officials said there have been 73 suspected cases of the illness statewide and investigators are doing a deep dive into the circumstances.
Gov. Andrew Cuomo shared an update Friday, announcing the death of a 5-year-old boy, who CBS2 later confirmed died at Mount Sinai Kravis Children’s Hospital.
“Right now we have a new issue that we’re looking at, which is something we’re just investigating now, but, while rare, we’re seeing some cases where children affected with the COVID virus can become ill with symptoms similar to the Kawasaki disease or Toxic Shock-like syndrome that literally causes inflammation in their blood vessels,” Cuomo said. “This past Thursday, a 5-year-old boy passed away from COVID-related complications, and the State Department of Health is investigating several other cases that presents similar circumstances.”
The hospital said in part, “We must emphasize that based on what we know thus far, it appears to be a very rare condition.”
WATCH: Gov. Cuomo Warns About New Disease Affecting Children Amid Pandemic
It’s still unclear exactly how the syndrome relates to the coronavirus.
The Westchester boy tested positive for COVID-19 antibodies, meaning he was previously infected and had recovered, CBS2’s Tony Aiello reported.
“And we know that in some of the households parents or grandparents or others were diagnosed with COVID and were actually on the record being positive, and apparently the children did not develop symptoms until two to four days before presenting to the hospital for treatment,” said Dr. Dial Hewlett of the Westchester County Department of Health.
“This is very serious. The disease can be fatal, and we want to make sure everyone in Westchester County is aware to be on the lookout for symptoms that may lead to this,” County Executive George Latimer added.
Web Extra: Health Advisory On Pediatric Multi-System Inflammatory Syndrome
Seek care immediately if a child has:
Prolonged fever (more than 5 days)
Difficulty feeding (infants) or is too sick to drink fluids
Severe abdominal pain, diarrhea, or vomiting
Change in skin color – becoming pale, patchy, and/or blue Trouble breathing or is breathing very quickly
Racing heart or chest pain
Decreased amount or frequency of urine Lethargy, irritability, or confusion
“So this is every parent’s nightmare, right? That your child may actually be affected by this virus. But it’s something we have to consider seriously now,” Gov. Cuomo said.
In New Jersey, a 4-year-old child with underlying health issues has also died. It’s unclear if he was affected by the inflammatory syndrome, but there are a handful of other suspected cases in Garden State kids.
“It’s a virus that’s proving to be extremely challenging at every level,” Gov. Phil Murphy said.
Dr. Gewitz said while COVID-19 is likely to infect a large number of children, “most of whom, at least many, are totally asymptomatic. This particular complication is relatively infrequent, unusual.”
SARS-CoV-2 Infection in Children
Of the 1391 children assessed and tested from January 28 through February 26, 2020, a total of 171 (12.3%) were confirmed to have SARS-CoV-2 infection. Demographic data and clinical features are summarized in Table 1. (Details of the laboratory and radiologic findings are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.) The median age of the infected children was 6.7 years. Fever was present in 41.5% of the children at any time during the illness. Other common signs and symptoms included cough and pharyngeal erythema. A total of 27 patients (15.8%) did not have any symptoms of infection or radiologic features of pneumonia. A total of 12 patients had radiologic features of pneumonia but did not have any symptoms of infection. During the course of hospitalization, 3 patients required intensive care support and invasive mechanical ventilation; all had coexisting conditions (hydronephrosis, leukemia [for which the patient was receiving maintenance chemotherapy], and intussusception). Lymphopenia (lymphocyte count, <1 .2="" 10-month-old="" 149="" 2020="" 21="" 4="" 6="" 8="" a="" admission.="" after="" and="" as="" been="" bilateral="" child="" common="" condition="" death.="" died="" discharged="" div="" failure="" finding="" from="" general="" ground-glass="" had="" have="" hospital.="" in="" intussusception="" liter="" march="" most="" multiorgan="" of="" one="" opacity="" patients="" per="" present="" radiologic="" stable="" the="" there="" total="" wards="" was="" weeks="" were="" with="">
Two COVID-19 infected children, aged 12 and 13, die in Belgium and UK
By Alasdair Sandford with AFP, AP • last updated: 01/04/2020
A health worker in the intensive care ward observes a COVID-19 patient at a hospital in Belgium, March 27, 2020. (AP Photo/Francisco Seco, File)
A 12-year-old girl in Belgium and a 13-year old boy in the UK infected with the novel coronavirus have died, authorities said.
