„ In the case of depressurization of the cabin in the aircraft, adults are advised to put an oxygen mask on themselves first and then put the baby's oxygen mask on. It's a similar situation now. We made a vaccine, we put on an oxygen mask, we're kind of protected from Omicron. We have a duty to help the kids.! ..."
The news from Moldova have saddened me a lot in recent days, especially the news about children affected by infection with the Omicron strain, the news about overcrowded paediatric departments in hospitals and, of course, the fears of parents.
The writing of this Op-Ed was determined, to a large extent, also by my maternal instinct.
Like any mom, I can't forget sleepless nights during periods when my children were young and sick. Even a banal cold awakens a lot of anxiety in the mother's soul. I want to hug every mother who is now looking after her child infected with Omicron.
I will try to help by observing the principle of "everyone does what they can".
To understand the situation more holistically, I will try to describe what happens to a child when he becomes infected with Omicron.
How does Omicron enter the human body?
Since the discovery of the new Omicron strain, researchers have begun to study the interaction of this strain with the host organism. Studies were conducted on hamsters for the most part, but they allowed to collect convincing data on the behaviour of this strain in a living organism.
Among the discoveries some were very important. Omicron enters the body through the upper respiratory tract, that is, through the nose and mouth. Omicron multiplies in the upper and lower respiratory tract 70 times faster and more compared to the Delta strain. It is for these reasons that the nose, pharynx, larynx are affected, respectively, the voice is lost, nasal congestion and rhinitis appear, as well as other classic symptoms of diseases of the upper and lower respiratory tract.
Omicron almost does not connect to lung cells or connects very little, that is, it is not able to multiply much in the lungs. For these reasons, there are fewer cases of pneumonia with this strain.
This valuable information once again confirms that if we wear a good mask and wear it correctly, we will be protected to a certain extent.
What happens to the kids in this wave with Omicron?
Since the beginning of 2021, vaccination has become a privilege for adults. Vaccines were initially tested only for people aged 16 or 18 years and, accordingly, the introduction of vaccines was approved exclusively for adults.
During 2021, studies with the introduction of mRNA vaccines were also conducted in children, initially in the age segments of 12-18 years, then in the age segment of 5-11 years.
Vaccination rates among children in the world remain very low anyway, so children are currently the main targets for new strains, including the Omicron strain.
Young children don't wear a mask. It's very difficult to get a young child to wear a mask. This factor is now complicit and helps Omicron to infect children more easily.
However, the main factor in the mass infection of children in this pandemic wave is physiological.
All those who have raised children understand that these upper respiratory tracts in children are extremely vulnerable to various "respiratory" infections. The diagnosis of "acute respiratory viral infection" is present in almost most medical records. The upper respiratory tract in children is not yet ready to meet with such a pathogen as Omicron. The younger the child, the less protected he is, since physiologically the surfaces of the mucous membrane are not yet mature enough for such an external invasion.
In addition, the child's immune system is also not yet ready to face such an intensive replication of an aggressive virus. Children with weakened immune systems are the most vulnerable in this wave. As a result, we have a lot of infected children, a lot of children hospitalized, a lot of anxiety in the community, a lot of questions that are looking for answers.
I wrote above that this strain of Omicron multiplies 70 times faster in the nose and throat, and is also easily transmitted to others, in the classroom, in the family.
So in this pandemic wave with Omicron, we have a new picture. The kids in this wave are not only good carriers and transmitters, they're also the most susceptible to infections, and so they go through the disease with symptoms.
The number of children hospitalized with Omicron infection is lower compared to the number of children hospitalized with Delta. Of the 100 children infected with Delta, 3 were hospitalized, mostly with lung disease. With Omicron, out of 100 infected children, only 1 child is admitted to the hospital and most often without lung damage.
The positive side is that all these children who go through the infection will be left with some immune protection against COVID-19 that will be in place for the next six months. The negative side is that there is limited knowledge about the long-term effects of this Omicron on the body of a growing child.
What are the tactics of dealing with Omicron?
Omicron is more contagious, more affects children, spreads quickly and massively. It seems impossible to control. Many countries are lifting restrictions for precisely these reasons. Omicron is gaining strength every day more and more.
But people are also more prepared now, compared to the start of the pandemic in January 2020:
- We now have more knowledge about the virus.
- We have testing capabilities, including several versions of rapid testing.
- We have therapy options, including antiviral therapy.
- We have sufficient infrastructure for intensive care.
- We have vaccines that give us a certain degree of protection.
Why is the situation with children in this wave more difficult in Moldova?
Let's imagine now, as in a real movie, what happens to 700,000 children in the country.
We assume that 99% of these children are not vaccinated against COVID-19.
A lot of them are daily on malnutrition, malnourished and do not receive vitamins or food supplements.
Most of these children have not gone to the doctor in this last year of life, for a routine examination, have limited access to paediatric services, which have been "successfully reformed" in recent years.
I think that I will not be mistaken if I say that half of these children have parents working abroad, they live with grandparents or tutors, third parties.
Omicron infection is treated in the early days as a simple cold in these children. Accordingly, this is done without drugs, by herbal or folk remedies.
Moreover, these children are sent to school, to the community, and not isolated.
Let's not forget about the specific local features
The wave of Omicron in Moldova is just beginning, and the paediatric departments in Chisinau are already overcrowded. Since we do not have the opportunity to find out the real number of infected children now, and calculate the correct hospitalization index, it would be good to take some steps to prepare.
It's not too late to do the following:
- Activate children’s beds in the district hospitals, where possible.
- Paediatric clinical protocol for Omicron infection, to be compiled and made public as a matter of urgency along with an algorithm for triage of sick children.
- Begin training doctors of other specialties in the practice of treating children with this Omicron infection.
- Expand the capacity of family medicine by replenishing personnel from the reserves of personnel with other specializations. No child should be left without medical care.
- Involve the social assistance services and social workers to ensure full control of all children in their territories.
- Conduct a mandatory medical examination after COVID-19 for absolutely all children who have gone through the disease, regardless of the severity of the disease.
- Antiviral drugs against Covid-19 do not have paediatric indications, therefore, is required a close attention to the methods of treatment used, according to the principle: do no harm!
- Intensify open communication through all possible channels with parents and tutors of children, with an explanation of the risks and necessary steps.
The evolution of a pandemic follows certain rules. Even when people try to rewrite them or neglect them, the pandemic goes its own way.
We're now on the crest of waves, swept away by a wave, covered by a wave, we can write whatever we want, but we don't have the moral right not to help our children now.
In the case of depressurization of the cabin in the aircraft, adults are advised to put an oxygen mask first on themselves, and then put an oxygen mask on the child. It's a similar situation now. We made a vaccine, we put on an oxygen mask, we're kind of protected from Omicron. We have a duty to help the children!