Our live coverage of the coronavirus pandemic has ended for the evening.
A baffling condition called Multi-Inflammatory Syndrome in Children (MIS-C) started showing up in kids about three weeks after the peak of the coronavirus pandemic passed through, a team at a large New York health system reported Monday.
The team at Northwell Health reported on 33 cases of the syndrome, which many doctors believe is some sort of delayed response to a coronavirus infection.
All 33 children recovered with treatment, the team reported in the Journal of Pediatrics. Dr. Charles Schleien, who chairs the pediatrics department at Northwell’s Cohen Children’s Medical Center in New Hyde Park, said doctors were at first mystified by what was happening.
“We were pretty shocked as it was playing out,” Schleien told CNN on Monday. “The whole syndrome came out of the blue. We had been comfortable for months [in the belief] that kids weren’t affected all these months by coronavirus.”
The flow of affected children peaked about five weeks after Covid-19 hit New York City and the surrounding areas hard, Schleien and colleagues reported in the Journal of Pediatrics. “These are families I am sure thought they were off the hook,” Schleien said.
Many showed up in shock, with plummeting blood pressure that required immediate treatment.
“We treated these kids as they were coming in having no idea what it was,” Schleien added. As many other medical centers have reported, the symptoms at first looked like Kawasaki Disease, a rare syndrome that usually affects very young children.
“We treated them as though they had Kawasaki Disease despite the age range,” Schleien said. The children with MIS-C ranged in age from 2 to 17. Almost all had gastrointestinal pain and diarrhea, the team reported.
They also had clear evidence of inflammation as shown on blood tests, and 79% of them required intensive care. All tested positive for coronavirus. Schleien said the team excluded a handful of other children who did not test positive. Other teams have reported that MIS-C patients had no symptoms of infection before, but that most of them later tested positive for antibodies to coronavirus, indicating a past infection.
All got treatment of some sort, including aspirin and intravenous immune globulin (IVIG), a standard Kawasaki treatment. Some also got the antiviral remdesivir or strong anti-inflammatory medications normally used to treat conditions such as rheumatoid arthritis.
All recovered and Schleien said he does not know which treatments helped or hurt. Some may have heart damage.
“They are all going to be seeing cardiologists for a while yet,” Schleien said.
He said parents and pediatricians need to make sure that any children with lasting fevers and diarrhea get examined right away.
A closely watched model that predicts Covid-19 deaths is now forecasting there will be more than 201,000 deaths in the United States by October 1.
The projections continue to show that the fall is going to be difficult, with a sharp rise in daily deaths forecast in September and October.
Last week, the model, from the Institute for Health Metrics and Evaluation at the University of Washington, predicted 170,000 deaths for this same time period. The model was often cited by the White House early in the pandemic and is one of 19 models currently featured on the US Centers for Disease Control and Prevention website.
As of today, the model projects that 201,129 people will die from Covid-19 in the US by October 1, with a possible range of 171,551 to 269,395 deaths. Ali Mokdad, one of the model’s creators, said they’ve raised the number of projected deaths for two reasons.
“Increased mobility and premature relaxation of social distancing led to more infections and we see it in Florida, Arizona, and other states. This means more projected deaths,” Mokdad told CNN in an email. “The second part is that we are now projecting to October 1st, which means that an increase in this wave will results in our starting point for the second wave (more seeding), so the second wave will be higher and we are capturing parts of that. Remember second wave starts at the end of August early September.”
Daily deaths are expected to decrease through June and July and remain relatively stable through August, but the model forecasts a sharp rise in deaths through September.
In the model, projected daily deaths nearly double from 743 on September 1 to 1,241 on October 1. The model’s uncertainty does increase the farther out it projects in time.
To make the model, analysts use cell phone data to show people’s increased mobility. As people move around, they have a higher chance of coming into contact with someone who is sick, but it isn’t entirely clear exactly how mobility corresponds with infections. Wearing a mask and physical distancing can reduce the rate of disease transmission.
IHME has also said that it looks at other factors in making the model, including the numbers of people who wear masks, air pollution figures, testing, pneumonia trends and population density, among other factors.
The IHME model has been criticized for some of its assumptions and predictions. At one point, it projected that deaths would stop in the summer, many experts at the time called that unrealistic. Since then, IHME has revised its methodology.
Mokdad said that it is important for people to remember to remain cautious about interacting with others.
“We all need to wear our masks and stay away from each other to reduce the circulation and to be in a better place at the beginning of the second wave,” Mokdad said.
The National Institutes of Health has launched a national database to collect medical information on coronavirus patients in the United States.
