16. PEACE, JUSTICE AND STRONG INSTITUTIONS

‘Straight-Up Fire’ in His Veins: Teen Battles New Coronavirus Syndrome – The New York Times

‘Straight-Up Fire’ in His Veins: Teen Battles New Coronavirus Syndrome  The New York Times


Listen to ‘The Daily’: A Teenager’s Medical Mystery

How the case of one 14-year-old could help doctors understand a frightening new illness linked to the coronavirus.

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transcript

Listen to ‘The Daily’: A Teenager’s Medical Mystery

Hosted by Michael Barbaro; produced by Clare Toeniskoetter and Jessica Cheung; with help from Rachel Quester; edited by Liz O. Baylen and Lisa Tobin

How the case of one 14-year-old could help doctors understand a frightening new illness linked to the coronavirus.

michael barbaro

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 Belluck 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 21.

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?

pam belluck

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 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 days later I got an email from a hospital in New York City. The person said we’ve got two 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.

michael barbaro

And tell me about this visit.

pam belluck

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 welcomed me and our photographer Gabriela 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.

john mcmorrow

He sent him a letter.

jack mcmorrow

Yes. Can I explain something —

john mcmorrow

Oh, come on. I’m giving backdrop here. You can explain all you want.

jack mcmorrow

No. First of all, I wanted to talk about how the virus was behaving like a bacteria.

john mcmorrow

OK, you’re gonna, but I just want to say —

jack mcmorrow

That was way back when.

john mcmorrow

— Randall —

jack mcmorrow

This thing’s probably not picking up anything.

doris stroman

I hope you know she’s taping all of you because —

john mcmorrow

Yeah, we barter like this all day long.

doris stroman

I got a bell from school —

jack mcmorrow

Stop with the bell.

doris stroman

— because they bicker. And I have to do this —

john mcmorrow

And it’s a timeout bell.

doris stroman

— and tell them to both go to each corner.

jack mcmorrow

I’m sorry about all this chaotic —

pam belluck

It’s wonderful. It’s wonderful.

john mcmorrow

And these cleaned arteries, they have to bring you right back.

jack mcmorrow

I was coherent at this time.

john mcmorrow

No, I know. But I know you’ve been jumping things, and I know when you’re excited.

jack mcmorrow

Me jumping things?

pam belluck

You’re doing great. You’re doing great.

jack mcmorrow

Dad, you went from day one to me in the new I.C.U. That’s like a —

doris stroman

Do I need to get my bell?

jack mcmorrow

— huge jump. Dude, if —

speaker

Oh my God.

michael barbaro

And tell me about this family. Who are they?

pam belluck

So Jack’s father is John McMorrow.

john mcmorrow

I know it’s your story, son.

pam belluck

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 five and six-year-old kids. She was wearing a mask that had The Rolling Stones tongue logo on it.

doris stroman

— to figure out what was going on, starting with his pediatrician.

pam belluck

And Jack is 14. He’s a ninth grader. He goes to Catholic school in Queens.

jack mcmorrow

Yeah, and I have a whole bunch of other prop replica stuff.

pam belluck

So you’re a Star Wars fan?

jack mcmorrow

I like Marvel a lot more than I do —

pam belluck

Oh, you’re more of a Marvel person. OK.

jack mcmorrow

This is the Infinity Gauntlet from “Avengers: Infinity War.” I really have to —

doris stroman

They don’t have time for that, Jack.

jack mcmorrow

This is why —

michael barbaro

And, Pam, what is the story that Jack and his parents tell you about this mysterious condition that he has?

pam belluck

So Jack was living the world of a New York City teenager in a pandemic.

doris stroman

He never left the house.

jack mcmorrow

I haven’t left —

john mcmorrow

Since March 13, he’s been in the house.

doris stroman

You never left the house. His school —

john mcmorrow

In his room, not even in here.

doris stroman

His Catholic school was one of the first that were closed.

pam belluck

Oh wow.

doris stroman

Didn’t leave the house.

pam belluck

March 12 was his last day of school, and he was doing the online learning thing.

doris stroman

The one time he left the house other than — was to help me with the laundry and didn’t want to touch anything.

jack mcmorrow

I took a shower after I came up from the laundry room.

doris stroman

Yeah, the kid just —

jack mcmorrow

I’m a germophobe.

pam belluck

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.

