Regional diplomacy and security will this mean an end to the 2 state solution. Israel the next station on a just. Can you watching this train today were going to be looking at coronavirus 100 children a mother she seems to impact children in a different life than in adults packing about 1000 and keeps an area i spoke to tell me and today almost 6 and 7 year old nephews in london are asked them what would you like to ask our expert panel and civilization. When we able to play for our friends a game. They always do you know no one tonite. Thats a question that became so i know you like to get it what did i want to know when i can play by friends again. They will get anywhere and well theyre getting me. I am sure you have questions as well if youre watching on you cheat jump into the chat and you can be part of todays conversation. I am going to say hello to the guest the guests will say hello to the he me it is great to have you back on the stream introduce yourselves to our International Audience my pleasure for me thank you for having me my name is dr yunus and if it just as hes physician for the 1st 20 years working in the cool of the frontlines good to have you done to angelenos lovely to see you tell everybody who you are. Thanks for having me here today sammy i mean im still aracely i said i am a viral objects to Columbia University i study the host response to viral diseases including sars coronavirus to work overnight and today im here to talk about biology and susceptibility great to have your expertise in our conversation and ran a welcome back to the strain remind everybody who you are. Thanks for having me for me im a general pediatrician in a small town in Washington State for the last 20 years and obviously im seeing kids that either have disease or whose parents have disease and so i think thats more what im here to talk about plus probably answer your niece and nephews questions. Many many many questions. And this is this is an entire i showed a question that he asked and im going to start if he doesnt ranch im aware of the covert 900. 00 cases all around the well it seems like children immune to the disease why a lot makes them so different that they can get a common flu but no sign of the covert 19 virus what if you see with the kids that you can treat. Well i will say they are getting sick and they are getting symptoms the hard part is theyre not testing positive so you soon when your parents test positive for kovan 1900 if i have a family for example with 8 children and even though all 8 children dont have symptoms its assumed when one of them is 103103 degree fever that they most likely have disease. And again we just cant get the testing to be maybe as accurate as we hoped so in a nutshell kids are getting it but i think what is probably happening is theyre not getting a sick you know up to about 10 to 15 percent or asymptomatic and the question is whether other spreading the disease and in reality i dont really think theyre as likely to spread it as the adults and we think that you know theres Something Different about the fact theyve been exposed to coronaviruses recently and so they have some cross immunity or theres Something Different about those specific receptors youre going to hear a lot about a stew or suckers which is the receptor that the virus gets in and then makes copies and sends copies out into the body of the virus and theres got to be Something Different about their receptors and surely that is not making them immune but making them maybe protected from getting as many complicated to the into the loss of ideas out that will want to use setting on to any sections disease specialist so kids uncovered 19 and not seem to be as sick as adults why. Number one nobody is immune i think that we need to be very clear that thats a very dangerous a. V. This is a novel minus everybodys susceptible and whether youre one day older 100 years old the outcomes could be very different because everyone is susceptible so i think there are theres a lot of confusion but still there is a lot that we have understood and discovered about this virus in the past 6 months we know that this virus is primarily respiratory we understand that some of these symptoms can be. In other body systems we also know that about 80 to 85 percent of the patients will heal by themselves at home so that statistic has been validated over and over again in holland and it in the new york we know that about 5 to 8 percent of the people will end up in hospital and nobody really knows the mortality but there is a broad consensus now there is going to fall some get around one percent we also know that the vaccine is on the horizon so i think theres a lot of good news the top and we are discussing today unfortunately we dont know a whole lot about with this is aware there are a lot of questions but once again i must say good stuff is less than 5 percent of children are getting hospitalized to give you some data points 22 percent of u. S. Population is under the you defeat but if you go and ask any large hospital today about 457 percent of all their covert admissions or under the age of 15 so we know that theyre not getting as sick we know that the death rate so far again its all evolving its but. We know that the is symptomatic really is so i look at them as the beautiful innocent population they are i think we adults have to get our act together and kids will be fine. And include these 2 year and this is from zanny who is watching right now. Is it true that children are at a low risk of turning into. A great make since pilot ties adults for the vaccine when it comes out. Thats an excellent question it kind of gets right at what we were just talking about and that children do appear to be less susceptible to severe disease adults are much more at risk of coming down with severe disease and we dont know why that is it may be that children have a different pattern of the receptor receptors that doctor or other tensions maybe that children are responding to infection differently so one thing we know when adults is that. Severe disease is associated with out of control inflammation something we call a cytokine storm which means basically that the body is responding