Lancet India Task Force on Saturday commissioned an advisory highlighting the planning, protocols and policy guidelines for paediatricians, ahead of a likely third wave of Covid-19 that is speculated to impact children.
The Lancet expert group comprising of doctors from various private and public hospital doctors from across the country, including three doctors from the paediatrics department of New Delhi's All Indian Institute of medical sciences (AIIMS).
It discussed and decided on protocols for India specifically for children.
Lancet selected experts from private as well as government hospitals across India who are dealing with cases of Covid-19 infection in children. A meeting of the Task Force was also organised with experts from the UK and the American Academy of Paediatrics (USA).
From AIIMS, the Head of Paediatric Pulmonology Dr SK Kabra, Professors of the department of Paediatrics Dr Sheffali Gulati and Dr Rakesh Lodha participated.
Dr Kabra told ANI, "There are two types of illness in children - acute Covid infection and multi-organ inflammatory syndrome (MIS-C). We tried to provide an algorithm for these children suffering from acute Covid-19 infection which will be managed in a routine paediatric ward, Intensive Care and high-dependency unit."
"An advisory has been made that suggested provision to allow parents to stay with the children rather than keeping them away. Secondly, the doctors and nurses should know how to take care of the children once they are sick by using the algorithm we have provided," he said.
A separate section has been included in the advisory for children who might suffer from multi-organ inflammatory syndrome (MIS-C).
"They might require treatment in the main paediatric ward in any hospitals. In that case, we have made suggestions to strengthen the paediatric hospitals. There should be an increase in beds, beds for intensive care, and increasing beds for high dependency units. And importantly there should not be the use of unnecessary use of medication," a doctor suggested.
In the discussions of the Task Force, experts clarified that there is no reason to suspect or predict that there would be a more severe disease in children in the third wave and it is less likely that the children will be affected more. Third-wave may come following the nature of the virus however managers should get ready.
"The speculation of third-wave hitting children is based on three observations. Firstly there is speculation that below 18 will remain susceptible after immunisation drive began for beneficiaries above 18 years. Secondly, people who already got infected may have resistance against the third wave and thirdly due to immunization of the adult group, there will be a mutation in the virus. All these reasons may not be true though there is a possibility that the third wave of Covid-19 may be there but no reason to believe that this will be more severe in children," Dr Kabra explains.
A clinical management protocol for children with Covid-19 has been initiated by the researchers in the study which states that some children may present with symptoms of the acute abdomen it other GI symptoms or rare CNS symptoms. It also stressed confirming Covid-19 before determining severity.
The study along with the above observation also pointed out that no investigation is required for children who are asymptomatic or suffering from mild symptoms.
With moderate infection, no lab test is required unless indicated by an associate co-morbid condition. However, CBC and CRP may be done if there is worsening of symptoms or the child is not improving.
Multiple agencies are making protocols and recommendations for the third wave specifically for children.
( With inputs from ANI )
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