Then in mid-April, Jack’s parents start to notice some unusual things.

john mcmorrow

Three weeks ago, he came out to me with a rash on the backside of his hands.

jack mcmorrow

Yeah.

john mcmorrow

I thought it was —

jack mcmorrow

It was bad.

john mcmorrow

— from the antibacterial soap. You know, Purell. Maybe he’s doing it too much. He’s sensitive.

jack mcmorrow

Yeah, for like — we thought it was nothing more than eczema.

john mcmorrow

And then I think a day or two later he —

jack mcmorrow

No, it was like —

john mcmorrow

— your mother told you something about your eyes. She thought you were playing video games too much.

jack mcmorrow

Yeah, the eyes definitely, but I don’t know if that was —

pam belluck

They went on, and then the next week — and this was April 21 —

jack mcmorrow

I had got a normal fever, like 101, 102.

pam belluck

— Jack gets a fever.

jack mcmorrow

I woke up one day with —

doris stroman

Sore throat.

jack mcmorrow

— sore throat. That was the first inflammation symptom that we had, which was —

doris stroman

On his hands, on his feet —

jack mcmorrow

On my hands, on my feet —

doris stroman

— on his neck.

jack mcmorrow

— and on my neck. That was the first —

pam belluck

And then around Friday, April 24, things start to get more severe.

jack mcmorrow

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.

doris stroman

That was alarming.

pam belluck

By the next day, Saturday morning, he wakes up and he’s got a 104.7 fever.

michael barbaro

That is a real fever.

pam belluck

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 days before he gets the results.

michael barbaro

So at this point they think it might perhaps be Covid-19.

pam belluck

It doesn’t look like Covid-19, but we’re living in a world of Covid-19, and so I think that they are just sort of saying, well, let’s just test him. We don’t really know what this is. They send him home. Things just keep getting worse and worse. And by Monday morning, Jack wakes up. He cannot move. He can’t move.

jack mcmorrow

Because I wake up, and to even sit up, I screamed for them. And I had 105 almost.

pam belluck

And he’s lying on the couch.

jack mcmorrow

I was sleeping with my socks on, and he kind of saw red. And he takes off my socks to reveal my entire feet, right here, had just rashes on the insides and bottom.

doris stroman

At that time —

jack mcmorrow

And my hands.

doris stroman

— we thought that was the apex.

jack mcmorrow

And my hands.

doris stroman

But it wasn’t until days later.

jack mcmorrow

Yeah, they thought that was bad. My hands here on my palms, a little bit at the back, all rashes. So my skin — to even touch my skin and feel —

pam belluck

It’s terribly, terribly frightening. And he says to me, I was very emotional.

jack mcmorrow

I’m using the word emotional to try and cover up the fact I was crying like a baby. It was so bad.

pam belluck

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 had to take him to the hospital. They had to figure out how to get him out of the house. He can’t move. So John and Jack kind of demonstrate this for me.

jack mcmorrow

I put my hands on his arms like this and, not kidding, shuffled my way.

john mcmorrow

And I had to then hold him up —

jack mcmorrow

With his arms.

pam belluck

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.

doris stroman

And when we got to the hospital —

john mcmorrow

They took a wheelchair.

doris stroman

— they took a wheelchair.

jack mcmorrow

Yeah, I took a wheelchair.

doris stroman

He couldn’t walk.

john mcmorrow

He couldn’t walk no more. He couldn’t bend his legs.

pam belluck

So he gets to the hospital. They are trying to figure out, again, what’s going on. They don’t know.

john mcmorrow

— everything back and forth. You had a cardiologist department. You had the pulmonary specialist, infectious disease experts, and then you had the immunology all throwing numbers and prescriptions and how they count through each other to deal with him. And this is stuff that I — it’s French to me. You might as well just tell me —

pam belluck

And while he’s there, they get the coronavirus test results back from the clinic that he went to on Saturday two days earlier.

michael barbaro

And what does it say?

pam belluck

They’re negative. So they’re crossing that off the list. They say, we really should probably send you home because we don’t really know what this is, and we think maybe you can just kind of watch it at home.

doris stroman

Because they were riding the wave that he tested negative.

pam belluck

Well, Doris is not happy about that. She says —

doris stroman

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 —

pam belluck

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. Why not? So they do another coronavirus test. And then while they’re there waiting, another symptom emerges.

doris stroman

When he woke up, his eyes were like this. And I was just like, what just —

jack mcmorrow

Yeah, they were rolling in the back of my head.

doris stroman

And they were red.

pam belluck

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. And his eyes are rolling back into his head, and they’re bright red.

doris stroman

He was like, I’m fine, I’m fine, like this. I’m fine. I’m fine.

