More Research On COVID-19 And Cardiovascular Symptoms Needed, Say WHO Experts
Transmission electron microscope image of SARS-CoV-2, the virus that causes COVID-19

As reports of COVID-19 patients presenting with cardiovascular symptoms continue to surface, World Health Organization experts say more research is needed to understand all of the clinical presentations of the new disease. Still, they underlined that the new coronavirus primarily causes respiratory disease.

“It is clear that in a proportion of patients, [COVID-19] is causing a broader inflammatory response, either within the vascular system – that’s the blood carrying system – or in other parts of the body,” said WHO Executive Director of Health Emergencies Mike Ryan. “But when we look at COVID-19, we need to see that obviously as a respiratory disease that’s spread by a respiratory route. It causes a respiratory syndrome.””

Ryan’s comments come just days after The Lancet published a correspondence describing eight young COVID-19 patients who had presented with symptoms similar to Kawasaki’s disease – a pediatric heart condition caused by swelling of the blood vessels. Just a day before, New York City health officials had released an official notice describing 15 similar cases among children 2 to 15 years old, ten of whom were previously exposed to COVID-19. Many of the patients did not present with significant respiratory symptoms. 

WHO COVID-19 Technical Lead Maria Van Kerkhove again attempted to reassure parents that the syndrome was still rare, and added that WHO would be rolling out a new form tailored specifically to collecting information on the ‘Kawasaki-like’ illness. 

But so far, it seems like COVID-19 still primarily causes a respiratory illness. Data from rare reports of the virus attacking other parts of the body must be collected systematically in order to determine how frequently these syndromes occur, or whether they are associated with COVID-19 at all.

“Very often with new emerging diseases, they don’t always have just one target organ. They tend to cause a much more disseminated disease that may affect multiple organs,” explained Ryan. “We’ve also seen reports of encephalitis or swelling or inflammation of the brain. We’ve seen other reports of other effects of the disease.” 

“We’re at the very early stages of understanding how this virus affects the body, and how disease progresses,” added Van Kerkhove. “I have to remind myself that we’re in month five of this pandemic.”

So far, over 10,000 detailed case reports of COVID-19 patients have been collected using a standardized form co-designed by WHO and the International Severe Acute Respiratory Infection Consortium (ISARIC). Individual hospitals are also collecting data on different clinical presentations of COVID-19, which is how the ‘Kawasaki-like’ illness in pediatric COVID-19 patients was first identified. But WHO is “hoping that more and more case records can be obtained so that we could better understand this [disease],” said Van Kerkhove.

Switzerland Will Deploy Official Contact Tracing Application Alongside ‘Old-Fashioned’ Contact Tracing; WHO Emphasizes Finding Active COVID-19 Cases Over Monitoring Virus In Wastewater

Meanwhile, in Switzerland, Swiss Parliament adopted a motion to use a contact tracing application in synergy with classical contact tracing, said Swiss Federal Council Alain Berset at a press conference today. The application will be tested in the next few weeks, before being deployed widely. Switzerland has reported 80 new cases over the pas 24 hours, and 30 207 total cases so far according to the Swiss Federal Office of Public Health.

In Switzerland, the situation is ‘evolving favorably’ and current measures will be further softened on Monday to open schools and libraries, said Berset. Although Switzerland can be “optimistic” right now as the outbreak calms down, Berset urged citizens to  remain ‘prudent’ and ‘pragmatic’ – “The virus is still here,” he warned. Physical distancing measures must be respected and vulnerable populations need to be considered, he said. 

Switzerland’s focus on contact tracing in its reopening strategy aligns with WHO recommendations that countries ramp up capacity to detect, isolate, and treat every case as countries gradually lift lockdown measures. Early detection and isolation of contacts is crucial, as it can prevent people from transmitting the virus before they themselves present with symptoms.

WHO is also exploring other ways of monitoring COVID-19 – including testing for COVID-19 antibodies, or monitoring wastewater for the presence of the virus. Fragments of SARS-CoV-2, the virus that causes COVID-19, have been detected in wastewater, no live or infectious virus has been found in any samples so far.

But while environmental monitoring or antibody testing are important for “understanding the long term trajectory of the pandemic,” countries must not neglect core public health strategies, said Mike Ryan.

“We seem to be avoiding the uncomfortable reality that we need to get back to public health surveillance. We need to go back to where we should have been; finding cases, tracking cases and contacts, testing cases, and isolating people who have tested positive,” said Ryan.

Total cases of COVID-19 as of 7:32PM CET 8 May 2020, with active case distribution globally. Numbers change rapidly.

280 Rohingya Refugees Quarantined Offshore Bangladesh ‘As Precaution’; UN appeals for US$ 6.7 billion To Support Vulnerable Populations

Some 280 Muslim-majority Rohingya refugees were precautionarily quarantined off the coast of Bangladesh on the Bhasan Char island due to fear of coronavirus spread – a move that sparked criticism by Human Rights Watch. Bangladesh is South East Asia’s second fastest growing pandemic hotspot after India, with over 13 000 cases and almost 800 new cases in the past 24 hours.

“Bangladesh faces the tremendous challenge of assisting Rohingya boat people while preventing the spread of Covid-19, but sending them to a dangerously flood-prone island without adequate health care is hardly the solution,” said Brad Adams, Asia director of Human Rights Watch. “Any quarantines need to ensure aid agency access and safety from storms, and a prompt return to their families on the mainland.”

Last weekend, a smaller boat with 29 Rohingya refugees was also taken to Bhasan Char island.

There are approximately 1 million Rohingya refugees in Bangladesh, most of whom are based in the Capital’s Cox Bazar. 

The UN appealed for US$ 6.7 billion to fund an updated plan for responding to the COVID-19 pandemic in 63 of world’s most fragile countries, many of which are hosting refugees, the UNHCR said in a statement released Wednesday. The UNHCR called on countries to support vulnerable populations – with explicit reference to the Rohingya. 

“We call on States in the region to uphold the commitments of the 2016 Bali Declaration as well as ASEAN pledges to protect the most vulnerable and to leave no one behind. Not doing so may jeopardize thousands of lives of smuggled or trafficked persons, including the hundreds of Rohingya currently at sea.”

Despite the UN’s call on South East Asian countries to allow vulnerable populations to land on their coasts, South East Asian nations have not followed.

Meanwhile, neighboring India’s Asian Infrastructure Investment Bank (AIIB) signed a $500 million “COVID-19 Emergency Response & Health System Preparedness Project” on Friday to help respond to the pandemic and strengthen public health preparedness. India has over 64% of South East Asia’s cases, with almost 54 000 total confirmed cases and 3561 new cases reported over the past 24 hours.

South Africa Releases 20 000 Prisoners From Jails And Facilitates Movement Of Civilians Through New Amendment

To curb the spread of COVID-19 in jails, South Africa released nearly 20,000 prisoners on Friday, announced South African President Cyril Ramaphosa.

Some 45% of Africa’s 35 470 cases are in South Africa, Algeria and Nigeria, and almost 50% of new cases in the past 24 hours were reported in these three countries.

South Africa will also allow individuals and businesses to move premises across the country, including citizens who were not able to do so due to the lockdown, said a statement from the South African government from Thursday. 

Zixuan Yang contributed this story.

Image Credits: NIAID-RML, Johns Hopkins CSSE.