<html><head><meta http-equiv="Content-Type" content="text/html; charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; line-break: after-white-space;" class="">Gotham\u2019s <a href="https://www.gothamnetworking.com/page/covid_19_resources" class="">COVID Resources</a> site linked from the top of the Gotham <a href="https://www.gothamnetworking.com/index.php" class="">website</a> home page continues to provide important and useful information. Just added is the most recent NYS Health Dept. Advisory (Please scroll below my email signature or just click on link above.).<div class="">Thank you to Gotham Counsel Ben Geizhals for his guidance on what to post and Gotham Webmaster Mitch Tobol who maintains this important Gotham resources and ensure it gets updated as necessary.</div><div class="">Stay safe.</div><div class="">-Corey<br class=""><div class=""><br class=""></div><div class=""><div class="" style="orphans: 2; widows: 2;"><div align="CENTER" class="" style="font-family: Helvetica;"><font face="Times New Roman" class=""><font size="4" class=""><b class=""><font class="Apple-style-span" color="#1c39f6">Corey B. Bearak, Esq.</font><br class=""></b></font></font><font face="Times New Roman" class=""><font size="4" class=""><font class="Apple-style-span" color="#ac7824">Government & Public Affairs Counsel</font></font></font></div><div align="CENTER" class="" style="font-family: Helvetica;"><font face="Times New Roman" class=""><font size="4" class=""><font class="Apple-style-span" color="#0e23a3"><i class="">Networker of the Year-2012</i></font>| co-chair, <font class="Apple-style-span" color="#3a7620"><i class="">GO</i></font>tham <font class="Apple-style-span" color="#3a7620"><i class="">GREEN® |</i></font> <font class="Apple-style-span" color="#004aa4">Gotham Towers |</font> <font class="Apple-style-span" color="#dd1811">LI Legal</font></font></font><font class="Apple-style-span" style="font-family: "Times New Roman"; font-size: large;"> |</font><font class="Apple-style-span" style="font-family: "Times New Roman"; font-size: large;"><span class="" style="text-align: -webkit-auto;"><font color="#7a4442" class=""> Gotham</font></span><span class="" style="text-align: -webkit-auto;"><font color="#7a4442" class=""> Power Breakfast</font></span> <span class="" style="text-align: -webkit-auto;">Chair</span><i class=""> </i>| </font><font class="Apple-style-span" color="#007aaa" style="font-family: "Times New Roman"; font-size: large;">Gotham Sponsorships</font><font class="Apple-style-span" style="font-family: "Times New Roman"; font-size: large;"> </font><font class="Apple-style-span" style="font-family: "Times New Roman"; font-size: large;">Chair</font><span class="" style="-webkit-text-decorations-in-effect: none;"> </span><span class="" style="font-family: "Times New Roman"; -webkit-text-decorations-in-effect: none;"><font size="4" class="">| </font></span><span class="" style="font-family: "Times New Roman"; -webkit-text-decorations-in-effect: none;"><font size="4" class=""> <i class="">Gotham Sundays Blogger</i></font></span><span class="" style="-webkit-text-decorations-in-effect: none;"> </span><span class="" style="font-family: "Times New Roman"; -webkit-text-decorations-in-effect: none;"><font size="4" class="">| </font></span><span class="" style="font-family: "Times New Roman"; -webkit-text-decorations-in-effect: none;"><font size="4" class="">Moderator, <i class="">Fredslist </i>& <i class="">Gotham Promos</i></font></span></div><div align="CENTER" class="" style="font-family: Helvetica;"><font class=""><font color="#1013e0" class=""><font face="Times New Roman" class=""><font size="4" class="">P.O. 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If you are not the intended recipient, you are hereby notified that any disclosure, dissemination, copying or distribution of this transmission is strictly prohibited. If you have received this transmission in error, please notify this office by telephone immediately so that we can arrange for the return of the documents to us at no cost to you.</font></font><font face="Times New Roman, serif" class=""></font></i></font></font></font></p><p align="LEFT" class="" style="font-family: Helvetica; margin-bottom: 0in;"><font color="#2824a0" class=""><font face="Times New Roman, serif" class=""><font size="2" class=""><i class="">[sent from my MacBook Pro]</i></font></font></font></p></div><div class="" style="orphans: 2; widows: 2;"><br class=""></div></div><div class=""><a href="https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf" class="">NYS ADVISORY Possible COVID-Related Illness in Children</a></div><div class=""><div class=""><br class=""></div><div><div style="word-wrap: break-word; -webkit-nbsp-mode: space; line-break: after-white-space;" class=""><div class=""><a href="https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf" class="">https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf</a></div><div class=""><br class=""></div>
