COVID Stories

Kids can carry coronavirus in respiratory tract for

weeks, study suggests
Updated 5:39 PM ET, Fri August 28, 2020

(CNN) - Children can carry coronavirus in their noses and throats for weeks
even if they don't show any symptoms, which might explain how the virus can
spread silently, researchers in South Korea reported Friday.

"In this case series study, inapparent infections in children may have been
associated with silent COVID-19 transmission in the community," the
researchers wrote in a new study.

"Interestingly, this study aligns with adult data in which up to 40% of adults
may remain asymptomatic in the face of infection," Dr. Roberta DeBiasi and
Dr. Meghan Delaney, both of Children's National Hospital in Washington, DC,
wrote in an accompanying editorial. Neither was involved in the research.

"In this study, the authors estimate that 85 infected children (93%) would have
been missed using a testing strategy focused on testing of symptomatic
patients alone," they wrote.

The study comes out at a time when the US Centers for Disease Control and
Prevention has been criticized for changing its guidelines on asymptomatic
testing, which the American Academy of Pediatrics called "a dangerous step
backward" in a statement on Friday.

In the CDC's updated guidelines, some people without symptoms may not
need to be tested, even if they've been in close contact with someone known
to have the virus.

This newly released research adds more evidence as to why casting a wide
net when it comes to contact tracing is a key strategy to mitigate viral spread.

"We know that children often show few or no symptoms of COVID-19. We

also know they are not immune to this virus, and they can become very sick.
Testing exposed individuals who may not yet show symptoms of COVID-19 is
crucial to contact tracing, which helps identify and support other people who
are at risk of infection," AAP President Dr. Sally Goza said in the statement.
Hard to diagnose

The study, published in the journal JAMA Pediatrics on Friday, included data
on 91 asymptomatic, presymptomatic and symptomatic children diagnosed
with Covid-19 between February 18 and March 31 at 22 centers throughout
South Korea.

Among those patients, 20 of them -- or 22% -- did not show any obvious
symptoms and remained asymptomatic throughout the study.

Another 18 children -- or 20% -- were presymptomatic, meaning they didn't

look or feel sick at the time but eventually got symptoms later.

In total, more than half of the children -- 71 kids or 78% -- did show symptoms,
which included fever, cough, diarrhea, abdominal pain and loss of smell or
taste, among other symptoms. The duration of the symptoms appeared to
vary, ranging from one to 36 days.

"This suggests that even mild and moderately affected children remain
symptomatic for long periods of time," DeBiasi and Delaney wrote in the
editorial.

The data showed that only 8.5% of those patients with symptoms were
diagnosed with Covid-19 at the time their symptoms began. Most -- 66.2% --
of the patients with symptoms had symptoms that were not recognized before
they were diagnosed, and 25.4% developed symptoms after they were
diagnosed.

"This highlights the concept that infected children may be more likely to go
unnoticed either with or without symptoms and continue on with their usual
activities, which may contribute to viral circulation within their community,"
DeBiasi and Delaney wrote.

Virus remained in respiratory tract

The study found genetic material from the virus was detectable in the children
for a mean of 17.6 days overall. Even in the children who had no symptoms,
the virus was detectable for 14 days on average. It's also possible that the
virus remained in the children even longer, the study said, because the date of
initial infection wasn't identified.
However, this doesn't necessarily mean the children were spreading virus,
experts say.

The presence of the virus genetic material in swabs "need not equate with
transmission, particularly in people who do not have important symptoms such
as cough and sneeze," Calum Semple, professor in child health and outbreak
medicine at the University of Liverpool who was not involved in the study, said
in a written statement on Friday.

In addition, "sensitive molecular detection methods may detect viable,

infective virus but also nonviable or fragments of RNA with no capability for
transmission," DeBiasi and Delaney wrote.

More research also is needed to determine whether similar findings would

emerge among a larger group of children from other parts of the world.

Still, the new study provides information that can be used by pubic health
officials when considering the spread of the virus in schools, according to
DeBiasi and Delaney.