john mcmorrow

When was this?

pam belluck

Then the doctor comes in and tells them that, guess what? The new coronavirus test, the second one, it was positive.

michael barbaro

Pam, how could that be that he has a negative test and just a few days later, suddenly a positive test?

pam belluck

Well, unfortunately this is kind of the reality of coronavirus testing right now that they are not 100 percent 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.”

jack mcmorrow

That, I would say, had scared me to death. But it more scared me to life. It scared me to fight.

pam belluck

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.

michael barbaro

We’ll be right back.

jack mcmorrow

I’m getting to the pain now. It was a throbbing, stinging rush of, like, you could feel it going through your veins.

pam belluck

So when Jack gets to the hospital, he is just exhausted and in so much pain.

jack mcmorrow

You could feel — it was almost like someone injected you with straight up fire. Just fire.

pam belluck

The major symptom that’s going on with Jack is that he has very low blood pressure.

jack mcmorrow

You’ve got to remember, my heart rate was at 165 while I was sleeping. That’s like a marathon runner.

pam belluck

And he has a very, very fast heart rate, because his heart is trying very 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. 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 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.

jack mcmorrow

They don’t get a lot of kids that can actually talk to them since it’s pediatrics.

pam belluck

And 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.

jack mcmorrow

We were going back and forth with the whole — especially the way my heart related to my cardiovascular and circulatory system, never mind my —

pam belluck

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 two —

jack mcmorrow

It was scary.

pam belluck

— he did feel like he wasn’t going to come out of it.

speaker

It didn’t look like I was coming out of it the same, if at all.

michael barbaro

And how do the doctors try to treat Jack during this time?

pam belluck

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.

michael barbaro

Wow.

john mcmorrow

They were going to intubate him. And I said, you know, that was breaking my heart.

doris stroman

If they were to —

john mcmorrow

And so did they. They didn’t want it, because they know that they had to brace me on the realistic approach that only 20 percent come off.

pam belluck

So they say, well, you know, why don’t we try some steroids? Now, steroids are this widely used medication that works in a lot of different ways and works for some things, it doesn’t work for other things, and 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 —

jack mcmorrow

They were bringing me Icees and ginger ale —

john mcmorrow

They were bringing him everything, lollipops —

jack mcmorrow

— and I hadn’t had water.

john mcmorrow

He hadn’t no water, nothing in his mouth for over 48 hours because they were —

jack mcmorrow

For 48 hours.

john mcmorrow

— preparing him to do the tube.

jack mcmorrow

My mouth was — I felt like I was dying. And then they were throwing Icees my way. They were like, here you go, kid. They gave me lollipops. They gave me ginger ales. I was, like, living the life.

pam belluck

So it seems like the steroids worked, but doctors actually don’t know that 100 percent. And John, Jack’s father, called the pediatrician, their longtime pediatrician, and said, what happened? I don’t know what happened. And —

john mcmorrow

He laughed. And I said, why? Why? Why? How did this happen? What did he do? And he goes, I don’t know. I said, you know my family’s 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.

pam belluck

My family is going to think that it’s a miracle. And the pediatrician says, well, that works for me because I don’t really know either.

michael barbaro

And Pam, beyond the steroids and whether or not those worked, what did the doctors understand about what was going on here?

pam belluck

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. And 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.

michael barbaro

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.

pam belluck

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, 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.

michael barbaro

So this is not coronavirus for kids. It’s some kind of later-down-the-line, affiliated set of horrible conditions that follows it.

pam belluck

Exactly.

michael barbaro

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.

pam belluck

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. 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.

michael barbaro

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, 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?

pam belluck

It definitely puts a serious complication in those plans. It’s something that governors, federal officials, they are already thinking about — they are going to have to think about. It’s not like you can test kids and say, OK, you’re negative, or you have antibodies, you’re going to be fine. Because you could have antibodies, and then you could end up with this. So it makes that issue much more tenuous and much more complicated, and I don’t think anybody has a good answer for that right now.

michael barbaro

And Pam, how is Jack doing at this point?

pam belluck

He’s doing OK. He’s home.

jack mcmorrow

And I came home to take the best shower I’ve ever had in my entire life. Not even gassing it. It was like 30 minutes.

doris stroman

You can’t get him in, and then you can’t get him out.

jack mcmorrow

No, no, no. It was like —

doris stroman

You know. You have kids.

jack mcmorrow

It was like 30 minutes, this one. And it felt fine, and then I was like, I got to stop running around because I’m going to fall. I’m going to get lightheaded and pass out. But 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!

