free c-span radio app. >> weeknights this month, we're featuring american history tv programs as a preview of what's available every weekend on c-span3. tonight, at 8:00 p.m. eastern, a police training film from 1964 on how to handle protests and civil disturbances, including techniques for mob control and the use of tear gas and batons. federal laboratories, inc, was a manufacturer of a riot gun used to fire gas canisters. watch "reel america, police training films" tonight beginning at 8:00 p.m. eastern. enjoy american history tv this week and every weekend on c-span3. joining us next is dr. roberta debasi of the infectious

diseases division chief at children's national hospital. thanks for being with us this morning. >> good morning. >> how many cases of covid-19 have you treated among children at the hospital? >> well, we started ten cases in the middle of march and we've now had over 600 children that have come to the hospital with symptoms. about a quarter of those have been admitted to the hospital. so about 150 of those. and about a quarter of those to a third of those have needed our intensive care unit. >> what's the pattern among children, what do you see and how are their symptoms different from adults? >> we really are seeing several different patterns of disease. so of those 600, the vast majority of them, and this has been seen in other parts of the country, as well. they have mild to moderate illness, where they have typical respiratory symptoms, fever, cough, runny nose, sore throat.

so mild, moderate illness. but the children admitted fall into several different categories. some of them from what is similar to what the adults have seen with the severe pneumonia or clotting issues. but then we have another set of children who are very young who have more just non-specific fever, what we call neonatal sepsis type picture. then the third category, we have about 50 of these children that have come in since the beginning of may, with this multisystem inflammatory disorder, which is a little bit different where they don't have the respiratory symptoms, but are coming in with prolonged fevers and other symptoms that show inflammation throughout their body, including their heart or their coronary artery or other organs. >> since the start of the virus broadly, what do you think we have learned, how has our treatment changed in terms of treating children? >> well, we have certainly

learned much, both in the adults and in the children. but we have very much still that we need to fill in the gaps. so what we have clearly learned is that in the beginning, we thought, and we heard from other countries, that perhaps children were not able to get infected or not infected as much as adults. because it's been very clear that the children are hospitalized at a much lower rate than adults. and that's really important for everyone who is listening to know. even though i'm telling you about these severe cases, the vast majority of children do not end up in the hospital and have a mild-to-moderate illness. however, in the last several weeks and months, there are more and more data coming out of many countries, including the united states, that show that children clearly are infected. at all age groups. so for instance, even at our own center when we published a study looking at the different age groups, starting from 1 to 5 or

5 to 10, we did not see any difference in the number of infections across those age groups. however, it's the children that are younger or your vuvery youn seem to get more of those children that end up hospitalized. there was a very important study that came out just last week out of chicago that looked at the amount of virus that was out of the nose. it's obviously there. they're at higher levels, in some cases, than adults. what we don't know yet is how well does that virus that's there transmit to other children and to other adults. and there's many studies, including in the united states, there's the study of 6,000 people, which is going to be a cohort of 2,000 families looking carefully at how the virus is transmitted throughout those families, is it going from the

adults to the children or more likely going from the children to the adults. >> go ahead and finish your comment. >> i was going to say there's important studies in schools coming out of the united kingdom as well as germany where they'll be looking at the amount of transmission both by virus and antibody levels in both the students as well as the staff and teachers in those schools. >> our guest is dr. roberta debiasi. she's the infectious diseases division chief with the children's national hospital here in the nation's capital. welcome your comments, questions for dr. debiasi. if you're a parent, that line is 202-748-8000. here in the washington area you

see young kids wearing masks. >> there are certain circumstances where that doesn't apply. if you have a child under two years of age it's really not considered safe to do that, or a really developmentally disabled child that can't keep it on or has problems with their respiratory secretions, it's not recommended. but for other people over two years of age, otherwise normal children, really should be wearing their masks and this was highlighted again last week. there was a study of a -- unfortunately a large outbreak in a camp in georgia. and even though that camp took many measures that the cdc has recommended to try to distance, the one thing they didn't do was masks. they had children in cabins overnight and they were unable to use masks when they were in other congregate settings. there was a large number of people, almost 50% of the people

at that camp became infected. masks are important. this is going to be a key part of how we think about going back to school. >> you mentioned dr. fauci's comments on the infectiousness of children, the headline from cnbc on his testimony last week before congress, dr. fauci says, 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 and questioning from representative maxine waters of california. >> and so 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, that children -- whatever that means. what does that mean? children are almost immune from this virus? >> generally, when you say a person is immune, they're protected from getting infected.

