Health Ministry Issues Guidelines On Operationalization Of C
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The Union Health Ministry has issued guidelines on operationalization of COVID care services for children and adolescents. "It is anticipated that there may be intermittent surges in the number of cases. A combined effort from private and public sector is needed to handle any surge in future after the withdrawal of the lockdown, school re-opening or as third wave over next 3-4 months," the ministry said.

The guidelines said that children have less severe disease than adults. In the majority, infection is asymptomatic or mildly symptomatic. It is uncommon to have moderate to severe Covid in healthy children and children with co-morbid conditions have more severe manifestations and poorer outcomes; they should be a priority group for vaccination, once vaccines are approved for children.

Based on sero-surveillance reports, Covid-19 infection in children above 10 years of age occurs in similar frequency to that of adults, even though, among the confirmed cases, below 12 percent are individuals below 20 years of age. Most drugs used in adults such as Ivermectin, HCQ, Favipiravir and antibiotics such as Doxycycline or Azithromycin have not been tested in children for prevention or treatment of COVID infection in children. Therefore, these are not recommended in children.

The ministry said that the estimates for additional bed capacity for pediatric care may be calculated based on the peak daily cases in different districts during the second wave. From this number, projections for pediatric cases and number of admissions required can be derived. For children with multisystem inflammatory syndrome (MIS-C), who test negative for acute COVID, care has to be provided by the existing pediatric facilities.

The guidelines said, "It is desirable to augment the existing Covid care facilities to provide care to children with acute Covid. This will need additional pediatric specific equipment, infrastructure, and pediatric formulations. Adequate number of trained manpower- both doctors and nurses should be provided."

The guidelines said that health authorities should initiate capacity building programs for appropriate pediatric care. In standalone paediatric hospitals, separate arrangements for example - separate bed for paediatric COVID care need to be established.

The ministry added that it is important to ensure data collection at all levels and transmission from community to higher centers. A national registry should be launched for pediatric COVID. There is need to encourage and facilitate research in area of pediatric COVID; this could cover various aspects of management. Medical officers should provide leadership to ensure service delivery locally by involvement of community health workers, the ministry said.

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