Helping children, adolescents infected with Covid-19 

The current wave of Covid-19 has heightened anxiety among children and adolescents. 
Unlike in the first outbreak in 2020, where mainly the elderly were affected, in the second wave, the younger population has been affected as well. 

In the case of Uganda, according to the presidential guidelines, schools were to close promptly and children to go back home too. Unfortunately, many schools had already been hit! Social media was awash with parents complaining about how they found their children seemingly sick and on testing discovered they were Covid-19 positive. People also shared the sad news of deaths of children who had succumbed to the disease.

It is important to realise that living in these pandemic times is also hard on children and adolescents. Apart from having to deal with the disease when they get it, there are also emotional aspects to consider. 
Eva Kharono, a counselling psychologist with Sermo Therapy Consult, says childhood is the most critical period in any human’s life and marks the foundation of emotional resilience capacity of a person. 

“There are several new stressors children are currently facing such as impromptu stopping of school, seeing and hearing about their fellow children suffering and dying from Covid and the constant worry is they too might fall prey to the disease,” Kharono explains. 
She adds, “Children are sensitive to repeated stress activation because their brains and bodies are just developing and therefore high doses of adversity affect their brain structure and function including the structural development.”

So how can one help their children manage physically and emotionally through this time?
Look out for signs and symptoms
Several parents are worried and are seeking guidance on treating and testing their children for Covid-19. 
Dr Sabrina Kitaka, a senior pediatrician at Mulago National Referral Hospital says while testing is quite costly, it is important. 

“If your child has been in contact with someone who tested positive, they are considered as contacts and alerts and therefore should be tested. Children of all ages can become ill with the disease but most children who get it do not become as sick as adults and some may not show any symptoms. 
“The signs and symptoms among babies and children could be quite different from those of adults. Therefore, it is really important to understand how the disease presents among them, and how to prevent it for clear guidance.” 

Symptoms include high grade fever, chills and rigors, nasal congestion or a runny nose, cough or sore throat, shortness of breath or difficulty in breathing, fatigue, muscle or body aches, diarrhoea, poor appetite, loss of sense of smell (anosmia), loss of sense of taste (agousia), and pain in the abdomen. 
Such symptoms, the doctor says, should alert parents and guardians that this could be Covid19 thus the need to keep the child at home. “Do not let your child expose other children.”

Seek qualified medical care
Dr Kitaka urges parents not to self-medicate the children but to seek for medical care from a qualified medical practitioner who will be able to evaluate the child and determine whether they are mild, moderate or severe. 
“The diagnosis will then guide the health care provider to determine whether the child will be treated at home or in the hospital. Parents should offer supportive treatment to the child, giving them a balanced diet, allowing them enough sleep and ensuring that they are able to bask in the sunshine. Parents should also encourage the children to take all their prescription medications.” 

She adds that treatment doses given to children are determined by the weight of the child.
 “Any excess in treatment can cause severe damage to the child’s key organs such as the heart, liver, kidneys or pancreas. There are parents who are giving their children the ‘Uga concoction’ of red pepper,  ginger,  lemon but please, be cautious with them because these are real acids and could turn your child into an emergency of peptic ulcers. Be cautious because all we need is for that child to be well hydrated,” she advises.

Remind them to keep SOPs
Dr Kitaka emphasises the need to follow SOPs as much as possible. 
“It is difficult to totally isolate a child in the home, especially smaller homes, therefore using masks often and hand washing is important. All persons above the age of six years should mask up even in the house. Let everyone else in the house be socially distanced, wear a mask as often as possible, open the windows, wash their hands as frequently as possible and get that child to eat as many fruits as possible; give them fresh juice and lots of water.”

Kharono adds that there is need to talk about these SOPs in detail and let the children know that the intention is to reduce  the spread and not to just isolate them. 
“Find professional help to support the child in case of a panic attack and to guide you on the right steps to take in treating the child when found positive.”

Let children express themselves
Kharono says children and adolescents should be given platforms to express how they feel at any given moment. She stresses the need to listen, comfort and reassure children. 
“Encourage them as much as possible to share their concerns and ask as many questions as they can.
“It is also important for care givers and parents to understand the emotional needs of children and adolescents and be able to recognise signs of any psychological distress, especially during this time.” 

Depending on the child’s age, they can act out or go silent in the face of fear while others may express their anxiety through hyperactivity. Recognise signs of psychological distress such as change in eating, playing, sleeping problems and any other new behaviour that you notice and if you cannot address it, get support from a professional. Remember that explaining to children the right information about Covid-19 and how one can prevent it is crucial to reduce anxiety.

Normalise the situation
Kharono advises parents and guardians to normalise the situation by reassuring the child that they will get all the support and they have high chances of getting well. “The reaction of the care giver can either decrease or increase fear of the positive child. Therefore it is not good to panic in their presence, rather, deal with your fears privately then be strong for them. Remember their resilience will depend much more on your reassurance.” 

Moderate news
“Reducing on perplexing news feeds from social media allows for a relaxed environment at home; allowing children to engage in other activities that can distract their young minds for a time. If someone dies in the family or an institution where they are receiving support, children’s anxiety will be heightened and therefore it is important to talk to a professional for further support to enable the child deal with the grief.”

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