Pat Hartman | Childhood Obesity News

Coronavirus Chronicles — Schools Must or Must Not Open, Continued

Pat Hartman August 5, 2020 No Comments

Toward the end of June, a statement from the American Academy of Pediatrics (AAP) prioritized the physical presence of students in brick-and-mortar schools. After the American Federation of Teachers, the National Education Association, the School Superintendents Association, the Infectious Diseases Society of America and the HIV Medicine Association had weighed in, the AAP issued a revised statement clarifying that decision-making must be guided by science, community circumstances, and evidence provided by public health agencies, but not by political considerations.

Among the public, there is in some quarters a very strong feeling that the safety of educators and school personnel is not being taken into account, and neither, for that matter, is the safety of America’s children. The grimmest moralists’ interpretation is that America’s eagerness to reopen bars, beaches and amusement parks ruined our chances to reopen schools. As Paul Krugman puts it, in his piece for The New York Times, “America Drank Away Its Children’s Future.” He writes,

Other countries stuck with their lockdowns long enough to reduce infections to rates much lower than those prevailing here; Covid-19 death rates per capita in the European Union are only a 10th those in the United States — and falling — while ours are rising fast. As a result, they’re in a position to reopen schools fairly safely. So we’re now facing a terrible, unnecessary dilemma. If we reopen in-person education, we risk feeding an out-of-control pandemic. If we don’t, we impair the development of millions of American students, inflicting long-term damage on their lives and careers.

The graphic on this page was created by Covid19 Recovery Consulting, self-described as a group of experts in medicine, public health, and infection prevention, experienced in “helping private businesses safely reopen and intelligently resume operations after COVID-19 closures and restrictions.” In other words, a business that exists to be hired by other businesses.

Showing their Risk Index here does not imply endorsement of every tenet. However, the graphic is offered for free (download the PDF file) and should prove a useful starting point for parents, students, school employees, and any interest group or institution that needs to influence, implement, justify, or enforce policy.

Rose Levine, a 5th grade teacher in Massachusetts, suggests that maybe schools should not be held responsible for the entire upbringing and formation of young citizens. She widens to the bigger picture, the one in which all citizens should take stock of our preconceptions and realize that other segments of society could use some remodeling and rehabilitation too. She writes,

Many Americans are finally recognizing for the first time that our schools have been serving less as educational institutions and more as life rafts. Our schools and teachers have, for decades, picked up the slack as our nation has systematically defunded and disenfranchised all the other components of a caring community. We have provided schooling, yes, but also nutrition, health care, counseling, social work, and — most critically — free childcare that allows the nation to abdicate all of its responsibilities to working families.

Your responses and feedback are welcome!

Source: “Doctors, teachers reject Trump’s pressure to reopen U.S. schools,” Reuters.com, 07/10/20
Source: “America Drank Away Its Children’s Future,” NYTimes.com, 07/13/20
Source: “The Case Against Reopening Schools,” UseJournal.com, 07/14/20
Image by Covid19 Recovery Consulting

Coronavirus Chronicles — Schools Must or Must Not Open

Pat Hartman August 4, 2020 No Comments

Now, at the beginning of August, conflict around school is rampant. The strongest sense of urgency at the moment is connected with education, and big cities, whose school systems are already assailed by innumerable problems, are having the worst time. Smaller places are not doing so great either. Matters having to do with curriculum and such mundane academic matters are pushed to the background.

The difference between in-school education and virtual learning can be enormous, and without a doubt there are hands-on courses that require equipment and supplies only found in buildings dedicated to education. When physical school is closed, any child who wants to become an Olympic swimmer or a football star is simply out of luck. Unfortunately, for them, merely returning to school might not help much, because the awareness of contagion is bound to change almost everything about the conduct of sports.

Physical education might be limited to running around an outdoor track at a respectful distance from other students. It could suffice to save a certain number of ordinary children from obesity, but those who need intense, specialized training are likely to be disappointed.

In-person school is needful for many reasons. At the moment, millions of children do not have enough to eat. Others have too much to eat, and spare time to spend on recreational eating. Both these problems are alleviated by going to school.

