Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1731605
Preparedness for Pediatric COVID-19 Using Systems Approach: Experience of a Health Care Facility from India
![](https://www.thieme-connect.de/media/10.1055-s-00045654/202201/lookinside/thumbnails/10-1055-s-0041-1731605-1.jpg)
Abstract
A pandemic leads to disruption and stretching of an existing health care system and its resources. Coronavirus disease 2019 (COVID-19) data show distinct and severe manifestations in children necessitating critical care. Children need prioritization as they are susceptible to COVID-19 as part of the family cluster, varied presentations, and mortality. The purpose of this report is to discuss the optimization of the health care system for pediatric care. The key initiatives were to identify our objectives, bring out changes to the organizational processes, and integrate the same into the existing system. A systems approach to health care delivery by optimizing infrastructure, human resources, materials, funding, leadership, and governance was undertaken. This resulted in creation of distinct COVID-19 and non-COVID-19 service areas, management protocols, and trained health care workers. Partnership was forged with the public health system. This preparedness and continued responses to the demands of the health care system helped us manage children ranging from neonates to adolescents efficiently. Though the health care system is mostly open, acting upon the modifiable factors gave better preparedness in a short time.
Keywords
children - health care system - infrastructure - modifiable factors - pandemic - systems approachPublication History
Article published online:
06 July 2021
© 2021. Nitte (Deemed to be University). Nitte University. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020; 20 (06) 689-696
- 2 CDC COVID-19 Response Team. Coronavirus disease 2019 in children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (14) 422-426
- 3 Shekerdemian LS, Mahmood NR, Wolfe KK. et al International COVID-19 PICU Collaborative. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatr 2020; 174 (09) 868-873
- 4 Walker DM, Tolentino VR. COVID-19: the impact on pediatric emergency care. Pediatr Emerg Med Pract 2020; 17 (Suppl 6-1, Suppl 6-1) 1-27
- 5 Hong H, Wang Y, Chung HT, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol 2020; 61 (02) 131-132
- 6 Dong Y, Mo X, Hu Y. et al Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e20200702 DOI: 10.1542/peds.2020-0702.
- 7 She J, Liu L, Liu W. COVID-19 epidemic: disease characteristics in children. J Med Virol 2020; 92 (07) 747-754
- 8 Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395 (10229) 1033-1034
- 9 Verdoni L, Mazza A, Gervasoni A. et al An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020; 395 (10239) 1771-1778
- 10 Pathak EB, Salemi JL, Sobers N, Menard J, Hambleton IR. COVID-19 in children in the United States: intensive care admissions, estimated total infected, and projected numbers of severe pediatric cases in 2020. J Public Health Manag Pract 2020; 26 (04) 325-333
- 11 Remy KE, Verhoef PA, Malone JR. et al Caring for critically ill adults with coronavirus disease 2019 in a PICU: recommendations by dual trained intensivists. Pediatr Crit Care Med 2020; 21 (07) 607-619
- 12 Fernandes ND, Cummings BM, Naber CE. et al Adult COVID-19 patients cared for in a pediatric ICU embedded in a regional biothreat center: disease severity and outcomes. Health Secur 2020; DOI: 10.1089/hs.2020.0225.
-
13 Novel coronavirus disease – Situation update report 8 [Internet]. New Delhi: Ministry of Health and Family Welfare; 2020 Mar [cited 2020 April 24] p. 6. Report No.: 8. Available from: https://www.who.int/docs/default-source/wrindia/situation-report/india-situation-report-8bc9aca340f91408b9efbedb3917565fc.pdf?sfvrsn=5e0b8a43_2. Accessed May 26, 2021
-
14 NitteDU-KSHEMA handbook of COVID-19 protocols (version 3.1). Available at: http://www.kshema.nitte.edu.in/img/pdf/covid-19-hb.pdf. Accessed June 10, 2021
- 15 Kim CS, Lynch JB, Cohen S. et al One academic health system’s early (and ongoing) experience responding to COVID-19: recommendations from the initial epicenter of the pandemic in the United States. Acad Med 2020; 95 (08) 1146-1148
- 16 Blumenthal D, Fowler EJ, Abrams M, Collins SR. Covid-19 - implications for the health care system. N Engl J Med 2020; 383 (15) 1483-1488
- 17 Cheung R, Roland D, Lachman P. Reclaiming the systems approach to paediatric safety. Arch Dis Child 2019; 104 (12) 1130-1133
- 18 Ajith Kumar AK, Anoop Kumar AS. Deadly Nipah outbreak in Kerala: lessons learned for the future. Indian J Crit Care Med 2018; 22 (07) 475-476
- 19 Ravikumar N, Nallasamy K, Bansal A. et al Intensive Care Chapter of Indian Academy of Pediatrics. Novel coronavirus 2019 (2019-nCoV) infection: Part I - preparedness and management in the pediatric intensive care unit in resource-limited settings. Indian Pediatr 2020; 57 (04) 324-334
- 20 Sundaram M, Ravikumar N, Bansal A. et al Intensive Care Chapter of Indian Academy of Pediatrics. Novel coronavirus 2019 (2019-nCoV) infection: Part II - respiratory support in the pediatric intensive care unit in resource-limited Settings. Indian Pediatr 2020; 57 (04) 335-342
- 21 Chawla D, Chirla D, Dalwai S. et al Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF) and Indian Academy of Pediatrics (IAP). Perinatal-neonatal management of COVID-19 infection - guidelines of the FOGSI, NNF, and IAP. Indian Pediatr 2020; 57 (06) 536-548