- The Washington Post is reporting that cell phone data tracked by the University of Maryland’s Transportation Institute showed that tens of thousands of people flocked to Georgia after businesses were permitted to open. Over 60,000 more trips into the state were recorded than the week before the opening on April 24. Most of these travelers came from Alabama, South Carolina, Tennessee and Florida. I’ll be keeping an eye on new case data for these five states over the next 2-4 weeks to see if numbers there start to move and will post updates.
- This week my home province of New Brunswick, Canada had its first new cases of COVID-19 in two weeks. At least one of the cases is travel related. The positive individuals are in the Saint John and Fredericton areas and come just as the province has begun a phased reopening. By all estimation the province’s public health department has done a superb job managing the pandemic within its borders. The new cases serve as a reminder that the virus isn’t gone and that even in communities who have done almost everything right, it will invariably find its way back in via the path of least resistance.
- Though known for a while, there are increasing reports that patients with COVID-19 are suffering from abnormal blood clotting. A study published in the Annals of Internal Medicine found that 58% of 12 post-mortem examinations found deep vein thromboses in patients with COVID-19. There is a growing use of blood thinners to treat the sickest patients in centers around the country. It’s difficult to know at this point whether these clots are part of a well known medical phenomenon related to severe inflammatory states and shock called disseminated intravascular coagulation (DIC). In DIC, extremely ill patients both bleed too much and clot too much at the same time–it’s a clotting system gone haywire and a very difficult problem to manage in critically ill patients. Some of my worst nights during training were spent at a kid’s bedside trying to get them to stop bleeding and clotting, a tragically difficult task. It could also be that there’s something about COVID-19 that specifically causes abnormal clots to develop. Large scale studies are needed to determine the cause and to sort out appropriate treatment but blood thinners seem to be working their way into current standards of care.
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- Doctors in New York have issued an advisory warning of a possible inflammatory complication of COVID-19 in children. Sixty-four kids in New York have developed a condition described as an inflammatory syndrome affecting multiple systems including the heart and blood vessels. The syndrome appears to be similar to another more well-known pediatric condition called Kawasaki Disease. Children with Kawasaki Disease have prolonged fever, rash, enlarged lymph nodes, red lips and tongue, joint pains, swollen hands and feet, and conjunctivitis without discharge or pus. Kids with Kawasaki Disease are at risk for inflammatory changes to the coronary arteries that can cause the heart vessels to develop life-threatening aneurisms. While the new COVID-19 related syndrome affects the heart it’s unclear if it causes the same aneurisms as Kawasaki Disease or instead causes general inflammation of the organ. Some children with the COVID-19 related inflammatory syndrome have develop cardiovascular collapse similar in appearance to Toxic Shock Syndrome, a finding not typically seen in Kawasaki Disease.
CHRIS DAEL 
