The incidence of Covid-19 in children in the second wave is far higher than the first wave. Many parents are still not aware of the severity of it and hence can get casual about the impact of COVID-19’s second wave in their children. With the exclusive series, “Covid in Children”, Medicircle aims to spread awareness among parents by speaking to eminent pediatricians so that parents and family members can keep their children safe and protected with appropriate measures.

Dr. Saloni Pahwa is a Pediatrician based in Mumbai and associated with SMC Centre. She specializes in Consultation, Vaccination/ Immunization, Nebulisations, NewBorn Care and Childhood Infections. She is a Gold Medalist and has been trained under the esteemed guidance of Dr. YK Ambdekar, at Wadia Hospital, Mumbai. 

COVID-19 is bypassing the antibodies of children in the second corona wave

Dr. Saloni mentions, “Last time children were asymptomatic carriers but this year, symptoms are being found in them as well. So, they are not just carriers this time but patients as well. This year’s mutation of the virus; which is a double and triple mutant, is of such a nature that it is bypassing antibodies of younger people and children as well. That’s why complications of different kinds are evident this time.”

How can we make children aware of precautions in a positive way?

Dr. Saloni explains, “It is difficult to inculcate the habit of social distancing, use of mask and face shield in children; especially below 2 years of age. There is a problem with self-isolation too in such a tender age group. If children above 2 years cooperate, then make them wear masks. The best preventive measure is to keep them indoors because if they go out to play or for classes etc. they would not only themselves get infected but would infect the elders too. If very small children have to go out for something important like to the hospital, then for children below 2 years mask is not recommended. It is advisable to cover their face with a cloth or to make them wear a face shield. Parents should keep on sanitizing and washing their hands and make their children do the same.

Since there is a sense of fear and anxiety in adults, it is bound to be the same in children as they imbibe the anxiety from the adults around them. Parents are advised to explain the significance of staying indoors during these times with positive words and logic. Children definitely understand this way and would quietly cooperate.

Behavioral issues, tantrums, and negative emotions are getting built up in children. However, with honest and logical communication and without using any kind of fear factor, rather with the use of positive words, the benefits of safety and security can be explained. They would surely cooperate this way to adapt to this new phase of change,” advises Dr. Saloni.

Do not take ailments of children lightly

Dr. Saloni points out, “Last time children were getting infected by adults but this time, they could be the first person in the home to get infected. Covid in them could be asymptomatic to severe. The symptoms could be cough and cold, low-grade fever, high fever, body ache, loose motion, throat pain, stomach ache, etc. There could be some of these symptoms or all at once. So, if children are falling ill, then it should not be taken lightly and instead of assuming that it might not be Covid, doctors should be consulted. They should be kept away from the elderly people like grandparents at home because children would come out of Covid in a few days but it can get more severe in the elderly.

For those who are above 12 years, it is being observed that their symptoms resemble that of adults like lung infection, loss of smell or taste. Doctor’s consultation and being in touch with them twice or thrice if there is no change in fever pattern or if symptoms are not getting resolved even after 5 days is important  to avoid complications. Most children are getting out of the Covid infection in 3-5 days, so that’s a positive thing,” says Dr. Saloni.

Should  RT PCR tests be done in children or not?

Dr. Saloni advises, “Even if symptoms are not severe, isolate the child and keep exposure to other family members low. If the child is small, a parent will have to isolate him /her along with the child. Isolation should be done even if the symptoms are not severe. At that time the parent who is in isolation with the child, needs to be in precautions like wearing a double mask or N-95 mask, sanitizing, and washing of hands. If a child is above 5 years of age, an RT PCR test can be done.

Ideally, the protocol should be such that if a child and adult are not well at the same time, then the adult should go ahead with the RT PCR test. If that is positive, the child would be positive too. If the child does not get well after all precautions in 3-5 days, then RT PCR is recommended for him /her too,” says Dr. Saloni. 

MIS-C – the post-covid syndrome common in children this time

Dr. Saloni informs, “Just like some adults are suffering from the post-covid syndrome, children of 7 years and above are suffering from problems like body ache, weakness, headache, etc like adults, which gets resolved after some time. There is a syndrome that is specifically being found in children and that is MIS-C - Multisystem Inflammatory Syndrome in Children. Some children who have had covid previously or were in contact with a covid positive person in the last 4-6 weeks are showing symptoms like rashes on the body, tendency of persistent vomiting, red eyes, fever, stomach ache, dry skin which is peeling off, etc. The treatment of this syndrome can be done in the hospital only specifically if there is a covid history attached to it in the child or the family. The problem can get very severe if timely treatment is not done.

We are finding more cases of MIS-C this time majorly because the number of cases in children is more. Last time, the cases of MIS-C were there but very low in percentage as covid cases in Children were low,” explains Dr. Saloni.

(Edited by Amrita Priya)