Portugal’s children are “suddenly becoming ill all at once”

“The feeling we have is that, suddenly, the children are all becoming sick at the same time”.

These are the words of pediatrician Joana Martins, one of the child-health experts interviewed by Expresso for an article about how ‘confinement and measures of prevention of the pandemic have weakened the immune system, making us (all) more vulnerable to infections. 

“The effects are most obvious in children” whose immune systems are in the making.

Children need to come into contact with dirt (or put more scientifically: bacteria, microorganisms, viruses in general) in order to build immune systems that will carry them through the rest of their lives.

“All the sanitary measures necessary in a pandemic” have meant that this very necessary contact has been massively reduced, pediatrician Mário Cordeiro tells the paper, leading to babies and toddlers particularly becoming dangerously ‘vulnerable’.

Ironically, the youngest members of society – the one’s born during the pandemic – are now at risk from a respiratory virus (VSR) that is potentially much more harmful for them than SARS-CoV-2.

While SARS-CoV-2 infection will rarely develop in children into any serious form of Covid-19, VSR can precipitate acute bronchial infections that can see them having to be admitted into hospital.

And this is what has already started happening.

Says Expresso, in his 40 years of service as a pediatric doctor Alberto Caldas Afonso has “never seen anything like it in the Centro Materno-Infantil do Norte: many children with respiratory infections, in some cases very serious, being admitted to hospital every day during high summer, a time of year when traditionally A&E departments are much calmer.

“The unusual affluence over the last few weeks has taken pediatricians all over the country by surprise, and this is happening throughout Europe and in the United States”, says the paper.

“The phenomenon is what various specialists have already dubbed “weakened immunity”, a state of greater fragility in bodily defences indirectly caused by the pandemic”.

Public health institute Dr Ricardo Jorge has confirmed the “higher than normal number of positive cases of VSR” in children this year. It’s a virus that babies usually get in the first year of life – but due to last winter’s lockdown, many toddlers are only getting it now.

“If we hold children back, we’re delaying their contact with viruses that are unavoidable in the construction of their ‘immune library’. This is what has happened”, Joana Martins of Lisbon’s pediatric Hospital Dona Estefânia tells Expresso. “In the end, with confinement we delayed the inevitable. The truth is we have a group of children under the age of two now who have a long way to go in terms of new infections. And they all seem to be keeping step with each other…”

Mário Cordeiro likens the children’s situations as being like ‘greenhouse plants’ (not as robust as plants that have grown naturally).

It might be fine if exposure to VSR and other microbes now could toughen the country’s youngest citizens up instantly, but doctors are concerned.

“If they are getting sick now, at a time when there are less viruses in circulation, specialists fear the size of the wave of infections that could arrive in the autumn/ winter” when many more viruses are around and people spend more time in enclosed spaces “facilitating contagion”.

In England, right now, fears are that the colder months will see an increase of between 20% to 50% of children with respiratory diseases needing hospital treatment. This has seen authorities “double” the number of intensive care beds.

Countries in the southern hemisphere (where it is winter now) are being watched caarefully. New Zealand, for example, has seen “several hospitals convert surgical blocs into pediatric wards to respond to the number of admissions”.

Specialist in clinical immunology Mário Morais de Almeida puts the situation succinctly: “The first two, three years of life are defining for the construction of the immune system. Right now there are children of two years old who have lived practically their entire lives in a pandemic. They have had very little contact with pathogenic agents than would have happened before, thus, as normality returns, they are going to catch anything and everything – at least until they can recover the delay in creating their own defences”.

Older children, teens, young adults and adults will be equally vulnerable this winter, as their immune systems have also been allowed to get ‘flabby’ with all the measures of protection in place, so they will have less capacity to react when life returns to normal.

Mário Morais de Almeida sees this autumn/ winter as the moment when lots of other viruses will be circulating, and people need to use their intelligence.

If they ‘abandon’ all measures of protection from one day to the next, there could be a huge problem, he predicts. It will be a bit like expecting couch potatoes to suddenly rise up en-masse and (try to) run a marathon.

But for the children who have missed so much in this masked and sanitised world, pediatricians simply hope winter 2021/ 22 will be enough to bring their backward immune systems up to speed.

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