'However, whether the future waves will affect children more or with increased severity are speculations'

The coronavirus pandemic situation can have severe effects on children's mental and physical health, Director, Department of Paediatrics, Lady Hardinge Medical College, Dr Praveen Kumar, has said.

"Pandemic can have a severe effect on children's mental and physical health. They are confined at home for more than a year. Moreover, illnesses in the family, wage losses for parents have increased stress. Children may express psychological distress (sadness) by acting out in a different way each child behaves differently. Some may become silent while others may express anger and hyperactivity," Kumar said according to the Ministry of Health and Family Welfare.

Kumar noted that here families will have a role to play. “Caregivers need to be patient with children and understand their emotions. Look for signs of stress in young children, which could be excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration. Families also need to support children to cope with stress and also allay their anxiety,” he said.

Whether the future waves will affect children more or with increased severity, Kumar noted, are speculations. “People speculate that future waves may affect children more as most of the adults will be vaccinated in the next few months while we do not have any approved vaccine for children at this point in time,” he said.

“Though we don’t know how the virus is going to behave and affect children in the future, we need to protect our children from the contagion. Adults in the house should follow COVID-Appropriate Behavior, and limit their social engagements to reduce the chances of infection as they may carry and transmit the infection to others. Besides, all the adults should take vaccines, which will also protect the children to a great extent,” he added.

Further, he said that now vaccines available for pregnant women and lactating mothers will give a certain degree of protection to the growing foetus and new-born against the deadly infection.

On the impact of COVID-19 second wave on Children, he further said it had affected equally compared to adults. "COVID-19 is a new virus and it affects all age groups because we do not have natural immunity against this virus. As per the NCDC/IDSP dashboard, approximately 12 percent of infected COVID was contributed by patients less than 20 years of age."

According to Kumar, recent surveys have shown similar seropositivity in children and adults. However, due to a larger number of people affected during the second wave, the number of infected children was also more as compared to the first wave. So far, the mortality rate in children is lower as compared to adults and is usually seen in children with comorbidities.

On the multisystem inflammatory syndrome, he said that MIS is a new syndrome seen in children and adolescents (0-19 years of age). Most patients report it two to six weeks after the peak of COVID-­19 infections in the affected population.

"Three types of clinical course are described: Persistent fever with Raised Inflammatory parameters, Classical Kawasaki Disease like presentation and Shock, LV dysfunction with the inotropic requirement. For establishing the diagnosis of MIS-C, advanced investigations are required. All suspected cases should be referred and managed in a tertiary care hospital with HDU/ICU facility. If identified early, all these cases can be treated," he added.