Maharashtra to rope in 6,000 paediatricians to combat 3rd Covid-19 wave

Following Covid protocols continues to be one of the most effective ways to break the chain of transmission, experts say. File pic

With the third wave of Covid-19 anticipated to hit in the next six to seven months, the state's nine-member paediatric Covid-19 task force will be reaching out to 6,000 paediatricians in the state over 15 days to prepare them for the onslaught. The uphill task is to make the system ready to deal with paediatric cases. A task force member said that creating a nursing team and intensivists to handle patients in ICU will be a challenge.

Healthcare workers screen children for symptoms at LTT

Accordingly, starting next week, paediatricians will be trained in intensive care. Presently, only around two to three per cent of paediatricians are said to be trained intensivists. For nursing care, the task force plans to take local paediatricians' help.

"There are very few ICU doctors. In Mumbai itself, we have some 20 trained paediatric intensivists. There are 1,200-1,500 paediatricians in Mumbai. We have to train those inclined to look after ICU patients and oversee them. Our training modules will form the backbone of the programme," said a member of the task force headed by Dr Suhas Prabhu.

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Modules are being made to treat mild, moderate and severe Covid-19 in children. "We have submitted our recommendations, guidelines to the state government. We will submit training modules by this weekend. The modules will tell primary health care doctors, peripheral hospital doctors how to suspect, when to suspect and the treatment to be given in a simplified manner," the member said.

The task force's plans also incorporate Anganwadi workers. "For them, we have simplified the program. In rural Maharashtra, they will play a major role in Covid-19 management. The program has algorithms, charts that can be put in clinics," said the member.

Tackling rampant medication

Amid worries over the rampant use of steroids, antibiotics and other medications in the treatment of adults, the task force has laid out a clear treatment protocol. "There aren't many drugs. It will mainly be paracetamol, supported drugs and steroids. People are rampantly using remdesivir, tocilizumab. Our module has clear instructions on when to use them," the member said.

Experts suggest Covid-19 testing of children only if they have positive kin or symptoms for over three days. File pics

So far, 11,144 children up to nine years and 28,869 in the 10-19 years age group have been affected by Covid-19 and 17 and 33 have died in the respective group. Paediatricians prescribe tests for children only if kin have tested positive or if there are symptoms and fever for more than three days. According to the Indian Academy of Pediatrics (IAP), 60-70 per cent of infected children are asymptomatic and about one to two per cent of symptomatic ones need ICU treatment.

"There was definitely a percentage rise in paediatric cases in the second wave. We presume that since adults will have access to vaccines, the lower ages will get affected more," said Dr Shashank Joshi, member of the state task force on Covid-19.

He said that the timing of the next wave is proportional to two things - easing of restrictions and adherence to Covid-19 protocols.

"The probability and possibility of transmission breaks will be low if we follow Covid-19 rules. Also, if we saturate densely populated areas with vaccines, we can delay the next wave. The idea is to remove the sting out of the next wave. It is presumed by mathematical modules, which a virus may not follow, that the next wave will come in six months or later," said Dr Joshi.

1,500
Approx. no. of paediatricians in the city

20
Approx. no. of city paediatricians trained in intensive care

Six
No. of months post which the third wave is expected to arrive