Transcripts For CSPAN Washington Journal Dr. Roberta DeBiasi

The chief of the pediatric at Childrens National hospital. Thank you for being with us this morning. How many cases of covid19 have you treated among children of the hospital . Guest we started seeing cases in the middle of march, and we have now had over 600 children come to the hospital with symptoms. E have been admitted to the hospital, so about 150 of those and about a quarter of those or a 1 3 of those have needed our intensive care unit. Host whats the pattern among children, what do you see and how are their symptoms different from adults . Guest we really are seeing several different patterns of disease. So of those 600, the vast majority of them, and this really has been seen in other parts of the country as well, they have mild to moderate illness where they have typical respiratory symptoms either fever or cough and then have runny nose or sore throat so very mild moderate illness. The children admitted fall in several different categories. Some of them have what is similar to what the adults have seen with a severe pneumonia or clotting issues. But then we have another set of children very young who have a neonatal c fever, sepsis type picture. And our third category we have 50 of these children that have come in since the beginning of may with this multisystem inflam story disorder which is a little bit different where they dont have the respiratory symptoms but are coming in with prolonged feefers and other symptoms that show inflammation throughout their body including their heart or coronary artery or other organs. Host since the start of the virus broadly what do you think weve learned and how has your treatment changed in terms of treating children. Guest weve certainly learned much in the adults and children and have very much still we need to fill in the gap. What weve clearly learned is that in the beginning we thought and we heard from other perhaps children were not able to be ineffected or not as much as adults but its clear children are hospitalized at lower rates than adults and is certainly important for everyone listening to know. Though im telling you about these cases the vast majority of children dont end up in the hospital and have a mild to moderate illness. However in the last several weeks and months there is more and more data coming out of many countries including the United States that show clearly children are infected at all ge groups. Even in our own center when we published looking at different age groups 01 or 510 we did not see a difference in the number of infections across the age groups but its the or young who are likely to be hospitalized but its the minority of those children that end up hospitalized. There was a very important last that came out just week out of chicago that looked at the virus that could be recovered from the nose of children in particular Young Children and its there its obviously there at higher levels in some cases than adults. What we dont know yet is how well is that virus thats there transmit to other children and ther adults. Many studies in the United States a study of 6,000 people which will be a cohort of 2,000 families looking carefully at how the virus is transmitted throughout the family, is it going from the adults to children or more likely going from the children to the adults. And also theres really important studies in schools coming out of the united ngdom as well as germany where theyll look at a regular basis the amount of transmission by virus and antibody levels in the students as well as the staff and teachers in those schools. St our guest is dr. Roberto dbiasi Infectious Diseases division chief with the Childrens National hospital in the nations capital. Welcome your comments and questions for dr. Diabia, i. A parent 2027488000 and all others 2027488001. In the Washington Area you see young kids wearing masks. In your view its the proper thing to have kids doing . Guest absolutely. There are certain circumstances that doesnt apply. So if you have for instance a child under 2 years of age its not considered safe to do that or a developmently disabled child that cant keep it on or has problem with their respiratory secretions its not recommended but for other people 2 years of age, otherwise normal children should be wearing their mask and this was highlighted just last week and unfortunately a large outbreak of a camp in georgia. Even that camp took many measures the c. D. C. Recommended and to distance and do as much as they could, the one thing they didnt do is masks and they had, for instance, children in cabins up to 15 ids overnight in cabins. And unable to use masks in congress get settings and a large number of people, almost 50 of the people in the camp became infected. Masks really are very important and weve seen it in adults and now seen it in children as well. And this is going to be a key part of how we think about oing back to school. You mentioned dr. Fauci from his testimony last week before congress, dr. Fauci said kids over 9 years old can transmit the coronavirus as well as adults as some schools reopen. I want to play you the comments of dr. Fauci in questioning from representative maxine aters of california. Now this president who expects us to believe him rather than the medical experts is saying children are almost immune. Is that an expert medical conclusion, dr. Fauci . What does that mean, children are almost immune from this virus. Dr. Fauci generally when you say a person is immune, theyre protected from getting infected and children who get infected. This is not an expert medical conclusion we have documented somewhere . Dr. Fauci if youre talking about a conclusion that children in general are immune, that children do get infected we know that, so therefore theyre not immune. I must say when children get infected that when you look at consequences they do much better because if you look at the hospitalizations children have a much lower rate of hospitalizations than adults. In fact the curve goes way up as you get older and older and when you get to the age group of children, they generally do not get serious diseases much. I understand that and have been listening and understand what youve just described. But what i was asking really is about this president s latest comment that children are almost immune and so i think i ot the answer to that. Host let me ask you about immunity among kid and others, how will we know when immunity presents itself . How will that become apparent in treatment of patients . Guest this is a complicated issue. So the atlanta body test is a test that looks at the Antibody Test is a test that looks at the response of the virus and is going on through multiple groups including our federal government in multiple cities looking at the Community Level in certain cities and looking nationwide to see how many people actually have had evidence of infection, whether or not they realize it. Because another thing weve seen is that up to 40 of people will have no symptoms whatsoever. So what i mean is they dont have any idea, they dont remember having symptoms but we can find evidence from their blood that theyve had an immune response or antibodies. So what is going on right now in Childrens Hospital