Dr Pallavi talks about Tackling COVID – 19

Dr Pallavi talks about Tackling COVID – 19…

The World Health Organisation has declared COVID-19 as a pandemic and a global emergency. It has become a major public health threat to people across the globe.

Dr Pallavi Shriram Todase is a Paediatrician, presently working as a Specialist Paediatrician at Lifeline Hospital in Oman. She has completed her M.B.B.S, M.D (Paediatrics), D.N.B (Paediatrics) and Fellowship in Paediatric Neurology. She initially worked at B.J. Wadia Hospital for Children at Mumbai, followed by Sir H.N.Reliance Hospital, Mumbai. She was previously working as an Assistant Professor in Paediatrics at Sree Narayana Institute of Medical Sciences, Kochi.

Dr Pallavi talks to MAXXO about how to tackle threats of the novel coronavirus affecting the Pregnant women and Newborn babies…

  1. What is COVID-19?

Coronavirus Disease – 19 is an illness caused by a new coronavirus strain called SARS-CoV-2, which was first reported on 31st December 2019 from Wuhan city, Hubei province of China. It was declared a global pandemic by WHO on 11th March 2020. It mainly affects the respiratory system, the most common symptoms being cough, fever, breathlessness or altered sense of smell, or sometimes manifesting with gastrointestinal symptoms like diarrhoea or vomiting, or sometimes being completely asymptomatic. Corona viruses are a vast family of viruses which cause illness in humans and animals. 7 types of Corona viruses have been known to cause diseases in humans of which Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) were reported of ‘jumping’ from animals to humans.

How does the virus affect pregnant woman, fetus, and newborn? 

A lot of research is still going on and since the virus is relatively new, concrete evidences are lacking. However, till date it is observed that pregnant females per se are not at a higher risk than the general population. But since we know that the immunity of t.he body is low during pregnancy and some infections can get troublesome because of it, it is imperative to take proper advised precautions against COVID-19 during pregnancy. In case if the pregnant woman gets severe pneumonia due to COVID-19, there are some reports suggestive of preterm births, premature rupture of membranes, and few newborns getting admitted to NICU. As far as fetal affection is concerned, till date the virus has not been detected in amniotic fluid. Also vertical transmission or transmission of infection from mother to child when the child is in utero has not been detected. However, the risk of transmission of infection to the newborn after birth still remains through respiratory transmission, though the disease seems less severe.

  1. Can the virus be passed to the baby through breast milk?

Till date there are no reports showing transmission of the virus through breast milk, hence it is safe to breastfeed the child. Moreover breast milk is known to contain a lot of protective antibodies and anti-infective factors which are beneficial to the baby.
However, the chances of transmission of the virus through droplet infection can still occur during breastfeeding or handling the baby. Hence it is essential to follow proper respiratory and hand hygiene precautions while feeding the baby.

  1. How can the baby be kept safe from the virus?

If you have been diagnosed with COVID-19, opting for institutional deliveries is of paramount importance since any complications arising can be tackled judiciously. Your neonatologist will assess and guide you about the proper care of your baby, about the need of any tests required, and if at all the baby needs NICU care. At home, you should follow the proper advised hand hygiene and cough etiquettes while handling the baby. You should wash your hands frequently with soap and water or use alcohol-based hand rub, wear face masks every time you feed or handle the baby. You should also avoid contact with sick people and avoid gatherings with friends and family.

  1. How many visitors can be allowed to see the mother and newborn baby after the delivery?

This depends on individual hospital policies. To decrease the chances of transmission, the hospitals are following the policy of as less visitors as possible.

  1. Newborn care during this time

If a baby is born to COVID 19 positive mother, it is advised to bathe the baby as soon as reasonably possible to clean the body surface of any potential virus present, after wearing protective PPEs. Breastfeeding the child is always encouraged. If direct breastfeeding is not possible, expressed breast milk can be given to the baby after meticulous hand hygiene and surface disinfection protocol. Some mothers may have difficulty with breast milk production, in such cases formula feeds can be given, but again diligent hand hygiene and cleaning of breast pumps and utensils has to be ensured. Skin to skin contact to promote adequate growth and development of the baby should also be practiced. However, if the mother is critically ill, the child may need to be separated from her. In that case, another person who is healthy under the age of 60 years, and who is motivated to look after the child, can take care of the baby with proper precautions.

  1. Why does COVID-19 affect children differently?

As per the reports till now, children have been affected less severely than adults. But the exact reason for this is unknown. Though, it is postulated that this might be because of differences in the working of immune system and differences in the function of the receptors which are needed by the virus to attach themselves and act. But still, children may act as asymptomatic carriers and hence it is important to protect them from this infection.

  1. What do you have to say about the immunisations being withheld now?

Immunisation as we all know is important to prevent vaccine preventable diseases in children. Recently, in view of the pandemic, routine immunisations were withheld to prevent the possibility of exposure of children to the virus. However, the current guidelines suggest to resume the routine vaccination as soon as possible. This is because, if children are not adequately vaccinated there will be a significant cohort of inadequately vaccinated children prone to diseases in near future.

  1. How is the present condition at your workplace in Oman?

Here in Oman, the government has imposed necessary restrictions which the general public is following and everybody is cooperating well with the government to ensure that we flatten the curve.

  1. How has this COVID -19 impacted the doctors and nurses lives across the globe?

Life has become tough and scarier. There’s a global shortage of PPEs, and many of us are working without adequate protection. There’s always a fear of getting the infection back home to our families. Every day there is some or other news of doctors or nurses getting infected. And to make things worse, there are incidences of assault on doctors even in these critical times. And I speak on behalf of my medical community here, it saddens us. We work for the people, even while knowing we are at a great risk of contracting the infection. All of us are and will always put our best foot forward and do our best to serve the people. Because it’s our job, we will fulfil it. After all “I will turn away no patient, even those with dreaded, contagious diseases” is our oath!

  1. Lastly, please emphasise on the importance of Hand Washing.

Hand washing has been a recognised method of prevention of spread of infection since long. In 1847, a Hungarian doctor named Ignaz Semmelweis, rightly called as the Father of Hand Hygiene, explained the importance of washing hands so as to prevent infection. After decades, mankind is re-learning the importance of this simple but effective strategy which can help mitigate a number of infections.  Also, we don’t have an effective vaccine or treatment yet, so following proper hand hygiene can greatly reduce the burden of this disease. Hence as advised, wash your hands for at least 20-30 seconds with soap and water, making sure you clean your thumbs, tips of your fingers, and inter digit spaces since these are the most neglected areas. Get yourselves and your children into the habit of hand washing. It is a simple yet cost effective method, which can make a huge difference.

Wash hands and Save the world!

Dr. Pallavi Shriram Todase,
M.D Paediatrics,
D.N.B Paediatrics,
Fellowship in Paediatric Neurology.