THIRUVANANTHAPURAM: With health experts warning of an inevitable third wave which could affect children more, Kerala has initiated steps to ramp up paediatric infrastructure. But the state is staring at a herculean task as both private and public healthcare institutions have very limited critical medical care infrastructure to treat children. It is estimated that one in three children may require intensive care when the third Covid wave does arrive.
Statistics, as of June 7, 2021, reveal that over 2.51 lakh children below 18 were affected by the coronavirus infection during the first and second waves in Kerala. According to officials, private healthcare institutions would play a key role as there is a severe dearth of paediatric facilities at public institutions. The current plan is to get Covid positive children screened by a paediatrician in the government sector and refer them to private institutions. It is learnt that the state government will have to take care of the treatment cost of children admitted to private hospitals in that fashion. Discussions are on to draw up a plan in that regard, a health department source said.
Of the total children who contracted Covid, 53,422 were below five years while 57,641 were in the 5-10 age group. As many as 22 deaths have also been reported since the outbreak. A top official with the Directorate of Health Services pointed out the possibility of more children getting infected with the virus as children are not getting vaccinated. Reopening schools would increase the possibility of infection.
“The Delta variant is more contagious and we are going to step up awareness campaigns to educate the public on the same. This is one way of controlling the spread and protecting children,” the official said. As part of the preparation, the health department has launched special training programmes for paediatricians. “If there is a surge, the current number of paediatricians will not be enough. So more doctors will be trained to handle Covid-related paediatric cases,” said a senior health official.
There is no need to worry as the fatality rate among children is considerably less compared to others, the official said. State secretary of the Indian Medical Association, Dr P Gopikumar pointed out that paediatric ICUs and ventilators are less in both private and government sectors. “The plan should be to increase the infrastructure at hospitals with paediatric departments, and for hospitals with paediatricians to manage the surge. Speciality and multispeciality hospitals have paediatricians, and enhancing infrastructure will not be a problem there. There is a serious dearth of paediatric ventilators at hospitals as adult ventilators and ICUs cannot be used for children,” said Gopikumar.
However, experts feel that increasing Covid ICUs alone will not serve the purpose. The government should be focusing more on managing Covid-related Multisystem Inflammatory Syndrome (MIS-C), said an expert.“MIS-C is a dreaded complication which often manifests three to four weeks after Covid infection. Non-Covid ICUs would be needed to treat MIS-C. We have recommended the government set up more facilities to manage MIS-C in every district. The state has done well in managing Covid and MIS-C among children so far,” said a senior health official. Human resources too should be increased, the official said.
“In Kerala, after the peak last October, the pandemic plateaued and then we had the second wave. If there is a huge surge, other doctors too will have to step in. Training sessions on paediatrics are already under way for other doctors too,” said Dr Anish TS, an assistant professor with the department of community medicine, Thiruvananthapuram medical college hospital.