scholarly journals Serological identification of SARS-CoV-2 infections among children visiting a hospital during the initial Seattle outbreak

2020 ◽  
Author(s):  
Adam S. Dingens ◽  
Katharine H. D. Crawford ◽  
Amanda Adler ◽  
Sarah L. Steele ◽  
Kirsten Lacombe ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
Neutralizing Activity ◽  
Number Of Children ◽  
Serological Identification ◽  
Viral Testing

Children are strikingly underrepresented in COVID-19 case counts1–3. In the United States, children represent 22% of the population but only 1.7% of confirmed SARS-CoV-2 cases1. One possibility is that symptom-based viral testing is less likely to identify infected children, since they often experience milder disease than adults1,4–7. To better assess the frequency of pediatric SARS-CoV-2 infection, we serologically screened 1,775 residual samples from Seattle Children′s Hospital collected from 1,076 children seeking medical care during March and April of 2020. Only one child was seropositive in March, but seven were seropositive in April for a period seroprevalence of ≈ 1%. Most seropositive children (6/8) were not suspected of having had COVID-19. The sera of seropositive children had neutralizing activity, including one that neutralized at a dilution >1:18,000. Therefore, an increasing number of children seeking medical care were infected by SARS-CoV-2 during the early Seattle outbreak despite few positive viral tests.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Inappropriate prescriptions for the aging population of the United States: an analysis of the National Ambulatory Medical Care Survey, 1997

2002 ◽  
Vol 11 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Boji Huang ◽  
Kenneth A. Bachmann ◽  
Xuming He ◽  
Randi Chen ◽  
Jennifer S. McAllister ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
Aging Population ◽  
The United States ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
Inappropriate Prescriptions

THE PEDIATRICIAN AND THE PUBLIC

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 839-845
Keyword(s):  
United States ◽  
Child Health ◽  
Medical Care ◽  
Undergraduate Students ◽  
The United States ◽  
Child Health Services ◽  
The Public ◽  
The Status ◽  
Infant And Child Health ◽  
And Child Health

The eloquent statement on the status of Negro medical care and education in the United States by the eminent anatomist, Dr. W. Montague Cobb (Brown America's Medical Diaspora: A Paradox of Democracy, in The Pediatrician and The Public, Pediatrics 3:854, 1949) requires the attention of all physicians interested in the distribution of medical care. Although pediatricians cannot begin to assume responsibility for this entire problem, it is possible to demonstrate leadership in the same manner in which the Academy study of infant and child health services provided leadership to the profession and the public. We refer specifically to an extension of training facilities in pediatrics for Negro physicians. Certainly 15 certified Negro pediatricians in a country with 14,000,000 Negro people represents a serious discrepancy in the distribution of training facilities. Admittedly most of the problem has its origin in the distribution of training facilities for undergraduate students and the basic problems responsible for this situation. However, we have observed—as has Dr. Cobb—that many Negro physicians desiring training in pediatrics (as well as other specialties) are discouraged from applying for training because of what seems to be a dearth of positions open to them. It has been our impression, however, that many centers would consider Negroes for training appointments if qualified applicants applied. Would it not be advisable, therefore, for the American Board of Pediatrics to circularize the approved training centers in pediatrics in order to establish a roster of those centers which would consider Negro applicants for training positions?

PUBLIC HEALTH

PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 343-347
Author(s):  
George M. Wheatley ◽  
Stephen A. Richardson
Keyword(s):  
Public Health ◽  
United States ◽  
Cause Of Death ◽  
United States Public Health ◽  
The United States ◽  
Vital Statistics ◽  
West Germany ◽  
Medical Attention ◽  
Age Group ◽  
Number Of Children

IN ALL COUNTRIES for which there are vital statistics, accidents are a major cause of death and disability among children. In countries where the food supply is adequate and infectious diseases have been brought under control, accidents have become the leading cause of death in the age group 1 to 19 years. For example, in such countries as Australia, Canada, Sweden, West Germany, and the United States, more than one-third of all deaths in this age group are caused by accidents. The number of children who are injured by accidents fan exceeds the number who are killed. Although no accurate international figures are available, the Morbidity Survey conducted by the United States Public Health Service indicates that in the United States, for every child under 15 killed by accident, 1,100 children are injured severely enough to require medical attention or to be restricted in their activity for at least a day.

This Child is Mine!

1978 ◽  
Vol 23 (7) ◽  
pp. 433-439 ◽  
Author(s):  
Robert Krell
Keyword(s):  
United States ◽  
Expert Testimony ◽  
Marital Relationship ◽  
The United States ◽  
Emotional Stability ◽  
Child Psychiatrist ◽  
Psychiatric Consultation ◽  
Number Of Children ◽  
Unique Position ◽  
The Family

In Canada and the United States there are over one million divorces annually involving at least that number of children. Divorce frequently involves matters of access and custody. Lawyers acting on behalf of their clients may request psychiatric consultation as to the emotional stability of the client. In custody cases, the child or children may be evaluated by a child psychiatrist. In a divorce action between two adults, it may be valid for the psychiatrist to see one party to the dispute and offer a psychiatric opinion. In custody matters, a psychiatrist must see both parties to the dispute as well as the children. If only one parent is seen it is almost impossible to offer expert testimony. Divorce proceedings result from marital incompatibility. The deficits attributed to each spouse in the marital relationship do not necessarily bear upon the ability to be a parent. Yet in custody contests, frequently the two qualities of suitability for marriage and suitability for parenting are confused. When a child psychiatrist is involved, he or she is asked to comment not only on the emotional stability or problems of the child but also on the fitness of the parents. If each parent has a child psychiatrist involved in the evaluation, the adversary position is fortified and the possibilities for compromise are jeopardized. Since the children are invariably traumatized, guilt-ridden and insecure, it is important that the child psychiatrist attempts to minimize the vindictiveness and anger which are inherent in some custody disputes. By acting in the child's interests, and guiding the lawyers to allow one child psychiatrist to perform the total evaluation, some loosening of an adversarial stance is likely, and new possibilities for negotiation and compromise are created. The structuring of such an evaluation must be completed before any member of the family is seen. A case illustration is provided to point out the nature of the requests made of the lawyers and techniques used in negotiations. The child psychiatrist, in remaining child-focused, is in a unique position to avoid representing one side to the conflict and to provide the court with an evaluation which will aid the judge to make an informed decision.

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