We all go crazy

There is a huge psychological component. For obese children who are bullied at school, staying home is a relaxing vacation from persecution. On the other hand, like it or not, a big part of normal development seems to include the need to compare oneself with one’s peers. It is at least possible that the frequent sight of athletes can help teens remember to rein in their self-destructive habits.

When kids have nowhere to be but home, there is bound to be friction between them and their parents. For children in situations that are not just annoying, but seriously abusive, being sentenced to the prison of home is miserable. If parents still have jobs that require physical attendance, leaving kids home on their own most of the time is not so great either.

Decisions need to be made on every level. Teachers are maximally vulnerable. They need to make heavy decisions about housing, acceptable risk, family responsibilities, community obligations, and so on. Knowing whether you will have a job next month is pretty important. Making a plan for if you wind up on a ventilator is also important.

For Commentary, Noah Rothman wrote,

A late May survey found that nearly two-thirds of educators polled by teaching-industry publication EdWeek’s Research Center wanted to keep schools closed indefinitely. A USA Today/Ipsos poll from the same period confirmed that one-in-five teachers would refuse to go back to school if their classrooms reopened.

That apprehension has not abated in the intervening weeks. As the New York Times reported on Saturday, teachers around the country have taken to social media to argue that classrooms should not reopen at all until their localities had seen zero new COVID-19 cases for at least two weeks.

Rothman formed an impression that legislators were leaning in favor of the cautious teachers, but as we will see, that impression may have been incorrect.

Your responses and feedback are welcome!

Source: “The Coming Showdown over Schooling,” CommentaryMagazine.com, 07/13/20
Image by Narumi/CC BY-SA 2.0

Coronavirus Chronicles — United Kingdom Meets COVID-19

Pat Hartman August 3, 2020 No Comments

What has been happening in Europe’s second-fattest country? The United Kingdom, comprising England, Scotland, and Wales (collectively known as Great Britain) plus Northern Ireland, is all one country, where the majority of adults carry health-threatening amounts of weight, and the kids are catching up quickly.

The National Health Service (NHS) announced that over the past five years, hospital admissions directly linked to obesity increased by 20%, with women much more likely to be affected than men. The announcement goes on to say,

Nationally, there were 876,000 admissions due to obesity in 2018-19, a 23 per cent increase on 2017-18, with the most deprived areas worst affected.

Childhood Obesity News takes a special interest in the U.K., because the Brits are so much like Americans, but different enough to make them interesting. Looking back over headlines for the past couple of years, it is easy to spot some trends and notice a few stories that seem extreme.

Parents insist on overfeeding babies, and resent having to tell children they are overweight. Activists want shops to sell sweets under very limited conditions or not at all. Businesses push back. Restaurants and markets say all the laws around labeling and calorie counts and packaging and placement and advertising are expensive and pointless.

In the public mind, advertising is a perennial scapegoat, with an odiferous reputation that proves time and time again to be well-deserved. The NHS accrues blame because it will pay for bariatric surgery, but not psychological help. There is never enough money for schools to do their main job to the utmost, yet they are expected to deal with childhood obesity, which is considered by many to be a big ask.

As everywhere, when people are fat or sick, race is a factor for either genetic or socioeconomic reasons. More obese people with diabetes are losing their feet to amputation. More children are hospitalized with rotting teeth. Hospital morgues have to reinvest in bigger refrigeration compartments. There was even a mention of Artificial Intelligence predicting the obesity levels of a city’s people, just by looking at the buildings.

How are they doing over there with the coronavirus?

One endearing characteristic of the British is that their government continues to optimistically formulate obesity-fighting plans. Another is that they will, when pressed, open their eyes to recognize the serious implications of a worldwide pandemic. The latest proposals take into account the chilling fact that overweight and obese people are quite vulnerable to the virus, and more likely to suffer disproportionately or even die.

We are used to the kind of obesity where something bad could happen 20 or 30 years down the line, in the misty future. The virus brings the potential death penalty into sharp foreground focus. The government says,

Nearly 8% of critically ill patients with COVID-19 in intensive care units have been morbidly obese, compared with 2.9% of the general population.

The newest campaign calls COVID-19 a wake-up call which makes “tackling the obesity time bomb” more urgent than ever before.

