The recognition and description of new diseases often resemble the parable of the blind men and the elephant, with each declaring that the part of the beast they have touched fully defines it. As the coronavirus disease 2019 (Covid-19) pandemic has evolved, case reports have appeared describing children with unusual febrile illnesses that have features of Kawasaki’s disease, toxic shock syndrome, acute abdominal conditions, and encephalopathy, along with other reports of children with fever, elevated inflammatory markers, and multisystem involvement. It is now apparent that these reports were describing different clinical presentations of a new childhood inflammatory disorder.

A case definition for the emerging disorder was published in late April 2020, after U.K. pediatricians alerted the National Health Service to an unusual inflammatory illness, termed “pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus (SARS-CoV-2),” or PIMS-TS. Similar cases were rapidly reported from many other countries.3,4 The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) subsequently published their own differing definitions of the disorder, which they named multisystem inflammatory syndrome in children (MIS-C).
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Overall, a consistent clinical picture is emerging. MIS-C occurs 2 to 4 weeks after infection with SARS-CoV-2. The disorder is uncommon (2 in 100,000 persons <21 years of age) as compared with SARS-CoV-2 infection diagnosed in persons younger than 21 years of age over the same period (322 in 100,000). Most patients with MIS-C have antibodies against SARS-CoV-2, and virus is detected in a smaller proportion. A relatively high proportion of cases have occurred among black, Hispanic, or South Asian persons.

Critical illness leading to intensive care develops in some patients, with prominent cardiac involvement and coronary-artery aneurysms in 10 to 20%. Elevated levels of troponin and B-type natriuretic peptide are common in severely affected patients, particularly those with cardiac dysfunction, and most have elevations in levels of C-reactive protein, ferritin, lactate dehydrogenase, and d-dimers, as well as in neutrophil counts. Anemia, lymphopenia, hypoalbuminemia, and abnormal coagulation indexes are also common. Most patients have recovered with intensive care support and after treatment with a range of immunomodulatory agents (including intravenous immune globulin, glucocorticoids, anti–tumor necrosis factor, and interleukin-1 or 6 inhibitors). A small percentage of patients have received extracorporeal membrane oxygenation support, and 2 to 4% have died.

Coronavirus infections across the United States have passed 2.5 million, with record numbers of cases reported in the states of Florida and Texas.

The surge in cases in southern states comes after businesses were allowed to re-open in recent weeks. On Saturday, Florida reported more than 9,500 new cases, up from almost 9,000 on Friday, the previous record. The spike has led state officials to tighten restrictions on business again - as Texas also did on Friday.

The leading US government adviser on coronavirus, Dr Anthony Fauci, said last week that the country had a "serious problem". On Saturday, Johns Hopkins University said the total number of cases in the country had risen to 2,505,593.

While some of the rise was down to more extensive testing, the rate of positive tests in some areas is also increasing. Health officials estimate the true number of cases is likely to be 10 times higher than the confirmed total. The US Centers for Disease Control (CDC) said up to 20 million Americans may have been infected.

The surge in cases was being driven by young people - those aged between 18 and 34 - testing positive, especially in the south and west of the US, said the head of the CDC, Dr Robert Redfield.

The Russian intelligence unit behind the attempted murder in Salisbury of the former double agent Sergei Skripal secretly offered to pay Taliban-linked fighters to kill British and American soldiers in Afghanistan, according to US reports.

The revelation piles pressure on the UK to take robust action against the Kremlin amid continuing anger over the government’s delay in publishing a key report on Russian attempts to destabilise the UK.

The bombshell report in the New York Times says there has been a major escalation by Moscow to undermine the White House and its coalition allies, including the UK, as President Trump seeks a peace deal with the Taliban.

According to the paper, Trump was briefed on the activity months ago, but no discernible action has been taken. The UK received the intelligence last week. The 29155 unit of the GRU, an arm of Russia’s military intelligence agency, was responsible for executing the plan, according to the paper. In recent years, it has been linked to assassination attempts aimed at destabilising the West.