to the virus and exaggerate it and im controlled fashion and that response itself is whats harmful children are not as likely to have that type of response so it does make sense that we might prioritize higher risk individuals such as adults for a vaccine when it comes out but thats not to say that children should not be prioritized because some children do become very sick its more rare however children are not completely immune to this virus and they are susceptible to contract in the virus as well as to developing severe disease from it so we do need to be careful on once a vaccine is available how it is rolled d out but it may make sense to prioritize adults and households before children to stop the spread and protect the people who are most at risk doesnt im just wondering who would you even he have a child a vaccine in the early days we cant be a risk associated with that im just wondering how many of the chinese have in them either. So far i havent seen any trials that have chips in them im not i dont think we in general really with research we dont start out with children and you know its an interesting question because to compare it to the flu for a 2nd the flu vaccination is decreases mortality in children from the flu so theres a really good reason to give it even if its not the most effective vaccine at preventing disease its really effective at reducing Child Mortality or death from the flu and in a disease where we dont have a lot of. The other doctors on here are talking about where we have a really much lower risk of severe disease to be honest with you i think we should be cautious obviously i dont have the answers to this exactly but i certainly would be reticent to lean with vaccinating children only because they their mortality rate is much much lower than the popular than the older population whos really at risk. Teens i want to put this one to you this question from. Chief. How does occur and if i was affects a malnourished children in the developing well its because children who have the wildness acceptable as you say no one is immune so a few may be not getting all of the new changes if the hatchie come from a part of the wells where even basic facilities a quite hot basic infrastructure have you seeing any i read any details about how that may well affect its. Yeah i think if you broaden the question a little bit and include all the vulnerable populations whether theyre refugees from this children malnourished of course so then to be at much higher risk we dont have specific studies looking at it but we have enough data that this is like the comorbidity os earlier thinking that children are going to likely to do well because they have less risk of diabetes cancer Heart Disease all of the comorbidities that to me about the irish men is going to be a comorbidity and yes you will see. A lot of the problem once again is going to be all of those kids going to have access to testing and hospitalization and all the other support systems so that worries me. And let me share this headline with you guests in an audience as well rand multisystem inflammatory syndrome in children in 1000 coronavirus we saw his head on a little while ago when everybody was so shocked because up until that point we were told well it doesnt mean pat children are not much and and they seem to be quite resilient and and weve had lots about children and know about them being impacted 19 and what more can you tell us about this. So this is really what i raised out so this is really what i was just speaking about is that oftentimes a severe disease is associated with these out of control d on any or an inflammatory response says and we dont understand the basis of this at all but some children do appear to be susceptible d to experiencing this type of response to being infected so we dont really know what what makes one child more likely than another to develop that type of rare. System and slam a tory situation like. A disease like states but that is something that were going to have to look into more carefully im so that we can better identify and potentially preemptively treat children who are at risk of developing that condition doesnt know and im you know and the girl or coco go ahead im about what i can hear you. Look like what are the symptoms that they are presenting so i was just to piggyback a little bit on dr angelas answer to pediatricians are well trained to look for callous sakis disease i always say i never let the sun set on 5 days of a fever higher than 101 without working up now sakis because its its always in the back of our mind as a possible complication of illness and so the good news is at least for families that are listening out there most Board Certified pediatricians across the country are already aware of misc which is the multi system inflammatory disease and watching for it and then were were well used to watching for our signs of callous archys disease anyway and i know there are different entities but its something that were familiar with and were keeping close eye on and so anyway just to get you back that and then what was your question just wondering what to keep. Meeting for the 19th. Right so well theres not really any treatment per se other than reassurance but in a nutshell they look like they look similar to the adults in that im seeing fevers im seeing some of the older teenagers more are reporting short of shortness of breath the younger generally arent they have runny nose coffee or some g. I. Symptoms. But as you get closer to adulthood say from 15 to 18 the kids that ive seen that im pretty convinced you have disease and have significant exposure history those kids are short of breath ears and cough and they dont look well you know i mean they look like they dont feel well and then obviously there are some that are asymptomatic but again thats kind of not necessarily the norm. I want to go back to. Tell me whos 7 years old and hasnt been to school for a couple of months now hes in london and they had no down messages and tammy was really concerned about schooling and he had a couple of ideas so lets go back to tammy and have a listen to he still so thats when when they try and. Tell you can school and why anything