#104 - COVID-19 for kids with Olivia Attia

KEYPOINTS

• 01

  A kid-level Q&A recorded early in the pandemic

  Recorded in April 2020, this short episode has Attia's daughter Olivia asking her own questions and those of other kids. He says up front that he is 'pretty much a newb' on viruses, despite months of reading. His answers reflect what was known at the time. Several, such as surface transmission and when school would return, were openly uncertain.

• 02

  Viruses can't copy themselves without a host

  Growing taller or growing longer hair comes from your own cells dividing. Viruses lack the machinery to divide on their own, so they infect a host and use its cells to make copies. Many viruses do this without causing much harm.

• 03

  Coronaviruses are astonishingly small

  A virus is about 100 nanometres wide, and a nanometre is a billionth of a metre. Olivia guesses hundreds could fit across the cut tip of one of her hairs. Attia says it is about a thousand, which is why they can only be seen with special microscopes.

• 04

  SARS-CoV-2 probably jumped from bats via pangolins

  Attia explains that the virus is called SARS-CoV-2 and the disease COVID-19. Based on the genetic analysis available then, he says it probably went from bats to pangolins and then to people. Pangolins are small, scaly, endangered anteater-like mammals, illegally poached in China, partly for their scales. The first human case was probably in Wuhan around November 2019. He was describing the leading view at the time, not a settled conclusion.

• 05

  Earlier coronaviruses were deadlier but spread less

  SARS killed about 10% of those infected (one in ten) and MERS about 30% (one in three), but neither spread very far. Other coronaviruses cause nothing worse than a miserable cold. SARS-CoV-2 is harder to contain because it spreads more aggressively than flu.

• 06

  The US response was late and underprepared

  Attia admits this topic 'gets my blood a little bit boiling'. There was no adequate national stockpile of protective equipment. The US could have doubled down on developing tests or used tests others had made. It was also slow to work out how to handle infected people. South Korea had its first case at about the same time, yet the US already had more than five times as many deaths per million.

• 07

  Earlier quarantines would probably have helped, especially in dense cities

  Attia believes earlier action would have helped in New York, New Orleans and probably Florida. In New York, people sit close together on the subway, which amplifies spread from a virus passed on by breathing. He thinks New York did the best it could but started later than ideal.

• 08

  Herd immunity by deliberate infection is risky

  Olivia had been vaccinated against chickenpox, while Attia had the disease as a child, before the vaccine. Either way you're unlikely to get it again, apart from shingles later in life. With COVID, he says, nobody yet knew what immunity looked like or how long it lasted. And even if at least 80% (perhaps 95%) of people recover, some are at high enough risk that letting them get infected isn't acceptable.

• 09

  Kids are at very low risk, but they can pass it on

  At the time, not one person Olivia's age had died of it in the US. Risk rises with age and with conditions like high blood pressure or diabetes. Her real risk is giving it to a grandparent or someone vulnerable.