is a big part of this in d. C. , particularly in the pediatric population. We really have no idea what percentage of children in the city, for instance, new york or in d. C. Where there were large number of cases, what percentage of the children have actually been infected because we know that they are less likely to get severe disease. So the zero prevalence is really going into a population and figuring out how many people have actually been infected. The second part of that thats really complicated and waiting to find out is how long do those antibodies last and are those antibodies even protective against a second infection if this came around again in your community . Host before we get to callers let me ask you one more thing about the severe side effect that happens among a very small number of kids called multiinflammatory syndrome, misc, how prevalent is it and tell us a little bit about its symptoms. Guest as i mentioned at the beginning, this was after we had seen the first wave of infections throughout the United States and really throughout the world, right around the end of april and the beginning of may, our colleagues in europe and then right away right after that in the United States we started seeing this different presentation associated with sars covid19 infection and for the most part these children dont have symptoms of covid, meaning not but we can find evidence with antibodies in their blood that they recently had it. And what these children are coming in with is what we call hyper inflammation or too much you mean immune response. Children, for whatever reason, and we are studying this, is it something about the children, is it something about the virus that has changed, for some reason, that a mean response is not turned up. They show up with prolonged fevers and a variety of organ systems involved, whether that is their heart, their coronary artery, their kidneys, their liver, their skin, redness of their eyes, multiple ways they can present. The good news is there have only been around 300 cases in the United States. All of our colleagues are putting our Heads Together to come up with the best treatment. The good news is they do seem to respond to antiinflammatory treatments. Each hospital is doing a variety of different things. We are going to soon have information about these children six months down the line from all of these different treatments we have been using. Host we have calls waiting on our guest, dr. Roberta debiasi. Good morning in nashville, go ahead. Caller good morning. Old, basicallys the last year of his adolescen ce, sliced a consider him an adolescent, even though he is 21, he got it, his roommate got it. He had four days of fever and maybe six hours of gastrointestinal upset, and then was fine. He is going to have the Antibody Test. He is under the care of our doctor. Hes going to have the Antibody Test in a couple of weeks. Middle of august is what the doctor said. He is being monitored. Of course, he is fine. His school, middle Tennessee State university, he will be a senior this year, they are having inperson classes. I guess my biggest concern is him getting it again and or having some adverse effect in the future. Did something happen in his body that we need to be worried about . Like a said, he is fine, he feels great. He is a very good eater. I think a lot of the information problem with kids has to do with their diet. Far too manyeat carbs, fat, sugar, and salt in america. He is a healthy kid. He is doing well. I guess my question for you is, effects. Affects i know it is hard to say because nobody really knows what will happen to the kids that have had it. I am worried about his internal organs. He did not have the respiratory issues, but is it going to come back . Will you be ok in the future . Will he be ok in the future . Host thanks, derby. Guest you are asking the same questions we ask in our families, communities, and schools. How is this affecting our children and how will we know and when will we know . We all have to remember even though it feels like we have been home forever, as has been going on only for several months. In the d. C. Area, we have only had cases in children from around march. We have less than six months of followup on these children. Like your son, the vast majority of children will be completely fine. Six years fromou now we will not know more and perhaps there may be some side effects. Someone had pneumonia, it could have longterm effects on their lungs. It is also possible they will have no longterm effects. We dont have the answer to that. To tellif people try you they have the answer, it is not true. We do not have enough longterm followup on these children. Children with inflammatory syndrome, we are more focused on their hearts and the coronary arteries because we know from a similar presentation of kawasaki disease that those children can have longterm issues with her heart. That is a very intense area of focus across the world, to follow up very carefully on children with multiinflammatory disease. As a mention, that is a very small number of children, in smaller than the number that have the typical pulmonary disease of covid. Your question about going back to school and you are worried it will come back, it is possible there will be more waves of disease. We are seeing this now. We had this short time where things seemed to settle down on the northeast coast. But now we are seeing large numbers of increases across the south, southwest, california, and out west. Point of how we decide when it is appropriate to go back to school. The very first thing we need to look at is the local situation. I mean the county, the district even, because looking at a state is not helpful. It can be vastly different what is going on in her parts of different states. The schools are working closely with the Health Departments and jurisdictions. That is the first step deciding whether we can take the step one decision to have inperson classes. An editorial cartoon over the weekend capturing perhaps some of the dilemma parents face. Damned ifyou do and you dont. Megan is on the line. I want to give my sincere apologies to the woman whose son was affected. I hope everything works out well. We live in hempstead, maryland. We have people leaving states like new york and florida, hotspots, and they are coming to different states even though they were supposed to put mandatory restrictions. Going back to school i do not believe is a wise thing to do. I dont to get has to do with their diet. Children are less immune to getting this. Should we guest not go back . World we know it is better for children to be in school, and not just for academic reasons, there is a host of reasons why going back is important. School,ing elementary primary school, there are socializations that are not fear and theoretical damage. When we weigh the risk and benefit of going back, we are not saying staying at home is a harmless thing to do, and we cannot compare that to the potential risk of going back. We know that we have had huge increases in anxiety russian, concerns about suicide, children being targeted on the internet with pornography because people know they are at home. We have people with special needs not getting access to their care, occupational