The Daily - A Teenager’s Medical Mystery

Episode Date: May 21, 2020

From the earliest days of the coronavirus outbreak, health officials believed that it was largely sparing children and teenagers. But the rise of a mysterious inflammatory syndrome — with symptoms ranging from rashes to heart failure — in children testing positive for the virus is challenging that belief. Guest: Pam Belluck, a health and science writer for The New York Times, spoke with Jack McMorrow, 14, and his parents in Queens about his experience contracting the coronavirus. For more information on today’s episode, visit nytimes.com/thedaily Background reading: “If I send you home today, you’ll be dead by tomorrow.” This is what Jack heard after learning he had a mysterious illness connected to the coronavirus in children. “I would say that scared me to death but it more like scared me to life.”The new syndrome has been compared to a rare childhood illness called Kawasaki disease. But doctors have learned that it affects the heart differently and is appearing mostly in school-age children, rather than infants and toddlers.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, from the earliest days of the coronavirus, health officials believed that it largely spared children and teenagers. But recently, that belief has been challenged. My colleague, Pam Bellock, on the story of a 14-year-old boy whose case is being studied to better understand the impact of the virus on children. It's Thursday, May 21st.

Pam, when does this understanding that we all seem to have about the coronavirus and how it spares children, when does that start to change? In late April, there was this bulletin that was sent out by a pediatric health service in the United Kingdom. It just said, we're noticing some kids, not very many. They seem to have these symptoms of inflammation. We don't really know what this is about. Some have tested positive for coronavirus, some haven't. And it was just kind of saying, we think we're seeing something. So I've talked to my editors about it and we were trying to figure out whether we should explore it more at that point. And we decided, well, we don't really know a whole lot. It seems like a small number of cases. We can't even say for certain that it's connected to coronavirus. And so we just kind of put it aside for a bit and watch it. And then I think a couple of days later, I got an email from a hospital in New York City. The person said, we've got some cases of this syndrome that they've been talking about in the UK. If you want to talk to somebody, let us know. And that's how I got to know Jack

McMorrow and his family in their apartment in Queens. And tell me about this visit. It's a very warm kind of cozy apartment. There are all these welcome home banners and balloons for Jack. And the family, Jack and his father, John, and his mother, Doris, they just immediately welcome me and our photographer, Gabriella, in. And they all just start talking. I just know immediately I have to put on my tape recorder because there's no way I'm going to capture all this writing things down. We're not picking up anything. No, no. I got a bell from school with the bell. Because they bicker. And I have to do this. I'm sorry about all these KIs.

It's wonderful. I was coherent at this time. No, I know. But I know you've been jumping things. And I know when you're excited. Me jumping things? Dad, you went from day one to me in the new ICU. That's like a huge jump. And tell me about this family. Who are they?

So Jack's father is John McMara. He is a truck driver. He works as a teamster for the film industry. He was recently laid off because of the pandemic. And his mother, Jack's mother, is Doris Stroman. She works at a lab school with like five and six year old kids. She was wearing a mask that had the Rolling Stones tongue logo on it. And Jack is 14. He's a 9th grader. He goes to Catholic school in Queens. Yeah, and I have a whole bunch of other, like,

prop weapons and stuff. So you're a Star Wars fan? I like Marvel a lot more than I do here. Oh, you're more of a Marvel person. This is the Infinity Gauntlet from Avengers Infinity War. They don't have time for that, Jack. This is who I am. And Pam, what is the story that Jack and his parents tell you about this mysterious condition that he has?

So Jack was living the world of a New York City teenager in a pandemic. He never left the house. I haven't left the house. March 13th, he's been in the house. In his room. His Catholic school was one of the first that were closed. Didn't leave the house. March 12th was his last day of school.

And he was doing the online learning thing. The one time he left the house other than, was to help me with the laundry and didn't want to touch anything. I took a shower after I came up from the laundry room. I'm a germaphobe. They just kind of stayed in. He was playing video games. He was chatting with his friends and that kind of thing.