and children do get infected. >> and so this -- this is not an expert medical conclusion that we have had documented somewhere? >> well, if you're talking about a conclusion that children in general are immune, children get infected so therefore, they're not immune. i must just say, congresswoman, when children get infected, when you look at the consequences, they generally do much, much better. if you look at the hospitalizations that children have a much, much lower rate of hospitalizations than adults. in fact, the curve goes way up as you get older and older. when you get to the age group of children, they generally do not get serious diseases, much -- >> i understand that. and i've been listening. and i understand what you just described. but what i was asking, really, was about this president's latest comments that children

are almost immune and so i think i got the answer to that. >> dr. debiasi, let me ask you about immunity itself among kids and others. how will we know when immunity presents itself? how will that become apparent in treatment of patients? >> this is a really complicated issue. so the antibody test is a test that looks at our ability to make a response to the virus and this is really what's going on by multiple groups, including our federal government, in multiple cities, looking at the community level at certain cities, looking nationwide to see how many people actually have had evidence of infection. whether or not they realized it, because, another thing we've seen is that up to 40% of people will have no symptoms whatsoever. so what i mean is, they don't have any idea, they don't remember having symptoms, but we can find evidence from their blood that they've had an immune response or antibody.

so what is going on right now and children's hospital is a big part of that, we have no idea what percentage of children in a city, for instance new york or in d.c. where there were a large number of cases, what percentage of the children have been infected. we know that they're less likely to get severe disease. so the sero prevalence is going into a population and figuring out how many people have actually been infected. and the second part of that that is really complicated is how long do those antibodies lasting and are they protective against a second infection. >> before we get to calls, let me ask you about one more thing, about this severe side effect that happens among a very small number of kids called multi

inflammatory syndrome in children. how prevalent is it? >> as i mentioned in the beginning, after we have seen the first wave of infections throughout the united states and 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-cov-2 infection. they do not have symptoms of covid, don't even remember having pulmonary symptoms, but we can find evidence with antibody in their blood that they recently shhad it. and they're coming in with hyper inflammation, or too much immune response to the virus. as i mentioned to you, it's appropriate to make antibody and try to clear a virus when you're infected. but these children, for whatever

reason, is it something about the children, the virus that has changed, for some reason, that immune response is too much and is not turned off. and the way they show up is with prolonged high fevers and a variety of organ systems that are involved, whether that is their heart, coronary artery, kidneys, liver, skin, redness of their eyes. there have only been around 300 cases in the united states but they've been across the u.s. and all of our colleagues are putting our heads together to come up with the best treatments and the good news is they do seem to respond to what we call antiinflammatory treatments. each hospital is doing a variety of different things. and we're going to soon have information about these children six months down the line from all of these different treatments that we have been using. >> we have calls waiting. our guest is dr. roberta

debiasi. your comments, 202-748-8000 for parents. >> caller: good morning. my son, 21 years old, okay, basically the last year of his adolescent, he got it, his roommate got it. he had four days of fever and maybe six hours of gastro intestinal upset and then was fine. he is going to have the antibody test. he's under the care of our doctor. he's going to have his antibody test i guess in a week or two, a couple weeks. i'm not sure when they're planning -- the middle of august is what the doctor said. he's been monitoring, of course he's fine. his school, middle tennessee

