Wearing a mask is not recommended for children below 5 years of age, the Directorate General of Health Services (DGHS), which comes under the Health Ministry has said.
The government has issued guidelines for the management of COVID-19 among children, stating that kids aged 5 and below are not required to wear masks. Children aged 6-11 may wear a mask depending on the ability of the child to use the mask safely and appropriately under direct supervision of parents/guardians.
The guidelines suggested a six-minute walk test for children above 12 years. “It is a simple clinical test to assess cardiopulmonary exercise tolerance and is used to unmask hypoxia. Attach a pulse oximeter to his/her finger and ask the child to walk in the confines of their room for six minutes continuously,” said the guidelines.
For severe COVID-19 among children, the guidelines said, “In case shock develops, necessary management should be initiated. Antimicrobials to be administered if there is evidence/strong suspicion of superadded bacterial infection. May need organ support in case of organ dysfunction, Renal replacement therapy,”.
Remdesivir has not been recommended and High-resolution CT (HRCT) imaging has been suggested in the guidelines. Additionally, the DGHS also said that Remdesivir is not recommended for children. “There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age,” it said. Rational use of HRCT to see the extent and nature of lung involvement in patients with COVID-19 is suggested.
“However, any additional information gained from HRCT scan of the chest often has little impact on treatment decisions, which are based almost entirely on clinical severity and physiological impairment. Therefore, treating physicians should be highly selective in ordering HRCT imaging of the chest in Covid-19 patients,” it said.
Steroids are said to be harmful in asymptomatic and mild cases of infection. “Steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided,” read the guidelines.
For asymptomatic and mild cases, antimicrobials are not recommended for therapy or prophylaxis. Whereas for moderate and severe cases antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection.