Coronavirus in children mild, infectious disease experts support schools reopening

Coronavirus in children in Pakistan has been relatively mild compared to adult patients. Most children developed a mild form of the disease and are not believed to be major drivers of the virus spread, according to the country’s infectious disease experts. Doctors now support the reopening of educational institutes with strict adherence to SOPs.

Federal Education Minister Shafqat Mahmood announced that schools will reopen from September 15, after a final decision was made on September 7. Many parents have been anxious about the decision but doctors now say that the damage done to students’ education by delaying the reopening of schools will outweigh their risk of catching COVID-19.

“Children make up a very small proportion of cases and most of those infected did not develop severe symptoms,” said Dr Azizullah Dhillo of Civil Hospital Karachi on Thursday.

Children have lower susceptibility to the new coronavirus (SARS-CoV2) compared to adults, according to the Medical Microbiology and Infectious Disease Society of Pakistan.

Studies from around the world have shown that children account for 1-7% of COVID-19 cases. Few require hospitalisation and even fewer (less than 0.1%) die from the virus, the MMIDSP added. 

Data from the Sindh health department as of September 8 reveals that in Pakistan, children between one to 10 years made up 10,213 of the total 299,233 reported cases in the whole country. Around 22,500 cases were reported in children between 11 to 20 years of age.

“Though all hospitals had set up wards for children with Covid-19, hardly any child was admitted since the disease outbreak,” Dr Sadia Aamir of Liaquat National Hospital pointed out.

She added that children had already been put at risk when families took them to parks, malls and restaurants where no one was following SOPs. Everything else has been opened up, it makes no sense to keep schools closed, Dr Aamir said.

Children need social interaction to develop social skills, said Dr Shobha Luxmi of Dow University of Health Sciences. In-person schooling is in the best interest of students for normal development including physical and mental health, Dr Luxmi said.

The doctor added that parents needed to use this remaining time to teach their children precautionary measures such as:

  • Washing hands properly
  • Wearing a mask at all times
  • Asking them to limit physical contact such as hugging, hand shaking
  • Discourage sharing of masks
  • Once they get home, asking them to change clothes, wash hands, shower and then interact with the family

Masks, however, were not suitable for every child, said Dr Bushra Jamil, MMIDSP president and a professor at AKU. The WHO had advised against masks for children under 12 years, she said.

In addition to the precautionary measures mentioned earlier, Dr Jamil also suggested parents teach children how to use hand sanitisers and if possible send children with it to school with personal sanitisers. She recommended schools ensure proper ventilation according to their resources to limit transmission. If that wasn’t possible, they could consider open air classes like some schools had done abroad. 

Responding to SAMAA Digital’s question on cases of multisystem inflammatory syndrome, the MMIDSP president said very few cases had been reported in Pakistan. 

The syndrome, also known as Kawasaki-like multisystem inflammatory syndrome, is a rare illness of unknown origin found after coronavirus infection in young children which causes inflammation in the blood vessels of the body.

The first sign of the syndrome is usually fever, followed by stomach ache, vomiting or diarrhoea, red eyes and a rash on the trunk. Some children also develop an inflamed red mouth and tongue while few have swollen glands in the neck. If detected early, it can be treated. 

Dr Asma Nasim of the Sindh Institute of Urology and Transplantation said even in infected children with renal failure, such as the ones admitted at SIUT, cases of COVID-19 had been mild.

“We got very few cases and no child was admitted to the ICU or required steroid therapy,” Dr Nasim said, adding that no child undergoing dialysis was admitted to the ICU.

However, adults at SIUT who got COVID-19 were serious enough to require ICU care, she said, explaining that this showed even in children with underlying conditions the disease was not alarming. 

The best available evidence from countries that have reopened schools suggests that COVID-19 poses low risk to school-going children, says the MMIDSP.

About the situation in Pakistan, Dr Luxmi said: “right now, everything is a prediction. In October it will become clear what effect reopening schools had.”



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