Even because the Covid state of affairs in West Bengal is exhibiting important indicators of enchancment, the state is cautious of decreasing its guard and has already shifted its focus to averting a attainable third wave. As an announcement of intent, it has already laid out a roadmap in anticipation of a 3rd wave, with concentrate on youngsters.
The state Health Department has drawn up a blueprint and is within the strategy of placing the requisite infrastructure in place.
For optimum and efficient use of those amenities and assets, medical officers and nursing employees will undergo particular coaching below Paediatric Covid Management programme. It may even organize a modular on-line and off-line coaching programme, beginning June 23 (Wednesday), for medical officers and nursing employees throughout the state.
On Monday, the state authorities arrange a particular 10-member professional committee to “supervise and monitor the evolving situation and suggest suitable interventions for effective management of Covid-19 third wave”.
“Children accounted for around three per cent of the people infected during the second wave. Not more than 200 were hospitalised at a time. Due to thick nasal mucous membrane and the fact that children have more nasal secretion, the virus got washed away before it could reach the target cell. Secondly, as colleges and schools are shut, they had less movement outdoors were, therefore, at lesser risk of exposure to the virus. During the second wave, the fatality was higher in the age group of 31 to 45. One of the reasons for this was that this age group socialised a lot and didn’t take necessary precautions. However, once schools reopen and children start stepping out more, they will be at a higher risk of being infected. Also, the wait continues for a children’s vaccine. Hence, they remain vulnerable going forward,” Dr. Ajoy Chakraborty, Director of Health and Service, instructed The Indian Express.
To deal with the third wave, the state has deliberate to guard the youngsters by “escalating in-patient Covid facilities for the younger age group”.
The Health and Family Welfare Department has put collectively an professional committee to enhance PICU (Paediatric Intensive Care Unit), SNCU (Sick Newborn Care Unit), Paediatric HDU beds within the state. It has deliberate to coach human useful resource to deal with the brand new challenges other than upgrading infrastructure, gear and logistics. The state can be planning to develop six new PICUs in Jalpaiguri, Cooch Behar, Uttar Dinajpur, Purulia, Rampurhat and Diamond Harbour districts. Apart from changing grownup wards to into these for paediatric sufferers, the state can be within the strategy of procuring oximeters and ventilators, other than different gear for crucial sufferers.
On July 14, the Health and Family Welfare Department issued an order stating that the present PICU/NICU will likely be utilised for non-Covid providers and shouldn’t be transformed into Covid wards. Around 1,300 present Covid CCU/HDU beds at grownup wards will likely be geared up with needed objects in order that they could possibly be used as Covid PICU.
“Around 1,300 Paediatric ICU beds (PICU) will be arranged at the existing Covid CCU/HDU before the 3rd wave. Such PICU will be set up at all MCHs, all District Hospitals and Sub District Hospitals. Paediatricians from the respective facility will guide and supervise patient management,” learn a portion of the order issued by the well being division.
According to medical doctors, whilst circumstances have decreased considerably within the prevailing second wave, counting the lifeless is necessary at a time when the state is planning to deal with the third wave.
“If we see case fatality of Covid, it is at 2.2 percent globally, 1.2 percent in India and 1.1 percent in Bengal till date. India has, so far, recorded nearly 3 crore cases, while Bengal has logged nearly 15 lakh. Even when the second wave peaked in Bengal and daily cases numbered nearly 20,000, the number of Paediatric Covid cases were limited to approximately 200. So, we are drawing up a plan assuming that a maximum of 500 patients would require hospitalisation at a time. The numbers are not very high but we don’t want to take any chances. We have to keep aside 5 percent critical care units and 10 percent high dependency units (HDUs) for Covid patients,” Chakraborty stated.
According to Health Department officers, the state, for the third wave, wants 250-300 PICUs, which can be elevated to 500, and 500 HDUs which can be elevated to 1,000, if required. It can be planning to maintain 800 (PICU & HDU) beds prepared, which can be elevated to1,500 when required.
“For infants (less than one year old) we have 68 SNCUs and if SNCU patients turn critical, we have neonatal intensive care units ready and equipped at a few hospitals which could be used in a segregated manner, if need be. We have 26 general beds (40 percent for female and 60 percent for male patients). The ratio will be reversed to make it 60 percent for women. In case of mild and moderate paediatric Covid positive cases, children, who are 90 days to 12 years of age, will be admitted to the Covid female beds where mothers will stay with their babies. Ten thousand such beds have been earmarked,” Chakraborty added.
