COVID 19 UPDATE

Last updated on June 1, 2020, John Hopkins Corona Virus Dashboard and Worldometer

Cases Worldwide

• TOTAL CASES       -  6,263,901

• Recovered     -  2,846,713  

• TOTAL DEATHS    -     373,899

Cases in the U.S.

• TOTAL CASES       -  1,837,170

• Recovered     -     599,864

• TOTAL DEATHS    -     106,195
• Unemployed        -  26.4 million

Cases in California

• TOTAL CASES       -     112,584   
• TOTAL DEATHS    -        4,240
• Unemployed        - 2,170,108

UPDATE
From the beginning of the COVID-19 pandemic, children were relatively untouched by the novel coronavirus.  When infected, children often had few symptoms unless an underlying condition compromised their health.  It was believed children could have the disease without suffering from the symptoms.  Children recently have been presenting with a rare but potentially dangerous complication thought linked to the coronavirus and now identified in at least seven states and the Washington, D.C., area.

For the record, pediatric multi-system inflammatory syndrome or PIMS hasn’t been definitively linked with COVID-19.  “The general thought is that most of these cases that have been reported so far were a consequence of a COVID-19 infection,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.  Doctors indicate it is the result of increased awareness of the problem.  Information regarding PIMS is still extremely limited due to the small numbers of cases compared with the staggering numbers of people affected by COVID-19.  Pediatric specialists around the country, including those at Children’s Hospital Los Angeles, are focusing their efforts on determining whether more cases exist.

What is MIS-C?

MIS-C stands for multisystem inflammatory syndrome, formerly called pediatric inflammatory multisystem syndrome, or PIMS.  It describes a health condition in children who have been infected with novel coronavirus, recovered and developed a immune response that results in significant levels of inflammation in organ systems and symptoms.  Children who have MIS-C generally did not have obvious symptoms when infected with the coronavirus, such as a cough, and generally were healthy prior to developing MIS-C.

Experts at Children’s Hospital Los Angeles (CHLA) noticed an increase in the number of patients diagnosed with Kawasaki disease during the month of April compared to the previous two years.  CHLA’s team began testing to determine if patients had antibodies demonstrating past COVID-19 infection.

By conducting serology testing for antibodies, Children’s Hospital Los Angeles had diagnosed three patients with MIS-C.  Each child was initially believed to have Kawasaki disease and received treatment.  Positive antibody testing of the patients, combined with symptoms consistent with other patients around the world and additional negative viral testing, led the CHLA team to diagnose these patients with MIS-C 

Hospitals in the United Kingdom and New York City started reporting children with significant inflammation, toxic shock syndrome and symptoms of Kawasaki disease following infection with the novel coronavirus.  There are still new things experts are learning about MIS-C that has hospitalized children in the U.S., with at least 120 children across New York State, as of May 18, 2020.

The symptoms are similar to pediatric inflammatory conditions such as Kawasaki disease, staphylococcal and streptococcal toxic shock syndromes, bacterial sepsis and macrophage activation syndromes. 

• Kawasaki disease or Kawasaki syndrome is a rare childhood condition that typically impacts children under the age of five, according to the Centers for Disease Control and Prevention (CDC).  The disease causes inflammation in the walls of the arteries and can decrease blood flow to the heart.  Symptoms include a high fever, rash, swollen glands in the neck, swollen hands and feet, cracked lips, and red eyes.

• Toxic shock syndrome (TSS) is a serious and sometimes fatal condition that is caused by a toxin created by some types of staphylococcus bacteria, per the U.S. National Library of Medicine.  Symptoms of TSS include confusion, diarrhea, headaches, high fever, low blood pressure, muscle aches, nausea, vomiting, red eyes, seizures, and organ failure.

• Bacterial sepsis - when the immune system releases chemicals into the bloodstream to fight an infection.  Those chemicals can attack normal organs and tissues. The immune overreaction is called sepsis and can cause inflammation, blood flow problems, low blood pressure, trouble breathing and vital organ failure. Sepsis in children and adults

             can be life-threatening.

• Macrophage activation syndrome - the immune system is uncontrolled and works in overdrive, leading to too much inflammation in the entire body.  The inflammation can be in any organ system including bone marrow, the liver and spleen.  This inflammation is very serious and can often make children very ill - it may also result in organ damage.

What are the symptoms of pediatric multi-system inflammatory syndrome or MIS-C?