Your responses and feedback are welcome!

Source: “Thousands admitted for obesity related illnesses in North Somerset,” TheWestonMercury.co.uk, 05/15/20
Source: “New obesity strategy unveiled as country urged to lose weight to beat coronavirus (COVID-19) and protect the NHS,” Gov.uk, 07/27/20
Image by Alvin Leong/CC BY-SA 2.0

Coronavirus Chronicles — Teachers As Health Gatekeepers

Pat Hartman July 31, 2020 No Comments

In regard to the communicability of COVID-19, the latest estimate says that about 40% of transmissions are initiated by people who display no symptoms of illness. Elevated body temperature is one of those symptoms, so, to put it another way, the average asymptomatic person has a window of about a week in which to pass the disease on to others before they themselves experience any signs of sickness, including fever. And, apparently, a very large percentage of coronavirus victims never develop fever.

Yet, this is the Number 1 test proposed as a diagnostic to determine whether or not there should be in-person school classes this fall. Meanwhile, the general, overall situation of America in relation to the virus is no better than it was in the spring, when schools were abruptly closed.

Who gets the job?

Childhood Obesity News looked at the possibilities of designating parents as the temperature monitors, or making school bus drivers assume the responsibility. Who is left? School nurses have become almost as obsolete as chimney sweeps, but even if a school is lucky enough to have one, how long does it take for one nurse to point a temperature-sensing device at 1,000 students?

If temperature-checking is delayed until the child reaches the school building, what happens if they don’t pass? If the teacher or staff member says, “You can’t be here,” is the school system responsible to get that child back home safely? What if they won’t leave? Who deals with these arrangements and complications? At any rate, teachers could be asked to divide up the task of temp-checking everybody.

As if they don’t have enough to do already

An article from the American Academy of Pediatrics (AAP) contains a long, scary passage about students who have asthma attacks at school and need on-site nebulizer treatment, which is described as an aerosol-generating procedure. So an asthmatic student who was unfortunate enough to pick up the virus would be a very dangerous individual, with the potential to become a superspreader, as the virus travels via aerosolized particles.

None of this sounds good, and in fact sounds far above and beyond what should be required of a teacher. The AAP also mentions that a child infected with the virus “may have only gastrointestinal tract symptoms.” This paints a picture of teachers being required to not only take temperatures, but to interrogate each child about the current state of his or her bowels.

Teachers and other school personnel will need training in how to recognize potential symptoms in both children and adults. Not just the routine ones, like a runny nose, which is widespread due to other causes, and is virtually meaningless as an indicator of COVID-19. Does any person in the building have diarrhea, difficulty breathing, persistent chest pain or pressure, or blue-tinted lips or face? Is anybody unable to stay awake, or acting more confused than usual?

A rash inside the mouth has recently been added to the symptom list. Could teachers be asked to conduct oral inspections? No mask, and so close? It would not seem like a wise move, but because the study of this disease is both new, and subject to many stressful influences, opinions differ on what constitutes a good idea.

But it gets worse

A whole separate and higher level of alertness will be demanded, to know when to summon immediate emergency medical care. In case a student shows up with the rare but very serious MIS-C (Multisystem Inflammatory Syndrome in Children), there are many additional signs to watch out for. Fever or diarrhea, of course, plus neck pain, rash, bloodshot or red-rimmed eyes, extreme fatigue, “pseudo-frostbite” or (pink or purple) “COVID toes,” diffused redness of the chest, hives, cracked lips, bumpy “strawberry” tongue, swollen hands and feet, irritability, and sluggishness.

Also, pediatrician Dr. Bo Stapler reminds us that educators and other school personnel need to be on the lookout for blood clots, swollen lymph nodes, abdominal pain, seizure, or stroke. Will children be asked to remove their shoes and socks? To show their chests and stick out their tongues? Will teachers be expected to feel around for swollen lymph nodes? Will they be required to gain certification as field medics?

And what about teacher safety?

