The corona virus disease (COVID -19) is a highly transmissible and pathogenic viral infection caused by the severe acute respiratory syndrome corona virus 2 (SARS-COV2) which first emerged in Wuhan China in December 2019 and has gradually spread round the continents of the world with a huge number of deaths recorded in many developed worlds where the best care facilities and care are made available to its citizens. Nigeria has had its own share of deaths as well, notably reported in mainly adults. However, very little has been reported about this viral disease in children.
The disease is known to be transmitted via droplets infection acquired during sneezing, coughing, or even by direct contact with an infected person. Children often contract the infection by direct or close contact with an infected adult usually a member of the household. Children of all ages can become infected with the virus with only few becoming symptomatic and falling ill. A majority of children however are not symptomatic hence serving majorly as carriers of the disease. There have been reports of children acquiring the disease from as early as a few days after delivery. According the American Academy of Pediatrics and children’s hospital association, in the United States children represent about 10% of all COVID-19 cases. In Nigeria a much lesser percentage has been reported probably due to less COVID-19 confirmatory tests done in them and perhaps prioritizing adult testing with limited availability of test kits in the country. Some research suggests that children younger than ages 10- 14 years are less likely to become infected with the virus that causes COVID -19 compared to people age 20 and above. Hospitalization rates for children have also been much lower than for adults. However, if children are hospitalized they will need to be managed in an intensive care unit.
The symptoms of the disease in children include fever, nasal congestion or runny nose, cough, sore throat, shortness of breath or difficulty in breathing, fatigue, headache, muscle aches, nausea or vomiting, diarrhea, poor feeding or loss of appetite, new loss of taste or smell in older children able to communicate, stomach pain. More recently children have been found to have another rare manifestation of the disease which occurs 2- 4 weeks after initial infection. This is known as the paediatric inflammatory multisystemic disease which manifests as skin rash, reddish eyes(conjunctivitis), diarrhea, vomiting, abdominal pain, hypotension and shock in children.
Children are solely dependent on their parents or respective caregivers for protection against undue exposure to contracting the disease as well as adequate care should they become infected. The care giver challenges ranges from inadequate finance or dwindling family finance from pay cuts or job losses of the family breadwinner in times when there was a total lock down to sustain a habitable shelter, provide balanced diets to protect children from being infected and let alone to conduct the tests should a child be suspected to have the disease. Care giver emotional issues such as fear of the unknown, guilt and stigmatization of an infected child have been known to occur and are quite rampant. Should the child be asymptomatic or have mild symptoms of COVID-19 and only requires home care, caregivers are faced with isolating a child in the household while at the same time trying to prevent other children and household members from contracting the disease. This can be quite challenging in children who are less than 7 years who love to play and move around all the time.
For many months after the onset of the COVID- 19 pandemic, all schools were shut down to limit the spread of the virus. Schooling remains the major place where many children learn as well as engage in recreational activities. Months of being at home without any form of education could be detrimental to children. Lack of social interaction with other children and lack of active physical exercise tipping many children into being overweight and obese is also detrimental to the health of these children. Bad health itself is a risk factor for many diseases which includes COVID-19. With the recent easing of lockdowns schools are gradually reopening and caregivers are faced with the option of sending or not sending their children back to their various schools.
The above listed challenges may be tackled by caregivers by first arming themselves with knowledge about the disease viz a viz ways of preventing or limiting contacts with infected persons, ensuring and encouraging good hygiene practices while carrying along every member of their house hold. Ensuring that a healthy and balanced meal is prepared for all members of the family to help them build a good immune system is highly beneficial. For individuals with suspected infection in the family, they should be taken to a health care facility for prompt care and treatment. The choice to send a child or ward back to school as schools gradually reopen should entirely be based on the assessment of the care giver in terms of school hygiene, provision of clean portable water and other sanitary measures as well adequate child distancing in class. If the assessments of these are satisfactory to the caregiver then returning back to school may be a good option for the child.
Without a doubt, with the onset of the COVID-19 pandemic we live in unprecedented times as the disease is still evolving and researches on management and probably future cure are still evolving particularly in children. Current measures to help protect children and prevent losses from the disease still remain general health education with good health promotion to prevent children from contracting the disease as well as limit its spread in the society.