Doctors treating patients in India 🇮🇳 have marked a distinct trend during the 2nd wave—#COVID19 now appears to be impacting children more severely. Children and adolescents are now showing more obvious symptoms such as prolonged fever and gastroenteritis.🧵hindustantimes.com/india-news/in-…
2) During the first wave, most children remained asymptomatic, and a large number of them went untested because of that,” said paediatrician Dr. Bakul Parekh. “We tested children only when someone in the family had a history of Covid-19.”
3) Over the last fortnight, Parekh, who runs a children’s hospital in Ghatkopar, has admitted six children between 1 and 7 years old to the hospital -- three with severe gastrointestinal infections and fever, and others with breathlessness and fever.
4) “Those with gastrointestinal infections had to be put on intravenous fluids. The patients who were breathless required steroids and oxygen support,” said Parekh.
During the first wave, Parekh does not recall referring even a single child who needed hospitalisation.
5) He links new mutations with the increased impact on children. “The available medical literature shows that the ‘double mutation’ found in Maharashtra (now called B1.617) can be one of the reasons behind it,” he said.
6) “Children are definitely more symptomatic now than what we saw in the first wave,” said Dr. Tanu Singhal, a paediatrician and infectious disease specialist at Kokilaben Dhirubhai Ambani Hospital. “The severity of their illness has gone up,” she said.
7) “As the number of cases rise, infection among children has also increased. However, the percentage of children and adolescents affected in the first wave and the second wave hover around 10% of total cases. What is striking is the change in symptoms, underline experts.
8) “Children are coming in with abdominal pain and severe diarrhea, which we didn’t see in the first wave,” said Dr. Soonu Udani, paediatrician and critical care specialist at SRCC Children’s Hospital.
9) “Some of them require intravenous fluids. In the first wave, most children were simply kept under observation, and in case of mild symptoms, they would respond to basic medication like paracetamol,” she said.
10) “Last year, of the paediatric patients who came to SRCC Hospital for other procedures and treatments, about 5% tested positive for Covid-19. “This time, we have about 30% to 40% of the children testing positive,” said Udani.
11) Doctors have observed some distinct changes in the presentations of adults, too. “Conjunctivitis is definitely more common now. Many adults are coming with post-vaccination Covid-19. The unusual thing is that they have developed antibodies, “ said Dr Sujeet K Rajan

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More from @DrEricDing

17 May
Pediatric warning from Singapore health minister on the new #B1617 variant, first detected in India 🇮🇳, that it appears to affect children more, says 🇸🇬 Health Minister— this is why schools are taking a more cautious approach they say. #COVID19

2) “Education Minister Chan Chun Sing said in a press conference (May 16): “We know that there are many new strains of the Covid-19–there are various new mutations and some of these mutations are much more virulent and they seem to attack younger children.
todayonline.com/singapore/new-…
3) “So it is an area of concern for us, and the way we manage the situation must (be to) constantly keep abreast of such developments and pre-empt them where possible.”
Read 6 tweets
17 May
The USDA has just been sued by doctors for urging Americans to go big on milk, cheese and other dairy—claiming that the Trump USDA’s 2020 dietary guidelines are looking out for the interests of the meat and dairy industries rather than health. 🧵
washingtonpost.com/business/2021/… Image
2) Trump’s USDA in Dec 2020 suggested that Americans consume three servings of dairy each day. The doctors allege in the federal lawsuit that the dietary guidelines contradict current scientific and medical knowledge, harming the quarter of Americans who are lactose-intolerant.
3) “But the guidelines influence school lunches in many ways. For example, for a school to offer a plant-based milk alternative, a student must present a doctor’s note about a disability.
Read 7 tweets
17 May
#B1617 ARRIVAL—we just now learn that the #B1617 Indian variants first arrived in NYC in April 5-11th, but retroactively reported now. It has grown in NYC, just as #P1 from Brazil 🇧🇷 also increases in %.

HT to shrewd eyes @perdidostschool @maslowsneeds
www1.nyc.gov/site/doh/covid… Image
2) there is a ton of concern about the specific #B16172 sub lineage of #B1617, because it is even faster transmission than the already faster #B117. This was a warning this week from the U.K. 🇬🇧 govt report.
3) To be clear, if that is true, it could mean #B16172 is one of the fastest if not fastest variants identified to date… 2.4x faster than original.
Read 4 tweets
15 May
HEALTHIER THAN EVEREST CLIMBER? Mount Everest 🏔 base camp outbreak—expedition cancelled after climbers sickened by #COVID19—An American climber & 3 Sherpa guides from a 51-person expedition were evacuated from base camp & hospitalized in Kathmandu Nepal🇳🇵
nytimes.com/2021/05/15/wor…
2) “A second wave of the coronavirus is ravaging Nepal, overwhelming its feeble health care system. On Saturday, the authorities reported 8,167 new cases and 187 deaths.
On the peaks, the spread of the virus is unclear, but signs of trouble are growing…”
3) “Starting this month, hundreds of foreign climbers, Sherpas and other support staff have lived at Everest’s high-altitude base camp, preparing for an ascent to the world’s tallest peak.
Read 5 tweets
15 May
BREAKING—Taipei, Taiwan 🇹🇼 has raised its local #COVID19 crisis rating to Level 3 alert for the first time, after 180 domestic transmission cases. Masks will now be required indoors & outdoors. 🇹🇼 has 23 mil people—first time exceeding single digit average daily cases in a year.
2) Under the CECC's four-tier alert system, a Level 3 alert means people are now required to wear masks at all times when they leave their homes, indoor gatherings of more than five people are not allowed, and outdoor gatherings are limited to 10 people.

focustaiwan.tw/society/202105…
3) A Level 3 alert, which has been in imposed in Taiwan for the first time, stops short of a lockdown and goes into effect when more than three community clusters are confirmed in a week or over 10 domestic cases of unknown origin are reported in a single day.
Read 7 tweets
15 May
⚠️FASTER TRANSMISSION warning from UK🇬🇧 govt of #B16172 variant—“confident that B16172 is more transmissible than #B117, & realistic possibility that #B16172 could be 50% more transmissible & would lead to a substantial resurgence of hospitalisations.”🧵
assets.publishing.service.gov.uk/government/upl…
2) the SAGE report also warns: “In the areas where numbers of infections are increasing rapidly under the measures currently in place, an even faster increase can be expected if measures are relaxed (high confidence)”
3) “There are local areas where new infections is increasing. Some local areas have had continued rapid growth in variants—particular concern is B.1.617.2 variant (first identified in India, now widespread). There are now multiple fast-growing clusters of this variant in the UK.
Read 6 tweets

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