Dr Jayashree, Chairperson, Advanced Pediatrics Centre (APC), Covid-19 Committee at PGIMER, Chandigarh on Saturday said that the second Covid-19 wave WAS impacting more youth and kids than the first and adults around kids must follow Covid appropriate behaviour and protocols to protect them from the virus. Since February this year, 99 children infected with Coronavirus were admitted at PGIMER, during the ongoing second wave while 242 kids admitted during the first wave of the pandemic from March 2020 to January 2021.
Dr Jayashree says that there are designated beds for Covid-19 positive children at PGIMER Covid-19 hospital and additional facilities for admitting all Covid-19 suspected children in Advanced Pediatrics Centre. She says that expecting kids to adopt Covid appropriate behavior in the form of masks, social distancing is very difficult and practically not feasible, therefore the responsibility rests on the adults of the house to adopt these practices to protect the kids. She said that the delivery of a Covid positive pregnant woman should take place at a designated Covid hospital and usual standard protocols are to be followed. After birth, the woman should breastfeed and provide the usual baby care. Post-birth also, she should follow the standard precautions.
In an interview with ‘The Pioneer’, Dr Jayashree talks about the current status of coronavirus cases among children especially in the group of 0-12 years as well as arrangements made at PGIMER for kids infected to Covid-19: Excerpts from the interview:
Chandigarh and its neighbouring states Haryana and Punjab are witnessing the second wave of Covid-19. How many Covid-19 cases have been reported among children in Chandigarh so far? How do you read the numbers?
A total of 99 children infected with Coronavirus from Chandigarh have been admitted at PGIMER in the second wave. I think the numbers are worrying. Not following Covid behaviour protocols, letting our guard down and carelessness have been the major contributors to this second surge. Since the risk of exposure to kids is usually from close family contact, the parents should suspect once an adult has tested positive at home and the child develops common symptoms of Covid-19 including fever, cough, cold, sore throat, muscle pains, diarrhoea and vomiting and restlessness. The preventive measures recommended against this virus are uniform and standard. Masks, social distancing, hand hygiene, avoiding crowded places, good cross ventilation in rooms. Masking in children, especially below six years of age is difficult. WHO recommends that fabric masks with elastic bands may be used in children between 6-11 years of age. Attractive colourful masks with designs may increase the acceptability of masks in older kids. Children must be taught the importance of good hand hygiene.
Amid surge in Covid-19 cases in Chandigarh, Haryana, Punjab and other States, what are the special arrangements made at PGIMER for kids?
There are designated beds for Covid-19 positive children in PGIMER Covid-19 hospital and additional facilities for admitting all Covid-19 suspected children in the Advanced Pediatrics Centre.
As no vaccine has been approved for kids so far, how can children be protected from Coronavirus?
Masks, social distancing, hand hygiene, avoiding crowded places, good cross ventilation in rooms. Most importantly the adults in and around the kids must follow Covid appropriate protocols to protect the kids.
In Haryana, a new born baby was found covid-19 positive recently. What precautions pregnant women should take to prevent themselves and their upcoming newborn baby from the virus?
The preventive measures against this virus are uniform and standard. Appropriate Masks, social distancing, hand hygiene, avoiding crowded places, good cross ventilation in rooms are required. The same measures have to be followed by the pregnant mother and her family. The delivery of a Covid positive pregnant woman should take place at a designated Covid hospital and usual standard protocols are to be followed. After birth, the woman should breastfeed and provide the usual baby care. Post-birth also, she should follow the standard precautions mentioned above.
Is it possible that Kids can suffer from symptoms (coronavirus) that may be completely different from adults?
Common symptoms of Covid-19 in children include fever, cough, cold, sore throat, muscle pains, diarrhoea and vomiting and restlessness. The acute covid-19 symptoms in the majority of kids are usually mild. The post-covid-19 multisystem inflammatory syndrome (MISC) is an entity more commonly described in children than adults. Children of MISC can present with fever, loose stools, abdominal pain and rash. These symptoms are seen in a small proportion of children about 2-4 weeks after acute Covid-19.
In the second wave of the pandemic, a number of young people including children are getting severely infected. What are your observations on how this wave is different from the first one?
There is a perception that more kids are getting infected this time. Many pediatricians all over the country feel so. In terms of actual data, we need to do a detailed analysis to see if this is actually true. Since the overall adult numbers are very high in the second wave, proportionately the affected children numbers have also automatically gone up.
As per, recent ICMER data shared on April 19, from zero to 19 years, the difference was 5.8 percent versus 4.2 percent and in 20-40 years, the difference was 25 per cent versus 23 percent. There is a marginal difference in this.
As you are a part of the Covid committee so what have you learned in this one year in terms of treatment, management of Covid-19?
For children, the treatment modalities in the second wave remains the same as in the first wave of the pandemic.
The disease, fortunately, is still mild in a majority of the kids and can be managed with home isolation, adequate hydration, diet, and paracetamol for fever. A small proportion especially those with underlying comorbidities are at risk and require hospitalization. Children, however, need to monitor for post-Covid Multisystem Inflammatory Syndrome (MIS-C), an entry described in a small proportion of children and can present 2-4 weeks after acute Covid. Recurrence of fever along with loose stools, abdominal pain and rashes should alter parents to seek medical help.
Any word of caution for people, especially the youth?
Most important is the adoption of Covid appropriate behaviour –social distancing, masks and hand hygiene. There is no other magic bullet. Second, believe in science. Take the available vaccine when your turn comes.