“This effort aims to transform clinical information into knowledge urgently needed to study COVID-19, including health risk factors that indicate better or worse outcomes of the disease, and identify potentially effective treatments,” the agency said in a statement Monday.
The NIH said the platform data will include clinical, laboratory and diagnostic information from hospitals, labs and other health care providers
The database will help researchers and health care providers answer critical questions relating to Covid-19 illness — for example who might need kidney dialysis, who may need a ventilator or what kinds of therapies a particular patient may need.
“By leveraging our collective data resources, unparalleled analytics expertise, and medical insights from expert clinicians, we can catalyze discoveries that address this pandemic that none of us could enable alone,” said Melissa Haendel, the director of the National Center for Data to Health (CD2H) at the Oregon Health & Science University School of Medicine.
The NIH’s National Center for Advancing Translational Sciences, which is paying for the new database, said it should help address future pandemics, too.
The agency said that the only identifying data on the platform will include the zip code of the health care group providing the information and the dates of service. No other personal patient information will appear on the site. Only approved users will be able to access the site and they can only study the information while on the platform and only for Covid-19 research and public health surveillance, the NIH said.
Colorado Gov. Jared Polis announced Monday new safer-at-home guidelines, which will go into effect on June 18.
Residential summer camps can reopen, allowing only 10 children indoors and 25 children outdoors.
Indoor events, including museums, receptions and conferences, can also start to open.
Meanwhile, restaurants, houses of worship and bars will be able to open with 25% capacity or up to 50 people.
Non-critical manufacturing facilities can allow in-person workforce.
United Airlines says that starting Thursday, passengers who do not wear a mask in flight will be banned — at least temporarily — from flying with the carrier, pending a “comprehensive incident review” and subject to some exceptions.
Flight attendants will warn passengers who don’t comply and offer them a mask. If further de-escalation is unsuccessful, the flight attendant will file a report after the flight reaches its destination. After a review, the passenger could be placed on an “internal travel restriction list” and unable to fly “for a duration of time to be determined.”
United sent out an internal memo to employees on Monday evening laying out the new guidelines, ratcheted up from an initial pandemic policy of keeping passengers who refuse masks from boarding and flight attendants “strongly encouraging” passengers to wear masks in flight.
The world’s third largest airline says passengers who are eating or drinking do not need to wear a mask as well as those with certain medical conditions or small children.
The Brazilian health ministry reported at least 20,647 new cases of novel coronavirus on Monday, bringing the country’s total to at least 888,271.
Brazil also recorded at least 627 new Covid-19 deaths over the past 24 hours, bringing the country’s death toll to at least 43,959, according to the health ministry.
Monday also marks one month that Brazil has been without a health minister. The ministry has been led on an interim basis following the May 15 resignation of Nelson Teich.
Since Teich’s resignation, Brazil's health ministry has been led by Eduardo Pazuello, an army general and the former executive secretary of the ministry. Brazilian President Jair Bolsonaro signed a decree making Pazuello’s role as interim minister official on June 2.
Teich’s resignation in May was the second departure of a Brazilian health minister during the Covid-19 outbreak following Bolsonaro’s firing of Teich’s predecessor, Luiz Henrique Mandetta, in April.
How Rio de Janeiro's favelas are trying to stop coronavirus spread:
Major US airlines announced they intend to more strictly enforce mask wearing aboard their planes, including potentially banning passengers who refuse to wear a mask.
The announcement comes in lieu of a federal regulation requiring all passengers to wear masks – the sort of enforceable measure that governs requirements to wear seatbelts and not smoke.
Seven major airlines – including American Airlines, Delta Air Lines, Southwest Airlines and United Airlines – pledged to roll out new policies requiring masks, enforced with a penalty as severe as a ban on flying with that particular airline.
“Each carrier will determine the appropriate consequences for passengers who are found to be in noncompliance of the airline’s face covering policy up to and including suspension of flying privileges on that airline,” said Airlines for America, the carriers’ industry group.
The lack of federal action has driven the airlines to act, according to a source familiar with the discussions. The airlines are expected to lay out specific policies as well as enforcement procedures for crewmembers to follow in the coming days, the source said.
Austin Mayor Steve Adler tweeted Monday that he is extending stay home orders to August 15, as the number of Covid-19 hospitalizations increase statewide.
Texas reported on Monday a record high number of Covid-19 hospitalizations. At least 2,326 people have been hospitalized.
There have been at least 89,108 cases of Covid-19, and at least 1,983 deaths in the state.
CNN's Ashley Killough contributed to this post.