How can we help kids amid Covid-19 third wave threat?

Children are not miniature adults. The symptomatology, diagnosis, treatment, psychological implications in children are entirely different from adults. Half a tab of adult dose may not equal a child’s dosage!

The second wave of Covid-19 has scared children. The third wave, if it comes, is said to be worse for children. The first wave of Corona had spared children, but the second wave has a mutant virus which is said to be more virulent and thus spreading like a wildfire. This time it has not even spared the newborn. Children below one year are more susceptible as the immune system is not that well developed. The only solace is that it has not shown to be as serious as that of adults and many of them can be treated at home.

We come across problems faced by children and parents and find them in many precarious situations.

Social problems

A few difficulties faced are truly social problems than medical. Here are such queries posed to doctors, in particular, seeking solutions.

We both are tested positive for Covid, and we have 3yr old child, what do we do?

I have lost my wife due to Covid and we have a three-month-old baby and no one at home. I have also tested positive. Please advise me.

Our friends have tested positive, father and mother both are hospitalised and father is in ICU. They have two kids. One has tested positive and the other is negative. How to manage them?

A child is an orphan as both parents have succumbed to Covid19. We do not understand what to do.

These are truly social problems. Even otherwise children have no schools and they watch TV to see deaths, scenes of crematoriums, ICU and crying people who have lost their relatives.

Children may not express themselves but land in headaches, anxiety, tension, stress syndrome, depression. Few of them particularly small ones throw temper tantrums as they are caged, not allowed to go out of the house or meet friends. This has led to a lot of psychological problems in children. It is unfortunate that this Corona has snatched away the enjoyable childhood from these children. This leads to frustration, anger, border, emotional stress, exhaustion.

Finding right symptoms

Parents should also be smart enough to pick up symptoms in children which could be due to coronavirus. Unlike adults, children do not suffer from severe symptoms. Some infected children may not have any symptoms also. Such children become super-spreaders of Coronavirus.

However, the common complaints by children are cough, body ache, sore throat, fatigue, loss of smell or taste, fever with chills, body ache, difficulty in breathing, nausea and vomiting.

Parents need to be on their guard on children to find difficulty in breathing, inability to keep down any liquid, confusion, inability to wake up and bluish lips. Children below two years, born prematurely or obese children, children with chronic lung diseases are at higher risk.

Multi-system inflammatory Syndrome in Children (MIS-C) is a very important condition to be identified. If one finds persistent fever or fever more than 100.4°F which lasts for more than 24 hours, red rash, abdominal pain, red cracked lips, red eyes, swollen hands and feet should make one think of MIS-C and approach a paediatrician or a doctor immediately.

These children may need to be investigated. Firstly, get an RT-PCR test which is the gold standard and confirmatory. Many parents are reluctant, which is not the right decision. Biomarkers like CRP, D-dimer, CPK, LDH, Serum Ferritin, X-ray Chest help in identifying the severity of the disease.

In mild cases, CT Chest (Computerized Tomography or HRCT (High Resonance CT) are never done but certainly in moderate or severely ill children it is done, to guide the treatment. A negative RT-PCR test will not rule out Covid-19 disease, as false-negative reports due to various reasons.

Children suffering from heart diseases, kidney, neurological, liver diseases or steroids need to be hospitalised for close observation. A small percentage of children only may need hospitalization. However, the majority need to be under home quarantine.

(The author is a Dharwad-based paediatrician)