Fernando Aguinaga, Pediatric Society: We are seeing many children already affected by COVID, who have a cough, but the vast majority, luckily, recover

Fernando Aguinaga is president of the Ecuadorian Society of Pediatrics, Pichincha subsidiary. In an interview with this newspaper, he talks about the effects of family meetings of December, the omicron variant in children and recommendationss for parents of respiratory affections in minors, as well as the anti-COVID-19 vaccination process.

In the Pablo Arturo Suárez hospital there are six pediatric patients out of a total of 13 hospital beds. In your opinion, is this a reflection of the new variant (ómicron) or the previous one (delta)?

It’s a reflection of what happened with the festivities rather. We have seen that with this new variant there are more infected children not only in Ecuador but worldwide, and it is being seen that the majority of children, luckily, recover without any problem; but there is a small group of children who are going to need to get to the hospitals, luckily, the majority who get to the hospitals recover very well, without needing to go to intensive care, but obviously we are seeing that by breaking the distancing measures , hand washing, wearing a mask, there were many more infected, especially in more vulnerable groups that were not vaccinated.

Can it be attributed to the omicron variant?

Also, because being more contagious makes it easier for the entire population to become infected, and the more children infected, statistically there are going to be more children who could need support in a health unit.

According to the Secretary of Health of the Municipality of Quito, there is an increase in the first week of the year in the presence of children under 5 years of age in the hospital system.

Children under 5 years of age are the ones who have not been vaccinated, they are the most vulnerable and we have seen that children, even those under one year of age, are the group that arrive at hospitals with complications. Worldwide, we are seeing that more or less of the total admissions, which are not many yet, because children defend themselves, the vast majority are fine, but those who arrive at hospitals, 50% will be children and another 50 % are going to be adults, that is half.

Is there any special characteristic of these children, perhaps, the ones who arrive at the hospitals, do they have a problem, some pre-existing illness?

If they have pre-existing disease, there is obviously a higher risk of complications, but the vast majority of patients are presenting an inflammation of the upper respiratory airway, which makes them very hoarse, very dysphonic, with a dry cough, which in some In some cases, the inflammation becomes such that it makes it difficult for them to breathe and that is why they go to hospitals for oxygen, hydration, because they do not eat, because of the great inflammation.

And in that case, what could be a recommendation to parents?

Maintain social distancing, support vaccination, in the cases of children who can already be vaccinated, the Minister (of Health) mentioned that vaccination is open from the age of 3, so go to the vaccination centers so that the children get vaccinated and if a child has a high fever, breathing problems do not stay home but take him to a medical center or a doctor who treats him as soon as possible.

Is there a massive, medium or low presence of children affected by COVID in pediatric consultations?

At the pediatric level, I am sure, because that is happening in my own practice, we are seeing many children already affected by COVID, who have a cough, but luckily the vast majority recover with medication, analgesics, hydration, general measures.

According to your reality, how many children go daily versus how many went before?

Of the children who go to the clinic, sick children, more than 80 or 90% are going to have a respiratory illness and it could possibly be COVID.

And that can be seen in this month, in December?

After the holidays, when the number of cases has already increased, we could see that they increased rapidly.

Ecuador could end this week with more than 20,000 cases of COVID-19, says Minister of Health

How would you evaluate vaccination for children from 5 years of age?

Vaccination in the country was one of the great processes that have been carried out and it was quite successful. I think we still have a long way to go in vaccination, in this group, but compared to other countries we have done quite well. We have to continue reinforcing and, above all, convincing families and parents that vaccination is safe, that it has been done in millions of children and that it is safe, and that we see that the aspects of vaccination are positive. If this same effect had happened without the vaccines, we would be living what we lived a year ago, people looking for oxygen, intensive care units full. So we are seeing that vaccination has a positive effect on the population.

What would be the strategy to convince parents who still do not want to take their children to be vaccinated?

First, we would have to detect which children are not vaccinated and secondly, talk to their parents and explain to them the benefits of vaccination versus the risk that those children who have not been vaccinated run, because in the case of children, not only is the acute stage of the disease, in some cases there is a post-infection, which is called multisystem inflammatory syndrome or Kawasaki disease, which can become very serious and lethal.

Would this conviction be through going to schools, going to homes by brigades?

I believe that the conviction is speaking, speaking directly with the parents, knowing what their fears are, clarifying them and looking for the taboos that exist against this vaccination to see in each case, if it is a cultural matter, if it is a matter of belief , why they are not agreeing, remember that this is not just a problem in Ecuador.

Is it convenient to start vaccinating children between 3 and 4 years old?

Yes, totally. There are some countries that took this initiative and there is scientific evidence that supports it, the more we get to vaccinate more population, the less risk of complications we will have.

For them, would there be any special consideration?

Not now. The vaccine that is being applied to them is the Sinovac, which is being applied in Colombia, in Chile, in other countries that have been seen to be a fairly safe vaccine with a technology that we have been using for many years.

95% of users would have presented anti-COVID-19 vaccination documentation when using inter- and intra-provincial transport

And what about the regular vaccination schedule?

It is important that children complete their regular vaccination schedule, but that is why we should not delay the COVID vaccine because COVID is a priority right now, which is why we are living. So knowing that if one is not up to date, nothing happens, put on the COVID one and then it will match the normal vaccination schedule.

Is a second dose recommended for children from 3 years of age?

Yes, everyone has to complete the second dose and international organizations such as the American Academy of Pediatrics, the FDA, are approving children over 12 years of age and are already suggesting the reinforcement of the third dose, even.

In what time?

The same scheme every 28 days. The scientists who developed the vaccine saw that, in this period of 28 days, there was a good immune response.

What recommendation would you as a guild make about this return to classes since February with 100% of the capacity?

First, the individual situation of each family must be taken into account, the situation of each city or each place of residence, because although we are afraid of contagion, in turn, we have to take into account that there are parents who have been badly hit. because of the pandemic and they do not have the option of contracting their internet or having access to the internet, and the other is that the parents are working and the children have no one to stay at home with; So, each reality is different, some parents will have the facilities to maintain virtual education and others will have to start doing face-to-face education with all the precautionary measures.

Would a requirement be that they are vaccinated with the full doses?

In children who can, the ideal would be for them to be vaccinated. Let us be very aware that if a child is sick, do not send him to class, set an example, parents, of hand washing, wearing a mask, social distancing.

And this of requiring the vaccination certificate for children, in your opinion is it right?

We Ecuadorians have been one of the most pro-vaccine cultures, it is not the first time that to enter a school or college they ask us for a vaccination certificate; most schools did it as a prerequisite for children to attend school. Not be something punitive, rather be something that promotes vaccination where we encourage parents to vaccinate their children.