That was Jack's world. and that kind of thing. That was Jack's world. Then, in mid-April, Jack's parents start to notice some unusual things. Three weeks ago, he came out to me with a rash on the back side of his hands. Yeah. I thought it was from the antibacterial soap,

you know, for a while. Maybe he's doing it too much. He's sensitive. Yeah, for like, we thought it was nothing the antibacterial soap, you know, for a while. Maybe he's doing it too much. He's sensitive. Yeah, for like, we thought it was nothing more than eczema. And then I think a day or two later, your mother told you something about your eyes. She thought you played video games too much. Yeah, the eyes definitely, but I don't know if that was... They went on, and then the next week, and this was April 21st.

I had got a normal fever, like 101, 102. Jack gets a fever. I woke up one day with sore throat. That was the first inflammation symptom that we had, which was... On his hands, on his feet? On my hands, my feet, and on my neck. That was the first inflammation symptom that we had, which was on my hands, my feet, and on my neck. And then around Friday, April 24th, things start to get more severe. That ended up being a swollen lymph node that grew to about the size of a tennis ball that you could visibly see coming on the side of my neck. see coming like on the sideline by the next day saturday morning he wakes up and he's got 104.7 fever that is a real fever that is a serious fever they call their pediatrician at 7 30 in the

morning and she says you guys you got to get to an urgent care clinic. And they do. And there he gets a coronavirus test, but it's going to be a couple of days before, you know, he gets the results. So at this point, they think it might perhaps be COVID-19. It doesn't look like COVID-19, but we're living in a world of COVID-19. And so I think that they're just sort of saying, well, let's just test them. We don't really know what this is. They send them home. Things just keep getting worse and worse. And by Monday morning, Jack wakes up. He cannot move. He can't move. I wake up and to even sit up I screamed

for them and I had 105 almost. And he's lying on the couch. I was sleeping with socks on and he kind of saw like red and he takes off my socks to reveal my entire feet right here had just

rashes on the insides and bottom at that time he thought that was the apex and my hands yeah they thought that was bad my hands here on my palms a little bit of the back, all rashes. So my skin, to even touch my skin and like feel... It's, you know, terribly, terribly frightening. And he says to me, you know, I was very emotional. I'm using the word emotional to try and cover up the fact I was crying like a baby. It was so bad. They happen to have a home blood pressure monitor, so they take his blood pressure. And this is where, as if all of these symptoms weren't alarming enough and frightening enough, the blood pressure is very low. And so they know they have to take him to the hospital.

They have to figure out how to get him out of the house. He can't move. So John and Jack, you know, kind of demonstrate this for me. I put my hands on his arms like this. And not kidding, shuffled my way with his arms. John picks him up, puts Jack's feet on top of John's feet, and then walks backward out the apartment door, sort of shuffling Jack along. And when we got to the hospital,

they took a wheelchair. They took a wheelchair. Yeah, I took a wheelchair. He couldn't walk. He couldn't walk no more. He couldn't even, he couldn't, he couldn't bend his leg. So when they get to the hospital,

they are trying to figure out, again, what's going on. They don't know. You had a cardiologist department, you had a pulmonary specialist, infectious disease experts, and then you had the immunology, all throwing numbers and prescriptions and how they account to each other to deal with them. And this is stuff that I, it's French to me, you might as well just tell me.

And while he's there, they get the coronavirus test results back from the clinic that he went to on Saturday, two days earlier. And what does it say? They're negative. So they're like crossing that off the list. They say, you know, we really should probably send you home because, you know, we don't really know what this is. And we think maybe you can just kind of watch it at home. Because they were riding the wave that he tested negative.

Well, Doris is not happy about that. She says... And I said, well, he needs to be tested again. And she said, we only test those who are admitted. And I said, well, then he needs to be admitted. We have nowhere to be, like... So there's a communication around that. And they agree, there's no harm in

doing another coronavirus test why not we don't really know what's happening you know why not so they do another another coronavirus test and then while they're there waiting another symptom emerges well when he woke up his eyes were like this. And I was just like, what is... His eyes turned bright red. As his mom is telling me about this, she is pointing to a red pillow on their couch, and she says, it's like this, you know.

