Paediatricians emphasize on training staff, infra ahead of Covid third wave

Prayagraj: Predicting that the third wave of Covid-19 is likely to attack children mainly, paediatricians have started taking up measures in advance and are preparing to face the challenge of providing timely care to children in case the third wave does harm kids predominantly.
Paediatricians, however, added that the possible predominant childhood diseases in children are likely due to the unvaccinated status of children less than 18 years of age and hence their naive immunity, highly mutagenic nature of the virus is the next big area of exploration in aetiology (study of the cause of diseases).
Noted paediatrician, Dr Surabhi Chandra told TOI that there are certain unique features when it comes to the care of children due to which building or boosting infrastructure alone might not alone suffice.
She added that there are subtle signs in children accompanied by the major symptoms of any disease and given the inability in infants and younger children in articulating the issues they are facing, prescribing medicines becomes a task.
Dependency on parents for feeding, emotional support and care, makes it mandatory to have at least one attendant who can stay with the patient throughout, besides medical and paramedical staff. Besides, the limited number of faculties and residents trained in assessing and managing the children (including writing prescriptions which mandate each drug, each infusion to be made in terms of per kg body weight and ensuring adequate drug delivery over a specified period.
The key to successful management of the third wave will hence depend not only on the availability of adequate infrastructure but also on well-trained doctors and staff. This is the need of the hour and for that training programs should be aimed at teaching recognition of subtle signs and their interpretation is a must.
Dr Chandra, who is also an associate professor, further said that procedural skill-based training of residents and nursing staff should also be done. Charts mentioning vital signs in different age groups, doses of common drugs and their administration, as well as paediatric basic (BLS) and Advanced Life Support (PALS) algorithms should be prepared and kept handy in the paediatric wards and ICUs.
Infrastructure should be tailored keeping in mind the care of the paediatric patients. She claimed that just giving half the adult dose does not always work.
There is also the requirement of a large number of consumables since even a moderately sick child may require 2-3 infusions ongoing at a time. Round the clock meticulous clinical monitoring, which might not be possible just by placing a child on monitors, different age-wise cut-offs, management norms and ventilator settings.
"Prevention is the mainstay and parents should be very cautious. They should get themselves vaccinated and avoid even casual exposure to children," said Dr Chandra.
In the second wave, paediatric cases are 1 per cent to 5 per cent of the total affected population across the country. Though most of them are asymptomatic or have mild illness and mortality is low, illness can take more serious forms as well. Multisystem inflammatory syndrome-Covid-19 (MISC) seen almost exclusively in the paediatric age group, may not necessarily present in the acute phase of Covid-19 illness. It may occur even after the child has become Covid negative and can have potentially fatal outcomes.