"A surveillance strategy that tests only symptomatic children will fail to identify
children who are silently shedding virus while moving about their community
and schools," they wrote. "In regions where use of face masks is not widely
accepted or used by the general public, asymptomatic carriers may serve as
an important reservoir that may facilitate silent spread through a community."

The Friday statement from AAP's Goza reinforced the need for systematic,
wide-ranging tracking.

"Without data and transparency, science and medical professionals are

hampered -- and families are harmed -- as we lack information that helps us
understand how easily this virus can be transmitted to others and how to stop
it," she said.

Europe's fight against Covid-19 shifts from hospitals

to the streets
Updated 12:02 AM ET, Sat August 29, 2020

Marseille, France (CNN) - At first, the front line of Europe's fight against the
Covid-19 pandemic was fought in hospitals by overstretched health care
workers. Now as European countries seek to avoid the long-dreaded second
wave, that line has shifted to the streets and is being manned by police forces.

In the last week, several European countries have seen record infection rates.
Not since the spring have countries like France, Germany, Italy and Spain
seen such a surge in the number of new cases. Countries like Greece and
Croatia, largely spared by the first wave, have seen fast rises in August as
tourists, taking advantage of the reopening of Europe's internal borders in
June, have headed to the beach for their summer holidays.

With authorities determined to avoid a second wave of lockdowns, legislation

has been introduced to try and stop the spread of the virus. Nightclubs have
been closed in Italy and in Greece, curfews introduced in Spain, Italy and
Greece and facemasks made mandatory in an ever-growing number of public,
outdoor spaces, in most EU countries: a gradual tightening of regulations that
will now have to be enforced. The fight against Covid-19 has become, in these
last couple of weeks in Europe, a matter of law and order.

Until recently many of the regulations applied to indoor businesses and were
enforced by owners, or to public transport, where they were enforced by the
conductors and drivers themselves. Across Europe there were reports of
difficulties in the enforcement of the mask rules, from passengers who refused
to wear them being made to disembark from "vaporettos," the small boats that
ferry tourists around the waterways of Venice, to the tragic killing in France of
a bus conductor in July, who died after being attacked by passengers who'd
been asked to put on their masks.

Now with the obligations on mask-wearing extending to the outdoors and with
their enforcements shifting to the police, there is a sense of relief from many
of those who had previously been in charge. "We were on the front line", says
Damien Cospanza, a bus conductor in Marseille in the south of France where
mask-wearing was made mandatory in the entire city on Tuesday.

"Sadly people need to be scared. They need be fined for them to understand
that it is mandatory, especially in a city like Marseille. People won't listen
much to a conductor but they will listen to the police."

But if the burden has shifted from conductors and shopkeepers to the police,
there is now a question of overstretch over the long-term, as regulations
tighten and the number of cases continues to grow.

Police stretched on many fronts

On Thursday, the French Prime Minister announced that masks, already
mandatory in some parts of Paris, would be made obligatory throughout the
city. "It isn't enough to create new laws, they also have to be respected," Jean
Castex pointed out. Since August 17, he said, 30,000 police checks had been
carried out on indoor businesses with 1,900 fines levied and 53
establishments closed.

In Marseille, a tourist hot-spot where the obligation to wear a mask outdoors

was extended on Tuesday to the entire city, a special team of national
policemen has been sent to help local forces enforce the new rules.

As CNN followed the officers around Marseille's old port last week, the unit's
commander, Jean-Marc Cortes, explained that his job was more about helping
people to understand the new rules, than actually imposing the 135-euro
($159) fine for non-compliance. "If there weren't police on the street enforcing
the rule," he said, "people would wear it less. When they see us, it reminds
them that it's mandatory and often that's enough."

But already, two weeks after masks were first made mandatory outdoors in
France, 700 fines are being issued a day, by an already overstretched police
force that has had to deal these last few years with both terrorism and
massive protests. "We've had the yellow vests and now it's Covid," says Eric
Moulin, the regional secretary of the UNSA police union, "and while we are
busy with those missions we cannot also fight other crimes like delinquency ...
and that is our primary role, fighting general delinquency. And that is going to
take more resources."