They are believed to be the youngest victims of the disease in their respective countries.
The 12-year-old girl's death was announced during the daily news conference given by Belgium's health service, at the end of its regular update on casualty figures and hospitalisations.
“It's an emotionally difficult moment because it involves a child, and it has also upset the medical and scientific community,” said spokesman Dr Emmanuel André, visibly upset.
"We are thinking of her family and friends. It's a very rare event, but one which devastates us."
Another spokesman added that the child had had a fever for three days and had tested positive for the coronavirus. No other details were given of the girl's background.
Until now the youngest person to die from the virus in Belgium was a 30-year-old female nurse, according to Belgian media.
Just a few hours later, London's King's College Hospital announced that a 13-year-old COVID-19 patient had also died.
"Sadly, a 13-year old boy who tested positive for COVID-19 has passed away, and our thoughts and condolences are with the family at this time," a Trust spokesperson said in a statement.
"The death has been referred to the Coroner," it added.
An appeal posted on the GoFunMe crowdfunding platform by Madinah College, named him as Ismail and said that he didn't have "any pre-existing health conditions.
"Sadly he died without any family members close by due to the highly infectious nature of COVID-19," it added.
Ismail is believed the be the youngest victim of the disease in the UK.
Last week French authorities said a 16-year-old girl had died at a children's hospital in Paris. The death of the teenager, identified as Julie A. and described as otherwise healthy, has provoked strong emotions in France.
Coronavirus in France: healthy 16 year-old dies of COVID-19
Deaths from COVID-19 among people so young are exceptional. Health authorities have said previously that serious cases of the illness -- although predominant in older and more vulnerable age groups -- can occur in adults of any age.
Last weekend the US state of Illinois announced the death of an infant under one year old who had tested positive for coronavirus. The cause of death was being investigated. Medical reports on cases in China have documented the death of a 10-month-old baby and a 14-year-old boy.
A recent US study by the Centers for Disease Control and Prevention (CDC) of 2,500 patients found no cases of deaths among people aged under 19. But it did find that people of all ages were liable to become seriously ill: more than a third of those hospitalised were aged between 20 and 54.
Coronavirus in Europe: Latest numbers on COVID-19 cases and deaths
The Belgian girl's death was included among the latest national figures released on Tuesday, confirming nearly 200 more deaths since the previous update. More than 700 people in the country have died from coronavirus since the outbreak began.
Hospitals in three regions have been particularly badly affected, the authorities say -- around Brussels, in Limburg in eastern Flanders, and in Hainaut in Wallonia to the west.
With 12,775 confirmed COVID-19 cases as of Tuesday, Belgium has the 10th highest number of infections among countries worldwide, according to data compiled by the US Johns Hopkins University Coronavirus Resource Center.
State Reporting of Cases and Deaths Due to COVID-19 in Long-Term Care Facilities Priya Chidambaram Published: Apr 23, 2020
Our data collection effort finds that in the 23 states that publicly report death data as of April 23, 2020, there have been over 10,000 reported deaths due to COVID-19 in long-term care facilities (including residents and staff), representing 27% of deaths due to COVID-19 in those states.
Our data also finds that there have been over 50,000 reported cases, accounting for 11% of coronavirus cases in 29 states. In six states reporting data, deaths in long-term care facilities account for over 50% of all COVID-19 deaths (Delaware, Massachusetts, Oregon, Pennsylvania, Colorado, and Utah; Table 2).
High case and death rates may be attributed to a number of factors, including high rates of testing within long-term care facilities and low rates of testing of the general public.
The total cases and deaths from reporting states accounts for just over half (53%) of all cases, and 81% of all deaths. Given that not all states are reporting data yet and the continual lag in testing, the counts of cases and deaths are an undercount of the true number of cases and deaths in long-term care facilities.
Purging the elderly and their votes with Covid-19
COVID-19 U.S.A. DEATHS a failure at the highest level, the president of the USA...IMO.