and physical therapy, hearing interventions, children who are develop me disabled or not ting to live or not children who are developmentally disabled are not getting their care. Children who depend on school for their food. We can talk about for an hour on this. That does not mean we say everyone must go back to school. Was it does mean we have to carefully weigh the known harm against the potential risk, and that risk is vastly different in different communities. There is no circulation. When they way their riskbenefit in maine, it is in favor of going back because there is a harm if they stay home. In new york, there was a large outbreak, but new york is a model and they hardly have any circulation going on. A person cannot go to new york because you have a higher amount of certain. Know those to counseling will have to know that is very specific. He could be the number of over evan date. Be the number of over a sevenday period. It is very clear there are many parts of the country where things are in control and not in control cannot have a onesizefitsall. You feel like there is any attentive meant . Any protective equipment . Guest we learned from what happened in new york because that huge wave that overwhelmed the Health System overwhelmed other parts of the country, including d. C. To very significant shutdown measures. That really did flatten our curve in the d. C. Area. We had lots of cases, but they did not come in and twoweek period. We did not get overwhelmed. We had enough protective gear. Our icu did not get overwhelmed our icus did not get overwhelmed. We did not have that situation, but that is a direct effect of people taking this seriously and not allowing the number of cases hand, markedly out of like we are seeing in some parts of the south right now. Host everyone is on our parents line. Ift number is 202 7488000 you are not apparent, that number is 202 7488001 caller i wonder if there has ever been data taken on these children of whether they have had all of their childhood inoculations because it seems to me because they have had inoculations recently, they are kind of covered somewhat for all diseases. And i have another part to my question. What happened to the home testing kits the president promised us in april . Host ok, donna. Guest the first question about vaccinations, unfortunately, vaccines for different pathogens, for instance against the pneumonia bacteria, will not protect you against a viral pneumonia like influence or covid. There is not crossprotectivity. We have not seen that children with no vaccines are likely to get covid. Conversely, we have fully vaccinated children, the vast majority of kids that get this disease, they are not less likely to get covid. There is not a crossreactive protectivity you are suggesting might exist. What was the second part . Host she asked about the availability of home test kits. Guest we want to be able to do testing on a bigger level than we have. We are doing much better in the United States with access to testing in general. We cannot all just do a test in our house we have learned testing is not the whole answer. In some cases, it can give a false sense of security. If i was aware of one of my family members that had covid and i was exposed to them, there is a 14day window where i could develop symptoms. If i do a test five or 10 days after that exposure and it is negative, that does not mean i am not infectious because i could develop it in the next three days. This was seen in the camp outbreak i told you about in georgia. You had to bring a piece of paper and say you had a test within 12 days of showing up to camp. In the additional 12 days, the children and adults were in the community doing other things. The only way testing would be helpful is if you could do a test on yourself every day before you go off and do something. That will not be practical even with a homebased test. It is too expensive and there will not be enough tests to do that every single day. We need to have tests when someone has symptoms in a School Setting or office so we can do Childrens National<\/a> hospital. Thank you for being with us this morning. How many cases of covid19 have you treated among children of the hospital . Guest we started seeing cases in the middle of march, and we have now had over 600 children come to the hospital with symptoms. E have been admitted to the hospital, so about 150 of those and about a quarter of those or a 1 3 of those have needed our intensive care unit. Host whats the pattern among children, what do you see and how are their symptoms different from adults . Guest we really are seeing several different patterns of disease. So of those 600, the vast majority of them, and this really has been seen in other parts of the country as well, they have mild to moderate illness where they have typical respiratory symptoms either fever or cough and then have runny nose or sore throat so very mild moderate illness. The children admitted fall in several different categories. Some of them have what is similar to what the adults have seen with a severe pneumonia or clotting issues. But then we have another set of children very young who have a neonatal c fever, sepsis type picture. And our third category we have 50 of these children that have come in since the beginning of may with this multisystem inflam story disorder which is a little bit different where they dont have the respiratory symptoms but are coming in with prolonged feefers and other symptoms that show inflammation throughout their body including their heart or coronary artery or other organs. Host since the start of the virus broadly what do you think weve learned and how has your treatment changed in terms of treating children. Guest weve certainly learned much in the adults and children and have very much still we need to fill in the gap. What weve clearly learned is that in the beginning we thought and we heard from other perhaps children were not able to be ineffected or not as much as adults but its clear children are hospitalized at lower rates than adults and is certainly important for everyone listening to know. Though im telling you about these cases the vast majority of children dont end up in the hospital and have a mild to moderate illness. However in the last several weeks and months there is more and more data coming out of many countries including the United States<\/a> that show clearly children are infected at all ge groups. Even in our own center when we published looking at different age groups 01 or 510 we did not see a difference in the number of infections across the age groups but its the or young who are likely to be hospitalized but its the minority of those children that end up hospitalized. There was a very important last that came out just week out of chicago that looked at the virus that could be recovered from the nose of children in particular Young Children<\/a> and its there its obviously there at higher levels in some cases than adults. What we dont know yet is how well is that virus thats there transmit to other children and ther adults. Many studies in the United States<\/a> a study of 6,000 people which will be a cohort of 2,000 families looking carefully at how the virus is transmitted throughout the family, is it going