Children previously infected with novel coronavirus, recovered from it and later experienced an immune response that results in significant levels of inflammation in organ systems.  Many children affected did not display the common symptoms of COVID-19 and were  seen as healthy prior to developing the illness.  Symptoms vary depending on which organ system is affected, according to the New York Department of Public Health but, in general, these appear to be the main signs of pediatric multi-system inflammatory syndrome:

• Fever - for seven or more days in an infant, for which no other explanation is identified
• Skin rash
• Unusual or unexplained abdominal pain
• Vomiting or diarrhea
• Pink or red eyes
• Enlarged lymph node (“gland”) on one side of the neck
• Red, cracked lips or red tongue that looks like a strawberry
• Rash
• Swollen hands and feet, which might also be red
• Respiratory symptoms like a cough or trouble breathing

Some children have needed blood pressure support and several requiring mechanical ventilation, the New York Department of Public Health said.

Is MIS-C/PIMS contagious?

No, MIS-C/PIMS is not contagious.  In order to have MIS-C/PIMS, a child must have had the infection previously. It is believed that, for one to have the antibodies for COVID-19, a patient must be past the contagious stage of the disease.

Treatment for MIS-C/PIMS at Children’s Hospital Los Angeles

Currently, the treatment for MIS-C is a similar protocol to what is used to treat Kawasaki disease. The goal is to reduce the inflammation to avoid long-term damage to arteries in the child’s body and heart.  This is accomplished through transfusions of plasma, which reduces the body’s own immune response that is causing the inflammation.

When should you take your child to the doctor?

Symptoms of MIS-C vary right now, but if your child develops a rash, red eyes, a high fever, or abdominal pain, Dr. Schaffner says you should see your child’s pediatrician immediately.  If you’re not sure, call anyway—your child’s doctor should be able to guide you from there.

YOUNG ADULTS

Young adults have felt comfortable going to spots with large crowds, as media reports highlighting data from China’s outbreak, indicated younger people were not as susceptible to the coronavirus as older age groups or people with underlying conditions.  But, that hasn’t held true.  Now, in several major American cities, young adults between 18 and 40, account for the largest group testing positive. 

Attention was generally focused on their role in influencing the spread and community transmission rather than the severity of infection in children and young adults themselves," wrote Roberta L. DeBiasi, MD, chief of the division of pediatric infectious diseases at Children's National Hospital, Washington, and colleagues.

As of May 21, 2020

• New York City - 39% of cases were among those ages 18 to 44. 

• 1.8% of those patients within the age group died.
• 3.9% for the 45-64 age group,
• 9.5% for those 65-74 and
• 16.3% for those 75 and older.

•  Los Angeles County’s 7,194 confirmed cases, 2,409, or 33%, were in the 18-40 age range. 

• Nearly half of those testing positive in Travis County, Texas, which encompasses much of the Austin metro area, were between 20 and 39 years of age..

• Washington, D.C., released numbers showing that 40% of the district’s cases were ages 19 - 40.

“It Was A Complete Shock”

Young adults are now coming to terms with a new reality driven by statistics showing they are not safe from the coronavirus.  News reports, such as the  25-year-old dying from COVID-19 or the announcement by Texas public health officials that 44 college students tested positive after returning from a group spring break trip to Mexico.  This reality drove home the point that they, too, were at risk.

A tracking poll released last week found that most of the nation had adjusted its behavior to slow the spread of the coronavirus.  

• 82% of respondents reported they are sheltering in place and nearly everyone
• 92% now reports some kind of social distancing — up from 59% two weeks ago, according to the poll from the Kaiser Family Foundation.

A March 16, 2020, report from the Centers for Disease Control and Prevention (CDC) shows that as of March 16, 2020, 508 people were hospitalized for COVID-19 in the U.S.  38% were between 20 and 54 years old.  Half ending up in intensive care were younger than 65.

In a study published in the Journal of Pediatrics, researchers reviewed data from 44 hospitalized and 133 non-hospitalized children and young adults infected with SARS-CoV-2.  The study population ranged from 0.1 to 34 years of age, with a median of 10 years.

• Of the 44 hospitalized patients, 35 were non-critically ill and 9 critically ill, which was similar between hospitalized and non-hospitalized patients.

• The median age of critically ill patients was significantly higher, compared with non-critically ill patients, 17 years vs. 4 years.

• Children less than 1 year and adolescents/young adults over 15 years each represented 32% of the 44 hospitalized patients.

• 39% of the 177 patients had underlying medical conditions, the most frequent of which was asthma (20%). 

• Patients also presented with:  

• neurologic conditions - 6%,
• diabetes - 3%,
• obesity - 2%,
• cardiac conditions - 3%,
• hematologic conditions -3% and
• oncologic conditions - 1%

• Neurologic disorders, cardiac conditions, hematologic conditions and oncologic conditions were significantly more common in hospitalized patients, but not significantly more common among those critically ill versus non-critically ill.