And his eyes are rolling back into his head, and they're bright red. He was like, I'm fine, I'm fine. Like this. I'm fine. I'm fine. Then the doctor comes in and tells them that, guess what? The new coronavirus test, the second one, it was positive. Pam, how could that be that he has a negative test and just a few days later, suddenly a positive test? a negative test and just a few days later, suddenly a positive test? Well, you know, unfortunately, this is kind of the reality of coronavirus testing right now, that they are not 100% reliable. It's a little bit of a Wild West situation. So there are cases

of false negatives. And that's obviously what was the case with Jack. So once they realize that he is COVID positive, they decide at that hospital that he's got to go to a children's hospital. And Jack is not on board with this. He does not want to go. And the doctor says to him, if I send you home today, you will be dead by tomorrow. That, I would say, had scared me to death. But it more, like, scared me to life.

It scared me to fight. So Jack gets to the children's hospital in the ambulance and the doctors take one look and they realize this is not what we thought coronavirus infection looks like. This is not the way

it usually affects patients. And they know that by looking at Jack and figuring out what's going on with him, they are going to learn a lot more about what this virus can do to kids. We'll be right back. I'm going to get into the pain now. It was a throbbing, stinging, like, rush of, like, you could feel it going through your veins. So when Jack, you know, gets into the hospital, he is just exhausted and in so much pain.

You could feel, it was almost like someone injected you with straight-up fire. Just fire. The major symptom that's going on with Jack is that he has very low blood pressure. You got to remember, my heart rate was at 165 while I hard to compensate for that low blood pressure that is preventing him from pumping oxygen and nutrients throughout his body to his critical organs. So that's what they've got to treat, right? That is a condition that is called cardiogenic shock. It is heart failure. It is fatal if not treated. And he was telling me that, you know, he started to focus his energy.

He started to feel like, I have got to understand what is going on with my body. I've got to know. Because if I don't know what I'm fighting, then I can't fight it. So he starts to talk to the doctors. They don't get a lot of kids that could actually talk to them since it's pediatrics. And, you know, he's a ninth grade kid and he's been taking biology and he has some understanding about the heart and the lungs and how they all work. And so he's asking them lots of questions.

the heart and the lungs and how they all work. And so he's asking them lots of questions. We were going back and forth with the whole, especially with my heart related to my cardiovascular and circulatory system. And that made him feel much more in control, or at least it was a little bit less terrifying for him once he kind of realized what he could understand. But in that first day or know, day or two... It was scary.

He did feel like he wasn't going to come out of it. It didn't look like I was coming out of it the same if at all. And how do the doctors try to treat Jack during this time? So the first thing that they're trying to do is give him blood pressure medication to try to get his blood pressure up. But it's just not working. It's been 48 hours. And they are so worried about his heart, which is not pumping enough oxygen to his body, that they think they're going to need to put him on a ventilator. Wow.

They were going to intubate. And I said, you know, that was breaking my heart. If they were to... And so did they. They didn't want it because they know that they had to brace me on a... The realistic approach said only 20% come off, you know? So they say, well, you know, why don't we try some steroids the steroids are this you know widely used medication that that works in a lot of different ways and works for some things it

doesn't work for other things and it's it's really hard to know whether it's going to help him or not but within a few hours he starts to stabilize they decide they don't need the ventilator, and Oh, they were bringing me icees and ginger ale. He hadn't had no water. Nothing in his mouth for over 48 hours. For 48 hours. My mouth was, I was,

I felt like I was dying. And then they were throwing icees my way. They're like, here you go, kid. They gave me lollipops. They gave me ginger ales. I was like, living the life. So it seems like the steroids worked, but doctors actually don't know that a hundred percent. And John, Jack's father called the pediatrician, their longtime pediatrician and said, what happened? I don't know what happened. And I said, well, why, why, why, how did this happen? What did he do? And he goes, I don't know. I said, you know, my family is going to believe this was the power of prayer. And he goes, I'll go with that. Because we don't know why. We don't know.

