Another day of social distancing, another newsletter. Keep on sending me those emails, links and memes. If you missed a prior newsletter, you can find it   here . And continuous thanks for staying home, staying safe, washing hands and masking up!
  
Kids have suddenly found themselves very much in the spotlight of coronavirus-related conversations. One BIG topic: school. Or said another way, will it  ever  resume? Another major subject surging to the top of your news feeds: looks like kids do get ill with coronavirus after all. So let’s dive into both.
 
People from all corners of my life are asking my best guess as to when schools will go back into session and what that might look like once they do. My answer is four words long: I really don’t know. The questioners really don’t like that. But I am not a school expert, nor am I a public health guru or a member of government. Still, as a pediatrician I should have an inkling, right? So I take a stab at it. Today I’m sharing with you my series of educated guesses, with a giant asterisk that these are really just guesses, albeit based upon everything I have read and listened to. It helps that over the past couple of days, the news cycle has agreed with my theories. In particular, this article looks at  kids as vectors  – yes, they get less sick than adults, but they pass the virus far more efficiently, and so that needs to factor into our choice to reopen schools. And this one, written by my friend and fellow pediatrician, Tanya Altmann, imagines  what school needs to look like  based upon these  recommendations released by the American Academy of Pediatrics  on Wednesday. If you’re not one to click through to the links, here’s my short answer: when your kid’s school will reopen depends upon all of this:
  • Are we talking about a kid who lives at home and attends a local school or one who lives on campus at a boarding school or college?
  • Is the local community facing a rising tide of infections?
  • Is there adequate space to socially distance on campus?
  • Can teachers and administrators – the older folks at greater risk from coronavirus – be kept safe and healthy?
  • Does your community have enough testing to document who’s at risk for spreading infection?
  • Does your school have a plan when a coronavirus-positive kid or adult is identified?
Bottom line is that until we better understand how kids spread coronavirus, we don’t have a clear understanding of the implications of regrouping them at school. Let’s hope those answers become clearer before the fall, when many districts are eager to open their doors for other – social, economic, and yes, these are deeply important – reasons.
 
Last week I mentioned the connection between coronavirus and a form of acute vasculitis called Kawasaki’s disease. That topic has led the headlines over the past couple of days – like  this article about kids in NY  and  this one about kids across the globe . This morning I heard a newscaster refer to this new constellation of symptoms as more like a cross between Kawasaki’s and toxic shock. You are going to hear a lot more about  Pediatric Multisystem Inflammatory Syndrome  it in the days to come, I can promise you. And its existence may impact that whole earlier conversation above about returning to school during this pandemic.
 
Just in time, here’s an unanticipated piece of  good  news:  people with asthma are not more susceptible to COVID , which is a bit surprising because most viruses that attack the lungs hit asthmatics harder. Coronavirus certainly seems to aim for the lungs. But then again, this virus may really be attacking the blood vessels more than the lungs themselves (that’s the whole Kawasaki’s link). What’s more, asthma may in fact be protective. Yes, that’s right, a person with asthma may actually have a lower risk of getting super sick with coronavirus. That has to do with ACE2 receptors on our cells – these receptors are basically access points for coronavirus and asthmatics have fewer of them.
 
If you need a laugh,  Dave Eggers’s  take on the hypocrisies of coronavirus-related advice is so funny… until its not because it’s real.
 
On a more serious note, Anisha Abraham, another one of my pediatrician friends (it’s a theme today!), offers  lessons from Asia  to help guide parenting strategies at the moment.
 
And if you don’t know Shafia Zaloom yet, you should! She’s an amazing sex ed and consent teacher who wrote a  book every parent should read . Last week, she published this op/ed about  sexting in the time of shelter at home .
 
Meme time. I was going to post one, except this week I got a lecture from my kids that what my generation calls memes aren’t memes at all. They are jokes. Pictures with words, but words meant as jokes. Real memes, they explained, have pictures with words strewn across them but the picture/word combination intentionally makes no sense. Then, my kids showed me what they meant by “real memes” and yep, they were 100% right: these make absolutely no sense. So I am posting a “joke.”