Thanks to their Twitter accounts, we have the privilege of hearing from actual school employees, like librarian Abby Cornelius:

Saw my doc today for annual checkup. Her recommendations for me and my teacher friends:
1) have at least 5 n95 masks (no homemade masks) and label them mon-fri. Let them sit for a week between wearing.
2) with the n95, also wear a face shield.
3) wear mask in a high bun and cover hair because droplets can rest in hair and then spread if touched.
4) when getting home, clothes go straight to washer, don’t bring work stuff in house
5) buy life insurance and update will.

Here is a poignant message from teacher Heather Lynette:

I am from a district in WI and we have been told: 5 days a week, full days… Teacher MUST wear masks, but children don’t have to. At current, we will have full classes. (Pray for us)

Your responses and feedback are welcome!

Source: “COVID-19 Planning Considerations: Guidance for School Re-entry,” AAP.org, 06/25/20
Source: “Symptoms of Coronavirus,” CDC.gov, 05/13/20
Source: “For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19,” CDC.gov, 05/20/20
Source: “The Latest on the Mysterious Inflammatory Syndrome in Children,” Medium.com, 07/07/20
Image by muffinn/CC BY 2.0

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

Pat Hartman July 30, 2020 No Comments

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?,” News-Medical.net, 06/25/20
Source: “Obesity in Childhood Quickly Harms Heart Health,” DoctorsLounge.com, 07/14/20
Image by Travis Wise/CC BY 2.0

Coronavirus Chronicles — Drivers, Temps, and Tech

Pat Hartman July 29, 2020 No Comments

Previously, in discussing the resumption of in-person education, this page looked at the idea of appointing parents to be in charge of temperature-taking. It has also been suggested that school bus drivers should take temperatures. But a lot of schools tend to not receive all their students via school system buses. Often there is a mixture. Some kids might travel by city bus, or be dropped off by parents. A school bus driver might think, “As long as I can’t take all their temperatures anyway, why don’t we just have me not take any temperatures?”

Such an attitude would be reasonable. These days, municipal bus drivers are likely to be protected by keeping the frontmost door locked, and constructing a plastic shield between the driver’s seat and the passenger compartment. It would not be fair to subject school bus drivers to more dangerous conditions. They should be free to concentrate on matters having to do with the vehicle, the traffic, and their riders’ behavior.

Suppose school bus drivers are armed with thermometer guns and given the responsibility to make sure nobody goes to school with a fever. What happens when a child registers a temperature that is over the line? Obviously, the driver would have to kick them off the bus. Is there a duty to notify a parent? What if the parent/s already left for work, or the call goes to voicemail? What if the parent doesn’t have a phone — an increasingly real possibility as people lose work, and norms disintegrate.

The same question obtains if temperature-checking does not happen until the child reaches the school building. If the authority figure says “go home,” is the school system responsible to return that child back home safely?

Technology grows apace

The handheld device mostly in use now measures the infrared energy that radiates from a person’s forehead. Most public places apparently go by the Centers for Disease Control limit, which turns people away if their temperature tops 100.4 degrees.

There are other fever detection systems. Kate Morgan, via Medium.com, reports that Las Vegas casino employees use “smart rings” equipped with miniature sensors. In Houston, Texas, scanners posted at doorways are popular. A person has only to look at the thing, and if their body heat is above 99.5 degrees, it will alert. Maybe that aspect of the pandemic will become easier for everyone to deal with, when the world is more plentifully supplied with these devices.

Siva Vaidhyanathan wrote for The Guardian,

Teachers in Fairfax county, Virginia, have already pledged not to teach in person this fall because their district has not planned adequately for safety and educational quality.

Fairfax, like many counties proximal to the nation’s capital, is one of the wealthiest in America. When Fairfax County does not loosen its purse-strings enough to provide measures — fancy thermometers, masks, and whatever else they need, to assure the safety of its teachers, other workers, and students — then what might we expect from other jurisdictions?

On the school-opening question, of course it behooves us to worry about the kids. But it should be remembered that along with teachers and bus drivers, quite a large number of other adults are likely to be involved in running the institution. To take a random example, an online commenter who works in a three-grade elementary school noted that there might be as many as 85 adults on the premises daily. Even if it were true that children never catch or transmit COVID-19 (which it is not!), that’s a lot of adults to be potential carriers and victims.

