MUMBAI: With the focus shifting to children in the anticipated third wave of coronavirus, the state’s paediatric task force has stressed on the strengthening of two aspects mainly— effective home monitoring and timely referral to a hospital.
During a virtual meet chaired by CM Uddhav Thackeray with members of the paediatric task force on Monday, it was discussed that home monitoring must be at the heart of the strategy to curtail severe cases or deaths among children due to Covid.
To implement it, the experts suggested that ASHAs (accredited social health activists) and parents of affected children should be acquainted with tools such as a ‘monitoring chart’.
Data from first and second waves in the state has shown than over 90% children don’t require hospitalisation and remain either asymptomatic or mildly symptomatic.
Paediatrician Dr Vijay Yewale, a member of the task force, said that a patient monitoring chart has been designed for parents and ASHAs to monitor five key parameters: temperature, pulse, respiration, oxygen saturation and urine output.
The chart would have columns where caregivers or ASHAs (where a caregiver is not able to do the monitoring) will fill up twice or thrice a day.
“This will help them to pick up signs of deterioration swiftly,” he said.
“For instance, if the child’s oxygen saturation or urine output drops, it will be visible in the chart,” he said.
Thackeray emphasised ASHA workers will have a key role to play at the time of referrals too.
He said fever clinics too will have a crucial role to play.
Dr Suhas Prabhu, head of the task force, said that doctors at the fever clinics could be the first point of contact for Asha workers.
Depending on the child’s condition, the doctor could decide if he/she needs a paediatric Covid care hospital (PCCH) or paediatric high dependency units (HDU).
The task force has suggested that the monitoring chart should be printed and distributed at all district levels.
The doctors also said that it was important for children to complete 14 days in isolation even if their symptoms of fever, cold, cough subside after a few days.
“As far as possible, children above the age of 2 years should be made to wear a mask and kept away from senior citizens in the house,” Dr Yewale said.
As part of its preparedness for the projected third wave, the state plans to increase the number of paediatric Covid beds to nearly 2,300 from the existing around 600.
It is also creating graded healthcare facilities for management of moderate and severe Covid cases.
N Ramaswami, commissioner, National Health Mission, said that the state has around 68,000 ASHA workers, who are generally acquainted with the health conditions of children in areas within their jurisdiction.
Despite fears of children getting hit in the third wave, the state has maintained that the proportion of those affected below 5 years and below 18 years was in the range of 6% to 8.5% in the last six months.