doris stroman

Any time he runs around —

jack mcmorrow

And it was the best.

doris stroman

— and says I’m alive, I’m alive —

jack mcmorrow

No.

doris stroman

— we go, “I’m a real boy!”

jack mcmorrow

I’m a real boy.

doris stroman

I’m a real boy!

jack mcmorrow

No, no, no, because I said that.

doris stroman

From “Pinocchio.”

jack mcmorrow

No, because I was in the hospital, and I was like there are no strings on me because —

john mcmorrow

Because he did IVs —

pam belluck

He has some residual heart issues, but they think 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 a medical journal. Jack was very excited to learn about that. And he said to me —

jack mcmorrow

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.

pam belluck

I really want to do something with my life, now that I have it back.

jack mcmorrow

In any way that I can.

pam belluck

That is awesome.

jack mcmorrow

Yeah.

pam belluck

He said this while holding his Captain America shield. So I thought —

michael barbaro

He is, after all, a 14-year-old.

pam belluck

He is, after all, a 14-year-old boy.

jack mcmorrow

I literally sent my biology teacher an email, saying thank you for educating me.

pam belluck

Really?

john mcmorrow

Oh, that was the first thing he did.

jack mcmorrow

I can show you it if you want.

john mcmorrow

Yes. You should actually —

pam belluck

I would love to see it.

john mcmorrow

— show it.

doris stroman

No, no, not now. Not now. Let her have it so —

pam belluck

Yeah, why don’t you email it to me.

doris stroman

It’s long, so just let her read it when she gets a minute.

pam belluck

“OK, 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.”

michael barbaro

That’s lovely.

pam belluck

Isn’t that amazing?

michael barbaro

Is he back in school remotely?

pam belluck

He is back. Jack is back in school remotely. He’s taking that biology class and he’s seeing his friends. And he is — he is being Jack.

michael barbaro

Thank you, Pam. We really appreciate it.

pam belluck

Thank you.

michael barbaro

Last week, health officials gave Jack’s condition a name: Multisystem inflammatory 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.

archived recording (andy beshear)

Retail opened today. Big day, big step. And what we saw out there from everything that we could see is people trying really hard.

michael barbaro

On Wednesday, two months after the pandemic began, all 50 states began reopening to varying degrees.

archived recording (andy beshear)

And that’s important, because we have one shot at reopening the economy the right way.

michael barbaro

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.

archived recording (andrew cuomo)

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.

michael barbaro

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.

To hear more audio stories from publishers like The New York Times, download Audm for iPhone or Android.

When a sprinkling of a reddish rash appeared on Jack McMorrow’s hands in mid-April, his father figured the 14-year-old was overusing hand sanitizer — not a bad thing during a global pandemic.

When Jack’s parents noticed that his eyes looked glossy, they attributed it to late nights of video games and TV.

When he developed a stomachache and didn’t want dinner, “they thought it was because I ate too many cookies or whatever,” said Jack, a ninth grader in Woodside, Queens, who loves Marvel Comics and has ambitions to teach himself “Stairway to Heaven” on the guitar.

But over the next 10 days, Jack felt increasingly unwell. His parents consulted his pediatricians in video appointments and took him to a weekend urgent care clinic. Then, one morning, he awoke unable to move.

He had a tennis-ball-size lymph node, raging fever, racing heartbeat and dangerously low blood pressure. Pain deluged his body in “a throbbing, stinging rush,” he said.

“You could feel it going through your veins and it was almost like someone injected you with straight-up fire,” he said.

Jack, who was previously healthy, was hospitalized with heart failure that day, in a stark example of the newly discovered severe inflammatory syndrome linked to the coronavirus that has already been identified in about 200 children in the United States and Europe and killed several.

The condition, which the Centers for Disease Control and Prevention are calling Multisystem Inflammatory Syndrome in Children, has shaken widespread confidence that children were largely spared from the pandemic. Instead of targeting lungs as the primary coronavirus infection does, it causes inflammation throughout the body and can cripple the heart. It has been compared to a rare childhood inflammatory illness called Kawasaki disease, but doctors have learned that the new syndrome affects the heart differently and erupts mostly in school-age children, rather than infants and toddlers. The syndrome often appears weeks after infection in children who did not experience first-phase coronavirus symptoms.

At a Senate hearing last week, Dr. Anthony S. Fauci, a leader of the government’s coronavirus response, warned that because of the syndrome, “we’ve got to be careful that we are not cavalier and thinking that children are completely immune to the deleterious effects.”

