Jeff writes:

My wife and I are both scientists, and we are having a serious scientific disagreement. By studying the literature, she has decided that one can be infectious without the tests detecting the infection. She is not talking about normal false negative rate, but rather that there is a couple of day period before symptom onset where some patients can be infectious but not shedding enough virus to be detected by the standard tests, I.e., below the detection threshold of the test. I think that regardless of her reading around, this is impossible. I suppose that this might be slightly possible if somehow the virus is in your lungs but not in your nose, where the test is done. But this seems extremely unlikely to me, and would happen in a vanishing small number of cases. So, can you help distinguish between her reading around and my logic?




Director of Research, xCures
and Adjunct Professor
Symbolic Systems Program 
Stanford University

Zinta writes:

Dear Dr. Griffin,

I have been a faithful listener to TWiV during the pandemic. Thank you for your efforts to keep us all informed on best practice and scientific evidence!

Our daughter was born during the pandemic and, due to lockdown restrictions, has had limited contact to other children or adults. As a result she has never been sick with colds or other common illnesses. She is now 15 months and we would like to enroll her in daycare for socialization and learning. However the increasing rates of COVID-19 infection and hospitalization in young children is alarming, as you highlight in episode 797. I worry that by sending my 1 year old  to daycare I may be dooming her to COVID-19, with unknown consequences.

To minimize risks,  would you keep infants and toddlers out of daycare as long as possible and try to wait for a vaccine? Or can risks of infection be minimized by going to daycare two or three days a week or by dropping out if prevalence increases above a certain threshold in the community? Or is hospitalization still so rare in toddlers and infants that we really should not worry about COVID-19 and focus on the benefits of socialization at this young age?

Thanks for your advice! 

New York City

Jamie writes:

Hello Dr.Griffin 

I am an emergency physician and mom of 2, ages 1 and 2 years old, working in Albuquerque, New Mexico. You mentioned in the last update that the overall risk of hospitalization is 2% for children. I was wondering if we have more information about that, specifically, what is the breakdown by age group? I would imagine under one year’s old is most likely to require hospitalization, but beyond that? What is the median length of stay for those children? What interventions are being needed and what is the rate of children requiring intubation? What comorbidities or other factors contribute to risk of hospitalization? and lastly what is the rate of MIS-C, or do we even know? 

Thank you for all that you do! 
Jamie Santistevan MD

Thomas writes:

Dear Dr. Griffin,

my mother suffers from a few autoimmune diseases: 

– Systemic lupus erythematosus 

– Sjogren’s syndrome

– Antiphospholipid syndrome 

She hasn’t been vaccinated yet out of fear of thrombosis. Her doctor (specialising in dermatology and venereology) could only say that she (Doc), on one hand, recommends getting vaccinated, but on the other hand, she does not recommend it. 

One problem is that depending to which doctor she is going regarding her disease in general, some recommend getting anticoagulants and others tell her that she can live without anticoagulants by exercising much; so, she does not take anything against thrombosis as exercise might be enough  and is the more comfortable option for her.  

Since I doubt that herd immunity is around the corner anytime soon, my question I raise is “do I want to get infected with or without vaccine protection?”. 

What is the best way to go from here for my mother? 

Best wishes! 

Lena writes:

Hi TWIVer’s!

I am a long-time listener and have emailed a few times but never made it on to the show. I also sent this to Dr. Griffin since he’s talked a lot about kids lately.

I know I’m probably preaching to the choir since most of your listeners are like-minded, but I wanted to send this in anyway to give you and your listeners a picture of what you’re helping to protect by staying home, wearing masks, and getting vaccinated. I posted this to my personal Facebook page in hopes it would give anti-vaxxers an idea of what life is like for those who are scared.

Happy birthday to my sweet, sunshiney, delightful, green-eyed, freckle-faced boy, JJ! He is quirky, smart, and thoughtful. He loves to play Minecraft with his brothers, build Legos, swim, and draw pictures. He loves to tell people, especially his grandma, that he loves them. He wants pizza and a rainbow cake for his birthday dinner.

He has made it to age 7 only through the help of many doctors, medicines, and the alert and aware adults in his life. He is medically fragile. He doesn’t look it, but he is one of the millions among us with an invisible illness. He has been in the hospital multiple times and takes multiple medications every day. He is high risk. He is why we’re continuing to stay home, mask up, get vaccinated, and only allow vaccinated individuals to visit.

If you think a vaccine is traumatic, imagine watching your child struggle to breathe, grey skinned and blue lipped. If you think wearing a mask is too much, imagine watching doctors and nurses pump your child full of medicines to help him breathe. If you think staying home is hard, imagine a doctor telling you that they’re going to try one more thing, but if it doesn’t work, they’re going to have to intubate your child to give him a break from working so hard to breathe. If you think a cold is no big deal, imagine lying beside your child in a hospital bed watching the number on the oxygen monitor praying it stays above 90 so it doesn’t beep and summon the nurse again so you can get 5 minutes of sleep. Imagine that. Then imagine it again. And again.

This is only a fraction of what we’ve endured as a family. Those things are traumatic. Those things are too much. Those things are hard. Those things are a Big Deal. Those things are why we keep him safe. He is not disposable. He is not a burden. He is very much loved by everyone who knows him. He brings so much joy to our lives. He deserves to be protected. Protect him, and the millions of people who suffer from invisible illnesses.

Happy birthday, JJ. Thank you for teaching us so much.

JJ has 2 older brothers and a younger sister. To keep him safe, we are homeschooling all of them this year as Florida has nothing in place to protect children like him. I also work from home and my husband is a stay-at-home-dad as well as de facto teacher.  We only go out when necessary, continue to do grocery pickups, wear KN95 or N95 masks, and stay away from other people. We’ve been doing this since February of 2020 when the first cases cropped up in our state.  Thank you to each and every one of you who has been vaccinated and continues to be as safe as possible. Thank you for all that you do to educate the world at large about viruses. Thank you for helping to protect my family.