President’s intelligence briefing book repeatedly cited virus threat
President Trump delivers a television national address on the coronavirus pandemic from the Oval Office on March 11.
President Trump delivers a television national address on the coronavirus pandemic from the Oval Office on March 11. (Jabin Botsford/The Washington Post)
By
Greg Miller and Ellen Nakashima
April 27, 2020 at 4:22 p.m. CDT
U.S. intelligence agencies issued warnings about the novel coronavirus in more than a dozen classified briefings prepared for President Trump in January and February, months during which he continued to play down the threat, according to current and former U.S. officials.
The repeated warnings were conveyed in issues of the President’s Daily Brief, a sensitive report that is produced before dawn each day and designed to call the president’s attention to the most significant global developments and security threats.
For weeks, the PDB — as the report is known — traced the virus’s spread around the globe, made clear that China was suppressing information about the contagion’s transmissibility and lethal toll, and raised the prospect of dire political and economic consequences.
But the alarms appear to have failed to register with the president, who routinely skips reading the PDB and has at times shown little patience for even the oral summary he takes two or three times per week, according to the officials, who spoke on the condition of anonymity to discuss classified material...
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TUESDAY, APRIL 21, 2020
Covid-19 Hydroxychloroquine Study finds no benefit, higher death rate, study of 368 patients, 97 patients who took drug had a 27.8% death rate compared to 11.4% death rate that did not take drug
Texas City, Texas, Galveston County
COVID-19 Patients Given Unproven Drug In Texas Nursing Home In 'Disconcerting' Move
When Larry Edrozo got a phone call from his mother’s nursing home in Texas City telling him she was being treated for the novel coronavirus with an unproven pharmaceutical drug, he had two questions: why was she getting the drug if she had not been showing symptoms, and who gave consent?
President George W. Bush on Pandemic Flu in 2005
Trump disbanded NSC pandemic unit that experts had praised
By DEB RIECHMANN
March 14, 2020
WASHINGTON (AP) — Public health and national security experts shake their heads when President Donald Trump says the coronavirus “came out of nowhere” and “blindsided the world.”
They’ve been warning about the next pandemic for years and criticized the Trump administration’s decision in 2018 to dismantle a National Security Council directorate at the White House charged with preparing for when, not if, another pandemic would hit the nation.
CORONAVIRUS APR. 8, 2020
U.S. Intelligence Warned Trump of Coronavirus Threat as Early as November: Report
By Matt Stieb
We’ve removed our paywall from essential coronavirus news stories. Become a subscriber to support our journalists. Subscribe now.
One of the many, mutually exclusive excuses the Trump administration has provided for its profound delay in responding to the coronavirus is that they were fooled by reports of the outbreak coming out of China. “I will be very candid with you,” Mike Pence explained on CNN last week, “and say that in mid-January the CDC was still assessing that the risk of the coronavirus to the American people was low. … The reality is that we could’ve been better off if China had been more forthcoming.”
Pence, too, could have been more forthcoming about the information the administration was privy to, according to a new report from ABC News. According to two officials familiar with a report from the military’s National Center for Medical Intelligence, the White House was aware of a contagion which is now known to be COVID-19 as early as November. According to ABC News, the report, made up of data intercepts and satellite imagery, determined that the coronavirus was a potential threat to U.S. troops in the region. “Analysts concluded it could be a cataclysmic event,” a source told ABC News. “It was then briefed multiple times to the Defense Intelligence Agency, the Pentagon’s Joint Staff and the White House.”
Though Defense Secretary Mark Esper told ABC News on Sunday that the National Security Council was not briefed about the matter in December, the ABC News report says that the administration was aware of its contents as early as Thanksgiving:
The NCMI report was made available widely to people authorized to access intelligence community alerts. Following the report’s release, other intelligence community bulletins began circulating through confidential channels across the government around Thanksgiving, the sources said. Those analyses said China’s leadership knew the epidemic was out of control even as it kept such crucial information from foreign governments and public health agencies.
“The timeline of the intel side of this may be further back than we’re discussing,” the source said of preliminary reports from Wuhan. “But this was definitely being briefed beginning at the end of November as something the military needed to take a posture on.”