Joe Albanese @AlbaneseJoe
I live in Florida. I am a senior citizen. I want to thank President Trump and Governor DeSantis for not caring whether I live or die. But if I am alive in November I will crawl naked over broken glass smeared with covid virus in order to vote against Trump and every (R) I see.

(chart showing Florida cases skyrocketing to 8,900 case in one day)

11:48 AM · Jun 26, 2020

The family of a man who died after an incident in which police used stun guns on him filed a lawsuit against the city of Tulsa after their previous requests for independent investigations produced no results.

In August 2018, Joshua Harvey died following a violent encounter with Tulsa Police officers in downtown Tulsa. Two officers deployed stun guns on Harvey, 25, delivering multiple short bursts of high-voltage electricity during about a three-minute period.
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Harvey reportedly was heading toward the doors of the Arvest Bank at Fifth and Main streets when he saw police vehicles. Officers approached the bank as Harvey was pulling on the handle of a glass door that was magnetically locked, and a forceful pull shattered the glass. As Harvey ran into the building, an officer used a stun gun on Harvey. A second officer followed suit, resulting in what Solomon-Simmons said were 27 deployments between the officers.

The issue was not the officers’ use of force when Harvey entered the bank, Solomon-Simmons said, but the use of excessive force. Officers pushed Harvey’s chest into the ground and held him there for 15 minutes, the attorney said. The responding officers checked on Harvey and rolled him to his side when they noticed he became unresponsive.

Metro will operate extra trains and keep the system open late on July Fourth as the White House hosts a fireworks show despite concerns about the spread of the coronavirus.

More frequent service on all Metrorail lines will start at 4 p.m. on July 4 to “accommodate the ‘Salute to America’ event on the National Mall,” Metro announced Friday. The system will run trains until all customers have been accommodated.

Metro is expecting fewer visitors to the National Mall than last year but warned that social distancing may not be possible at all times. They urged riders to consider other means of transportation.

President Donald Trump and first lady Melania Trump will host the event from the White House's South Lawn and the Ellipse. The president will deliver remarks and a ceremony will include music, military demonstrations and flyovers. The evening will culminate with a “spectacular fireworks display over the National Mall,” a statement from the White House said.

The White House is moving ahead with a fireworks show over the National Mall on July Fourth, but D.C.’s mayor is asking residents to celebrate at home as the coronavirus pandemic continues.

Joining a large gathering of people is still a high-risk activity, Mayor Muriel Bowser said at a news conference Thursday. She urged residents to observe the holiday in place and help prevent any surge in new cases.

“Our strong recommendation is that D.C. residents celebrate at or near their home, in small gatherings,” she said. Bowser said she hopes the usual Independence Day crowds won’t form on the Mall this year.

The shutdowns have led to apocalyptic headlines proclaiming that the state could lose 1 million jobs, and at least $24bn by the end of the year. Oil and gas companies have paused or curtailed production and halted capital expenditures to conserve cash leading to mass layoffs as the world shut down. In April alone, the industry shed a historic 26,300 jobs in Texas.

New coronavirus cases are increasing to record numbers and the state has paused its reopening plans. But the oil and gas industry cannot afford another shutdown as it smarts from one of its worst years in decades.
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“Rig counts, which are potential proxy for oilfield activity, fell starting around January 2019 leading to overcapacity, and lower prices,” says Kunal Patel, a business economist with the Federal Reserve Bank of Dallas. In the second quarter of 2020, business activity in the sector hit its lowest level since the Dallas Fed started its survey four years ago.

“There’s a lot of stress in the industry,” says Patel. “There’s been a major pullback in drilling and completing wells.” The outlook of the 168 energy firms in Texas, northern Louisiana and southern New Mexico collated in the Dallas Fed’s Energy Survey has improved but is still negative. Output has fallen for both oil and natural gas and the employment index is significantly down as firms continue to cut headcount. “We reached the bottom, and now we’re trying to climb up. It will be quite a while to get back up the hole to the pre-Covid level of activity and service pricing,” one insider says in the survey.