Health officials in St. Vincent and the Grenadines (SVG) are considering strategies to respond to what they have presented as a worrying incidence of COVID-19 in the nation’s paediatric population.
“… there are some areas of concern which I wish to bring to your attention: 27% of cases are 18 years and younger. Children as young as one month old have been affected,” Minister of Health St. Clair Prince told a press conference this week.
“We are trying to focus on this area because we had been given the impression worldwide that older people are more at risk, yes, and young people don’t have to worry too much, but we have to change that mind-set,” the health minister said.
He said that two weeks after the school hubs opened to help students prepare for external examinations, there are three PCR-confirmed school hub cases — two students and one teacher.
“We are still investigating whether there are others. We have suspicions that there are others in these hubs.”
As of Thursday, SVG had recorded 2,059 cases of COVID-19 since March 2020. Twelve people have died of the illness and 206 cases remain active in the country.
552 paediatric cases
Speaking at Wednesday’s press conference, Dr. Mishka Duncan-Adams, a paediatric neurologist said there were 552 paediatric COVID-19 cases.
The doctor said that there was a peak in paediatric COVID-19 cases after April’s eruption of La Soufriere volcano, adding that some of these cases may been attributed to occupancy in emergency shelters.
“But it has also been found that a lot of persons are letting their guard down and there is a lot of loosening or relaxation of the mitigation measures that are in place and so we are seeing higher numbers, especially in children.”
The health ministry was having the media briefing three days after a massive crowd attended a cricket match at the Arnos Vale Playing Sports Complex, even amidst protocols and a law that bans outdoor gatherings of more than 20 people.
Most of the people at the cricket event — held primarily to feed cricket-starved fans in India, where COVID-19 has ceased play — did not wear face masks and many of those who did were wearing them improperly.
Duncan-Adams said there is a worldwide trend of children contracting COVID-19.
She said that even though children get a milder form of the virus, with 14% of cases in the United States being among children.
“This number may vary from country to country. Here in St. Vincent so far, we are seeing up to 27% so that is a significant number. But what is shown is that approximately 1% of persons infected who are children can die. So children are still at risk of dying, even though most of these children may have had a pre-morbid condition.”
Risk of complications
Duncan-Adams said that even if people do not die of COVID-19, they are at risk of having complications related to the disease that may cause hospitalisation.
She said these people include children and the complications may range from a mild infection to COVID-pneumonia, Guillain-Barré syndrome (which affects nerves and causes weakness of the lower extremities that could progress to the point of needing incubation or ICU treatment), memory issues.
The physician said worldwide, “a specific entity that is seen in children”, though rare, is multi-inflammatory syndrome.
“MIS is very life-threatening and can affect children to the point where they can die. A lot of these children are not infected with COVID when they exhibit the syndrome. They might have had a recent-past infection that is asymptomatic and weeks later they would start exhibiting fever, shortness of breath, kidney damage, brain injury, diarrhoea, vomiting, swelling and inflammation of the heart tissues.
“All of this can lead to death in children. Luckily, we have not seen any cases in St. Vincent and there are few cases reported worldwide but that is something that is specific to the paediatric population and it is something that is life threatening and it is related to COVID,” Duncan-Adams said.
She said there are other complications in young people that can take place as a result of COVID-19.
20-y-o woman severely affected
The paediatric neurologist spoke of a recent non-paediatric case in which a 20-year-old woman had “a COVID-related encephalitis — her brain was affected.
“She came in with status epilepticus where she was seizing continuously and had to be in ICU. Luckily, this individual survived but is still on the road to recuperation,” Duncan-Adams said.
“And this is something that was COVID-related. So this is real and it is something that happened. So, even though, thank goodness, she did not die, she was severely affected as a result.
“So it is something that happened and it is something that we as health professionals should know and persons should know that COVID is here, it is real and it is something which can be life threatening.”
The paediatric age range is particular because people under the age of 18 are not indicated to be vaccinated as yet, Duncan-Adams said.
She noted that the vaccines that are authorised in St. Vincent and the Grenadines at this point have not indicated as yet for persons under the age of 18.
Duncan-Adams said it is very important for families to protect themselves, including their children, against COVID-19.
“We also have to encourage and teach our children to do the different protocols in order to mitigate the spread of the disease,” Duncan-Adams said.
She encouraged people to continue with proper mask wearing, hand washing techniques and not to relax on these measures.
Duncan-Adams said people should continue social distancing and get testing.
“… get your family tested even though you may think that it is a hassle, it is something that should be done. If you have a child that is sick and has fever, please keep your child at home, avoid social gatherings.
“If you or your child is experiencing flu-like symptoms, joint pain. Fevers, cough and cold, it is wise to get tested.”
Vaccination of children?
On the topic of vaccination, the doctor said:
“As parents, there’s some hesitancy, as we know, about vaccinations and anything that is new would cause apprehension and hesitancy. But I would love to say the same thing that our minister said. Please read, I encourage you to read, get yourself educated about the coronavirus, about the vaccines and make an informed decision when making a decision.
“Really and truly, we are lucky, to this point, to not have any deaths in the paediatric age range, so persons under the age of 18. And our admission at the Milton Cato Memorial Hospital, we have had no serious cases under 18 admitted at Milton Cato.
“But, with the spike that we are seeing, the increased percentage that we are seeing and if persons continue to relax their ways and not follow protocols, this is something that is possible and it can be in the near future.”
Duncan-Adams encouraged people not to let their guards down, noting the situation in Trinidad, Guyana and India.
Meanwhile, responding to the question of whether children in SVG will be vaccinated, the Chief Medical Officer, Dr. Simone Keizer-Beache said that SVG only has the AstraZeneca vaccine, which is approved for use in people 18 and older.
“In terms of the children, however, we are actively seeking to get some Pfizer, specifically for the use in the paediatric population, because, as we know, it has been approved for children as young as 12, I think. So that’s what we are working on at this point.”