from the adults to children or more likely going from the children to the adults. And also theres really important studies in schools coming out of the united ngdom as well as germany where theyll look at a regular basis the amount of transmission by virus and antibody levels in the students as well as the staff and teachers in those schools. St our guest is dr. Roberto dbiasi Infectious Diseases<\/a> division chief with the Childrens National<\/a> hospital in the nations capital. Welcome your comments and questions for dr. Diabia, i. A parent 2027488000 and all others 2027488001. In the Washington Area<\/a> you see young kids wearing masks. In your view its the proper thing to have kids doing . Guest absolutely. There are certain circumstances that doesnt apply. So if you have for instance a child under 2 years of age its not considered safe to do that or a developmently disabled child that cant keep it on or has problem with their respiratory secretions its not recommended but for other people 2 years of age, otherwise normal children should be wearing their mask and this was highlighted just last week and unfortunately a large outbreak of a camp in georgia. Even that camp took many measures the c. D. C. Recommended and to distance and do as much as they could, the one thing they didnt do is masks and they had, for instance, children in cabins up to 15 ids overnight in cabins. And unable to use masks in congress get settings and a large number of people, almost 50 of the people in the camp became infected. Masks really are very important and weve seen it in adults and now seen it in children as well. And this is going to be a key part of how we think about oing back to school. You mentioned dr. Fauci from his testimony last week before congress, dr. Fauci said kids over 9 years old can transmit the coronavirus as well as adults as some schools reopen. I want to play you the comments of dr. Fauci in questioning from representative maxine aters of california. Now this president who expects us to believe him rather than the medical experts is saying children are almost immune. Is that an expert medical conclusion, dr. Fauci . What does that mean, children are almost immune from this virus. Dr. Fauci generally when you say a person is immune, theyre protected from getting infected and children who get infected. This is not an expert medical conclusion we have documented somewhere . Dr. Fauci if youre talking about a conclusion that children in general are immune, that children do get infected we know that, so therefore theyre not immune. I must say when children get infected that when you look at consequences they do much better because if you look at the hospitalizations children have a much lower rate of hospitalizations than adults. In fact the curve goes way up as you get older and older and when you get to the age group of children, they generally do not get serious diseases much. I understand that and have been listening and understand what youve just described. But what i was asking really is about this president s latest comment that children are almost immune and so i think i ot the answer to that. Host let me ask you about immunity among kid and others, how will we know when immunity presents itself . How will that become apparent in treatment of patients . Guest this is a complicated issue. So the atlanta body test is a test that looks at the Antibody Test<\/a> is a test that looks at the response of the virus and is going on through multiple groups including our federal government in multiple cities looking at the Community Level<\/a> in certain cities and looking nationwide to see how many people actually have had evidence of infection, whether or not they realize it. Because another thing weve seen is that up to 40 of people will have no symptoms whatsoever. So what i mean is they dont have any idea, they dont remember having symptoms but we can find evidence from their blood that theyve had an immune response or antibodies. So what is going on right now in Childrens Hospital<\/a> is a big part of this in d. C. , particularly in the pediatric population. We really have no idea what percentage of children in the city, for instance, new york or in d. C. Where there were large number of cases, what percentage of the children have actually been infected because we know that they are less likely to get severe disease. So the zero prevalence is really going into a population and figuring out how many people have actually been infected. The second part of that thats really complicated and waiting to find out is how long do those antibodies last and are those antibodies even protective against a second infection if this came around again in your community . Host before we get to callers let me ask you one more thing about the severe side effect that happens among a very small number of kids called multiinflammatory syndrome, misc, how prevalent is it and tell us a little bit about its symptoms. Guest as i mentioned at the beginning, this was after we had seen the first wave of infections throughout the United States<\/a> and really throughout the world, right around the end of april and the beginning of may, our colleagues in europe and then right away right after that in the United States<\/a> we started seeing this different presentation associated with sars covid19 infection and for the most part these children dont have symptoms of covid, meaning not but we can find evidence with antibodies in their blood that they recently had it. And what these children are coming in with is what we call hyper inflammation or too much you mean immune response. Children, for whatever reason, and we are studying this, is it something about the children, is it something about the virus that has changed, for some reason, that a mean response is not turned up. They show up with prolonged fevers and a variety of organ systems involved, whether that is their heart, their coronary artery, their kidneys, their liver, their skin, redness of their eyes, multiple ways they can present. The good news is there have only been around 300 cases in the United States<\/a>. All of our colleagues are putting our Heads Together<\/a> to come up with the best treatment. The good news is they do seem to respond to antiinflammatory treatments. Each hospital is doing a variety of different things. We are going to soon have information about these children six months down the line from all of these different treatments we have been using. Host we have calls waiting on our guest, dr. Roberta debiasi. Good morning in nashville, go ahead. Caller good morning. Old, basicallys the last year of his adolescen ce, sliced a consider him an adolescent, even though he is 21, he got it, his roommate got it. He had four days of fever and maybe six hours of gastrointestinal upset, and then was fine. He is going to have the Antibody Test<\/a>. He is under the care of our doctor. Hes going to have the Antibody Test<\/a> in a couple of weeks. Middle of august is what the doctor said. He is being monitored. Of course, he is fine. His school, middle Tennessee State<\/a> university, he will be a senior this year, they are having inperson classes. I guess my biggest concern is him getting it again and or having some adverse effect in the future. Did something