Coronavirus Chronicles — School and the Covid-19 Catch-22

School, school, school. Why is so much attention paid to this topic? There are arguments for scheduling all activities as usual, with children physically present at a central location. Kids need their education. Parents need to work, and regain their sanity. On the other hand, there is a big argument against having in-person class meetings — the virus. We don’t want kids to suffer from it, or to bring it home to other family members.

But wait, isn’t this page about children and obesity? Exactly! By weird coincidence, obese children happen to be one of the target demographics sought by COVID-19 organisms looking to plant their flag and establish new branches of their franchise.

Despite ever-increasing evidence to the contrary there is still, in some quarters, an outdated belief that a child cannot catch the virus, but if they do, they will not have a very bad case. This naive notion is countered by an ominous trend. Sometimes, a child will get over what appears, at the time, to be a light case. Sometimes a child is never even sick in an obvious way. But thanks to the phenomenon of recrudescence, the virus seems able to conceal itself temporarily in the child’s interior, invisible to detection attempts, and later make a devastating comeback.

This appears to be the mechanism that leads to Multisystem Inflammatory Syndrome, or MIS-C, which has been known to strike children who were declared to be out of danger. In younger kids it resembles Kawasaki’s Disease, and in older kids it manifests more like toxic shock.

A dangerous partnership

When two entities work together to form something bigger than both of them, synergy can promote a wonderful result; a whole that is greater than the sum of its parts. Synergy can also be toxic. When cleaning house, we avoid mixing bleach and ammonia, a mistake that could lead to hospitalization and even fatality.

The peculiar relationship between between obesity and COVID-19 is also toxic. Like two adolescent friends who keep daring each other to commit dangerous or criminal stunts, Obesity and COVID form an unhealthy mutual admiration society. Like two murderers involved in a folie à deux, they exacerbate each other to create a synergy that is detrimental to humans.

Dr. Liji Thomas addresses the question of how the risk of a poor outcome is increased by obesity. To her way of thinking, three major forces are at work. Obesity can alter the body’s immune responses, which makes an individual more vulnerable to the virus. Also, obese people often have associated chronic illnesses or co-morbidities, like cardiovascular disease and COPD, that increase the risk posed by COVID-19.

Third, there is evidence that, in obese patients, the virus has a different behavior repertoire. It seems, generally, to be obligingly adaptable in attacking human victims of vastly different ages, different races, different basic states of health, and so on. It would not be surprising to find in its toolbox a special implement custom-designed to take advantage of obesity.

Children’s Research Institute scientist Melissa Wake authored a study that exemplifies how obesity prepares a victim’s body to lie down and surrender to the coronavirus. The records of 1,800 Australian children demonstrated that the “seeds for heart disease are sown early in life.” Wake wrote,

Those who were obese or overweight as toddlers had evidence of stiffer arteries, thickened arterial lining and were at high risk of developing metabolic syndrome later in life. Metabolic syndrome is a group of heart disease risk factors that occur together. The signs of heart disease were worse the longer children were overweight or obese.

Along comes an obligingly adaptable virus that says, “Thank you for the deliciously weakened prey. If this person lives, life probably will be different, and will definitely create the opportunity for more fat cells to live long and prosper.” Obesity and COVID bump fists. Then, the immune system kicks into overdrive, and they’re off to the races.

Staying home may protect a child from the virus, but unless there is a home gym that gets regular use, staying home will increase the child’s obesity risk. Obesity will make them more apt to catch the virus, and to have a worse course of illness than a slimmer child would be likely to experience.

Going to school, on the other hand, may help the child to avoid obesity, but it greatly increases the chance of becoming infected. The debate about in-person school epitomizes the very serious catch-22 that schools are enmeshed in.

Your responses and feedback are welcome!

Source: “Obesity and COVID-19: Cause or effect?,”, 06/25/20
Source: “Obesity in Childhood Quickly Harms Heart Health,”, 07/14/20
Image by Travis Wise/CC BY 2.0


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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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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