And, returning to the subject of monitoring temperatures, it must not be forgotten what an unreliable indictor that is. A person is capable of transmitting the virus long before their temperature rises, and the latest research seems to indicate that less than half the positive-testing people ever even spike a fever at all. As a useful means to diagnose the presence or absence of COVID-19, apparently the thermometer gun is about on a par with a coin toss.

Your responses and feedback are welcome!

Source: “Get Ready to Have Your Temperature Taken — a Lot,” Medium.com, 07/23/20
Source: “America is not prepared for schools opening this fall. This will be bad,” TheGuardian.com, 07/13/20
Image by Phil Roeder/CC BY-SA 2.0

Coronavirus Chronicles — How Dangerous Are the Kids?

Pat Hartman July 28, 2020 2 Comments

The wisdom concerning how susceptible children might be to the coronavirus, and how much risk they present to other family members, is constantly evolving. Emily Oster is an economics professor at Brown University, with an impressive publications record including books on pregnancy and parenting. In early May she remarked on a study of 54 families in the Netherlands, “They have so far found no cases in which the child was the first one in a family to be infected.” A month later, she observed how “it is a travesty that we are not collecting more data to understand how child care is spreading the virus.”

At the end of June, the American Academy of Pediatrics, while acknowledging that not everything about the situation was known, opined that children were “less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection.” Their report also said, “In addition, children may be less likely to become infected and to spread infection.”

Around the same time, the United Kingdom’s Paediatric Intensive Care Audit Network compiled a statistical report providing “the first picture of how many children were severely ill with coronavirus, their ethnic and patient characteristics, and the number who died.” They reported that in children’s intensive care units the median age was nine years, with almost two-thirds of the young patients being male. This situation, however, obtained mainly in London.

At the same time, news from Mexico reported the birth of triplets who tested positive for COVID-19 on the day they were born. A week later, an American news outlet reported on a church-sponsored sleep-away camp in Missouri, containing children from 10 states. One day there were two positive cases, 42 the next day, and a total of 82 cases on the following day. Parents had been required to sign a waiver agreeing to freely assume any risk and not sue the company that ran the camp. Reportedly, this was not the only summer camp in a similar condition.

In mid-July came this chilling news:

Florida health officials have identified a troubling trend; approximately 31 percent, or one-third, of children in Florida tested for COVID-19 yield positive results.

At the same time, Dr. Lara Shekerdemian of Texas Children’s Hospital was asked if children could transmit the virus and answered, “I think the answer is conclusively, without a doubt — yes.” This was based on surveillance screening of the testing of all children admitted to the institution for whatever reason, which revealed “a higher percentage of them carrying the virus and not showing any symptoms.” This doctor noted that asymptomatic children present a danger to the community at large, because they are “less likely to stay at home sick and more likely to go out into the world unknowingly spreading the virus.”

Dr. Megan Culler Freeman of Pittsburgh’s UPMC Children’s Hospital announced that children have “the same amount of viral load in their noses as adults.” USA Today reporter Adrianna Rodriguez told America that only about one-third of positive-testing children had elevated temperatures. In the same week, although not specifically about children, CNN’s Paula Newton reported numbers showing that virus patients were, by and large, turning out to be younger than previous experience had led the medical profession to expect:

The Public Health Agency of Canada now says more than 55% of new infections over the past week have been in younger adults under the age of 39. Earlier in the pandemic that group represented about a third of all infections.

But at the same time, the Association of American Physicians and Surgeons was still saying, “COVID-19 has the unusual feature that children seldom either get sick from it or transmit it to others.” Earlier this week, it was reported that in just one county (Nueces), 85 children younger than two years have been diagnosed with COVID-19, and a six-week old baby died of it. That information comes from a Guardian article by Alexandra Villarreal, about things that could happen when schools reopen, which are predictable because they are happening now in Texas childcare facilities.

It is recommended to anyone willing to risk being scared witless.

Your responses and feedback are welcome!