happen in his body that we need to be worried about . Like a said, he is fine, he feels great. He is a very good eater. I think a lot of the information problem with kids has to do with their diet. Far too manyeat carbs, fat, sugar, and salt in america. He is a healthy kid. He is doing well. I guess my question for you is, effects. Affects i know it is hard to say because nobody really knows what will happen to the kids that have had it. I am worried about his internal organs. He did not have the respiratory issues, but is it going to come back . Will you be ok in the future . Will he be ok in the future . Host thanks, derby. Guest you are asking the same questions we ask in our families, communities, and schools. How is this affecting our children and how will we know and when will we know . We all have to remember even though it feels like we have been home forever, as has been going on only for several months. In the d. C. Area, we have only had cases in children from around march. We have less than six months of followup on these children. Like your son, the vast majority of children will be completely fine. Six years fromou now we will not know more and perhaps there may be some side effects. Someone had pneumonia, it could have longterm effects on their lungs. It is also possible they will have no longterm effects. We dont have the answer to that. To tellif people try you they have the answer, it is not true. We do not have enough longterm followup on these children. Children with inflammatory syndrome, we are more focused on their hearts and the coronary arteries because we know from a similar presentation of kawasaki disease that those children can have longterm issues with her heart. That is a very intense area of focus across the world, to follow up very carefully on children with multiinflammatory disease. As a mention, that is a very small number of children, in smaller than the number that have the typical pulmonary disease of covid. Your question about going back to school and you are worried it will come back, it is possible there will be more waves of disease. We are seeing this now. We had this short time where things seemed to settle down on the northeast coast. But now we are seeing large numbers of increases across the south, southwest, california, and out west. Point of how we decide when it is appropriate to go back to school. The very first thing we need to look at is the local situation. I mean the county, the district even, because looking at a state is not helpful. It can be vastly different what is going on in her parts of different states. The schools are working closely with the Health Departments<\/a> and jurisdictions. That is the first step deciding whether we can take the step one decision to have inperson classes. An editorial cartoon over the weekend capturing perhaps some of the dilemma parents face. Damned ifyou do and you dont. Megan is on the line. I want to give my sincere apologies to the woman whose son was affected. I hope everything works out well. We live in hempstead, maryland. We have people leaving states like new york and florida, hotspots, and they are coming to different states even though they were supposed to put mandatory restrictions. Going back to school i do not believe is a wise thing to do. I dont to get has to do with their diet. Children are less immune to getting this. Should we guest not go back . World we know it is better for children to be in school, and not just for academic reasons, there is a host of reasons why going back is important. School,ing elementary primary school, there are socializations that are not fear and theoretical damage. When we weigh the risk and benefit of going back, we are not saying staying at home is a harmless thing to do, and we cannot compare that to the potential risk of going back. We know that we have had huge increases in anxiety russian, concerns about suicide, children being targeted on the internet with pornography because people know they are at home. We have people with special needs not getting access to their care, occupational and physical therapy, hearing interventions, children who are develop me disabled or not ting to live or not children who are developmentally disabled are not getting their care. Children who depend on school for their food. We can talk about for an hour on this. That does not mean we say everyone must go back to school. Was it does mean we have to carefully weigh the known harm against the potential risk, and that risk is vastly different in different communities. There is no circulation. When they way their riskbenefit in maine, it is in favor of going back because there is a harm if they stay home. In new york, there was a large outbreak, but new york is a model and they hardly have any circulation going on. A person cannot go to new york because you have a higher amount of certain. Know those to counseling will have to know that is very specific. He could be the number of over evan date. Be the number of over a sevenday period. It is very clear there are many parts of the country where things are in control and not in control cannot have a onesizefitsall. You feel like there is any attentive meant . Any protective equipment . Guest we learned from what happened in new york because that huge wave that overwhelmed the Health System<\/a> overwhelmed other parts of the country, including d. C. To very significant shutdown measures. That really did flatten our curve in the d. C. Area. We had lots of cases, but they did not come in and twoweek period. We did not get overwhelmed. We had enough protective gear. Our icu did not get overwhelmed our icus did not get overwhelmed. We did not have that situation, but that is a direct effect of people taking this seriously and not allowing the number of cases hand, markedly out of like we are seeing in some parts of the south right now. Host everyone is on our parents line. Ift number is 202 7488000 you are not apparent, that number is 202 7488001 caller i wonder if there has ever been data taken on these children of whether they have had all of their childhood inoculations because it seems to me because they have had inoculations recently, they are kind of covered somewhat for all diseases. And i have another part to my question. What happened to the home testing kits the president promised us in april . Host ok, donna. Guest the first question about vaccinations, unfortunately, vaccines for different pathogens, for instance against the pneumonia bacteria, will not protect you against a viral pneumonia like influence or covid. There is not crossprotectivity. We have not seen that children with no vaccines are likely to get covid. Conversely, we have fully vaccinated children, the vast majority of kids that get this disease, they are not less likely to get covid. There is not a crossreactive protectivity you are suggesting might exist. What was the second part . Host she asked about the availability of home test kits. Guest we want to be able to do testing on a bigger level than we have. We are doing much better in the United States<\/a> with access to testing in general. We cannot all just do a test in our house we have learned testing is not the whole answer. In some cases, it can give a false sense of security. If i was aware of