- Nathalia Pasarinho
- From BBC News Brazil in London
In January, at the height of the Omicron wave in Brazil, two children, aged 1 year and 10 months, a boy and a girl, from different families, arrived at the ICU on the same day where pediatric intensive care physician Manuela Monte works in Fortaleza, Seyre.
Both tested positive for Covid-19 and were admitted to Albert Sabin Children’s Hospital with severe pneumonia and kidney failure. They did not have any health problems or conditions before becoming infected.
“They were admitted the same day, had already arrived at the hospital in critical condition. We did everything, but one of them died in less than 24 hours. The other died the next day,” said Monte, who is working. The first line in the pediatric ICU since the beginning of the epidemic.
“We lost two babies in less than two days. The babies were healthy before they were coved. It was one of the hardest moments. It moved the team a lot.”
In the following weeks, Monte witnessed other deaths and treated children of all ages in serious cases.
After the irresistible second wave of epidemics in Brazil in 2021, pediatricians thought the worst was over.
But unprecedented advances in Amicron have hit immunized children hard, while adults who have already taken two or three doses usually have less severe symptoms.
“We are a reference hospital, and our pediatric covid ICU was full in January, when adult care was relatively quiet,” he told BBC News Brazil.
“Children of all ages are coming with Covid. And we have had serious cases among children who have no health problems. Because Covid’s immune system is shaken, bacterial infections, pneumonia or meningitis are caught before they reach the hospital.”
Detected in South Africa in November, Omicron is much more contagious than other forms of the virus and is capable of re-infecting people already infected with covid, although in initial studies it may be less lethal.
Why are more children being infected?
Researchers are still compiling national data on age-based hospitalizations in January, but data from December and earlier this month indicate that Omicron may be hospitalizing more children in Brazil than at previous peaks of the disease.
In Rio de Janeiro, for example, 11-year-olds were hospitalized in December and January due to Covid-19, compared to the second wave of epidemics caused by gamma and delta forms. An epidemic bulletin of 24 December. January.
Pediatrician Manuela Monte believes that the increase in hospitalization and severe cases is due to a combination of factors. Since Omicron is more contagious, more children are being infected now than ever before, and this could increase the number of hospital admissions and eventually death.
Also, Monte recalls, ômicron came at a time when relaxing social exclusion rules in Brazil, combined with year-end parties and holidays, which increased children’s exposure to the disease.
“Omicron promotes more easily, which children express.”
And, about 70% of Brazil’s adult population has already received at least two doses of the vaccine against covid, after resistance from the federal government, vaccinations for children aged 5 to 11 began only around 17 January.
Infants and children have become a group more affected by Omicron than already vaccinated adults.
Finally, Manuela Monte evaluates that the belief that the Kovid-19 is lighter and milder than other variants of Omicron in children can create a “false sense of security”.
Many parents and caregivers take the time to take their children to the hospital because they are not aware of the potential risks associated with Covid-19 in children, doctors say.
Others live far away from referral hospitals and have difficulty accessing them.
“We have verified that some babies infected with Omicron have highly affected immunity during infection and they develop other diseases like pneumonia,” said the pediatrician.
“We see delays in seeking medical help. And the sooner we work, the better the chances of recovery.”
Fight to save the twins
The pediatrician’s recent memory was of the ICU team’s struggle to save twin sisters who were hospitalized at the same time.
The 17-year-old duo had a neurological condition and were already known to hospital doctors because they often returned for treatment.
“They both got covid and were hospitalized for a long time. Mom was very dedicated, she was a very nice person and we already had a bond with the girls. We fought hard to save them,” said Monte.
“We used to say: ‘We can’t lose both of them for Kovid. Losing one would be hard, losing both would be too much for this mom.’ So we fought a lot. Unfortunately, one died, but we managed to save the other.”
Amid the daily grief of giving hard news to parents and the joy of being able to release children returning home, health professionals still face the difficulty of welcoming and calming patients without the presence of their family members.
Due to the high rate of transmission in omicron waves, many ICU inspections have begun to be limited. Children who are aware communicate with the family of the unit where they work in Monte via video call.
But in some cases, parents are unable to say goodbye to their children. This was the case for children aged 1 year and 10 months who died within a day of each other.
“We try our best so that children can communicate with their parents through video calls.
“Unfortunately, with the two children, there was no time. We had to call the family on the day of death because it was too fast.”
Another challenge for pediatric intensive care physicians is to calm older children who are already aware of the seriousness and risks.
Manuela Monte says they recently found a 10-year-old girl in the ICU who already had lung disease and needed oxygen because her health worsened with Covid-19.
“She told her mother not to go to the hospital because she was scared. And she told him a lot not to get pregnant. But the situation was serious and it was necessary. She felt very bad because of the fear. And noticed the worsening,” he said. .
Fortunately, in this case, the child is improving, even though he is introverted.
The end of the peak?
According to Manuela Monte, as Brazil advances vaccinating children between the ages of 5 and 11, it is expected that the number of serious cases and hospitalizations will decrease – as has happened with other age groups who already have access to the vaccine.
“I strongly believe that vaccination should reduce Covid’s ICU mortality because it reduces the severity of the infection. We see mild cases in adults. And it can happen in children as well,” he said.
“Those who experience this experience of receiving patients in the ICU every day know how important it is to be vaccinated to reduce the severity of the disease.”
The number of hospital admissions in Monte has declined since the beginning of February. The number of hospital admissions is declining in other capitals, such as Sao Paulo. This could mean that the omicron wave is crossing the peak.
“It was complicated because we thought things were going to improve and then Ômicron came and we saw more and more children being hospitalized and seriously. But, in February, it started to improve,” Monte said.
“It was a wave where we saw more deaths in our ICU. But apparently it’s a small wave.”
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