Source: “Can Kids Transmit the Virus?, Substack.com, 05/04/20
Source: “COVID-19, Learning Loss and Inequality,” Substack.com, 06/15/20
Source: “New Advice for Getting Kids Back to School,” Medium.com, 06/29/20
Source: “‘Relatively rare’ cases — the children critically ill with COVID-19,” Leeds.ad.uk, 06/23/20
Source: “Kanakuk Kamps battle a COVID cluster,” NBCNews.com, 07/09/20
Source: “Almost one-third of Florida children tested are positive for the coronavirus,” TheHill.com, 07/15/20
Source: “Can kids spread the coronavirus? ‘Conclusively, without a doubt — yes,’ experts say,” USAToday.com, 07/17/20
Source: “Canadian officials warn young people are fueling a spike in Covid-19 cases,” CNN.com, 07/21/20
Source: “With COVID, When Can Schools Re-open?,” AAPSOnline.org, 07/21/20
Source: “Texas childcare facilities thrown into chaos amid coronavirus crisis,” TheGuardian.com, 07/24/20
Image by Dan Gaken/CC BY 2.0

Coronavirus Chronicles — Who Will Be the Body Heat Monitors?

Pat Hartman July 27, 2020 No Comments

Yesterday, we noted that three types of adults have been proposed as the takers of temperatures when children return to in-person school. This is not an inconsequential detail. If eligibility for education is to be granted on a body-heat basis, the stakes for literally millions of children are high. The program needs to be solid, and the people who implement it must be reliable — or else what is the point?

Suppose a child is forbidden to attend school with a fever above a certain number. Suppose the authorities put parents in charge of keeping a child home from school. With parents as the first line of defense against the potential spread of COVID-19, some questions arise.

Households no longer are generally equipped with mercury-powered glass thermometers, which represent several kinds of safety hazard. The very large majority of households do not possess electronic temperature measurement devices. Such consumer goods are expensive. At best, they invite innocent yet destructive experimentation by kids who like to fool around with gadgets and take things apart. At worse, they invite theft. To expect to find one of these in every home is unrealistic.

An optimistic view

But suppose a family does have a nice state-of-the-art electronic thermometer. Mom or Dad takes Junior’s temp, writes the number on a piece of paper and signs it. Junior carries the document to school, where it is trustfully accepted as a valid and official record. Really?

Or, suppose the authority figure doubts the document’s veracity. To double-check, somebody has to take the child’s temperature with the school’s device. In which case, why not just go ahead and have the school take everyone’s temperatures? Why involve the parents at all?

There are many kinds of households in America, and many kinds of parents. There are hard-working parents who need to not be awakened in the morning. There are troubled and short-tempered parents, maximally stressed by money worries, family obligations, and looming problems like the threat of eviction. This brings up another point that is unpleasant to think about. Parents can have ulterior motives, reasons of their own for wanting children to either go to school, or not go to school.

Children also have their own goals and preferences. If school is the only place where breakfast and/or lunch is available, a child might fill out a “my temperature is within normal range” document and forge a parental signature With parents as the first line of defense against the potential spread of COVID-19, some questions arise — and who could blame them?

Getting there, and being there

How will children get to and from school this fall? By school bus? Public bus? Do they walk or ride their bikes? Do the parents take turns carpooling? In what vehicles, and with how many passengers? Does an older child catch a ride with a friend who owns a car? Whatever transportation method is used, it needs to be looked at carefully. If kids are going to travel back and forth crowded together with other kids, or with the general public, how much good will it do to keep them masked and distanced while in the school building?

There are questions about whether young children have the self-discipline and sheer physical coordination to keep masks properly positioned all day long. And what about eating? What about lost masks? What about mean kids who think it’s funny to steal compliant kids’ masks? If parents don’t set a good example at home, how can the school compensate for that? Optimistic grownups like to believe that children are better behaved at school than at home. Supposedly, children adapt easily and unquestioningly to new realities. Maybe.

While all this is being vigorously discussed, a large number of parents reportedly have had the opportunity to learn that homeschooling is doable, and plan to keep their kids out of public schools, no matter how many square feet of space they are allotted, or how many times per day the space is scrubbed down. While success-oriented parents have long believed in starting formal schooling as early as possible, that trend has reversed, with far fewer kindergarten registrations than would normally be expected. Everything about this crisis portends massive, disruptive changes to established systems.

Your responses and feedback are welcome!