one of my family members that had covid and i was exposed to them, there is a 14day window where i could develop symptoms. If i do a test five or 10 days after that exposure and it is negative, that does not mean i am not infectious because i could develop it in the next three days. This was seen in the camp outbreak i told you about in georgia. You had to bring a piece of paper and say you had a test within 12 days of showing up to camp. In the additional 12 days, the children and adults were in the community doing other things. The only way testing would be helpful is if you could do a test on yourself every day before you go off and do something. That will not be practical even with a homebased test. It is too expensive and there will not be enough tests to do that every single day. We need to have tests when someone has symptoms in a School Setting<\/a> or office so we can do Contact Tracing<\/a> and follow the direct contacts with tracing to see who needs to be quarantined and isolated this is the part we are all still learning about. What is the frequency of testing that is best so we can keep people home and away from work or school as short as possible without putting other people at risk. One last thing i wanted to say. There is interest in the salivabased test. We do not know how those perform compared to our standard blood test. But that is one area we are studying at childrens trying to look at how well the salivabased home swabs will perform. Host dr. Debiasi a couple of times mentioned the outbreak at the georgia camp. Coronavirus infected scores of children and staff at georgia sleepaway camp. Good morning. Caller good morning. This is lauren from shepherdstown. You said in an ideal world, kids should be back at school. I agree. I am a parent and a teacher. We are talking about schools across the country that have been chronically underfunded. I am aware of schools where windows cannot open. Plenty of classrooms of my colleagues do not have windows at all. Finally, we have terrible ventilation systems. What do you say to those childrens parents and the teachers teaching in those circumstances . What is the ideal world then . Guest this is a great question. When we talk about going to school, lauren is a teacher and on the frontline. We talk about doctors and nurses on the frontline. Teachers will be on the front line, too. What we talk about when we go back to school is to not go back to the way it was. Let me take one step away from the situation she is describing where there is not good ventilation. The first step is looking at community circulation. We do not want to open schools when there is rampant circulation in the community. There should not be even be an attempt to have inperson classes. If you are in a region where it is controlled but there is still a bit of circulation, that is what is going on in virginia and maryland, then it is reasonable to think about opening schools. But then you have to look at the specific school. Every school even within a district is not going to be able to make the same decisions. Because, as lauren mentioned, if you have the ability to move your children to other Community Locations<\/a> to spread out the children, that is a big difference than a school where everyone has to be in one closedin smallspace area with windows that do not open and ventilation that does not work. That is a huge difference from a school where there can be outdoor classes for the summer and fall months, where there could be a movement to use other underused Office Buildings<\/a> that could be used for classes. It will also differ depending on the grade level of the kids. Elementary school may be more conducive to keeping kids in small cohorts and perhaps the teachers rotating rather than kids moving around all day. In high school, that is more challenging to do because there are different subjects and levels and the kids typically need to be moving around. Get back to laurens answer, if you are in an area with a small amount of circulation, those concerns about the ventilation are less of a problem but not zero. But if you are in a place with lots of circulation, they are a huge problem because ventilation is important. We want to keep windows open as much as we can. We want to be outside with the kids as much as we can. If you are in a situation where that is not possible, the risk level is going to be higher. The other point this teacher pointed out is we do worry about the children, but as we have heard from the data, they may not become as sick but we do need to worry about the teachers. And the teachers that have underlying conditions that are older. All those things need to be taken into consideration in a particular school making the decision about when to go back and how we go back. Host our guest is dr. Roberta debiasi with Childrens National<\/a> medical center. We go to california, eva is on the line. Caller thank you. I have a question. My granddaughter is 12 years old. She will see her doctor. When she was three years old, she had a rash like i see on tv happened to the kids. Could that be connected . Should we mention to the doctor . They said it was an allergy. Guest there are many, many causes of rashes. Your doctor will be able to take a history and get all the information about what happened before and what is happening now and make a judgment about whether things are related. For instance, there are rashes due to medications, due to changing your laundry detergent, due to other viruses, strep throat. There are many reasons why someone would have a rash. We dont want everyone to think every rash you have means your child has this extremely rare syndrome. It is unlikely. Host the caller asked about vaccines children are required to get to go to many schools. With the inability to see doctors or get the vaccines, how concerned are you that kids are prepared to physically go back and have the vaccines done before they enter the School Building<\/a> . Guest great question. In d. C. , we use schoolbased clinics to make sure kids are getting vaccinated. That is the main way vaccines are obtained. That is another reason why keeping schools closed may be a problem. I will say it is extremely important everyone get their influenza vaccine this year. It is almost impossible to tell a child coming to you with influenza or sarscovid infection. The more we can prevent influenza, the less confusing this will be as our societies open up. The less influenza we have circulating, the easier it will be to understand what is going on with covid. One thing we have not touched on is when we open up our society, school, businesses, communitylevel activities, we make the decision at the point when things are in somewhat control. But the most important part is to not let our eyes off the ball. We have to continue to survey, its disease comes back because of those changes. We have to be nimble and able to pull back if we need to. The ability to do this will be critical for any decision we make about school or any other reopenings. Host john is next up in palm bay, florida. Go ahead. Caller good morning. Dr. Roberta, it seems we are not prepared to open up schools right away right now. We have some schools going back next week. The way you sound and the way the president and our