• About 76% of the patients presented with respiratory symptoms including rhinorrhea, congestion, sore throat, cough or shortness of breath – with or without fever. 

• 66% had fevers
• 48% had both respiratory symptoms and fever.  
• Shortness of breath was significantly more common among hospitalized patients versus non-hospitalized patients, 26% vs. 12%, but less severe respiratory symptoms were more common among non-hospitalized patients according to researchers.

What can you do to protect yourself?

If you have a serious underlying medical condition:

• Wear a cloth mask or face protection.
• Stay home if possible.

• Wash your hands often with soap and water or clean them with an alcohol-based sanitizer.  This kills viruses on your hands.

• Practice social distancing - you can have and spread the virus without knowing it.  If you do have to go out, stay at least 6 feet away from others.

• Don’t touch your face - Coronaviruses can live on surfaces from minutes to several hours dependent on the surface.  If they get on your hands and you touch your eyes, nose, or mouth, they can get into your body.

• Clean and disinfect frequently touched services.
• Call your healthcare professional if you have concerns about COVID-19 and your underlying condition or if you are sick.

For more information on steps you can take to protect yourself, see CDC’s How to Protect Yourself

The Immune System

White blood cells are the first line of defense!  The immune system fights off disease causing microorganisms and engineers the healing process.  The immune system is vital to fighting every assault on the body!  Understanding the role the immune systems plays in overall health will provide you the ability to take responsibility for your own health.  The responsibility of the immune system is to learn and identify those things that naturally belong in the body and those foreign or harmful.

The Best Immune Boosters

• Sovereign Silver - Colloidal Silver - is a solution of microscopic silver atoms suspended in a liquid solution.  Colloidal silver can kill certain germs by binding to and destroying proteins.  It has been shown in studies to be antimicrobial and antibacterial.  It doesn’t disrupt the body’s balance of good bacteria or microflora.   It is totally safe to take on short term basis - especially for an immune system boost.  Sovereign Silver checks all of these boxes for purity and bioavailability

• Echinacea - is well known for its ability to support the immune system especially during the colder months.  For years doctors and herbalists in Europe have commonly suggested Echinacea to support immune health.  Echinacea appears to activate chemicals in the body's immune system that decrease inflammation, which might reduce cold and flu symptoms.
   

• Elderberry - affects the immune system.  Elderberry promotes activity against viruses including the flu and might reduce inflammation.   It has very high concentrations of a few immune supporting compounds like vitamin C and antioxidants.

• Probiotics - Not all bacteria is bad! 70-80% of your immune system resides in the digestive tract.  Probiotics help to populate your gut with good microflora that not only help with digestion but also support the immune system.

When taking probiotics for an immune boost, get one with a variety of Lactobacillus and Bifidobacterium strains and a high concentration of CFUs, colony forming units – this is the amount of live microorganisms that help to populate the gut.

• Zinc - is a mineral or an "essential trace element," because very small amounts of zinc are necessary for human health.  The human body does not store excess zinc it must be consumed regularly as part of the diet.  It is found in several systems and biological reactions, and it is needed for immune function, wound healing, blood clotting, thyroid function and much more.  Zinc might have effects against viruses.  It appears to lessen symptoms of the rhinovirus, common cold, but researchers can’t yet explain exactly how this works. 

• Vitamin C – the single most important antioxidant for the immune system.  It is essential for the formation on adrenal hormones and lymphocytes.  It also has a direct effect on bacteria and viruses

• Coenzyme Q10 – Supports the immune system, an oxygen enhancer to protect the cells and heart function. 

• Garlic – stimulates the immune system

• Kelp – supplies a balance of minerals needed for immune integrity

• Maitake, Reishi or Shitake extracts – build immunity and fight viral infections and cancer

• Grape Seed extract – one of the most potent antioxidants, protects cells

• Oregonal – helps digestion by increasing bile flow and fighting against some bacteria, viruses, fungi, intestinal worms and other parasites.  Research published in the International Journal of Food Microbiology found that oil of oregano is an excellent germicide capable of killing a wide range of fungi and bacteria.

• Bayberry, Fenugreek, Hawthorn, Horehound, Licorice Root and Red Clover enhance the immune system.

• Power Greens – “a glass a day!”   Should include spirulina, kelp, chlorophyll and made from:  
• Natural ingredients
• High veggie to lower fruit ratio
• Complete vegetable blend
• Vitamins and minerals
• Low in sodium and sugars
• Includes probiotics
• Includes super mushrooms

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

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