state university, he will be a senior this year. they are having in-person classes. i'm -- i guess my biggest concern is him getting it again and/or having some kind of adverse effect in the future. did something in his body that we need to be worried about? like i said, he's fine, he feels great, he's a very good eater. i think a lot of this inflammation problem with kids has to do with their diet. i think kids eat far too many carbs, fat, sugar and salt in america. and he is a healthy kid. he is doing well. i guess my question for you is, long-term effects. what's going to -- i know it's hard to say because nobody really knows what is going to happen to these kids who have

had it. i'm worried about his internal organs. i'm worried -- he didn't have the respiratory issues, but is it going to come back and will he be okay in the future? >> thanks, barbie. >> well, you know, this person is a mom and so am i. you're asking all the same questions that we ask in our families and in our communities and in our schools. this is the question. how is this affecting our children and how will we know and when will we know? this is really only been going on now for several months and here in the united states, in the d.c. area, we've only had cases since, you know, really in children around march. so we have less than six months of follow up on these children. what i will say is, like your son, the vast majority of children are going to be completely fine. i can't tell you six years from now, we're not going to know more and perhaps there may be

some side effects, for instance, if someone had in a pneumonia, could they have long-term effects on their lung, it's possible. but it's also possible that they'll have no long-term effects. we don't have the answer to that. i think if people try to tell you they have the answer, it's really not true. we just don't have enough long-term follow up on these children. the children the inflammatory children, we're focused on their heart and the coronary arteries because we know from a similar presentation called kwa with a sake disease, that those children can have long-term issues with the blood supply to their heart. they're following up very careful carefully on these children who had the multiinflammatory disease. your question about going back to school and worried it's going to come back.

it is possible that there will be more waves of disease. we're seeing this now, right? we have the short period where things seemed to settle down on the northeast coast, but now we're seeing these large numbers of increases across the south, the southwest and in california out west. this gets to the point that i'm sure some of the other callers are going to call in, how do we decide when it is appropriate to go back to school and the very first thing that we need to look at when we do that is the local situation. and when i say local, i mean the county, the district even. because looking at a state, even, is really not helpful. it can be vastly different what's going on in different parts of different states. so the schools are all working very closely with the health departments and jurisdictions as the very first step in deciding whether or not we can take that step one decision to have in-person classes. >> a cartoon over the weekend capturing some of the decisions

parents face. check one, damned if you do, damned if you don't. this is megan on our parents' line. hi, there. >> caller: hi. how are you? >> fine, thanks. >> caller: my apologizes to the woman whose son was infected. we would like to know, we live in maryland. we have people that are actually leaving states like new york, florida, which are very hot spots and they're all coming to different states, even though they were supposed to put state mandatory districts. as far as children going back to school, i don't think it is a wise thing to do. i don't believe it has to do with anything with their diet. obviously, children are less immune to getting this. they don't have a severe side effects. when the children go back to school, in-person learning right now when they have no vaccine nation is really not recommended. a lot of people want to get back

out there and get back to life and back to work. we all do. but going back to school in person is not good and the woman who called in before, her son gets it again, he may get it worse because we have no clue what this virus is actually doing. but these children can go to school in about 25%, i believe, the teachers are 55-plus. most people that are on the older age group actually do end up getting it and get more severe problems even if they don't have underlying conditions. >> great points that this caller raised. i want to touch on a couple of them. the first is this concept of should we just not go back to school, period. i think this is an important point that almost everyone agrees on. if in an ideal world, we know it's better for children to be in school. it's not just for academic reasons. there's a host of other reasons why going to school is very important. and for this i'm talking about elementary school, primary

school, high school. there are social implications that are not a theoretical damage. we've already seen this. and so when we weigh the risk and benefit of going back, it's not like -- just staying home is a harmless thing to do and we can't compare that to the potential risk of going back. so, for instance, we know already, we've had huge increases in anxiety, depression, concerns about suicide, children being targeted on the internet with pornography because people know they're at home. we have children who have special needs who are not getting access to their care. occupational therapy, physical therapy, hearing interventions. children that are developmentally delayed are not getting their ieps met. we have 12 million children don't have access to food in our country and they dependent on the school to get that food. we have a whole host of reasons.

