Thread by @KalainH

[Thread] This is going to be a long one, but here's what we've learnt in the last 24 hours about #COVID19 and children in T&T.

Quotes are from Dr. Joanne Paul, Senior Pediatric Emergency Medicine Specialist at the EWMSC.

There have been 65 MIS-C cases in T&T since March 2020 to present. Since September 2021, when vaccines were rolled out to 12-17-year-olds, there have been no MIS-C cases in that age group.

T&T has lost 4 children (under 18) to #COVID19. Two children (both male) were aged seven, one was 13 (female) and the other was 15 (female). All had “separate, preexisting medical illnesses that made them vulnerable to COVID-19.” Both teenagers were unvaccinated.

There have been 320 pediatric hospital admissions of children (under 18) due to COVID-19 in both Trinidad and Tobago.

Over the past three months or so, there has been an increase in pediatric cases coming each of the A&E and the Pediatric Emergency Hospital.

These admissions fall into 3 categories:

1) Babies (less than 3 months old admitted) with sepsis, typically a blood infection, resulting from a not-yet-developed immune system suppressed by COVID-19.

2) Adolescents with pre-existing medical conditions such as cardiac, obesity, renal, sickle cell, diabetes, and congenital disorders.

3) Asymptomatic COVID-19 cases but would have had something else bringing them to the hospital (fracture of the arm, etc.)

Children present with atypical #COVID19 symptoms: Fever, brain issues (seizures, drowsy/irritable/strange behavior), cardiac (irregular/fast heart rate), gastrointestinal (diarrhea – this is very common), sepsis (septic shock – more so with babies), and respiratory ailments.

On #Omicron: “It is going to be the dominant variant once it comes. It will take over Delta, for sure.”

And sticking with variants, overall, in T&T's latest batch of sequenced samples - 76% Delta, 24% Gamma.

In children: About 95% of recent pediatric COVID-19 cases were infected by the #Delta variant according to Dr. Joanne Paul. She also cites Delta’s increased transmissibility leading to increased pediatric cases compared to the previous #Gamma variant.

“With Gamma, it was a few cases of all different ages. With this Delta, it is much more children having it. Much more babies and the babies are coming in with septic shock and looking very unwell.”

“With babies, once you can get them in and take care of them, they’ll be fine. However, once in septic shock, there is a high chance they might die.” To date: no infant COVID-19 deaths. According to Dr. Paul, the trends are showing younger and younger people coming into hospital.

In T&T, there is a higher infection rate in children less than five compared to the adolescent age group but they are the ones with comorbidities so they are the ones being admitted to the hospital. Ages 5-12 are also being infected but they are the cases where MIS-C develop.

Recovery times for children versus adults are comparable depending on what the patient presents with.

On opening schools: “We will have transference of infection within schools, we can’t prevent that. If we all get vaccinated, it doesn’t matter when the kids in school get their vaccinations. Even if they transmit, it will be very mild, asymptomatic and they’ll be in school.”

“Open schools and get vaccinated to protect children.” - Dr. Joanne Paul, Senior Pediatric Emergency Medicine Specialist

/end.