governor here sounds, we need to hold back and maybe go back in january because we do not have a plan. I am a schoolteacher and a basketball coach. And we are still trying to have sports. I would like to get your opinion on sports for high school students. Host i will let you go. Go ahead, doctor. Guest you are in florida so you are kind of in the hot seat right now. I think this caller is highlighting that the local situation really does matter. One point you made is that we do not even have to say we are absolutely not going back to school for the entire year. In that particular location, it might be appropriate to have a delay and put in some measures to distance again so we can get the rate down where it is a safe number to open the schools. As we saw in march, when we all did a very good job of distancing and shutting down, which is not a permanent solution by any means and it is harmful to people socially, economically, and otherwise, but if we do that for a short period , we know that drives the rate of transmission down and puts you in a situation where you could consider opening the schools in a safer way. The question about sports is important. Not all sports are equal. If you are outside doing crosscountry running practice and everyone is far away from each other and outdoors, that is very different from a contact sport like basketball in an enclosed area in a gym where there is no way to not be within six feet of people. You are breathing heavily and in an enclosed space. You cannot do a blanket statement for sports. I will give an example. For soccer, it might be more appropriate ramping up to focus more on drills and skills where the kids can be outside working on all those important skills and drills but hold back on the competitive, intramural competitive activities. If you are going to have some competitions, keep it to a cohort of kids. Not have interschool competitions. Certainly not going to different states to compete. All of these are nuances that have to be taken into account in will we talk about going back to sports. Host what do you think about these socalled pods people are forming for education . I dont know about sports, but for kids to be together in a setting of known other kids and parents. Guest i think what youre talking about is if you choose not to go back to the full School Setting<\/a>, could you have a Smaller Group<\/a> of children doing distancelearning in a Smaller Group<\/a> at home so you are getting a little bit of the benefit of the socialization, the Group Interaction<\/a> . I think for some families, that may be a good option. We did not talk about this. I talked about the first level of look at your Community Level<\/a> of circulation. That is number one. Number two is to look at the specific school and situations. What is the ability of that school to do all the things we know will decrease the use of transmission . The masks, the distancing, alternating days, using more outdoor space, open windows, all those things. How good can the school do that . The third is even if all of those things are great, if you are in a household with four elderly people and a disabled child at higher risk, for you personally, it may not be the right thing for you to have your children going back to school because you will have problems, increased risk in your own household. This is the scenario where i think smaller pods are a reasonable thing for people to consider. But again, you have to know what the people in your pod are doing because the risk is when they leave the pod. If your friends in the pod are going to house parties and the beach and hanging out, that is more risk than going to a school where there are measures in place. Host a couple more calls. We will go to david, a parent, in fairfax, virginia. Good morning. Caller my question is more long term the Immediate School<\/a> year coming up. I am aware the cdc and various organizations are saying they estimate the number of people who have cases likely is about 10 times, the number is 40 Million People<\/a> probably have had it. My question is, at what point do you think we may reach some herd immunity . New york was awful for a time and it has come back down significantly since then. At what point do we see things slow down out of the natural process of a viral infection where the community has reached some sort of immunity . I know we dont know everything about covid right now. Is there some research that says at some point, we will reach a Tipping Point<\/a> and this will come down naturally . Host thanks, david. Guest this caller is right. If you let a disease go rampant, eventually it will run out of people to infect. The concept of herd immunity is when you get tweet critical Tipping Point<\/a> of people who have had or developed immunity that it is harder for the virus to spread from person to person. For some diseases, it is very high. You need to have 80 and 90 of people who have had infections to prevent it from spreading in a community. With this virus, we think it has to be at a minimum 60 to 70 of people. We are nowhere near that. In new york, we have looked at how many people have developed antibodies. It is still less than 10 in most big cities that have had an outbreak. In washington state, it is only Something Like<\/a> 3 of people that have had infection. We are nowhere near where we need to be for herd immunity. We cannot afford to just allow the virus to go rampant. Even in a place like new york, it completely overwhelmed the system. It is something we cannot allow in this day and age. We cannot do that ethically. Another point i think is important is all these numbers and herd immunity we are talking about our only true if the antibody or the immune response is permanent or durable, meaning at least six months to a year. What we are learning about these antibodies is they may not last that long. Many studies are being done to systematically look at how long those antibodies stay in the blood and trying to correlate at a quantitative level done in a lab, does it prevent infection . Those are all unknown questions we do not have the answer to get. But we are looking at it carefully. Host on twitter, an observation that children are bug bombs. You seem to get sick sometimes just from looking at them. Lets get a call from rodney in houston, texas. Caller good morning. Dr. Roberta, i would like to ask this question. Im asking you to be a straight shooter. I am from houston, texas, third ward where george floyd was from. I went to the same school. The reason i am bringing this up, we hear a lot of issues about black lives matters. Theres a lot of incidents of prejudice in schools. The teachers are being put at a disadvantage. This is a scenario. Lets say a white teacher is teaching black kids. The kids are not being taught how to wear the mask at home, or maybe they are, and the kid get that disease. What if a parent wants to accuse the teacher because they said you did not Pay Attention<\/a> to my kid, or my kid was not allowed to watch his or her hands, and they was not wearing their mask correctly, you did not do anything . To me, the teachers are at a risk. It seems like a lot of education should given in the home, from the schools, some kind of curriculum. And the last question i want to ask