we could talk for an hour just about this. all i'm saying is, that does not mean we say, everyone must go back to school. what it does mean is we have to carefully weigh that known harm against the potential risk and that risk is vastly different in different communities. for instance, in maine there is basically no circulation. when they weigh their risk benefit in maine, it's clearly in favor of going back because there is a harm, if they stay home, and there's a very low risk of transmission because of their community. the caller mentioned new york. it's true, there was a large outbreak in new york, but right now new york is a model. maryland and virginia are -- i as a marylander or virginia person cannot go to new york. so i think this is really key. people have to know that the

locals are very specific where dls -- what you call a hot spot or a large amount of transmission. we measure this by a variety of things. it could be the number of cases per the amount of population, it could be how overwhelmed the hospitals are, it could be the percent positive of test that is are coming up. we have many ways to monitor that. it's very clear that there are many parts of the country where things are in control and there's many parts of the country where they're not in control and we can't use a one size fits all approach to bringing kids back to school. >> did you ever feel overwhelmed at children's national and did your doctors, nurses, other professionals ever have any issues with equipment, personal protective equipment, ventilators and things like that? >> we were very lucky in the washington, d.c., region and this is not specific to our hospital. we learned from what happened in new york, because that huge wave overwhelmed the health system warned other parts of the

country, including d.c., to do very significant shutdown measures and that really did flatten our curve here in the d.c. area. we've had lots of cases but they did not all come within a two-week period. no, we did not get overwhelmed. we were quite busy. but we had enough personal protective equipment, our icus within the region did not get overwhelmed including at children's hospital. we were able to absorb some of the icu load from the younger adults, so up to 35 years of age. we were taking care of some of those patients. we did not have that situation. that's a direct effect of people taking this seriously and not allowing the number of cases to get markedly out of hand like we are seeing in some parts of the south right now. >> not surprisingly, everyone is on our parents line, that line is 202-748-8000. donna is in florida.

go ahead. >> caller: i just wonder if there's ever been data taken on these children of whether they've had all of their childhood inoculations because it seems to me that because they've had inoculations recently, they're 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 back in april? >> okay, donna. >> so the first question about vaccinations, unfortunately vaccines for different pathogens, meaning a vaccine, for instance, against the in a pneumonia bacteria, will not protect you against a viral in a

pneumonia for influenza or covid. we have not seen, for instance, a signal that children with no vaccines are more likely to get covid and conversely, we have perfectly well, fully vaccinated children, and that's the vast majority of these kids who get the disease, they're not less likely to get covid. there's not a protectivity that you're suggesting might exist. what was the second part of the question? >> she asked about the availability of home testing kits. >> yes. one part of this is that we want to be able to do testing on a bigger level than we have. we're doing a much better job in the united states with access to testing in general. but the caller is right, we can't all do a test in our house. one point, though, is we have learned that testing is not the whole answer and 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's a 14-day window where i could actually develop symptoms. if i do a test three days after that exposure or five days after that exposure or ten days after that exposure and it's negative, that doesn't mean that i'm not infectious because i could develop it in the next three days. and this was seen in that camp outbreak in georgia. one of the things they did in that camp, you had to bring a piece of paper to say you had a test within 12 days of showing up in the camp. that was not helpful at all. in those additional 12 days, those children and adults were in the community doing other things. so testing, the only way that would be helpful is if you could do a test on yourself every single day before you go off and do something. that's not going to be practical, even with a

home-based test. it's too expensive. what is really important is that we need to have tests when someone has symptoms. for instance, in a school setting or in an office, so that we can do what's called contact tracing and follow those direct contacts with testing to figure out who needs to be quarantined, who needs to be isolated. and this is the part that we're all still learning about, what is the frequency of testing that is the best so that 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 just wanted to say, there's interest now in these saliva-based tests. so far we don't know how those perform compared to our standard blood test. that's one area that we're studying at children's, head to head, trying to look at how well those saliva-based home swabs will perform in picking up cases compared to blood tests.