My family is going to think that it's a miracle. And the pediatrician says, no, that works for me because I don't really know either. And Pam, beyond the steroids and whether or not those worked, what did the doctors understand about what was going on here? Well, they're kind of mystified. I mean, they've got this kid and they know that he has a positive coronavirus test, but he doesn't have symptoms that kind of look like what they've come to expect from coronavirus. And at the same time, just that very morning, they've had two or three other kids show up with the same symptoms, very similar symptoms. And those kids have tested negative for coronavirus. So they don't have a live coronavirus infection. But the doctors are wondering. And so they have another test in their toolkit. They have what's called an antibody test, which can tell you not whether you have the live infection right now, but it can tell you whether

somebody has ever had coronavirus infection. And they think, let's just give these kids, these other kids that test and see. And lo and behold, those kids end up being positive for coronavirus antibodies. That means that all of these kids who are showing up with these mysterious symptoms that cannot be explained by anything else that doctors know have this one common denominator.

They have all had coronavirus. Pam, at this point, what do the doctors think that this is exactly? Because all of these kids have had coronavirus, but most of them don't still have it. What they think is this may be a kind of second stage effect of coronavirus that we didn't know was possible, that we didn't know was part of the way this virus worked. These kids didn't get the lung problems, the breathing problems, you know, that kind of assault on the lungs that is the primary way that coronavirus works. And so what the doctors think is that at the time of their infection, their immune system did a really good job of just swatting the infection away, of battling it away. That's why they didn't have any symptoms at the time. But that somehow

in the course of that fight, their immune system got so revved up and so hyperactive that it generated this inflammatory response weeks later, and their bodies had this incredible overzealous reaction that went throughout their bodies and caused all sorts of havoc. So this is not coronavirus for kids. It's some kind of later down the line affiliated set of horrible conditions that follows it. Exactly. I mean, what seems particularly scary about this is that theoretically, any kid who has had the coronavirus,

and I have to imagine there are tens of thousands, maybe hundreds of thousands of these across the United States, people like Jack, who probably showed no symptoms whatsoever from the original infection. It now seems possible that they could develop these really awful new secondary symptoms. That's exactly the risk here.

That's exactly the worry. We know that kids are just as likely to get infected as adults. They don't have any protection from infection. A whole lot of them end up showing no symptoms. And we wanted to think that that meant that they really weren't getting that sick. Right. But now we have this thing that shows up weeks later, and we don't have any idea who will end up with this inflammatory syndrome and when. Right. I mean, what are the implications of that as we think about reopening schools, for example? I mean, one of the kind of saving graces, silver linings of this pandemic was that kids were supposed to be spared.

Kids were supposed to be spared. And that understanding seems to have been the basis for plans to reopen schools. What does it mean that this second stage set of symptoms is now starting to show up among children? It definitely puts a serious complication in those plans. It's something that governors, federal officials, they are already thinking about, they're going to have to think about. It's not like you can test kids and say, okay, you're negative, you know, or you have antibodies, you're going to be fine. Right. Because you could have antibodies and then you could end up with this. So it makes that issue, you know, much more tenuous and much more complicated. And I don't think anybody has a good answer to that right now.

Right. And Pam, how is Jack doing at this point? You know, he's doing okay. He's home. And I came home to take the best shower I've ever had in my entire life, not even gasping. It was like 30 minutes. You can't get them in and then you can't get them out. No, no, no. We have kids. It was like 30 minutes, this one.

And it felt fine and then I was like, I gotta stop running around because I'm gonna fall. I'm gonna get lightheaded and pass out. So I completely ignoring my own self-advice, just ran into my room, put on my headphones, talked to my friends, and I said, I'm home! And they were all like, yeah! Every time he runs around and says, I'm alive, I'm alive! No. I'm a real boy!

I'm a real boy! No, no, no, because I said that. No, because I was in the hospital, and I was like, there are no strings on me, didn't I? Because I, like, hospital and I was like, there are no strings on me. He has some residual heart issues, but they think that most, you know, that his issues because he's so young and otherwise healthy, that he'll probably emerge from this with no real issues. They are going to be following him. They're going to be following these other kids too, because this is still a mystery and they don't really know whether it's going to have any long-term effects.

