COVID-19 tales: ‘Adults give us time to think, babies don’t,’ says Dr Aarti Kinikar

Aarti Kinikar says that children get critical very soon, and are harder to take care of. Pic/Mandar Tannu

Part Of Team That Delivered First Covid-Positive Baby In India

Dr Aarti Avinash Kinikar, 57, Pune
Professor and Head Pediatrics, BJ Government Medical College

As doctors, who had previously worked through the H1N1 pandemic in 2015, we had the experience of vertical transmission of a virus. We had reported the first H1N1 vertical transmission as well. So, we had strict newborn and paediatric protocols already in place at our hospital.

When this baby was born in July, 2020, a battery of tests were run. Swab samples were taken from his/her nose; we also preserved the placenta fluid and umbilical cord to test. When the results came back, the child was found positive. What was baffling was that the mother had experienced some symptoms before, but had tested negative. So, it was evident that the transmission had happened when she was positive, but she had healed.

We had to take good care of the infant since he/she was critical. The baby was suffering from oxygen deficiency and sepsis. We did a test on the mother for antibodies, and she had them. The child also later showed the presence of antibodies after it recovered.

The baby's age posed a challenge before us - a baby's health can deteriorate rapidly. Adults give us time to think [of treatment], babies don't. Their COVID-19 management is also very difficult as we had to figure what drugs work and the ones that don't. What helped us diagnose the infection was that we went in with the belief that both of them were positive, until they tested negative. So we took all the care and precautions regardless. As we gradually figured out the protocol and care of COVID positive babies with this infant, we were able to better handle the next batch of 20 COVID-positive babies born after.

At first, we were a bit lost as we had no experience of dealing with this infection and that too in an infant. We had to rely on literature from the UK and US, which in the end was not very helpful, as Indian babies behave very differently from those elsewhere in the world. They have low birth weight, and tend to have not developed as robustly as babies in the western world.

The challenge now is to keep monitoring the child for any long-term effects, as many adults who tested positive have reported conditions like fibrosis during post-COVID care. We are relieved that the child is almost a year old, and doing well.