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Atkinson’s removal is part of a larger shakeup of the intelligence community under Trump, who has long been skeptical of intelligence officials and information. Atkinson is at least the seventh intelligence official to be fired, ousted or moved aside since last summer.
Below is a timeline of Trump’s commentary downplaying the threat.
Jan. 22: On whether he was worried about a pandemic: “No, we’re not at all. And we have it totally under control. It’s one person coming in from China.”
Jan. 24: “It will all work out well.”
Trump reportedly dismissed January coronavirus warnings from Health Secretary Alex Azar as 'alarmist'
Tom Porter
Trump according to the Post was warned in a January intelligence briefing about the threat posed by the virus as well as by his health secretary, but in public statements for weeks continued to downplay the likely impact of the disease.
A Navy captain tries to save his sailors, and gets fired in the process
Navy secretary, in a transparent bid to appease President Trump, moves precipitously to relieve aircraft carrier captain of his command: Our view The Editorial Board USA TODAY
CDC
Last updated April 24, 2020
Why Forecasting COVID-19 Deaths in the US is Critical
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Working to Bring Together Forecasts for COVID-19 Deaths in the US
CDC works with partners to bring together weekly forecasts for COVID-19 deaths in one place. These forecasts have been developed independently and shared publicly. It is important to bring these forecasts together to help understand how they compare with each other and how much uncertainty there is about what may happen in the upcoming four weeks.
Columbia Universityexternal icon
Model names: CU 20% contact reduction, CU 30% contact reduction, CU 40% contact reduction
Intervention assumptions These models are based on assumptions of reducing the number of contacts per case. Three different adaptive scenarios of contact reduction are projected: 20%, 30%, and 40% contact reduction in US counties with at least 10 cases. Additional reductions are implemented with additional new cases, and all social distancing interventions remain in place until the end of the projection.
Methods Metapopulation SEIR model
Institute for Health Metrics and Evaluationexternal icon
Model name: IHME
Intervention assumptions This model assumes social distancing stays in place until the pandemic, in its current phase, reaches the point when COVID-19 deaths are less than 0.3 per million people. Based on these latest projections, IHME expects social distancing measures to be in place through the end of May.
Methods Non-linear mixed effects curve-fitting
Los Alamos National Laboratory (state-level forecasts only)external icon
Model name: LANL
Intervention assumptions Currently implemented interventions and the corresponding reductions in transmission will continue to be upheld in the future, resulting in an overall decrease in the growth rate of COVID-19. Over the course of the forecast, the model assumes that the growth will decrease over time. Methods Statistical dynamical growth model accounting for population susceptibility
Northeasternexternal icon
Model name: MOBS (Laboratory for the Modeling of Biological + Socio-technical Systems)
Intervention assumptions The projections assume that social distancing policies in place at the date of calibration are extended for the future weeks. Methods Metapopulation, age-structured SLIR model
University of Texas, Austinexternal icon
Model name: UT Austin
Intervention assumptions Estimates the extent of social distancing using geolocation data from mobile phones and assumes that the extent of social distancing does not change during the period of forecasting. The model is designed to predict confirmed COVID-19 deaths resulting from only a single wave of transmission.
Methods Statistical mixed-effects model.
University of Geneva (one-week ahead forecasts only)external icon
Model name: University of Geneva
Intervention assumptions The projections assume that social distancing policies in place at the date of calibration are extended for the future weeks. Methods Exponential and linear statistical models fit to the recent growth rate of cumulative deaths.
Youyang Gu (COVID-Projections)external icon
Model name: YYG
Intervention assumptions The projections assume that strong social distancing policies will remain in place through the projected period. Methods SEIS mechanistic model.
STATE BY STATE UPDATED DEATH PROJECTIONS (SEE TEXAS)
see Texas, and pray that it's not one of your Mom, Dad, Sister, Brother, or any other family members or friends, oh, that's right, it's o.k. to die, the economy is more important..GOP MAGA COVID-19
United States Coronavirus Cases: 1,326,200 Deaths: 78,790 and still mounting...tss
TEXAS COVID-19 DEATHS
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