Thread by @BrendanDabhi

Many experts say the third #COVID19 wave may not be as deadly to children as is being hyped. They may be right, so what?

What's happening is that years of pending upgrades of pediatric systems are being completed now 'cause nobody wants dead kids on their hands.

A Thread.

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Pediatricians in tertiary hospitals have for years, been complaining about the lack of staff doctors, nurses with PICU/NICU training, neonatal ventilators _ the fact that children on the brink of death keep getting sent to them w/o being stabilised.

Things could change now.

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In Nov 2017, protests erupted at Ahmedabad Civil Hospital after 57 infants died in 15 days around Diwali, most of them from peripheral districts.

Gujarat Assembly elections were held the next month.

Nobody sought the strengthening of peripheral pediatric infrastructure.

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A year earlier, in 2016, 81 infants died during Diwali fortnight at Ahmedabad Civil Hospital.

In 2018, 1,646 infants died in the PICU, while 1,453 died in 2017.

Nobody cared.

Story from Jan 2019 on state of Guj pediatric healthcare before Covid.

ahmedabadmirror.com/gujarat-strugg…

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Coming to #COVID19

Gujarat Task Force members Dr Sheila Aiyer of @SSGHOSPITALVAD & @ProfSomashekhar of @SKHKaramsad say children a/c for 12% patients, but actual no. of affected kids has risen in 2nd wave.

'We can increase adult beds whenever we need, not pediatric ones.'

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Task Force on Pediatric Covid Mgmt has thus sought a min. of 120 Pediatric + Neonatal beds be set up at 14 major govt hospitals in #Gujarat

Plus, they have sought purchase of 332 ped + neo ventilators. This is under process.

Part 1 of Two Stories

ahmedabadmirror.com/govt-to-ramp-u…

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A 145 posts of Pediatricians are vacant across #Gujarat of which 30 are of medical teachers in tertiary health facilities!

With these lemons, the Task Force is making lemonade by giving checklists so easy, they can be followed by MOs, nurses if Pediatrician isn't available.

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Comprehensive treatment protocols have been prepared for children suffering from Mild, Moderate or Severe bouts of #COVID19 by the Gujarat Task Force.

Primary: CHC: Mild
Secondary: DH: Moderate
Tertiary: MC: Severe, Critical

CHCs asked NOT to use steroids on children.

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But, in order to make sure critical #Covid children reach the nearest major hospital on time, there must be neonatal medical transport. But #Gujarat has just 10 neonatal ambulances. Now what?

While @Stanford is giving training to GVK-EMRI staff, this alone isn't enough.

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So, after years, #Gujarat has a Smart Referral System for early diagnosis of severity in Pediatric patients, set up a few months ago, said Task Force Member Dr Pankaj Buch of @rajkotpdu

@ProfSomashekhar suggests a public-pvt partnership would make this more effective.

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These are then, reasons why experts, while advocating the road away from panic, must carefully avoid downplaying the effect that the 3rd Covid wave may have on kids, since this is helping us ramp up healthcare for our children.

Part 2 of Two Stories

ahmedabadmirror.com/need-of-the-ho…

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