The second phase of the COVID-19 pandemic has seen a spurt in the infection and mortality rate among children in the age group of 0 to 18 years. The trend is expected to rise further in the third wave. Therefore, the state government has decided to set up a task force for this age group to advise treatment protocols. In an exclusive interview, leading Pediatrician Dr Bakul Parekh, who will be part of the proposed task force, discusses the strategy.
What is your view on the rise in infection and deaths among children due to COVID-19?
More children have been infected and are symptomatic in the second wave.
These could be attributed to multiple reasons, like children have started coming out to play and the mutated virus has become stronger. In high-rise buildings, the number of COVID-19 cases have surged after allowing the entry of servants, amongst others.
Infected children have been suffering from watery motions, severe pain in the abdomen, breathing problems, tiredness or weakness and/or red eyes.
The third wave is likely to be severe on children. Multisystem inflammatory disorder related to COVID-19 occurs usually after 6 to 8 weeks after being infected. We have already reached the peak of COVID-19 and now expect a third wave in the months of August and September with more cases.
What should the state government do to tackle this problem?
A group of pediatricians have advised the government to identify COVID-19 centers and hospitals for the admission of children. Government and private hospitals should have additional ICU beds and ventilators. They can ramp up their capacity. We have suggested that such facilities can be augmented for children in JJ Hospital, Nair Hospital, Nowrosjee Wadia Maternity Hospital and NH SRCC Children's Hospital, Apollo Hospital in Navi Mumbai and Jupiter Hospital in Thane.
At present, jumbo centers are available for adults. New jumbo centers can be set up for children considering their needs. The bed size will remain the same as the child will be accompanied by parents. These facilities should have sonography, X-Ray and laboratory facilities.
Many rural areas don’t have ICUs and hospitals. However, the government has been advised to strengthen the primary healthcare centers. The Indian Academy of Pediatrics will train all these doctors on how to diagnose and look for red flag signs and symptoms. The government needs to deploy more well equipped ambulances for the quick transfer of affected children to hospitals. Indian Academy of Pediatrics, through various training modules and teleconsultation, will train parents, primary health workers and doctors, including Anganwadi workers, to do so.
What is your take on launching the vaccination drive for children as being done in a few countries?
We suggested the acquisition of more vaccines within the country or through import. Trials for children of six months to 18 years have already been started abroad and in our country. The centre government needs to allow the vaccines for emergency use. We have urged the chief minister to acquire more vaccines and give emergency utilization certificates. In a few months, we will be able to vaccinate more children who constitute 35% of the population. By this, we can achieve herd immunity early. There are 32,000 pediatricians in the country, of which 5,000 are in Maharashtra. They should be allowed to administer vaccine doses, as they have established a cold chain and are already trained. It will be a game changer, as most of the population will be vaccinated rapidly. Prevention is better than cure. So this should be stressed and all efforts should be made to do so.
How BCG and MMR vaccines will be used to increase immunity among children?
They are re-purpose vaccines and known to increase immunity in general. It may help fight the COVID 19 infection also. R BCG vaccine can cover those children who are not vaccinated against tuberculosis. MMR campaigns can be carried against measles, mumps, and rubella as that will also help increase immunity.