>> the outbreak in that georgia camp, there's reporting on it in several publications, including here and "the washington post," coronavirus infected scores of children and staff at georgia's sleepaway camp. lauren next up in west virginia. good morning. >> caller: hello. this is lauren from shepherd's town. i have a couple of questions. first you said in an ideal world kids should be back at school. i absolutely agree. i'm a parent and i am a teacher. but we're talking about schools across the country that have been chronically underfunded, poor ventilation. i'm aware of schools where windows can't open. plenty of classrooms of my colleagues don't have windows at all. and then finally we have absolutely terrible ventilation

systems. what do you say to those children's parents and to those teachers who are teaching in those circumstances? what is the idea world then? >> this is a great question. you know, when we talk about going back to school, lauren, who is a teacher and is on the front line, we talk about hospitals and doctors and nurses being on the front line, teachers are going to be on the front line too, right? so what we talk about when we go back to school is not go back the way it was. and so let me just step back one step from the situation lauren is describing where there's not even good ventilation. the first step is looking at the community circulation. we don't want to try to open schools when there's rampant circulation in the community. that's a nonstarter. everyone agrees on that. if there's lots of circulation, there should not be an attempt to have in-person classes. if you're in a region where things are controlled but

there's a bit of circulation, that's what's going on in virginia and maryland, we've kept nice, low rates, less than 1%, over the last several months, it's reasonable to think about opening the school. but then you have to look at the specific school. every school, even within a district that has the same data, is not going to be able to make the same decisions because as lauren mentioned, if you have the ability to, for instance, move your children to other community locations to spread out the children, that's a big difference than a school where everyone has got to be in one closed in, small space area with windows that don't open and ventilation that doesn't work. that's a huge difference from a school where there can be outdoor classes, a movement, for instance, to use some of the underused other buildings, office buildings that are not in use, could be reused for different purposes for classes.

and it also will differ depending on what the grade level of the kids are. for instance, elementary school maybe more conductive to keeping kids in small cohorts and the teachers rotating, rather than kids moving around all day. whereas high school, that's a little more challenging to do because there's different subjects and different levels and the kids typically need to be moving around. so, you know, to get back to lauren's answer, if you're in a school in an area where there is a small amount of circulation, those concerns about the ventilation are less of a problem but not zero, but if you're in a place where there's lots of circulation, it's a huge problem. ventilation is important. you've heard from the cdc, the aap, 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're in a situation where that's not possible, the risk level is going to be higher. the other point that this

teacher pointed out is that we do worry about the children, but as we've heard from all of this data, they get the disease but may not become as sick but we do need to worry about the conditions. all of those things need to be taken into consideration in a particular school, in making the decision about when to go back, who goes back, how we go back. >> our guest is dr. roberta debiasi with children's national medical center. we go to daily city, california. eva is on the line. go ahead. >> caller: thank you. doctor, i have a question. my granddaughter is 12 years old. she will see her doctor when she was three years old. could that be connected? should we mention to the

doctor -- >> well, there are many, many, many causes of rashes. your doctor will be able -- what we call, take a history and get all of the information about what happened before and what's happening now. and make a judgment about whether or not things are related. but, for instance, there are rashes due to medications, rashes due to changing your laundry detergent, rashes due to other viruses, rashes due to strep throat. we don't want everyone to think that every rash you have means that your child has this extremely rare syndrome. it's very unlikely. >> the vaccines the kids are required to get to go into many schools with the inability to see doctors and things like that, or get those vaccines, how concerned are you that kids are prepared to actually physically go back and have those vaccines done before they enter the

