- MIS-C can happen about 2-8 weeks from the disease: Dr Manish Mannan
- Not going to the park is not safe at this stage: Dr Mannan
- A balanced diet, exercise and healthy mind is needed for immunity: Dr Manna
New Delhi: The second wave of the COVID-19 pandemic in India may be subsiding but experts have already cautioned about the possibility of a third wave, and ways to prevent it. Some experts believe that those below 18 years remain a vulnerable group as they cannot be vaccinated and so prone to infection. Banega Swasth India team spoke to Dr Manish Mannan, HOD, Paediatrics & Neonatology, Mother & Child Unit, Paras Hospitals to understand the likely impact of COVID-19 on children and how can parents safeguard their children from contracting the disease. Here are some excerpts from the interview.
NDTV: Why were more children getting infected in the second wave of the COVID-19?
Dr Manish Mannan: There are two reasons; firstly, in the first wave the number of tests which were done were less compared to the tests done in the second wave. Secondly, the number of children getting infected was high compared to that in the first wave throughout the world. However, symptoms in children continued to be mild as it was in the first wave. More than 50 per cent of the times, the parents didn’t even come to know when their child had got COVID. Yes, very small fraction of them did get critically ill. We had to admit only two kids out of the 300 which I had seen in past two months and they also recovered. So, probably the mutation, the Delta variant of COVID-19, which was more prevalent in the second wave, was responsible for a higher rate of infection in the younger age group but thankfully, the symptomatology was as mild as it was in the first wave in the children.
Children have been a reason for infection. They have been asymptomatic carriers as well. They themselves don’t get infected that’s why in the first wave we used to say, keep the children who are infected away from the seniors in the family. Many parents ask me, if the child is getting a very mild infection why do we need to test at all? We will presume he is positive and isolate him. Child getting COVID is not an as serious an issue at least till now, especially the younger kids. We need to test more. Whenever there is a suspicion, test so that at least you know that the child is positive.
NDTV: What is MIS-C and when to take appropriate action?
Dr Manish Mannan: MIS-C is a multi-system inflammatory syndrome in children. MIS-C is a hyper immune response which happens in the body wherein there is an inflammatory response which affects almost all systems from the liver to heart, kidneys and sometimes even the brain. In some children, it can cause myocarditis also. MIS-C can happen about 2-8 weeks from the disease.
Important features of MIS-C are high grade fever of more than three days; unexplainable fever; rash; any child who has had COVID or who has been exposed to a case of COVID which means a family who has had COVID and in them if you see a child who has high grade fever and rash. That should be a suspicion. My advice to all parents is, in this season, if a child gets fever, please consult your paediatrician. Also, if a child has recovered from COVID, and gets a fever within two months, take extra care.
You will be surprised to know that about 10-12 kids who we admitted in the last one month, they were all post COVID and none of the parents knew when the child got COVID. The disease itself was so mild in them that they didn’t even come to know but yes, the sequel (MIS-C) was there.
NDTV: Do children with asthma get sicker from COVID-19 and have more serious symptoms if they are infected?
Dr Manish Mannan: Any human being who has underlying comorbidity whether it’s bronchitis, bronchial asthma or any acute exacerbation of anything that can increase the morbidity of the respiratory system if the system gets affected. Again, the number of kids having respiratory system getting affected and requiring a CT-scan is much less. I would suggest parents to keep their child on regular inhalers which the child has been having. We don’t want an exacerbation and take the flu shot and preventive medications which have been prescribed by your pediatrician.
NDTV: Children are cooped up at home and parallely, elders are being vaccinated so why is it being said that the third wave might affect children more?
Dr Manish Mannan: The statement that kids will be affected more was made by a virologist at the peak of the second wave. The probable thought was that probably kids don’t get vaccinated hence, kids might get more affected but, there is no scientific or statistical evidence behind this. I don’t agree with this statement. We should be prepared for it if it happens, but we should not create panic.
NDTV: What precautions do we need to take to protect children?
Dr Manish Mannan: Firstly, stop giving multivitamins rampantly to your child. The immunity improves with the right kind of diet and when I say diet, I say, divide your plate into four parts – one-fourth should be green vegetables without potatoes, one-fourth should be fruits, one-fourth should be carbohydrates, there you can include potatoes and one-fourth should be protein where you have eggs, pulses, and other items. Also, add milk and milk products outside the plate.
Secondly, not going to the park and playing is not safe at this stage I would say. Children should go out and indulge in physical activity. There is a lot of data to say, about 50 per cent of kids today because of the lockdown have had multiple problems from depression to anxiety to obsessive compulsive neurosis to anger issues to sleep disorders. The number of psychiatric and psychological problems I have seen in the past few months I have never seen in the past 10-12 years. I had to give medicines to a child as small as 5 to sleep. This is a very worrying situation. Mental problems can cause a change in the personality which can affect the child for life.
Thirdly, please stop watching news with your children very often. Especially, the kind of news that creates a psychic and a depressing atmosphere. It gets on to your immunity. And whenever child falls sick, consult your doctor. If you do everything early, trust me, nothing will go wrong. A stitch in time saves nine, he added.
A balanced diet, a good state of mind, exercise and a lot of fluids will create good immunity. Also, follow COVID protocols; I would always advise repeated handwashing with soap rather than using hand sanitiser. Just tell your children one thing, before your hands touch your face and mouth, you should wash them with soap and water.
NDTV: How effective are flu shots to protect children against COVID-19?
Dr Manish Mannan: Centers for Disease Control and Prevention has recommended flu shots for all kids and the science behind that is a retrospective study conducted in Michigan between February to July, 2020. The data showed that the kids who had received the flu shot were less susceptible to the infection number and secondly, those who had the infection, even in them morbidity and mortality was less. Anyway, flu shots are recommended for all kids up to 5 years and beyond that all high risk individuals should also take flu shots. In the present scenario, I’ll recommend all kids to take flu shots. We don’t know how much but yes, some data is there to say it’s effective. It’s not going to harm the child.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.