In June police forces in France staged several demonstrations, calling for

more support from the government and more resources, as protests partly
inspired by the Black Lives Matter movement raised fresh concerns about the
methods used in several recent French cases of alleged police brutality.

In 2018 as well, there were protests by police calling for more resources,
some of them held illegally. Moulin says it is a good measure of the frustration
of rank-and-file police officers, now worsened by their extra responsibilities. At
the very start of France's lockdown in March, it was only the threat of a police
strike that prompted authorities to issue the protective equipment that officers
had been calling for.

Part of the problem is how confusing the new rules can be. With only some
neighborhoods affected by the new rules and little to remind tourists of their
limits, it can be difficult to know when you are leaving an area where you don't
have to wear a mask and entering one where you do. Take Marseille's 7th
district, where masks have been mandatory since August 10. At its seaside,
on the promenade, masks were being checked by police, but immediately
beneath them, on the crowded Les Catalans beach, there were few masks to
be seen. The officers explained that although the obligation to wear the masks
did technically apply to the beach as well, it would simply be too difficult to
enforce given the vast crowds of sunbathers.

There are also variations in the levels of enforcement of the new rules, both
within EU countries and between them. "There are no [nation-wide] orders
concerning masks, it's on a case-by-case basis, depending on the orders of
local prefects," said Christophe Crépin, speaking for France's "policiers en
colère," or "angry policemen" association.

"Sometimes you get repression, sometimes prevention, sometimes education.

We don't do police checks on 'good people' from 'good families' in nice
suburbs but we do them on the streets of Marseille," Crépin added.

Few extra resources

Despite the open borders of Europe, there are also variations in the
enforcement of the bloc's various rules. Take Italy, the original epicenter of the
European outbreak, which has so far had more than twice as many cases as
Belgium. And yet 100 fines over mask-wearing are issued every day in
Brussels alone, according to Belgian police; the figure in the whole of Italy is
on average around 40, according to the Italian interior ministry.

In Spain, which has the highest infection rates in Western Europe at the
moment, fresh regulations were announced by the Prime Minister this week,
including the closure of discos and a partial ban on smoking outdoors. Pedro
Sanchez also announced that 2,000 military personnel would be deployed to
help with contact-tracing. Sanchez also gave regions the power to declare
local states of emergency.

In Greece, a country largely spared by Europe's first wave, police checks have
also intensified. Last Friday, 59,882 checks were carried out with 560
violations of either face masks or social distancing recorded, according to
local press reports. There were also several fines imposed on businesses that
failed to respect a midnight curfew. Overall in August, 7,414 violations have
been recorded nationwide for various offenses ranging from the failure to wear
a face mask in public places, to operating businesses beyond designated
curfews.
In most countries, little has been announced in terms of additional resources
or changed policing strategies. On the whole, enforcement of the new
regulations appears to fall on the shoulders of ordinary police officers. The UK
Home Office says 6,000 extra police will be recruited by March 2021. But
these were part of an earlier drive to increase numbers; they are not linked to
the enforcement of Covid regulations. A spokesperson told CNN the police's
job was to enforce the law, whether related to coronavirus or not.

The danger of a growing pushback from Europeans as regulations tighten

could also lead to a further strain on police resources. In Germany, large
protests were held across the country on August 1, with some of the 20,000
protesters gathered in Berlin, shouting "we're the second wave" and
"resistance." Fresh protests that were planned for Saturday have been
banned, with authorities warning that the police will intervene should anyone
take to the streets. A spokesman for the German police told CNN that around
3,000 police officers would be deployed on Saturday to ensure that health
standards were adhered to.

During the first wave of the European coronavirus outbreak, with clear
messaging from authorities and health systems on the verge of collapse, there
was little pushback to the measures taken to try and stop its spread.

Now, with health systems no longer threatened and lower death rates, the
question of how far to regulate daily life becomes one of managing risk. And
for authorities that could prove more political and far more difficult with an
increasingly reluctant public facing an ever-growing burden of regulations.