i get it and and all the same that why are they going to prince to look easy and be not she says she does will be in place of using without any. Making gag. This is a big question no it isnt the u. K. Or other with oh well when do we send the kids back doesnt have a nice day. This is probably honestly the most important question right now at least as a pediatrician in my mind its something that i spend a lot of time thinking about and i think is critically important for the youth that america the American Academy of pediatrics 2 days ago came out with a statement that we absolutely must per ties getting children physically back in school and i actually i completely agree with them i think they were losing out on interacting with each other social im missing out on academics going back into being taught people who have been trained to teach ive done my best but im not a teacher and so i highly respect that profession and we need their help so in a nutshell i think we need to head back to school and i think what we need to concentrate on is the fact that we need to minimize adult to Adult Interaction thats probably the most important part so minimizing Staff Meetings minimizing staff interaction where we can minimizing or staggering drop off pick up times for children their parents are standing with each other waiting for kids and talking in spreading disease and often on each other and maybe go back to some traditional schooling so so whats called cohort ing children in the classroom meaning if this 1st grade classroom they eat lunch in their classroom they have schooling in their classroom their desks need should be roughly 3 to 6 feet apart the American Academy is more concentrating on whats practical so maybe that 6 feet barrier isnt practical obviously where its appropriate universal face coverings or face shields and in on children their disabilities if they need to see faces or read lips and so really you know working with some Common Sense Solutions and that way if one classrooms in fact did that classroom is going to be interacting with each other yes thats not ideal but then they wont necessarily spread it to the entire school so cutting out assemblies maybe having chance take a. Recess in there so according to their group meaning the 1st grade gets out then they go in the 2nd grade you know what i mean sort of taking each classroom and having them on their own schedule to avoid interaction with other classrooms and its not her effect but again i really based on what im seeing on the ground its adults its adults who need to have 1050 that are spreading disease more than anyone else and were seen those numbers go up even double in some places since memorial day and i think children are far less likely to spread disease and the reason i say that is i have been testing childrens noses for years for various diseases are a city flu exciter ive never had problems getting positive tests i really havent had a positive just yet and i know these kids have disease so if they dont have it growing in their nose and they sneeze i think that sneeze is less. Dangerous than an adult that doesnt even you have such a glamorous job of testing childrens names is im almost to go to im sure that her religionist and. How big 19 should schools be opening with kits. So i think this is a really difficult question to answer because i completely agree with that turnaround assessment that we do need to get kids back in school we need to be able to safely open our entire communities actually its not just schools we need to be able to figure out how to move forward reopening businesses making it safe for people to resume their normal lives one thing though that thats not clear to me is actually the risk for spreading of between children specifically so there are a lot of conflicting data about this study last week suggesting that children are not able to spread or they are happy susceptible as adults to contracting the disease which suggests that perhaps children may have the opportunity to interact with each other more however theres also data suggesting that children do. Have comparable ranges of viral loads meaning the amount of virus that is detectable in their noses compared to other categories of adults so including the highest risk adults ages 8 class so theres really a lot of data that we still need to gather about how capable children are of all contracting this virus as well as spreading its other people in their households and my thoughts in general about schools is that they really need to they are not a bubble they are not separate from the rest of society so we really need to think about ways to reopen our entire communities and not just our schools making it safe for all children and adults to be going back to business and interacting with each other in a safe. As low risk as possible way i want to bring in wolf before i go back to dr fay he says this is taught to poonam question she is a g. P. In the National Health service in the United Kingdom she brings up to it we havent talked about this. So far if your children have been impacted from the citys complications of coronavirus in comparison to adults however moving forward the biggest crisis i fear theyre putting to face is that on childrens social and Mental Wellbeing theyve been taken to prolong periods of time from school away from their friends from extended members of the family and potentially been living in very stressful environment and this is going to take a long time for the impact of this to unfold so really the governments charities need to Work Together to provide more support for children when they get back to school but also we need increased funding to be able to support the Mental Health services that are going to be looking after the aftermath of all of this will bring. Dr yunus is an Infectious Disease specialist im just wondering if you ever seen anything quite like this where weve asked our kids to stay away from each other stay away from school for such a long period of time what wisdom can you give to parents to teach as to families who are looking at the children who are missing or france. Sure 1st of all let me make a statement that we doctors make completely but. This is