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Credit…Gabriela Bhaskar for The New York Times

Jack’s recovery and the experience of other survivors are Rosetta stones for doctors, health officials and parents anxious to understand the mysterious condition.

“He could have definitely died,” said Dr. Gheorghe Ganea, who, along with his wife, Dr. Camelia Ganea, has been Jack’s primary doctor for years. “When there’s cardiovascular failure, other things can follow. Other organs can fail one after another, and survival becomes very difficult.”

New York State has reported three deaths and, as of Sunday, 137 cases were being investigated in the city alone. Last week, a C.D.C. alert urged doctors nationwide to report suspected cases.

“Everyone is doing everything they can to help look into this from all different angles just to get the answers that parents want, that we want,” said Dr. Thomas Connors, a pediatric critical care physician who treated Jack at NewYork-Presbyterian Morgan Stanley Children’s Hospital.

Neither Jack nor his parents, John McMorrow and Doris Stroman, know how he became infected with the coronavirus. After cleaning out his locker at Monsignor McClancy High School on March 18 to continue school online at home, he only left the apartment once, they said, to help his mother wash clothes in their high-rise building’s laundry room. His parents and 22-year-old sister also avoided going out and the tests they have had turned up negative.

Credit…Gabriela Bhaskar for The New York Times

Last week, in their apartment festooned with welcome-home balloons, the family — Jack wearing a blue bandanna as a mask, his mother in a mask with the Rolling Stones tongue logo on it — recounted their story. His father, a recently laid-off truck driver for the film industry, briefly choked up and Jack bounded over to hug him.

The week after his hand rash and stomachache, about a month after he had last set foot in school, Jack developed a 102-degree fever and a sore throat. Worried, his mother arranged a video visit with their pediatricians, who started him on an antibiotic for possible bacterial infection. For several days, he felt about the same, but then other symptoms rapidly emerged: swollen neck, nausea, dry cough, a metallic taste.

On Saturday, April 25, his fever spiked to 104.7, his chest felt tight, and when he took deep breaths, “it hurt down in the bottom,” he said.

Credit…via McMorrow family
Credit…via McMorrow family

That morning, Dr. Camelia Ganea video-conferenced with the family while still in her pajamas, discovering Jack could barely open his mouth. She prescribed steroids and suggested they visit an urgent care clinic. There, Jack was tested for the coronavirus, but it would be two days before results arrived.

By Monday, pain was “flowing through me like lightning,” Jack said, and a rosy rash covered his feet.

“I was very very emotional,” Jack said. He paused. “I’m using the word emotional to cover up the fact I was crying like a baby.”

Lying on the sofa, he could not move on his own and grasped for words to describe what was happening.

“Rooftop,” he implored his parents, seeking a shorthand way to ask them to bend his leg like a peaked roof.

“I didn’t know what I was trying to say, but I knew what I meant,” he explained later.

With a home monitor, they discovered his blood pressure was very low. Mr. McMorrow lifted him, placing Jack’s feet on top of his own, and shuffled him to the car. At NewYork-Presbyterian/Weill Cornell hospital, doctors gave Jack intravenous fluids and tried to diagnose his condition. He did not have the obvious respiratory distress of Covid-19. And then they got the results of his Saturday coronavirus test: negative.

Suspecting he might have a condition like mononucleosis, they prepared to discharge him, thinking he could be safely watched at home with instructions to return if his blood pressure dropped again, his parents said.

His mother was urging them to keep Jack longer when his eyes turned red with a “raging case of pinkeye” and rolled back in his head, she said. After a conversation with Jack’s pediatrician, the hospital conducted its own coronavirus test. It was positive.

The doctor decided Jack should be transferred to NewYork-Presbyterian’s pediatric affiliate, Morgan Stanley Children’s Hospital, which is treating many coronavirus cases. Jack begged to go home.

The doctor responded bluntly, saying she knew that teenagers often think they are invincible.

“She told me if I go home now, by tomorrow, I’ll be dead,” Jack said. “I would say that scared me to death, but it more scared me to life. It scared me to fight as hard as I could.”

Credit…Gabriela Bhaskar for The New York Times

Jack arrived at the children’s hospital so feverish that his father was “washing me down with ice-cold water and it only felt like a tingle,” he said.

His resting heart rate was 165 beats per minute, about twice as high as normal, as his heart struggled to compensate for his alarmingly low blood pressure, which was hampering its ability to circulate blood and supply his vital organs with oxygen and nutrients.

