Covid third wave: Outlook got in touch with Dr Amin Kaba, the Consultant Paediatrician, Masina Hospital, to get all their questions answered.
Even as the country is fighting the second wave of Covid-19, health experts across the country are calling for massive preparation for the third wave of the virus as they say if it is not tackled well then it could pose threat for children. Moreover, experts predict that the third wave of the virus is likely to hit the country later this year. They have categorically warned that children would be affected by the third wave more than adults.
While parents are worried for their kids, Outlook got in touch with Dr Amin Kaba, the Consultant Paediatrician, Masina Hospital, to get all their questions answered.
1. Is this second wave affecting children more? Also is it more dangerous?
A. The number of children who are coming with symptoms seems to be much more than last time. Despite this, the number of children with serious complications is still very few. But the current strain seems to be more infectious and affecting the entire family at one go.
2. How can I prevent my child from getting Covid-19?
A. The answer is still the same. Social distancing, masking, and sanitisation. No medicine or treatment modality has been proved to prevent Covid-19 infection.
3. What are the symptoms of Covid-19 in children?
A. Children can present with fever, cough, cold, breathlessness, headache, and body ache. They may even present with pain in the abdomen, loose motions, and vomiting.
4. When should I test my child?
A. Any child who demonstrates these symptoms for more than two to three days or a family Member has similar symptoms as the child or someone in the family is diagnosed positive and the child develops symptoms.
5. Which test should be done?
A. RT PCR or CBNAAT for Covid-19 only. No other test can confirm the diagnosis. Do not do a CT scan or blood tests indiscriminately without a doctor's advice.
6. Should children wear masks?
A. All children more than two years of age should wear masks. Under 2 years they should not be made to wear a mask because of safety concerns.
7. How do I know if my child is serious and should be rushed to the hospital?
A. Parents need to monitor the child and be in touch with the doctor constantly. The reasons for an emergency visit would be
- High fever lasting for more than 4 to 5 days
- Child unable to eat properly and very lethargic
- Child not passing urine for more than 6 hours
- Breathlessness in the child
- Saturation dropping to less than 94 (remember the oximeters for home use may not pick up the saturation properly in small children).
8. What can I do at home for my sick child?
A. Monitor the child's temperature as and when needed and you can give Paracetamol every 4 to 6 hours depending on her weight.
Plenty of oral fluids and good clean hygienic food. Make sure the child is hydrated. Avoid junk food. Monitor the saturation twice a day at least.
9. How many children become serious with Covid-19?
A. By and large most children will recover within two to four days of getting symptoms. A very small percentage of children will require hospitalization and an even smaller percentage require Intensive Care.
10. What is this MIS-C?
A. Multisystem inflammatory syndrome in children is a body's abnormal response that may happen in a very small percentage of children after about 1 month of having contracted Covid-19. The child may present with symptoms similar to Covid-19 infection, rash, red eyes, redness or swelling of hands and feet, redness or swelling of tongue, neck swellings (lymph nodes), breathlessness, fast heart rate, and confusion.
This is a serious condition and warrants good Critical Care.
11. Can a Covid-19 positive mother continue breastfeeding her child?
A. Yes. She should continue breastfeeding while wearing a mask and shield if possible along with regular hand sanitization and maintaining good hygiene.
12. What treatment can I give to my child?
A. Most children will not require anything besides Paracetamol. Vitamin C, vitamin D, and Zinc may have some role in recovery; however, do not unnecessarily self-medicate.
13. What precautions can the family take if a child is positive for Covid-19?
A. It is extremely difficult to quarantine children, especially the very small ones. If at least one caretaker is positive then the child can remain with that person.
If all caretakers are negative and only the child is positive then one caretaker should take proper precautions like masks, sanitisation, and even wear PPE in certain situations and stay with the child. However, do not make the mistake of sending the children away to grandparents if someone is positive in the house. You will be putting them at great risk. The minute a child is diagnosed positive make sure that the vulnerable population like chronically ill patients and old grandparents are quarantined and kept away from the child.
14. Will children get the vaccine?
A. Studies are already underway in a few of the western countries for the safety and efficacy of these vaccines. Few countries have already begun vaccinating children. We haven't received any approval in India as of now but it is expected that the approval should come within the next few weeks or months.
15. Why is this third wave expected to affect children more?
A. Children have been at home for a year and a half now. Their exposure to COVID-19 and other viruses, which they routinely were exposed to is almost non-existent now. Also, the Covid vaccines have yet to be approved for the pediatric age group. India has the youngest population in the world. Almost 40% of our population is below the age of 20 years. So we have a huge pool of immune naive population that will immediately come to be exposed to the virus once the lockdown eases. Add to that if the educational institutions are allowed to conduct physical classes, we may face terrifying numbers.
However, due to their physiology children are still protected naturally against serious infection. Despite that, the numbers can get intimidating. You also need to remember that good critical pediatric care is available mostly in metros only and that too is limited. Our rural population (which is a majority) wouldn’t have access or be able to reach these centers in time. That's the reason we have begun preparing for a war-footing. Pediatricians and family physicians are being trained to triage and standard protocols have been devised to efficiently manage patients. We have also implemented the lessons learned from the second wave and are gearing up with medicines, oxygen, and infrastructure to tackle any kind of emergency that may arise.