<div class="page" title="Page 1">
<img alt="page1image1667036736" apple-inline="yes" id="AB63A9BB-A2C0-4E2C-9FFE-43B2FAA7B9DF" class="" src="cid:EBD07D9D-BFD9-4BF1-82D2-51BC674CF9D1@home">
<div class="layoutArea">
<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">TO:
FROM:
</span></p>
</div>
<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">May 6, 2020
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Hospital Operators, Health Care Providers, Health Care Facilities, Clinical Laboratories, and
Local Health Departments<br class="">
New York State Department of Health (NYS DOH) Bureau of Communicable Disease
Control (BCDC)
</span></p><p class=""><span style="font-size: 12.000000pt; font-family: 'Arial'; font-weight: 700" class="">HEALTH ADVISORY: PEDIATRIC MULTI-SYSTEM INFLAMMATORY SYNDROME
POTENTIALLY ASSOCIATED WITH CORONAVIRUS DISEASE (COVID-19)<br class="">
IN CHILDREN
</span></p>
</div>
</div>
<div class="layoutArea">
<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">SUMMARY
</span></p>
<ul class="">
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Recently, the Novel Coronavirus (COVID-19) has been reported as possibly linked with a pediatric
multi-system inflammatory syndrome disease \u2013 \u201cPediatric Multi-System Inflammatory Syndrome
Potentially Associated with COVID-19.\u201d
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">As of May 5, 2020, sixty-four (64) suspected pediatric clinical cases compatible with multi-system
inflammatory syndrome associated with COVID-19 have been reported in children in New York
State hospitals, including New York City.
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Hospitals must </span><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">immediately report cases </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">of pediatric multi-system inflammatory syndrome
potentially associated with COVID-19 in patients who are under 21 years of age to NYS DOH
through the Health Emergency Response Data System (HERDS) application on the health
commerce system (HCS) and </span><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">perform a diagnostic and serological test </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">to detect the presence
of SARS-COV-2, the virus that causes COVID-19, or corresponding antibodies in the patient.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">ADVISORY
</span></p>
</li>
</ul>
<ul class="">
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">The purpose of this health advisory is to (1) ensure providers are aware of the pediatric multi-
system inflammatory syndrome potentially associated with COVID-19 and (2) provide guidance on
reporting of cases to NYS DOH and testing of patients who present with this disease.
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Please note that while older adults are at risk for severe COVID-19 illness, children can still get sick
with COVID-19, most often presenting with mild symptoms, but rarely becoming severely ill.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">PEDIATRIC MULTI-SYSTEM INFLAMMATORY SYNDROME POTENTIALLY ASSOCIATED WITH
COVID-19
</span></p>
<ul style="list-style-type: disc" class="">
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">In the United Kingdom and Europe, a possible link has been reported between COVID-19 and a
serious inflammatory disease recently termed \u201cPediatric Multi-System Inflammatory Syndrome
Temporally Associated with COVID-19.\u201d
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">As of May 5, 2020, sixty-four (64) suspected pediatric clinical cases compatible with multisystem
inflammatory syndrome have been reported in children in New York State hospitals, including New
York City.
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">This syndrome has features which overlap with Kawasaki Disease and Toxic Shock Syndrome.
Inflammatory markers may be elevated, and fever and abdominal symptoms may be prominent.
Rash also may be present. Myocarditis and other cardiovascular changes may be seen.