you, are we glad this is not a Nuclear Attack<\/a> . Host rodney, i will let you go. We are running short on time. Guest these are really important points. There are so many issues when we think about this virus and how it is affecting our society. Texas is an area that has a lot of circulation in several areas. I am not certain of the specific area where this person called from. The decision to go back to school will probably not be appropriate in a community where there is an controlled large amount of transmission, regardless of any other mitigating things we can do to lower risk in an area where there is low amount of circulation. None of those measures are going to cancel out the primary determinant, which is how much is going on in the community. The issue of Racial Disparities<\/a> is really important. We have seen in adults and children, and it has been confirmed in the study our center is putting out soon, the children ofhispanic ethnicity or black race are at higher risk for infection as well as hospitalization. We are also seeing this in our native american population. There are differences in our communities about who is at highest risk. We cannot ignore that. We also have to look at some of those sync up relations are at the higher risk of harm if they do not have access to food, education, and interventional services, Mental Health<\/a> services, all the things that Everyone Needs<\/a> but are at a higher need in those populations. It is a very complex issue. There really is not a simple answer. Host dr. Debiasi is the chief of Infectious Diseases<\/a> division at Childrens National<\/a> hospital. We look forward to talking to you again. Guest thank you. Thank you for being here this morning. The two sides met over the weekend the democratic theers in congress and chief of staff, mark meadows, and the treasury secretary, steven mnuchin. Where are we on this monday morning . Where do we stand on a possible breakthrough for coronas virus relief . It doesnt look like there was a ton of rake through, so to speak over the weekend, though the talks are continuing. Speaker pelosi and senator schumer, along with the chief of staff and treasury secretary mnuchin were huddling over the weekend. More meetings are expected. At this point, there is a fundamental disagreement on whether to do a stopgap measure wouldkinny measure that cover the eviction crisis and the matter of expanded Unemployment Benefits<\/a> which have now lapsed versus a broader package closer to the one House Democrats<\/a> past several months ago. The senate is going to do this week is they are going to have some votes on some various Unemployment Insurance<\/a> proposals without any sort of agreement, they are not going to go anywhere. So we are in this waiting for an ineement, the house is not town this week. They are waiting to find out whether there is a deal. Passed what they have called the heroes act, the 3 trillion measure. Now on the floor of the senate is the Senate Republicans<\/a> measure, a piece called the heels act which includes a reduction in unemployment increases to 200 weekly and would include 1200 for individuals, 2400 per couple, a new round of ppp program loans, Liability Protection<\/a> from covid19 lawsuits, money for Virus Testing<\/a> and 105 billion for schools and colleges. Liability piece which is near and dear to the heart of Mitch Mcconnell<\/a>, is that part of the negotiations from what you understand . Guest my understanding is that it is still part of the negotiations. The white house chief of staff is trying to make clear that this is a priority for the white house. But, if there is a skinny bill, it may not be as necessary because what we heard from the when these last week press secretary was asked whether or not this was a priority for president trump, she basically referred the question to senator mcconnell. Mcconnell will certainly want this in, but it is curious that this is not a big negotiation. This is a negotiation between the two Democratic Leaders<\/a> on the white house. We are not seeing Kevin Mccarthy<\/a> or Mitch Mcconnell<\/a> be in the stocks themselves. Host i was going to ask you about that. It appeared that way in the previous relief bills premuch the same way as well. Why are not Republican Leaders<\/a> part of that negotiation as a direct line and set of Democratic Leaders<\/a> . Fort part of the problem senator mcconnell now, and guess the same is true for the house that you are in a situation where mcconnell is freely admitting that there are maybe 20 members of his conference who wont vote for much of anything. Of the 50 plus Senate Republicans<\/a>, there is at least one third, maybe up to a half, who think enough has been done in terms of Economic Relief<\/a> related to covid19. Box,hen you are in that mcconnell has less leverage because ultimately, not even just to get over a filibuster, not even because their 60 votes, but frankly, mcconnell needs democratic votes to get to a simple majority. Host one more thing. This is from the lead editorial from the quote new york from the new york times. They are talking about the coronavirus cases reported in congress, most particular, congressman Louie Gohmert<\/a>. They pointed out a couple of months ago that the white house kitsffered 1000 rapid test to congress. Both to leader mcconnell and Speaker Pelosi<\/a> turned those tests down. Is there pressure to improve testing among congress, staff and the press on capitol hill . Certainly is, particularly in the aftermath of the Louie Gohmert<\/a> situation that played out last week. We have been hearing rumblings mccarthy, the House Republican<\/a> leader, the minority leader may be trying to come up with a system to get some sort of Testing Available<\/a> for republicans in the house. It may be broader than that, outside of the normal scope. Last i heard, Speaker Pelosi<\/a> and others were and saying it was up to the office of the attending physician. The problem that is going on in congress is that members keep going home to their districts and coming back. When you have that many people traveling to that many different parts of the country, there is a real argument for their needing to be more testing, and certainly my colleagues in the press corps on capitol hill regularly, a lot of them are getting tested. Close contact in with mr. Covert. Theres certainly this concern, even among the press corps that there is probably more testing that we would like to see as well. Host our guest is a familiar face here on cspan, the white house and congressional chief correspondent for roll call. Thank you so much for joining us this morning. Nice to see you. Thank you. Thank you very much. We will start by providing information on our response to isaias. L storm a very interesting name","publisher":{"@type":"Organization","name":"archive.org","logo":{"@type":"ImageObject","width":"800","height":"600","url":"\/\/ia801904.us.archive.org\/13\/items\/CSPAN_20200803_203600_Washington_Journal_Dr._Roberta_DeBiasi\/CSPAN_20200803_203600_Washington_Journal_Dr._Roberta_DeBiasi.thumbs\/CSPAN_20200803_203600_Washington_Journal_Dr._Roberta_DeBiasi_000001.jpg"}},"autauthor":{"@type":"Organization"},"author":{"sameAs":"archive.org","name":"archive.org"}}],"coverageEndTime":"20240716T12:35:10+00:00"}