This condition is a form of heart failure called cardiogenic shock, and Jack’s was “pretty severe,” said Dr. Steven Kernie, chief of pediatric critical care medicine at the hospital and Columbia University. “Over all, his heart wasn’t working very well,” he said. “It wasn’t pumping as strongly as normal.”

  • Frequently Asked Questions and Advice

    Updated June 5, 2020

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

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      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

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      Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

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      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

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      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

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      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

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      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

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      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

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      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


Doctors could not explain why Jack’s heart function had suddenly become impaired. Its structure and rhythm were normal. But blood vessels throughout his body were inflamed, a condition called vasculitis, so the vessels’ muscles were “not controlling blood flow as well as they should,” Dr. Kernie said.

Doctors also suspected that the heart was inflamed, known as myocarditis, which in untreated serious cases can cause lasting damage.

Jack’s condition was not only distressing, it reflected a frightening new pattern. “I remember that morning having admitted multiple children with a similar syndrome,” Dr. Connors said, “and it was kind of like, ‘What’s going on here?’”

The inflammation seemed driven by a hyperactive immune response, and Jack received medication for bacterial infection until tests ruled that out. “Whenever kids come in in shock you have to treat for everything,” Dr. Kernie said.

Jack’s positive coronavirus test was a clue, but others with similar symptoms had negative diagnostic test results, Dr. Connors said. The doctors then decided to check the other children for evidence of the coronavirus with a different test, one for antibodies, which signal they had an earlier, no-longer-active infection. Most children ended up having either a positive diagnostic or antibody test result.

By April 29, Jack’s third day in the I.C.U., the blood pressure medication was not helping enough and doctors began planning to insert a central line through his groin to deliver additional medications. They also prepared to put Jack, who was receiving nasal oxygen, on a ventilator, something doctors deem necessary when “your heart’s not doing its job,” Dr. Connors said. “We didn’t know which way this was going.”

The situation, especially the prospect of a ventilator, was terrifying to Mr. McMorrow, 51, who stayed in Jack’s hospital room round-the-clock, and Ms. Stroman, 52, who was at home communicating by text and FaceTime because only one parent was allowed in the hospital.

“You had a cardiologist, a pulmonary specialist, infectious disease experts all throwing numbers and prescriptions to each other, and this is stuff that’s French to me,” Mr. McMorrow said.

Jack mustered the energy to ask the doctors questions. “I needed to know because how am I supposed to fight something I don’t know I’m fighting,” he said.

He concluded that his condition essentially boiled down to: “Your coronary and pulmonary responses come back and bite you in the butt.”

But then doctors began giving Jack steroids, which can have anti-inflammatory and immunosuppressant effects. At last, something seemed to work. Within hours, Jack needed less blood pressure medication. As the family’s pediatrician, Dr. Ganea, who has training in infectious diseases and spoke to the hospital team, put it: “Jack turned into a normal Jack.”

Doctors are not sure the steroids made the difference, but since then, they have administered them much earlier to children with the syndrome, with encouraging results, Dr. Kernie said.

But Jack was not out of the woods even after moving to a regular hospital room. His heart rate was in the 30s, about half what it should be. The low heart rate might have been because of the steroids, doctors said, but they could not be sure, so they moved Jack to a unit with continual cardiac monitoring.

Over the next week, Jack recovered. He emailed his biology teacher from his hospital bed: “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.”

His mother knew Jack was his old self when, on the phone, he asked to speak with his sister, quoting the family’s favorite movie, “Midnight Run”: “Is this moron No. 1? Put moron No. 2 on the phone.”

Credit…Gabriela Bhaskar for The New York Times
Credit…Gabriela Bhaskar for The New York Times

On May 7, 10 days after being hospitalized, Jack went home and traipsed around the apartment channeling Pinocchio: “I’m a boy! There are no strings on me!”

He will require follow-up cardiology appointments and will take steroids and blood thinners for a while. He may have some heart-valve tears and residual cardiac inflammation, but doctors expect those to heal on their own. Jack and his family have taken genetic tests as part of research into the syndrome, and he and other survivors will be followed as doctors strive to learn how to recognize and treat it.

Pausing near a model of Darth Vader’s castle on his desk, Jack said he once considered becoming an actor. He was even an extra on the TV show “Gotham,” playing a kidnapped orphan. But before getting sick, he was thinking about studying medicine. “I was really into the heart,” he said. Now, he is even more interested.

“I just want to do more with my life now that I have it back,” he said, gesturing with his Captain America shield.

Source: nytimes.com

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