COVID-19 can affect anyone of any age including children and adolescents. Although children are less affected with COVID-19 infection and if infected, either they are asymptomatic or mildly symptomatic. Only a few severe cases of COVID-19 among children in India have been observed that require hospitalization.1
There is a fear among people that the third wave of COVID-19 will affect children. However, there is no scientific evidence to support this theory so far.2 As in the first wave, elderly people have gotten affected more, in the second wave, a lot of young adults have gotten affected. So, it has been assumed that, in the third wave, children will get more affected. There is also fear among people that because children have not been vaccinated yet, they are going to be more affected. To deal with this situation in the future, doctors and government officials are strengthening the preparedness for COVID-19 for third wave.
Symptoms of COVID-19 in children
According to the Ministry of Health and Family Welfare Guidelines on management of COVID-19 in paediatric age group, the foremost common symptoms of infection among children are cold, mild cough, fever, body pain, weakness aside from these like pain in the abdomen, diarrhoea, vomiting, loss of sense of smell or taste. It is important to early diagnose and treatment of COVID-19 among children. 3
To know if the child gets infected with COVID-19, it's important to get the child tested. If the child has been in contact with COVID-19 positive patient in the family or he/she has symptoms of COVID-19 or child has a fever that has continued beyond three days, then take medical advice by the doctor and get the child tested and isolate at home.
Management of COVID-19 positive children
If a child is found infected, it is important to isolate him/her immediately in a separate room from the rest of the family (if possible) and take medical advice. Family should connect with the child through calls or video calls and can have positive talk.
If the mother and her child/children both are COVID-19 positive, children can stay with their mother, unless their mother is too sick to care for them or is hospitalized. Mothers can continue breastfeeding to her infant as much as is possible and feasible. In a situation, where only the mother is COVID-19 positive and not hospitalized and very sick, but child is negative and no other childcare options are available, mother can take care of her children. However, while doing so she must continue to take the best possible sanitization measures and wear a mask properly.
Multisystem inflammatory syndrome in children (MIS-C)4
According Directorate of General of Health Services (DGHS) guidelines for management of COVID-19 in children, multisystem inflammatory syndrome (MIS-C) has been observed in children after 2 to 6 weeks of the recovery from COVID-19. The common symptoms of MIS-C in children are inflamed body parts, including the heart, lungs, kidneys, brain, skin, eyes, or digestive system. They can show symptoms such as fever, abdominal pain, vomiting, diarrhoea, rash, bloodshot eyes, confusion, shock, conjunctivitis or feeling tiredness. The cause of MIS-C is unknown. However, many children with MIS-C had been affected by COVID-19 previously. Early diagnosis and medical care and treatment is vital to reduce the risk of serious complications in children from MIS-C.
COVID-19 vaccine for children in India and other countries
At present in India, vaccination administration is only for adults. Clinical trial of Covaxin (Phase II/III) in children (above 2 years) and adolescent is under process5. Some of the countries have already started vaccinating young children of age 12 and above. After the successful clinical trial of the Pfizer-BioNTech in children of 12 to 15 years of age, the vaccine is being made available for everyone of age 12 or above. 6
Prevention from COVID-19 diseases
At present, the best way to protect children from COVID-19 is that they follow COVID-19 appropriate behaviours such as maintain physical distancing, wear age appropriate mask, wash hands with soap or use alcohol based hand rub. According Directorate of General of Health Services (DGHS) guidelines for management of COVID-19 in children, children below the age of five do not require to wear mask, children aged 6 to 11 may wear a mask under the supervision of parents and children above the age of 12 should wear masks.7
To keep the immune system strong to fight any diseases it's important to eat healthy and nutritious food including vegetables and fruits and maintain hydration. For children below 6 months, exclusive breastfeeding is the best nutrition for their health. Complementary food with breastfeeding can be given to children After 6 months. Routine immunisation for children should be continued.
Importance of mental health of children
It’s important for parents to take care of child’s mental health as well during COVID-19. COVID-19 not only can affect children’s physical health but their mental health as well and can cause stress, irritability, depression, anxiety and other symptoms. Parents can help children by providing assurance whenever needed and can spend quality time with them. They can also help them by connecting them with their friends virtually and engage them in indoor activities.8