Source: “Can kids spread the coronavirus? ‘Conclusively, without a doubt – yes,’ experts say,” USAToday.com, 07/17/20
Source: “Back to School? “No Thanks” Say Millions of New Homeschooling Parents,” FEE.org, 07/08/20
Image by Phil Roeder/CC BY-SA 2.0

Coronavirus Chronicles — Body Heat Goes Back to School

Pat Hartman July 24, 2020 1 Comment

Scientists are enamored of testing for multiple reasons. Theoretically, testing reveals who has the virus and who does not. That is a big subject, for another day. The exciting thing about testing is how it unveils misconceptions, like the one that the medical profession labored under for the first few months of the coronavirus crisis.

Even in late June, an American Academy of Pediatrics document said, “According to the CDC (Centers for Disease Control), children […] may be less likely to present with fever as an initial symptom…” The thing is, “may” and “likely” are what some call weasel words, the kind that leave plenty of wiggle room. Strictly interpreted, they mean that children may indeed be likely to spike a temp.

This matters a lot

Obesity prevention is only one of a multitude of reasons for wanting the kids back in school. But if there are to be in-person classes, someone has to decide who gets in. The desire to base the decision on temperature is understandable. Fever seems so objective and verifiable. Many businesses and institutions — including schools — rely on touch-free temperature instruments to determine who should be admitted to the premises.

What can go wrong? Several things, including device malfunction and operator error. A person might have a fever for some different medical reason. They might have been running to catch a plane. A person might be taking medication that hides the underlying fever. Apparently, certain other drugs can cause temperature elevation.

In consequence, people who should not be denied are kept out of places, or needlessly assigned to isolation. People who should not be admitted, do get in. For a hard-headed assessment of thermometer guns, check out this Business Insider report. It includes the words “notoriously not accurate” and implies that the use of the devices might be just another form of security theater.

In mid-May, the CDC also said,

The list of symptoms of COVID-19 infection has grown since the start of the pandemic and the manifestations of COVID-19 infection in children, although similar, is often not the same as that for adults.

In the interim, reports have come in of large-scale, random testing where it has been shown that not even half the people who test positive for COVID-19 have fevers. Other reports give an even worse impression. In her article on Medium.com, Alexandra Sifferlin wrote,

[One] one unique aspect of the virus that causes Covid-19 is that infected people are contagious in the period before they start to develop symptoms (if they do eventually develop them).

New data released from the clinical testing company Color found that among 30,000 people tested for Covid-19, 300 tested positive. Among those people […] 12% had a high fever.

While identifying 12% of people who might be at risk is not nothing, it’s also clear that a high fever is not necessarily the most reliable metric to screen people for Covid-19.

Consequently, it turns out that we really don’t know much — except that body temperature is a maddeningly unreliable indicator of disease, and basing the pass/fail system on it sounds a bit shaky. Letting kids go to school just because they don’t have fevers sounds pretty risky. Infectious disease and public health worker Ed Taboada wrote,

If one of the major components of your firewall against the virus is a diagnostic test that will catch fewer than half of those people that are infected and infectious, then I would suggest to you that your firewall is a bit of a failure.

Still, the temperature guns are all we have. The June AAP guidance discusses, at length, who (parents, bus drivers, or school personnel) should be taking children’s temperatures each morning, with each possibility owning its drawbacks. But whether the device is wielded by a parent, driver, or teacher, it does not tell the whole story.

Your responses and feedback are welcome!

Source: “COVID-19 Planning Considerations: Guidance for School Re-entry,” AAP.org, 06/25/20
Source: “Thermometer guns used to screen for coronavirus are ‘notoriously’ unreliable experts say, warning about improper use and false temperatures,” BusinessInsider.com, 02/15/20
Source: “Symptoms of Coronavirus,” CDC.gov, 05/13/20
Source: “What is the evidence of asymptomatic transmission of COVID-19 where symptoms NEVER manifested?,” Quora.com, 06/22/20
Source: “Taking people’s temperature at airports and restaurants needs to be part of a more comprehensive strategy.” Medium.com, 06/17/20
Image by MTA of State of New York/CC BY 2.0

Coronavirus Chronicles — Symptoms, Confusion, and Ongoing Harm

Pat Hartman July 23, 2020 No Comments

Apparently, as many as half of coronavirus-infected individuals never manifest any noticeable symptoms, which leads the curious to wonder, how bad can an asymptomatic illness be? But one study suggests that as many as half of those “asymptomatic” patients fall prey to a subclinical effect called “ground-glass opacities.” GGOs, as they are familiarly known, sometimes heal completely, but sometimes leave scars. These are…

[…] areas of lung tissue that appear gritty and opaque (like ground glass), and that tends to develop as a result of inflammation.