For now, it's simply too soon to know whether the new rules will help
authorities turn around the deteriorating Covid figures. But until they do,
authorities across Europe will continue to search for the right balance between
protecting public health and further infringing people's civil liberties, with the
police walking the fine line between the two.

Coronavirus outbreaks identified at 4 sororities at

Kansas State University
Updated 7:16 AM ET, Sat August 29, 2020

(CNN) - Coronavirus outbreaks have been identified at four sororities at

Kansas State University.
Residents of those Greek houses have been told to quarantine for 14 days
from the day the outbreak was declared. Alpha Delta Pi and Alpha Xi Delta
have six cases each, while Chi Omega and Kappa Delta have five cases
apiece, the Riley County Health Department said Friday.

More than 60 US universities and colleges in at least 36 states have reported

positive cases of Covid-19, and some have returned to remote learning to try
to stem the spread. More than 8,700 infections among American college
students and staff were reported through Friday, as the nation approaches 6
million confirmed cases.

At Kansas State, event permits associated with fraternity and sorority

organizations through September 10 have been canceled or revoked.

"It is no longer deemed safe to hold these events in person and they may not
take place," the county said in a statement.

Is it safe to go to college? Health experts weigh in

At the campus in Manhattan, 364 students are in quarantine, and 167

students are in isolation, the school said in a news release, noting an increase
of 149 in quarantine and 49 in isolation since last week. The entire student
population reports a 3.82% positivity rate, the release states.

Meantime, the University of Kansas reported a 10% positivity rate among its
Greek community, with 270 members of sororities and fraternities there
testing positive. That campus, in Lawrence, is about 75 miles from Kansas
State.

Statewide, Kansas has recorded more than 40,000 coronavirus cases, with
445 deaths.

Doctors find possible case of Covid-19 reinfection in

US
Updated 9:56 PM ET, Fri August 28, 2020

(CNN) - A 25-year-old Nevada man appears to be the first documented case

of Covid-19 reinfection in the United States.
Genetic tests indicate the patient was infected with two different varieties of
the virus, a team at the University of Nevada Reno School of Medicine and
the Nevada State Public Health Laboratory reported.

The patient was first diagnosed with coronavirus in April after he had a sore
throat, cough, headache, nausea and diarrhea, the researchers wrote in a
pre-print study posted Thursday. He got better around April 27, and he tested
negative for the virus twice afterwards.

He continued to feel well for about a month. Then on May 31 he sought care
for fever, headache, dizziness, cough, nausea and diarrhea. Five days later,
he was hospitalized and required ongoing oxygen support. He was tested
again for Covid-19 and the results were positive.

The Nevada researchers examined genetic material from both coronavirus

specimens collected from the man. Their analysis suggests he had two
distinct viral infections.

The pre-print study has not yet been peer-reviewed by a journal, but the
researchers noted that the findings suggest humans can catch Covid-19
multiple times.

It's not the first case documented globally.

Earlier this week, Hong Kong researchers said they found the first
documented case of coronavirus reinfection in a 33-year-old man. He tested
positive for Covid-19 twice this year.

The pre-print study -- which the University of Hong Kong said on Monday has
been accepted by the journal Clinical Infectious Diseases -- found that the
man was reinfected with two different versions of the virus 142 days apart.

"After one recovers from COVID-19, we still do not know how much immunity
is built up, how long it may last, or how well antibodies play a role in protection
against a reinfection," Mark Pandori, the director of the Nevada State Public
Health Laboratory, said in a news release Thursday.

"If reinfection is possible on such a short timeline, there may be implications

for the efficacy of vaccines developed to fight the disease. It may also have
implications for herd immunity," Pandori said. "It is important to note that this
is a singular finding. It does not provide any information to us with regard to
the generalizability of this phenomenon."
In the Hong Kong case, researchers said the man experienced coronavirus
symptoms during his first bout of Covid-19, but that he didn't have any obvious
symptoms the second time.