Bengaluru-based Ankit, noticed that his four-and-a-half-year-old son was unusually cranky and complaining of stomach and teeth pain on April 2. His temperature reading showed he had a fever of 99 degrees. After a paracetamol tablet, his fever came down. However, when Ankit got to know that his neighbour’s son was coronavirus positive, he got his son tested too, as the kids had been playing together.
After his son tested positive too, Ankit and his wife also isolated themselves at home. “Doctor also informed us that there is no medicine for kids so we didn't give any medicine apart from a syrup,” he tells TNM. Ankit and his wife did not develop any major symptoms and ultimately got a negative report on the RT-PCR test.
Doctors tell TNM that this time around, they are seeing more cases of children requiring medical intervention after they contract COVID-19, compared to the first wave last year. Dr Rakshay Shetty, the head of Pediatric Intensive Care Services at Rainbow Children’s Hospital in Bengaluru, says, “What we are seeing for sure in this wave are more symptomatic children – who may not get very unwell but need medical intervention – even if the overall number of children affected has not increased compared to the first wave.”
Dr Udayakumar, a professor of paediatrics who heads the Karthikeyan Child Development Unit at Sri Ram Chandra Medical Centre in Chennai, has the same observation. He adds that while there is an increase in children presenting with symptoms, it is not necessarily translating to a significantly higher number of severe infections. He adds, “However, we are seeing more infants – as young as 1.5 months old – and children under five years who are in need of medical intervention. This is likely happening because they are more dependent on parents, and are not able to adhere to physical distancing and hand hygiene.”
Ankit had a similar experience. “When my son tested positive for the virus, we were not able to maintain any distancing at all since he was cranky and he was sleeping with us only. He didn’t wear a mask at all,” he tells TNM. And since the child could no longer meet his peers and play, the parents had to entertain him through the 17 days of isolation too. “For entertainment, he started watching more TV. My wife was always with him, engaging with him,” Ankit adds.
Dr Rakshay also notes that he has been seeing comparatively more infants – those less than a year old – needing to get admitted to the hospital because of pneumonia. “While they respond well to treatment and only very few have required ventilators, the incidence is more in this wave,” he acknowledges. “But that more children are dying of COVID-19 is not true – they are just sicker if infected than they were in the last wave.”
Dr Vidya Vimal, consultant paediatrician at GG Hospital and SP Wellfort Hospital in Thiruvananthapuram, notes that symptomatic infections have increased in children over five years too, up to 12-13 years. She has also noticed that parents are resistant to getting their children tested. “In one case, a 10-month-old infant’s mother was hesitant to get COVID test done and kept insisting that the diarrhoea her child was experiencing was because of the recent change in diet,” Dr Vidya says.
The doctors say that diarrhoea, fever that is not going down for 2-3 days, breathing faster, vomiting, abdominal pain, unusual decrease in appetite, generalised muscle pain, nasal discharge, and cold and cough, are symptoms to look out for in kids when it comes to COVID-19. Dr Vidya says that it is imperative for parents to consult a doctor if a child presents with even mild symptoms of the above, and make use of the telephonic consultation option that many healthcare practitioners and institutes are providing.
The doctors speculate that the increase in children presenting with symptomatic COVID-19 may have to do with the new variants of SARS-CoV-2 that have been found in India, though more research is needed to establish how exactly they affect the human body. They also attribute difficulty in enforcing COVID-appropriate behaviour on young children and their dependency on adults around them.
Dr Vidya says that if a child tests positive for the coronavirus, parents should try explaining to them in an age-appropriate manner why they cannot go out and play, keep them at home and engaged, and encourage them to wash hands regularly.
For Sarah, a Bengaluru-based homemaker, engaging with her 12-year-old and 15-year-old sons who contracted COVID-19, was slightly easier because the younger one was asymptomatic throughout. “My older son had a fever, cold and cough – we thought it was a viral. After the third day, it started coming back to normal… but then my husband complained of lethargy, and the rest of us developed a mild fever. I developed a back ache so painful that it left me in tears,” she says. However, they were able to forgo individual isolation at home since everyone tested positive and supported each other. Both Ankit and Sarah also had help from their respective neighbours who sent the ailing families cooked food during their isolation period.
The doctors say that while more children are reporting with symptomatic COVID-19, parents and families should not panic as children – unless they have comorbidities in some cases – are generally responding to treatment quickly and well.