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I HOPE I find you well and in good spirits.

The lockdown to curb Covid-19 has been relaxed to Level 2. This is an encouraging development, more importantly for the children. They are getting a chance to learn in class after such a long time. As much as this may pose as potential trigger for a surge in cases, it can be managed well to allow continuity under the new normal.

It is unclear why more children are sick due to the delta variant outbreak, but medical experts believe the surges in paediatric cases are due to the variant’s hyper-transmissibility — how easy it is for the virus to circulate in a population that is unvaccinated.

The delta Covid-19 variant (B.1.617.2) was first detected in India. This is a concern because there is evidence that the risk of hospital admission is higher in people with the delta variant. Most of those admitted had not been vaccinated.

However, “If more children get sicker, that’s just because more kids are getting sick,” said Paul Offit, a vaccine researcher at the Children’s Hospital of Philadelphia. “It’s clearly increased contagiousness, not increased virulence.”

Some experts suggest that children might not be as severely affected by Covid-19 because there are other coronaviruses that spread in the community and cause diseases such as the common cold. Since children often get colds, their immune systems might be primed to provide them with some protection against Covid-19.

It’s also possible that children’s immune systems interact with the virus differently than do adults’ immune systems.

Some adults are getting sick because their immune systems seem to overreact to the virus, causing more damage to their bodies. This may be less likely to happen in children. The BCG vaccine, to prevent tuberculosis, given at birth has also been seen to have a protective effect in children against viral infections.

Babies under age one might be at higher risk of severe illness with Covid-19 than older children. This is likely due to their immature immune systems and smaller airways, which make them more likely to develop breathing issues with respiratory virus infections.

Newborns can become infected with the virus that causes Covid-19 during childbirth or by exposure to sick caregivers after delivery. If you have Covid-19 or are waiting for test results due to symptoms, it’s recommended during hospitalisation after childbirth that you wear a cloth face mask and have clean hands when caring for your newborn.

Keeping your newborn’s crib by your bed while you are in the hospital is OK, but it’s also recommended that you maintain a reasonable distance from your baby when possible. When these steps are taken, the risk of a newborn becoming infected with the Covid-19 virus is low. However, if you are severely ill with Covid-19, you might need to be temporarily separated from your newborn.

Possible symptoms in children can include:

Fever or chills

Nasal congestion or runny nose

Cough

Sore throat

Shortness of breath or difficulty breathing

Fatigue

Headache

Muscle aches or body aches

Nausea or vomiting

Diarrhoea

Poor feeding or poor appetite

New loss of taste or smell

Belly pain

The most common co-morbidities in hospitalised children are diabetes, gastrointestinal, neurological, cardiac and pulmonary diseases, specifically asthma. There is no evidence of a difference by age or sex in the risk of severe outcomes among children, which contrasts with the strong age-sex association observed among adults.

Children are rarely index cases, and scientific studies show that infectivity between children is significantly lower than between adults. Few children have needed intensive care and even fewer have died.

Post-acute sequelae of SARS-CoV-2 are characterised by persistent symptoms such as fatigue, dyspnoea, chest pain, cognitive impairment, and sleeping disturbances that last up to several months after infection
Knowledge of the consequences of school closures has increased. Possible negative effects such as loss of learning and impact on mental and physical health have been highlighted.

The negative consequences might have hit hardest against children who are already at risk, such as children with disabilities, children with underlying diseases, children in socio-economically disadvantaged groups and children living in social vulnerability and poverty.

Public Health England confirmed that its data showed an increase in outbreaks and clusters involving variants at primary and secondary schools in recent weeks. Numbers of cases of Covid-19 have been rising fastest in schoolchildren in years seven to 11.

Teenagers also transmit the infection to a greater extent than younger children, but to a lesser extent than adults. A contributing reason for greater transmission among teenagers may be that they move around more in society and often have many close contacts.

There is limited spread of SARS-CoV-2 in schools when appropriate mitigation measures are in place. However, transmission of SARS-CoV-2 in school settings is inherently difficult to assess, particularly when community transmission is ongoing, as transmission attributed to schools could have occurred in community settings or vice-versa.

Educational staff and adults within school settings do not seem to be at increased risk of severe Covid-19 compared to the general population, but appropriate measures, including full vaccination, should be taken to minimise the chances of infection of educational staff.

In some cases, it is difficult to determine whether the infection spread during leisure time or at school. The infection seems to spread during leisure time, in close-contact sports and in other social contexts, such as parties or camps.

A number of measures must be taken at schools, such as adjusting schedules to avoid congestion, not allowing parents to stay on the premises, holding some of the teaching outdoors and allowing teaching of secondary school students to take place partly remotely.

Contact Dr Tatenda Simango on [email protected], for more articles visit www.9thavenuesurgery.co.zw