Coronavirus Chronicles — The Seeming Paradox of a Symptomless Disease

The previous post outlined some of the crazy things that coronavirus does when it wants to remain incognito. Childhood Obesity News also touched on the topic of the asymptomatic version of the illness nearly a month ago which, because the news in this field replenishes itself so frequently, already feels like a year.

Since then, multiple institutions began to consider what to do about back-to-school. The American Academy of Pediatrics (AAP) issued recommendations based on certain beliefs:

Although many questions remain, the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection. In addition, children may be less likely to become infected and to spread infection.

Anecdotally — meaning in Twitter posts — parents report that their pediatricians are dutifully conveying the information that kids don’t really get it that badly, so the parents should not worry.

Currently, a large number of studies are obtainable as “pre-print,” before being peer-reviewed or published by reputable journals. Granted, some of them sound like science fiction. Back in “normal” times, a lot of this alleged news would have flown right under everybody’s radar. But today, all kinds of reports are out there, seen by the ignorant and the educated alike. In other words, the propensity for reading a headline and going off half-cocked is greater than ever. All that being said, still, the AAP’s ideas seem to have some holes in them.

We are told that, among the symptomatic young, their most likely symptom is intestinal disorder. Who would even know this? What federal agency keeps track of reports of every incidence of diarrhea in children and teens? In the current state of chaos, it is more likely that the medical profession as a whole has only a sketchy picture of what is going on with young people.

The Centers for Disease Control offers a list of potential symptoms that includes fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle aches, headache, sore throat, congestion, runny nose, nausea, vomiting, diarrhea, and new loss of taste or smell. Except for that last sign, the others are a dime a dozen. They are conditions a person might have for many other reasons. Pity the parent who has to decide whether to keep a child home or not. Especially when a sore throat is difficult to prove objectively, and the child may not particularly want to go to school.

More unease

An objection can be made to the part of the AAP communique about how children are “less likely to have severe disease.” That is difficult to accept after hearing about Multisystem Inflammatory Syndrome in Children (MIS-C), also known as Pediatric Multi-system Inflammatory Syndrome (PMIS). When kids have heart attacks before they reach puberty, that is not a trend to ignore.

Inside schools, the AAP document suggests ignoring the generally accepted six-foot social distance rule, because:

Evidence suggests that spacing as close as 3 feet may approach the benefits of 6 feet of space, particularly if students are wearing face coverings and are asymptomatic.

Whoa! Other evidence suggests the exact opposite! Even the six-foot rule is deprecated by critics, who say it was established many decades ago, when lab equipment was not sensitive enough to detect how far droplets from a contagious person can travel out into the world. In the section about school bus protocol, the document’s language seems to imply that six feet of distance is an acceptable alternative to masking, although common sense insists that both precautions should be in place.

And by now, it ought to be common knowledge that asymptomatic carriers can spread the virus like a house afire.

(To be continued…)

Your responses and feedback are welcome!

Source: “COVID-19 Planning Considerations: Guidance for School Re-entry,”, 06/25/20
Source: “Symptoms of Coronavirus,”, 05/13/20
Image by Susanne Nilsson/CC BY-SA 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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