school building? >> this is a great question. there are many school-based clinics and in particular in d.c., we actually use those school-based clinics to make sure that kids are getting vaccinated. it's a major way that children vaccine delivery is obtained. this is true in many parts of the country and another reason why keeping schools closed may be a problem. just one other thing in the list of harms to children. i will say that it's extremely important that everyone get their influenza vaccine this year because you can imagine, it's almost impossible to tell a child that's coming to you with influenza or with sars-cov-2 infection. the more that we can prevent influenza, the less confusing this is going to be as our societies open up. whether or not your child is going back to school or not. the less influenza we have circulating and cases, the easier it's going to be for us to understand what's going on with covid. and one thing we haven't touched

on is when we open up our society, either that school or businesses or community level activities, we make that decision at the point where 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 how much disease comes back because of those changes. and we have to be nimble and fast and able to pull back if we need to. so the ability to do this is going to be critical for anything -- any decision we make about school or any other reopening. >> john is next up in palm bay, florida. go ahead. >> caller: yes, good morning. dr. roberta debiasi, it seems like we're not prepared to open up schools right away right now. we have some schools going back next week and the way you sound and the way the president and our governor here in florida sound, it's just that we need to

hold back, have some discipline and maybe go back in january. we don't have a plan. i'm a school teacher and a basketball coach. and we're still trying to have sports and i don't think -- i would like to get your opinion on sports for high school this year. >> sure. >> i'll let you go there. go ahead, doctor. >> yeah. i think you're saying -- you're in florida. you're in the hot seat right now. i think what this caller is saying highlighting again the local situation really does matter. and one point he made is, we don't have to say we're not going back to school for the entire year. in that particular location, it might be appropriate to have a little bit of a delay and, in fact, put in some measures to distance again so we can get the rate down where it is a safe number to then open the schools. because as we saw back 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 is harmful to people both socially, economically and otherwise, 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 also important. not all importance are equal. so if you are outside, for instance, doing cross-country running practice and everyone is, you know, far away from each other outdoors, that's very different than a contact sport like basketball in an enclosed area in a gym where there's no way to not be within six feet of people. you're breathing heavily and you're in an enclosed space. each sport -- you can't do a blanket statement for sports. for soccer, it might be more appropriate, at least for a period where we're just ramping

up, to focus more on drills and skills where the kids can be outside, they can be working on all of those important skills and drills. but really hold back on the competitive -- the competitive activities. so, for instance, even if you're going to have some competitions to keep it to a cohort of kids, not have interschool competitions, certainly not going from different states to each other to compete. all of these things are nuances that have to be taken into account when we talk about going back to sports. >> what do you think about these cohorts, these pods that some people are forming between parents for education? i don't know about sports, per se, but certainly for kids to be together in a setting of known other kids and parents? >> yeah, so i think what you're talking about is if you choose not to go back to the full school setting, could you have a

smaller group of children who are doing the distance learning but in a smaller group at home so you're getting a little bit of the benefit of the socialization, the group interaction, and i think for some families, that may be a good option, particularly if -- we didn't talk about this. the third situation -- i talked about the first levels, look at your community level of circulation. that's number one. number two, look at the specific school and the situations, like i answered several teachers. what is the ability of that school to do all of the things we know will decrease the risk of transmission? the masks, the distancing, maybe alternating the day that is the kids come, using more outdoor space. all of those sort of things. but the third is even if all of those things are great, if you're in a household with, for instance, four elderly people and a disabled child who is at higher risk, you may not, for you personally, it may not be the right thing for you to have your children going back to

school because you're going to have problems -- increased risk in your own household. this is the scenario where i think these 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 going to the beach and hanging out and -- that's more risky than, you know, going to a school where there's actually measures in place. >> a couple more calls here. we go to david, a parent in f r fairfax, virginia, good morning. >> caller: my question a little bit more long-term. but i'm aware that the cdc and various organizations are saying that they estimate the number of people who actually have cases likely, whether they've been thesed or not, is about ten times the number of confirmed. something like 40 million people, probably, have covid or

