Who will step up as the young children suffer?

 

It’s a distressing time for families as more very young children are coming down with Covid-19 along with their parents.

With no vaccination yet for children – until at least the middle of this month and, even then limited to those with comorbidities and older children – and while the highly-infectious Delta strain is raging, doctors say more children have been infected and hospitalised, including babies.

Children admitted into hospitals for Covid-19 make up 10% to 12% of all Covid-19 admissions and a small percentage require oxygen or ventilation, said consultant paediatrician Dr Zulkifli Ismail.

However, most Covid-19 cases in children have been mild, in Categories 1 and 2, but this is enough to create anxiety among parents who are already suffering from their own Covid-19 infections and struggling to cope with caring for their young ones.

Kuala Lumpur-based Khoo, as she would like to be known, said a close relative in a southern state tested positive for Covid-19 and was admitted to hospital. Subsequently, his wife and sons aged two and four tested positive but his nine-year-old daughter was negative.

His wife was caring for the boys who had fever while she herself was having high fever and a bad cough. Her oxygen level dipped to 88% on one of the days.

She was admitted to hospital on Aug 24 after hesitating for four days as she did not want her relatives to risk getting infected by caring for her children. She was also concerned that her boys who had recovered from fever would be reinfected in hospital if they were warded with her, said Khoo, 53.

There was also another challenge. When Khoo received a call from her relative’s wife in the wee hours of the morning to be sent to hospital, she had requested that the ambulance take the two boys along as there was no one to care for them.

However, the ambulance could not take the boys because there was no space but they were later allowed to be warded in the same room with their parents.

Khoo said the hospital was arranging for the boys to be discharged and cared for by a relative. The eldest child who tested negative was forced to stay home alone while an aunt dropped off food and checked on her.

As adults are filling up spaces and overwhelming hospitals, are we prepared for a possible wave of infected children needing quarantine and hospital care?

Who should care for the children, especially the young ones who tend to stick to their parents? What about the risk of infection spreading to other family members at home?

What if parents and children are both Covid-19 positive and the parents are too ill to care for their young children?

The facilities we have are far from enough if there is a surge in cases and parents will have to plan ahead and government agencies need to step up efforts to support the needs of families.

Health ministry guidelines

For one, some children can be quarantined at home with strict adherence to SOP.

The health ministry’s guidelines on home monitoring and clinical protocol at primary care for Category 1 and 2 (mild) confirmed Covid-19 cases (revised version March 24, 2021) recommends that all children (18 and below) can be quarantined at home if they are Category 1 patients with no comorbidities and have suitable caregivers, and home condition.

For Category 2 cases, those aged two and above with no comorbidities and with suitable caregivers and home condition, and ability to adhere to SOP can also be quarantined at home.

Those with other high-risk medical conditions should be monitored in a quarantine centre or hospital and those below age two in Category 2 should be sent to a hospital.

In cases where whole families are positive, they get admitted, usually as a family unless one or both parents’ condition worsens and the individual needs to be transferred to the intensive care unit (ICU) or another hospital. The children are then left with no caregivers in the wards, said Zulkifli.

Currently, the frontliners at Covid-19-designated hospitals and hybrid hospitals have relied on close relatives to look after patients’ children but the social welfare department will need to assist too.

“In cases where parents have to be sent to the hospital and there is no one to care for the children, the department should assist by ensuring there is a responsible caregiver with adequate monitoring and aid to help see them through the ordeal,” Zulkifli said.

For children admitted in hospital, social workers should also complement paediatric caregivers by ensuring that the children’s online education continues.

“This is the time when government agencies, the existence of which had been supported by our tax money, should step up and be more proactive,” he added.

Kapayan assemblyman Jannie Lasimbang said the social welfare department should now focus on caring for children affected by Covid-19 and delegate its responsibility of giving out food aid to village heads or community leaders.

Last Thursday, Sabah hit a record high with 3,487 Covid-19 cases, with more than 300 cases involving young children and babies.

Jannie said the Likas Women and Children’s Hospital was already full and most of the children with mild cases were quarantined at the Likas Sports Complex.

The federal government should send more resources, including vaccines, to Sabah, she said.

Lastly, many parties have called for the government to come up with a proper plan to ensure the safety of Covid-19 orphans who had lost their parents in the pandemic and for them to be adopted or cared for.

The needs of the children are many and government agencies, NGOs and the community will have to move fast to support parents and protect children during the pandemic.

Prompt support and care for parents and children are likely to save them from landing in ICU or worse, dying from Covid-19. -FMT 

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.