As per a authorities order, the NRS Hospital has earmarked 25 beds completely for Paediatric Covid circumstances. Speaking to this newspaper, an official on the hospital revealed {that a} separate room will likely be used for this objective. A bathroom can be being constructed. The room may have two separate corners which will likely be used as ‘Downing Room’ the place medical doctors can don PPE kits earlier than getting into the ward, and ‘Doughing Room’ which they are going to use after exiting the ward submit remedy.
“A total of 25 beds has been earmarked, work on getting them ready has been started. By end of this month, they will be ready,” a employees stated.
Apart from NRS, M.R Bangur Hospital, R.G Kar Hospital, ID BG Hospital, Sambhunath Pandit Hospital, Kolkata Medical College, Calcutta National Medical College and Hospital are amongst few different medical institutions the place 25 beds every have been earmarked for paediatric circumstances.
The state authorities has additionally begun procuring 80 paediatric ventilators and oximeters for kids in anticipation of upper caseloads amongst them through the third wave.
“Adult pulse oximeters don’t work on children as their fingers are smaller in size. So, to check their oxygen saturation levels, the health department is buying and distributing oximeters for children. All districts will have dedicated paediatric units with adequate oximeters and ventilators,” added an official.
For correct utilisation of human assets, the well being division has ready a tenet based mostly on which coaching programmes are being designed. According to the division, the state has an satisfactory variety of paediatricians.
Few non-paediatric medical doctors may even be educated to handle paediatric circumstances. SNCU nurses, who’re already educated to deal with youngsters, will likely be uniformly positioned each time and wherever required. Every major tier facility will likely be linked to the closest increased tier centre. Round the clock tele-consultation with increased tier amenities may even be made accessible.
Also, transport amenities from the first tier to the upper centre will likely be organized by the well being division.
“It is being said that by the beginning of July, we will tide over the second wave. We may get a gap of three to four month before we are hit by a third wave. If we can create awareness, people follow Covid protocol and we do more vaccination, there’s hope that we’ll be able to push back the third wave by a few more months,” Chakraborty added.
The Centre has additionally issued complete pointers for administration of Covid-19 in youngsters, together with remedy of mucormycosis. Swastha Bhawan has additionally directed all hospitals to supply with the Weekly Incidence of MIS-C Cases (each for Neonates and Pediatric age group) in a selected excel format as requested by the Union Ministry of Health & Family Welfare.
“Though there is no scientific research to suggest that the third will majorly affect children, one musn’t take any chances. Children below five years of age don’t require masks. However, those aged between 6 and 11 years must wear masks and those aged above, till 18 years, must wear double masks whenever needed,” added one other well being official.
While the federal government is making all preparations on a war- footing, dad and mom are nervous a few attainable third wave and the way it would possibly impression their youngsters. Speaking to this newspaper, Dr. Pavitra Chakraborty, senior advisor (Paediatric), Bhagirathi Neotia Woman and Child Care Centre, stated, “If high fever persist for more than three days and isn’t subsiding by any means, one must consider taking the patient to a hospital. There have been many cases where a child was asymptomatic the first time he/she was infected and affected with severe symptoms such as high fever more than three days, rashes and breathlessness the second time. Should such severe symptoms manifest in a child, he/she must be taken to a doctor at the earliest.”
Dr. Somenath Gorain, a paediatrician at Bhagirathi Neotia in Newtown, stated the youngsters have been largely asymptomatic through the first wave of the pandemic. In the second wave gentle to reasonable signs have been seen in youngsters they usually largely recovered at house and only a few with persistent sicknesses required to be admitted to PICU beds.
However, he stated he’s extra nervous in regards to the MIC-S syndrome than Covid in youngsters. “This virus continues to shock. There’s a extremely probability that it’s going to migrate to those that should not vaccinated. Since, youngsters aren’t vaccinated for Covid, they’re weak. The Multisystem Inflammatory Syndrome in Children (MIS-C), which is brought on by Covid, is protecting us nervous. It is a severe Covid complication in youngsters which have to be handled on time.
This manifestation was seen largely one month from the time Covid was at its peak. Most youngsters of their adolescence (round 10) develop this syndrome. It impacts the tip organs,” he stated.
On June 18, the Union well being ministry issued a complete guideline for administration of Covid-19 in youngsters and its submit impact. A duplicate of the identical has been forwarded to all of the medical schools and hospitals.
Meanwhile, the state authorities has put collectively an professional committee, comprising ten members, to trace developments associated to the third wave. The panel will comply with evolving conditions arising out of the pandemic and recommend appropriate interventions for efficient administration of the third wave.
Also, to make sure optimum use of obtainable assets, medical officers and nursing employees will undergo particular coaching below the Paediatric Covid Management programme. The well being division will organize a modular on-line and off-line coaching programmes, beginning Wednesday, to coach the medical employees for tackling new challenges arising out of the pandemic.
