Lessons learnt from COVID-19Thursday, March 25, 2021
Observing the protocols instituted by the Jamaican Government to prevent the spread of the novel coronavirus causing COVID-19 seems to be a challenge for many of us in Jamaica. Supposedly it may be difficult for many to fathom how just the mere act of not having close contact could prevent the spread.
There is, however, tangible supportive evidence as we look at the admissions to the paediatric ward at Cornwall Regional Hospital prior to and after the institution of the lockdown. Infectious diseases are usually responsible for a significant number of cases of admissions to a paediatric ward at Cornwall Regional Hospital, which houses children between the ages of one month and 12 years.
In January 2020 there were 41 admissions to the paediatric ward. Of this number, 19 cases, or 46 per cent, were due to infectious diseases.
In February 2020 there were 32 admissions to the paediatric ward. Twenty of these cases, or 62.5 per cent, were because of infectious diseases.
On March 12, 2020, the Government of Jamaica imposed restrictions after the discovery of the first cases of the novel coronavirus in the island. In essence, close contact between individuals was limited to only those living in the same household.
In April 2020, the first month after the lockdown, there was a precipitous fall in the number of admissions to the paediatric ward. Only 14 patients were admitted, and only four cases, or 28.5 per cent, were as a result of infectious diseases.
In May 2020, 22 patients were admitted, of which only six, or 27 per cent, were due to infectious diseases. The trend continued in June with 20 admissions, of which only two cases, or 10 per cent, were due to infectious diseases.
The pattern is clear. Maintaining social distance led to a direct fall in the number of children being admitted to the paediatric ward with infectious diseases.
Infectious diseases are commonly spread by person-to-person contact. Some are by direct contact; that is, by touch, and some are by indirect contact, such as by droplet spread when people are close to each other.
This data clearly shows that when we maintain social distance the risk of spreading infectious diseases, any infectious diseases, of which COVID-19 is one, will be decreased.
There are lessons to be learnt from this as we move ahead when the pandemic is over. We can prevent the spread of infectious diseases among children, with its resultant morbidity and, in some cases, mortality. The economic impact that would result from the decrease in the number of hospital admissions goes without saying.
There is a lot of focus by the Ministry of Health and Wellness on the prevention of chronic non-communicable diseases. In a similar fashion, there now needs to be more focus on the prevention of infectious diseases, especially in children. The coronavirus causing COVID-19 is unique in that, for some strange reason, its most deleterious effects are mainly in the elderly. Most infectious organisms usually affect young children as much as it does the elderly because of the relatively decreased immunity in both groups. Therefore, going forward, some of the protocols now imposed will have to be incorporated into our daily lives.
Social distancing will have to be a part of our normal, especially among younger school-aged kids. This does not mean that they will have to be kept out of school. It means that, firstly, there will need to be strict regulations to prevent overcrowding in schools. Regulations will have to be in place that will restrict the size of classes in proportion to the spaces available. Varying modalities will now have to be utilised as part of the strategy to prevent overcrowding in schools. Thus, the online learning platforms will need to remain as a part of the education system.
Concomitant with the smaller class sizes, adequate social distancing will also need to be maintained in the classrooms and all the enhanced facilities presently in place for sanitisation must be kept and enforced. There will also need to be protocols regarding sick children being sent to school. Sick children need to be isolated at home. This is difficult for a lot of parents who have no caregivers to stay at home with the sick child while they go to work. On the other hand, some parents simply want their children to get an additional prize at prizegiving for best attendance, and so the sick child is sent to school, if only to be marked present and then return home.
As is obvious from this pandemic, different people will react differently to the infectious agent for one reason or another. What may seem like a totally innocuous illness in one person may prove fatal in another. The effect of a sick child attending school may not seem significant when there isn't a pandemic. However, even one death, or one severe illness, is one too many when it could have been prevented simply by not sending one sick child to school.
There are some children who are at risk for serious and life-threatening illnesses when other kids will only have mild illness or none at all. These include children with sickle cell disease, diabetes mellitus, cancer patients who are receiving chemotherapy, and children with other forms of immunosuppression. They are protected now as a result of the protocols instituted because of the pandemic. Outside of a pandemic, however, these kids are always vulnerable. We must continue to protect them when the pandemic is over. We must be more vigilant and non-tolerant with respect to limiting the spread of infectious disease in young children, and schools and nurseries are the best place to start.
This pandemic has taught us lessons, let us learn from them.
Dr Carleene Grant-Davis is a consultant paediatrician and head of the Department of Paediatrics at Cornwall Regional Hospital. Send comments to the Jamaica Observer or firstname.lastname@example.org.
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