The Centre on Tuesday announced that it is now focusing on coronavirus disease among children and is preparing operational guidelines for the same, a move aimed at countering concerns that have been raised about the third Covid-19 wave impacting children more.
“Childhood Covid-19 disease is gaining our attention. We have said earlier that paediatric population is generally asymptomatic; they get infection but their symptoms are minimal, almost nil. It often does not take serious enough shape to require hospitalisation. But the situation can change in paediatric population also if the virus happens to change its behavior, or epidemiological dynamics see a change in future, then there is a possibility that in children Covid-19 disease severity may also increase,” said VK Paul, member (health), Niti Aayog.
The government has been systematically looking at all related scientific developments on the subject. As on today, about 2-3% of the total number of children suffering from Covid-19 that requires hospitalisation.
“About 2-3% of children currently require hospitalization but we are preparing to handle at least two-and-a-half times more patient load as suggested by the expert panel. The government will act on the recommendations that include revised clinical management. We are working very systematically, comprehensively to address the problem of paediatric Covid-19 disease,” said Paul.
Paul reiterated that there will be not be any laxity in taking measures to deal with childhood Covid-19 cases, should the numbers rise, including putting out guidelines on effective clinical management.
“The data that we have at the moment, especially looking at the numbers in big tertiary care hospitals, children admitted in hospitals because of Covid-19 is a minuscule number. It has not happened so far that our paediatric health care infrastructure got overwhelmed because of Covid-19 cases. Having said that, as we go along, we are keeping a tab at all sorts of scenarios, and pushing preparedness measures accordingly.”
The Centre has created a dedicated working group of experts to look at childhood Covid-19 situation, and review updated evidence at hand.
“The experts are looking at a wide range of data that was not available three-four months ago, and co-relating the clinical profile, disease dynamics, pandemic behaviour, and nature of virus along with country’s own experiences so far, a new way has been devised, guidelines updated, to manage Covid-19 in children that should be out soon,” said Paul.
In children the manifestation of the disease usually happens in two ways: one is that a child gets fever, cold, cough, difficulty in breathing because of pneumonia setting in; and the second pattern that we have seen , even though in a small proportion, is that two-six weeks after recovering from Covid-19, the child gets fever again, body rash, conjunctivitis, dirrhoea, vomiting, breathlessness, or even bleeding tendency that is suggestive of multi-system inflammatory syndrome setting in as it indicates that the disease is not localised but involves multiple organs.
Since it is post Covid-19 complication, the virus will not be present in the body and the reverse transcription polymerase chain reaction (RT-PCR) test will likely return negative.
The government is also doing an audit of the facilities required for the purpose, and will strengthen the capacity accordingly.
Experts say, while it is good to stay prepared for any eventuality, as of now the trend does not seem to indicate that more children were infected than the previous wave.
“The number of children with Covid-19 was high this time because the overall numbers were high, and not because the disease impacted more children. Older children tended to develop serious disease and younger ones did better but then if you compare with adults, children did get milder disease,” said Dr Nitin Verma, senior consultant, department of paediatrics, Max Healthcare.