This scar tissue could cause or contribute to poor lung function and shortness of breath, or even, theoretically, a slight increased in the risk for lung cancer later in life.

This is only one of the many morbidities that children may fall prey to. Perspective is changing from “Kids don’t die of COVID-19” to “Kids don’t die right away.” Of course, because the disease is less than a year old, science does not have the records of actual long-term patients to study. But science has its ways of extrapolating and projecting. After reading some articles about possible bad outcomes, a reader might form the impression that it will be a miracle if any child survivor of COVID-19 can make it to age 40 without a lung transplant.

Cause for anxiety

Over the past several months, much parental focus has shifted from “How do I prevent my child from getting a concussion, or rotting their permanent teeth, or growing obese?” to “How do I keep my child alive long enough for any of those other things to become a concern?” Months ago, health officials had their reasons for believing that children rarely catch COVID-19, and if they do, they don’t pass it around.

As it turns out, those beliefs appear less well-founded every day. Another thing science has learned is that obesity and the virus enjoy a mutually supportive relationship. An obese person is more likely to contract the disease, and to suffer more intensely from it. A person sick with the virus is likely to be less active, more depressed, and for these and other reasons, more susceptible to obesity. This cozy little partnership is a serious threat.

A person wants to stay well-informed, especially about such a crucial topic. This literally is a matter of life and death, and the more children an adult is connected with, the more that adult is alarmed by random news items.

All kinds of news

We are advised to optimize our personal, internal immune systems. We are told that the chemicals in some cleaning agents and sanitizers act as immune suppressers. We are told to wash our hands many times per day with substances that are, basically, toxins.

We hear how a big new study determined that when it comes to spreading this virus efficiently, kids aged 10 to 19 are the equals of adults.

We hear that case totals are going up, while death totals are going down, and it doesn’t seem to make sense. This is probably the easiest puzzle of all to answer. Due to the nature of fatal illness, and of crisis, and of bureaucracy, as well as some other factors, there is a time lag in the recording and publication processes.

As The Atlantic writer Alexis C. Madrigal wrote,

It takes a while for people to die of COVID-19 and for those deaths to be reported to authorities.

Madrigal’s very pessimistic assessment reminds readers that a virus neither recognizes nor respects arbitrary lines drawn on maps, and that going at this problem state-by-state is a losers’ game.

Your responses and feedback are welcome!

Source: “Even If You’re Asymptomatic, the Coronavirus Can Do Damage,” Medium.com, 06/24/20
Source: “A Second Coronavirus Death Surge Is Coming,” TheAtlantic.com, 07/15/20
Image by muffinn/CC BY 2.0

Coronavirus Chronicles — Schools Must or Must Not Open, Continued

Coronavirus Chronicles — Schools Must or Must Not Open

We all go crazy

Coronavirus Chronicles — United Kingdom Meets COVID-19

How are they doing over there with the coronavirus?

Coronavirus Chronicles — Teachers As Health Gatekeepers

Who gets the job?

As if they don’t have enough to do already

But it gets worse

And what about teacher safety?

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

A dangerous partnership

Coronavirus Chronicles — Drivers, Temps, and Tech

Technology grows apace

Coronavirus Chronicles — How Dangerous Are the Kids?

Coronavirus Chronicles — Who Will Be the Body Heat Monitors?

An optimistic view

Getting there, and being there

Coronavirus Chronicles — Body Heat Goes Back to School

This matters a lot

Coronavirus Chronicles — Symptoms, Confusion, and Ongoing Harm

Cause for anxiety

All kinds of news

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

Food & Health Resources