</span></p>
</li>
</ul>
</li>
</ul>
</div>
</div>
<img alt="page1image1669310096" apple-inline="yes" id="66F1155D-4FD3-4267-955D-76F0B4395530" class="" src="cid:997CD55B-CC86-4891-AF63-5E96238DB96F@home">
</div>
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<div class="column"><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Additionally, some patients have developed cardiogenic or vasogenic shock and required intensive
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">care. This inflammatory syndrome may occur days to weeks after acute COVID-19 illness.
</span><span style="font-size: 11.000000pt; font-family: 'SymbolMT'" class="">\u2022 </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">The syndrome may include:
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'CourierNewPSMT'" class="">o </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Achildpresentingwithpersistentfever,inflammation(e.g.neutrophilia,elevatedC-reactive
protein and lymphopenia) and evidence of single or multi-organ dysfunction (shock, cardiac,
respiratory, renal, gastrointestinal or neurological disorder). This may include children
meeting full or partial criteria for Kawasaki disease.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'CourierNewPSMT'" class="">o </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Exclusionofanyothermicrobialcause,includingbacterialsepsis,staphylococcalor
streptococcal shock syndromes, and infections associated with myocarditis such as
enterovirus. Clinicians should not delay seeking expert advice while waiting for results of
these investigations.
</span></p>
<ul class="">
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Early recognition by pediatricians and prompt referral to an in-patient specialist, including to critical
care is essential.
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">This syndrome should be considered by pediatricians and specialists, particularly when other
microbial etiologies have not been identified.
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Pediatricians and specialists should elicit any recent history of illness with COVID-19 or close
contact with individuals who are known to have COVID-19 in children presenting with symptoms
that are compatible with pediatric multi-system inflammatory syndrome potentially associated with
COVID-19.
</span></p>
</li>
<li style="font-size: 11.000000pt; font-family: 'SymbolMT'" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">The majority of patients who have presented with this syndrome have tested positive for SARS-
COV-2 or corresponding antibodies. Some tested positive on diagnostic, molecular testing for
SARS-COV-2, others were positive on serological testing for corresponding antibodies.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">REPORTING AND TESTING
</span></p>
<ul style="list-style-type: disc" class="">
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Hospitals must </span><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">immediately report cases </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">of pediatric multi-system inflammatory syndrome
potentially associated with COVID-19 in patients who are under 21 years of age to NYS DOH
through the Health Emergency Response Data System (HERDS) application on the health
commerce system (HCS)
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">Hospitals must </span><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">perform a diagnostic and serological test </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">to detect the presence of SARS-COV-
2, the virus that causes COVID-19, or corresponding antibodies in patients who are under 21 years
of age and present with symptoms compatible with pediatric multi-system inflammatory syndrome
potentially associated with COVID-19.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">For questions about HERDS, providers can send an e-mail to </span><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class=""><a href="mailto:hospinfo@health.ny.gov" class="">hospinfo@health.ny.gov</a></span><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(19.600000%, 19.200000%, 18.800000%)" class="">.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'" class="">For other questions, providers can contact their local health department (LHD) at the link below or NYS
DOH BCDC at 518-473-4439 during business hours or 1-866-881-2809 during evenings, weekends,
and holidays.
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'Arial'; font-weight: 700" class="">RESOURCES
</span></p>
<ul style="list-style-type: disc" class="">
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class="">NYS DOH COVID-19 Website
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class="">NYS Local Health Department Directory
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class="">Centers for Disease Control and Prevention (CDC) COVID-19 Website
</span></p>
</li>
<li style="font-size: 11pt;" class=""><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class="">Royal College of Paediatrics and Child Health Guidance: Paediatric Multisystem Inflammatory
</span></p><p class=""><span style="font-size: 11.000000pt; font-family: 'ArialMT'; color: rgb(0.000000%, 0.000000%, 100.000000%)" class="">Syndrome Temporally Associated with COVID-19 </span></p>
</li>
</ul>
</li>
</ul>
</li>
</ul>
</div>
</div>
</div><div class="">
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