Authority for IMA cases seeks feedback from depositors on draft claim process

New Delhi, Apr 4: The Supreme Court on Friday urged Karnataka and Kerala to amicably resolve their issues concerning a border blockade that has choked the free flow of vehicles carrying essential items and patients in the midst of the COVID-19 outbreak.

Karnataka, which imposed the blockade, justified that its border was sealed to “combat the spread of the pandemic by preventing the movement of people from the bordering districts of Kerala to Karnataka”.

The State had moved the Supreme Court, challenging a Kerala High Court order on April 1 to open the border. Kerala has countered that patients from the State cannot be denied access to health care. Besides, the blockade has severely affected the supply of essential items, from medicines to food, to Kerala.

On Friday, a Supreme Court Bench of Justices L. Nageswara Rao and Deepak Gupta urged the States to not confront each other in the midst of an unprecedented public health crisis. Instead, it asked the Chief Secretaries of both States to sit with the Union Health Secretary and iron out a solution. Meanwhile, the apex court urged Kerala not to take any precipitative action based on the High Court order.

The court issued notice to Kerala on the appeal filed by Karnataka, represented by advocate Shubhranshu Padhi. It listed the case for further hearing on April 7.

Karnataka, in its appeal against the High Court order, said the blockade was put in place in the interest of public health. The situation regarding Coronavirus was “really dire”, it said. It warned that opening the blockade would cause a law and order issue as its local population wanted the border to remain sealed.

Karnataka argued that Kerala was the “worst-affected” State in the country with nearly 194 coronavirus cases. In this, Kasaragod, adjoining Karnataka, was the “worst affected” district of Kerala with over a 100 positive cases.

MP’s plea

The court also separately considered a writ petition by Kasaragod MP Rajmohan Unnithan for an order to forthwith open the State border.

The parliamentarian, represented by advocates Haris Beeran and Pallavi Pratap, urged the court to issue an ex-parte stay on the operation of the blockade imposed by Karnataka with its border States.

Mr. Unnithan said Karnataka’s blockade was “ill-planned and dangerous” and had led to loss of lives. Two patients from Kerala, in need of urgent medical care, died after their ambulances were denied entry at the border by the Karnataka authorities. 

May 12: Children suffering from non-respiratory disease symptoms like diarrhea and fever, or those with a history of exposure to the novel coronavirus, should be suspected of having COVID-19, a new study says.

According to the research, published in the journal Frontiers in Pediatrics, gastrointestinal symptoms first suffered by some children hints at potential infection with SARS-CoV-2 through the digestive tract.

"This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children," the scientists from Tongji Hospital in China wrote in the study.

They explained that the gastrointestinal symptoms could be arising since the type of receptors in lung cells targeted by the virus can also be found in the intestines.

Most children are only mildly affected by COVID-19, and the few severe cases often have underlying health issues, the researchers said.

"It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms, or suffers from another illness," said study co-author Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital.

"Based on our experience of dealing with COVID-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus," Li said.

In the study, the scientists described the clinical features of children admitted to hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.

"These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma," Li said.

The study noted that all the children had pneumonia, which was confirmed by chest X-ray scan before or soon after admission.

These children were then confirmed to have COVID-19.

While their COVID-19 symptoms were initially mild or relatively hidden before their hospital admission, four out of the five cases had digestive tract symptoms as the first manifestation of this disease, the researchers said.

Li hopes that doctors will use the findings to quickly diagnose and isolate patients with similar symptoms, which may aid early treatment and reduce transmission.

According to the researchers, the children's gastrointestinal symptoms, which have also been recorded in adult patients, could be an additional route of infection.

"The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans," Li explained.

Since the virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines, COVID-19 might infect patients not only through the respiratory tract in the form of air droplets, but also through the digestive tract by contact or fecal-oral transmission, the study noted.

While COVID-19 tests can occasionally produce false positive readings, Li said all the five children assessed in the study were infected with the disease.

However, he cautioned that more research is needed to confirm their findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital. The incidence and clinical features of similar cases needs further study in more patients," he said.