have had it and have recovered, asymptomatic or not. and my question is, at one point do you think that we may actually just reach some herd immunity. new york is an issue that was awful for a period of time and it's come down significantly since then. at what point do we see things ramp down and slow down, just out of the natural process of viral infection, whether the community has reached some sort of immunity. i know we don't know everything about covid right now. when do you think that -- or is there even any research that says, hey, at some point, we're going to reach a tipping point and this is going to come back down naturally? >> sure. this caller is right. if you just let a disease go ra rampantent, eventually it's going to run out of people to infect. when you get to a tipping point of people who have developed immunity, that it's harder for

the virus to spread from person to person. and that's thought to -- for instance, for some diseases it's high. you need to have 80% to 90% of people who have had infection to prevent it from spreading within a community. for this virus, we of course don't know for sure, we think it has to be 60% to 70% of people and we're nowhere near that. the other -- for instance in new york in those studies, multiple cities now and looked at how many people have developed antibody, it's still less than 10% in most big cities that have had an outbreak and in some places in washington state, it's only like 3% of people have had infection. we're nowhere near where we need to be for heard immunity and we cannot afford to just allow the virus to go rampant. even in a place like new york, you saw the effect of that. it completely overwhelms the health system and it's not something we can allow in this day and age. we can't do that ethically.

another point i think is important is all of these numbers in herd immunity that we're talking about are only true if the antibody and -- that you make, or that immune response is a permanent or at least a durable -- what we call durable, meaning six months to a year. from natural infection, these antibodies may not last that long. there are studies looking at how long those antibodies stay in the blood and trying to correlate, okay, if i have this antibody at this level on a quantitative level, this can only be done in a research lab, and i put that amount of antibody in a petri dish, does it prevent infection. those are all unknown questions that we don't have the answer to yet. we're looking at that very carefully. >> quick observation by jody on twitter saying, children are bug bombs in regular infectious situations. you seem to get sick, just from looking at them sometimes.

i see a covid-19 perfect storm. let's get another call from rodney in houston, texas. >> caller: yes, good morning. i appreciate you accepting my call. to dr. roberta, i would like to ask this question, i'm asking you to be a straight shooter here. i'm from houston, texas, third ward, where george floyd was from. i went to the same school and the reason why i'm bringing this up, we hear a lot of issues about black lives matter, there's a lot of issues with prejudice at schools. the teachers are being put at a disadvantage, let's say a white teacher is teaching black kids. the kids are not being taught how to wear the masks at home or

maybe they are. if the kids get that disease, what if the parents want to accuse the teacher because they say, you didn't pay attention to my kid or my kid wasn't allowed to wash his or her hands, and they weren't wearing the mask correctly. to me, the teachers are at a risk and it seems like a lot of education should be given in the home, from the schools, some kind of curriculum, and then the last question i want to ask you, are we glad that this is not a nuclear attack. because -- >> rodney, i'll let you go there. running short on time. dr. debiasi, any comments?

>> these are important points. there's so many issues when we think about this virus and how it's affecting our society. texas, as we mentioned, is an area that has a lot of circulation in several areas. i'm not certain of the specific area where this person called from. but, again, the decision to go back to school is probably not going to be appropriate in a community where there's out of control what we call, uncontrolled, large amount of transmission, regardless of any of the other -- these other -- what we call mitigating things that we can do to lower risk in an area where it's very 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 is really important and we have seen both in adults and children, it's been confirmed even in a study that our center is putting out soon, that the children that are of hispanic

ethnicity or black race are at higher risk for both infection as well as risk of hospitalization. and we're also seeing this in our native american populations. so there are differences in our communities about who is at highest risk and we can't ignore that and we also have to look at those similar -- some of those same populations are at the highest risk of harm if they don't have access to food, to educate, and to the interventional services, mental health services, all the things that everyone needs that are at a higher need even in those populations. it's a very, very complex issue. there's really not a simple issue. >> dr. debiasi is the chief of the pediatric infectious disease division. thank you for joining us and taking time-out from your schedule. look forward to talking to you again. >> thank you.