Emerging infectious diseases and children

Image of corona virus from CDCWe are in the grip of a pandemic and, to some extent, a global panic. A novel coronavirus first identified in Wuhan City, China in December 2019 has been identified around the world, and a global public health response has been activated. Other blogs, sites and journals are tracking and reporting on the explosion of science, epidemiology and clinical understanding of the virus and the disease states it is producing.

Children have been relatively ignored in this flight to action.

A number of terms are getting used at the moment. The virus may be designated SARS-CoV-2, and the illness COVID19: it may be helpful to try to think of it in the same way we do HIV/AIDS – the virus and the clinical syndrome.

So, as child health folks, what do we need to know?

  1. We’ve not been forgotten.
  2. Mostly the same ideas which apply to adults appear to apply to children.

(The ‘mostly’ here is broken by ‘visitors’. We are not heartless. In most hospitals, there’s an understanding that one uninfected parent can stay with an infected child – as long as the parent is assessed not to be at risk (i.e. immune compromised/ diabetic/ lung disease) – and they agree to stay with the child 24/7 ’till they are discharged. The parent needs to understand the risk. No other family member is allowed to visit)

If you’re looking, there’s a list of sites you’ve probably already visited here:

https://www.gov.uk/government/collections/wuhan-novel-coronavirus

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-guidance-for-clinical-diagnostic-laboratories

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-self-isolation-for-patients-undergoing-testing

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-self-isolation-for-patients-undergoing-testing/advice-sheet-home-isolation

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/wuhan-novel-coronavirus-wn-cov-infection-prevention-and-control-guidance

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/wuhan-novel-coronavirus-wn-cov-infection-prevention-and-control-guidance#PPE

  1. Clinical and academic teams are working together to make sure approaches are unified and commensurate with the knowledge we have and the risks as we understand them.

For special groups, such as children receiving chemotherapy, organisations such as the CCLG have produced specific parent information. The Royal College is working closely with PHE to make sure all information is updated and accurate and relevant for our groups.

 

  1. We need to use our special skills when facing the clinical challenge of disease in kids, just as we do with every other illness

Some particular issues which may face us include the management of severely unwell children without proven therapies, the psychological response to ‘full’ PPE wearing, and the management of severe health anxieties in parents as well as anxieties in children.

We’ll be hoping to be covering these in a series of blogs #PandemicResponse and would welcome offers of blog authors to work with us.

The best response of child health professionals to SARS-CoV-2/COVID19, along with every other health crisis for children and young people, will remain the measured use of best evidence, communicated skilfully and adapted to the needs of the individuals and groups we work with.

 

  • Bob Phillips, with thanks to Andrew Riordan (Alder Hey) and Liz Whittaker (ICH)

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