How the pandemic might change future medical support for children

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"About 658,000 children in the Western Cape were infected with Covid-19." Photo: taylor-brandon/Unsplash
"About 658,000 children in the Western Cape were infected with Covid-19." Photo: taylor-brandon/Unsplash

Since the Covid-19 pandemic began in March 2020, about 658,000 children were infected with Covid-19 in the Western Cape. Out of those, 46,455 were admitted to hospitals and 123 of them died, according to Dr. Heloise Buys, Head Clinical Unit: Ambulatory and Emergency Paediatrics at Red Cross Children's Hospital

Sharing this information in a virtual Ad Hoc Committee on Covid-19 meeting, Dr. Buys revealed that five million children worldwide lost a primary caregiver between March 2020 to October 2021. Even more children were affected by the Covid-19 lockdowns as their parents lost income, and schooling was affected. 

Read: Are we inching closer to the pre-pandemic normal?

Child-centered Covid-19 care

Dr. Buys said that children's needs were overlooked and sidelined as the attention was on adults affected by Covid-19 in the Western Cape.

Resources were diverted from pediatrics to adult Covid-19 care and concerns around infection led to the separation of infants and children from much-needed family support, she said.

She explains that quarantine and isolation facilities were prepared with adults in mind, noting that children older than 12 were put in single rooms without support or supervision, while intermediate care facilities for children were not an option due to fear of Covid-19 being spread to other vulnerable children and staff members.

Newborn babies 

Dr. Buys said research indicated that transmission to newborn babies was rare. This may be because of the strict Covid-19 precautions that were followed by the province, which included: 

  • General precautions such as screening, testing, and temperature checks took place.
  • Spacing in KMC rooms was controlled.
  • Breastfeeding continued to be promoted.
  • Covid-19 positive mothers and baby were kept together if both well.
  • Covid-19 exposed and positive babies were managed in closed incubators.
  • Mothers had 24/7 access, and video calls were encouraged for fathers.

Must see: WATCH | Pediatric doctor shares how Covid-19 is impacting children in hospitals

Dr. Buys also noted that at least 70 children in Red Cross and Tygerberg Children's Hospitals were affected by an illness called Multisystem inflammatory syndrome (MIS-C), of whom 40% required ICU admission and blood pressure support in the first 10 months of the pandemic.

Some of these babies were extremely ill and needed regular intensive care, expensive special investigations, and treatment.

Also see: What to know about your child's antibodies after they've had Covid-19 

Long Covid in children

Dr. Buys notes emerging evidence suggests that some children with long Covid-19, just like adults, experienced lingering symptoms weeks to months after infection, including fatigue or insomnia, muscle and joint pain, headache and inability to concentrate, and persistent nasal congestion and weight loss.

According to Dr. Buys, we need to raise awareness with families and colleagues as ongoing supportive care is required.

Lessons learned

Going forward, Dr. Buys suggests the provision of access to child-friendly platforms to talk about experiences and express concerns about Covid-19 and other illnesses.

Other recommendations:

1. Each child admitted to the hospital needs their bedside caregiver.

2. Keep mother-infant/young child dyads together, and promote breastfeeding.

3. Advocate for affordable medicines and diagnostic tests for children.

4. Protect resources and essential non-Covid-19 pediatric care

5. Ensure that clinical governance teams support child health reps to guide national and provincial command structures.

Dr. Buys noted that children become highly vulnerable when their parents are sick or die and they require support during this time of anxiousness, separation, and grief. Reflecting on what children lacked during the pandemic, Dr. Buys sees the need for support systems in place for those children.

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