And since his case, since his successful treatment, doctors have been using the same playbook on other kids with his issue. So they think that the steroids were what helped him and they are giving other kids steroids a lot earlier when they come into the hospital. So far, apparently the results have been pretty encouraging. They are writing up Jack's case along with some of the other kids

in an article that's going to be published in the medical journal. Jack was very excited to learn about that. And he said to me, it's been really good being back home, and I just want to do more with my life now, now that I have it back. I really want to do something with my life now that I have it back. In any way that I can. That's awesome. He said this while holding his Captain America shield. So I thought... He is, after all, a 14-year-old.

He is, after all, a 14-year-old boy. I literally sent my biology teacher an email saying thank you for educating me. Oh, that was the first thing he did? I could show you it if you want. Yes, you should actually show it. No, no, not now. Let her have it. It's long, so just let her read it when she gets a minute.

Okay. I'll try to make this email quick because I'm still in the hospital recovering. The complications of this virus have left me with pneumonia and more serious than that, heart issues. A mild heart blockage as explained by the doctors. This heart blockage is the main reason I'm not at home recovering right now but rather in a cardio monitoring room. As hard as it is to keep up with all of this and understand many aspects of these complications

because of how little they know of COVID, I have to say, once it came around to them talking to me about my heart and my systems, I'm confident that I was able to keep up with the conversation and understand what was wrong with me and what to do to keep fighting, or rather to keep my vitals in check. To summarize what I'm trying to say, and this is the honest truth, I would like to thank you for educating me as you did and for providing me the educational support to understand my body when I need to most. Because based off of my knowledge on my heart and circulatory system, I'm now able to work off of that knowledge and help myself understand the

doctors and communicate to them. I don't want to drag this out, and I know I said that I'd try to make this short, but I really do have to thank you for educating me enough to know what I needed to know. I'm sorry for making this email so long, and I really feel bad for disturbing you on a Saturday night, but seriously, I'm genuinely thanking you for educating me as you did, and I look forward to seeing you on Zoom or in class if we return this school year. I hope your family and yourself stay safe. Thank you. That's lovely. Isn't that amazing? is he back in school remotely he is back jack is back in school remotely he's taken that biology class and he's seeing his friends and he and he is being Jack. Thank you, Pam. We really appreciate it.

Thank you. Last week, health officials gave Jack's condition a name, multisystem inflammatoryflammatory Syndrome in Children. So far, it has been found in about 200 children in the U.S. and Europe and has killed several of them. Because the condition was just identified, it's unclear how many cases have remained unreported. We'll be right back.

Here's what else you need to know today. Retail open today. Big day, big step. And what we saw out there from everything that we could see is people trying really hard. On Wednesday, two months after the pandemic began, all 50 states began reopening to varying degrees. And that's important because we have one shot at reopening the economy the right way. Kentucky permitted retailers to let in customers. Connecticut allowed restaurants and malls to reopen with significant limits.

And New York allowed religious gatherings of up to 10 people. I understand their desire to get back to religious ceremonies as soon as possible. New York allowed religious gatherings of up to 10 people. I understand their desire to get back to religious ceremonies as soon as possible. As a former altar boy, I get it. I think those religious ceremonies can be very comforting. But there were signs on Wednesday that the reopenings would be slow and risky. Ford, which restarted its U.S. assembly lines earlier this week,

said it would halt operations at plants in Illinois and Michigan after workers there tested positive for the virus. That's it for The Daily. I'm Michael Barbaro. See you tomorrow. Yeah, actually, I'm trying to open my range and hang out more. Like, I want to fill my entire schedule. I don't want to ever be not doing something. I don't want to ever be not doing something.

Because I find myself, I used to find myself at often times like stuck in my own, in my own world not letting anyone in. Yeah. You know? Yeah. I'm a very doors closed type of guy. I need to go out and like shoot my shot and do my thing and go out to parties and stuff. What? What are you talking about?

I was asking. And I'm planning, like I'm planning to do all that during the summer of quarantine. Not in session. I have plans with friends and we are going to like go out and do stuff now. We are striving.

We're going to go to the beach. We're going to go on vacation. We're going to go. Right now I have them back home. I don't know anything about his plans, but they will not be going overnight. It's definitely not going to be overnight. It's going to be over a span of...

When this quarantine ends, me and my boys are going home. We go away a lot. We have a short place down.