Children at greater risk of COVID-19

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A two-month-old baby has died as a result of COVID-19 infection, the Ministry of Health reported last week. This is the second COVID-19 death of a child in Mongolia. Earlier, on June 6, an eight-year-old child died of COVID-19. As the pandemic spreads, the number of infected people is increasing by the thousands every day nationwide. In particular, the health sector says that the incidence of infections among children is rising. As more than 90 percent of adults have been vaccinated against the coronavirus, the risk for adults is relatively low. But for children, not all of them have been vaccinated, so the risk remains very high.

Based on the results of international surveys, Mongolia started vaccinating 16 to 17-year-old children in mid-June. From Monday, 12 to 15 year olds became able to get the Pfizer vaccine with the permission of their parents and guardians. They are to be given a second injection 21 days after the first dose. Medical experts highlight that immunity is built up sufficiently after another 14 to 21 days of the second shot. This means that the risk of COVID-19 infection among vaccinated children is likely to drop in about two months. There is no international experience in immunizing 0 to 12 year olds against COVID-19 yet.

Children accounted for 18 to 19 percent of all new cases last month. Last week, the figure rose to 24 to 25 percent. In particular, 20,015 children have been infected with the coronavirus in Mongolia. Of these, 17,332 live in Ulaanbaatar and 2,658 in provinces. It was also confirmed that 24 children who came from abroad became infected with COVID-19. Currently, 2,014 children are being treated for the coronavirus. Most of the infected children are aged between 6 and 14.

The majority of Mongolian adults, or more than 1.7 million people, have received a full dose of vaccine against the coronavirus. They are relatively unlikely to become infected or become critically ill. According to the Ministry of Health, there are four groups in the population that are at risk of contracting COVID-19. The first group includes more than 151,000 people who have never been vaccinated. The second is 171,000 people who have been vaccinated but have not yet reached the 14-day immunization period. Third, 381,305 people are at risk of infection even after a full dose of the vaccine. For example, scientists have found that the vaccine used in Mongolia has a 75 percent efficacy rate, and one in four people who receive the full dose are at risk of infection. The fourth group is children, which is the largest demographic at risk. Specifically, there are 1,185,991 children in Mongolia. The four groups at risk of infection accounted for 56 percent of the population. In other words, 56 out of every 100 people are at risk of contracting COVID-19, most of whom are children.

Head of the Health Care Policy Implementation Coordination Department at the Ministry of Health B.Buyantogtokh said that children are mostly infected from family members and parents.

“People under the age of 44 had the lowest vaccination rate. Highly active and hard-working young people are more susceptible to infection. However, people of this age had the lowest immunization rate. It is common for young people to live with their children. Therefore, children are more likely to be infected by their parents in the family environment. In close contact with infected people, the majority, or 75 percent, of children were infected through family members. One member of the family who is most active in social interactions becomes infected and transmits the infection to others. However, there are relatively few cases of infection at work and from friends.”

He recommended parents be responsible and follow an infection control regimen.

Doctor T.Navchaa said, “According to international studies, only one-third of infected children under the age of 12 had symptoms. In other words, most people at this age do not show symptoms when they become infected. Mortality and complications are lower than in adults. For the past two years, international researchers have been studying the risk of death in children. Based on this study, there are five possible causes of complications and deaths. First, children under the age of one, especially premature infants, are more likely to be infected. This is because the early immune and respiratory systems of children of this age are not fully developed. The second complication is being overweight. According to a study conducted before the pandemic, one in four children aged 6 to 11 in Mongolia is overweight and one in eight children under the age of five face the same problem. As we work with children on a daily basis, we see a significant increase in this number. The main reasons for this are poor nutrition and lack of exercise. Therefore, parents need to pay close attention to their children’s diet. Kindergartens and schools have been closed for the past two years. There were no sports clubs or extracurricular activity. Due to this, there are many children with physical inactivity. The third cause is paralysis. It means that children are always on the bed. They are at risk of serious infection symptoms. The next are children with hereditary diseases such as Down syndrome. The fifth risk is the same as for adults. In other words, children with severe chronic lung and heart disease who are undergoing immunosuppressive therapy are at risk for serious infection.”

Children with critical infection are currently being treated at the National Center for Maternal and Child Health. The center has four wards for the treatment of COVID-19 patients. Two of them are for children and the rest are for pregnant women. One of the two children’s wards is an intensive care unit and the other is a general treatment unit. More than 60 children are currently hospitalized in these wards. Doctors and experts say that the number of children at risk of complications is likely to increase in the future.

Head of the center Sh.Enkhtur commented on the symptoms of infected children, “When children get infected, there are relatively few complications. However, children’s health is deteriorating year by year. There are many children with comorbidities, underlying diseases, congenital heart defects and metabolic disorders. Children suffer from all diseases and disorders that occur in adults. In this case, because of the risk of complications for the child, we follow the guideline of preventive treatment and hospitalization. Some symptoms such as nasal congestion, runny nose, sneezing, coughing, vomiting, and diarrhea are more common in children under five years of age. Adolescents have symptoms such as chest, head and throat pain, and shortness of breath.”

Another issue related to child illness is discrimination. A single mother with three young children who delivers food became infected while working in May. Unaware of her infection, she transmitted the infection to her mother, three children, and family. However, she said that her families, especially their children, were discriminated against by their neighbors.

She says officials say “nice” things when they report to the public. For example, they say, “Infection among children have increased. Therefore, parents need to protect their children at home almost every day.”

But she says it’s impossible for her to provide for her family without a job. For this reason, she continued to work during lockdown. “I became infected and my family was infected too. We were treated at home because of the heavy workload and mild illness. Now everyone has recovered. But our neighbors are discriminating against us and still consider us infected. They see my children as carriers of the virus. Their children stopped playing with my children. There are also people who are clearly reluctant when we go outside,” she said.

There was also a case in Bayanzurkh District last winter where an infected woman’s two children were evicted from their home. The Department of Family, Child and Youth Development took them to a temporary shelter. As mentioned above, discrimination still exists openly and behind closed doors. In particular, many people say that children are more likely to be asymptomatic. However, the World Health Organization (WHO) has officially stated that children do not carry the virus for a long time, and if they recover, they will not spread the virus to others like adults.

Enkhnaranjav Tumurbaatar