सोमवार, 6 फ़रवरी 2023

फिर दूर से आवाज़ दे गया कोई

फिर दूर से आवाज़ दे गया कोई  

सुबह सवेरे एक बचपन के साथी  का फोन आया। पता चला बेबी भाई  थे।  यह भी के शकीला बेगम का फोन उनके पास आया था। बेहद याद कर रहीं थीं अपने खाविंद महरूम मुबीन भाई को। मुबीन हमारे तमाम बचपन के दोस्तों में एक कॉमन सर्व-सहमत नाम रहा है। 

मुबीन शब्द का अर्थ होता है :

  • स्पष्ट, व्यक्त, वाजेह, साफ़, खुला हुआ, प्रकट
  • सचमुच ज़िंदादिली की मिसाल एक खुली किताब थे मुबीन भाई यारों के यार ,यारी से काम। शैर ओ शाइरी का शौक़ उन दिनों खूब परवान चढ़ता था। रज़िया मंज़िल में अज़ीमतर शायर उस दौर में मिलें जबकि हमें शायरी का मुशायरे के मानी भी कहाँ मालूम थे। 
  • शकीला बेगम को मैंने तुरत फुरत फोन लगाया। 
  • ये क्या जीवन को दोहराते -दोहराते सिसकने लगीं मुबीन भाई को याद करके। 

  • आती थी कहकहों की सदा दूर से ,
  • जाकर करीब देखा तो आंसू रवाँ थे। 

  • बस बातों  ही बातों में बचपन के झरोखे खुले शैर और शायरी का सिलसिला बह निकला -"ये डायरी मुबीन भाई की है। बेगम भी उन जैसी ही हैं उर्दू अदबीयत का बेहतरीन तोहफा। अदायगी बे -मिसाल फख्र से उन्होंने बतलाया दसवीं ज़बान तक मेरे पास उर्दू थी।" 
  • चंद शैर उनके सौजन्य से मिलें हैं -हमारे लिए ताज़ातरीन -

  • ऐसी वैसी बातों से तो अच्छा है खामोश रहो ,
  • या फिर ऐसी बात करो ,जो खामोशी से अच्छी हो। 
  • तुम आसमान की बुलंदियों से जल्द लौट आओ ,
  • हमें ज़मीं के मसाइल पे बात करनी है। 
  • मुबीन भाई से सुना एक और शैर पढ़ा उन्होंने -
   
   लब खोलके कुछ भी न कह पाई ज़िंदगी ,
   खामोश रहके मौत ने सब कुछ सुना दिया। 

  दिल से निकली हुई हर बात ,असर रखती है ,
  "पर "नहीं परवाज़ की ताकत रखती है। 
   
   विशेष :पर यानी पंख उड़ने को ,परवाज़ यानी उड़ान। 

  मुबीन भाई  के घर "रज़िया मंज़िल "में एक दीवान जी  आते थे बुगरासी वाले सफ़ेद दाढ़ी लंबा कद खूबसूरत अदाकारी पास बिठलाकर आम खिलाते आम से ज्यादा रसीले शैर सुनाते। मैं नौवीं कक्षा का छात्र रहा होवुंगा उस दौर में। कंठस्थ है उनका पढ़ा हुआ हर शैर हालांकि तब शैर और शायरी की गहराई से वाकिफ कहाँ थे। 

रटा  हुआ भी खूब काम आता है साहब ।हम तो एमएससी कर गए रटते -रटते।  आज भी  चंद शैर  याद है उस दौर के -

अंदाज़ हू - ब- हू तेरी आवाज़े पॉ था ,
बाहर निकलके देखा तो झौंका हवा का था। 
एक और शैर को तवज़्ज़ो दीजिए -

ये कहते ,वो कहते ,जो यार आता ,
भई!सब कहने की बातें हैं ,
कुछ भी ना कहा जाता ,
जब यार आता।  
मुआफ करें ,आज मिलते बाद में हैं ,पहले प्रोपोज़ कर देते हैं -आई लव यु। 
अंदाज़े ज़िंदगी अब कुछ तरह  इस  से है -
कुछ लोग इस तरह ज़िंदगानी के सफर में हैं ,
दिन रात चल रहे हैं मगर घर के घर में हैं। 
वीरुभाई !
  

    
    

गुरुवार, 12 अगस्त 2021

भीड़ युवा का ध्यान धरो, संसद का सम्मान करो। मार्शल रखते ध्यान तुम्हारा ,तुम भी तो कुछ ध्यान धरो ,

 

मज़हब और जाति के घेरे ,घेरे मेरी संसद को

 मज़हब और  जाति के घेरे ,घेरे मेरी संसद को ,

 रहने दो संसद को संसद ,तोड़ो घेरा बंदी को। 

आसंदी का मान करो ,संसद का सम्मान करो ,

टेबिल पे चढ़के तुम भैया मत इतना अभिमान करो.

मत फैंकों कागज़ के टुकड़े सभापति के आसन पर ,

मत तोड़ो दरवाज़ों को ,दीवारों का ध्यान करो ,

वीडिओज़  का नित करते  खेला ,

भीड़ युवा का ध्यान धरो, संसद का सम्मान करो। 

मार्शल रखते ध्यान तुम्हारा ,तुम भी तो कुछ ध्यान धरो ,

मदमाया पद आनीजानी ,कहते सारे ग्यानी ,

कहलाते तुमभी तो ग्यानी ,अपना ही कुछ ध्यान धरो। 

रविवार, 4 जुलाई 2021

चीन का शताब्दी मार्च – साम्यवाद से साम्राज्यवाद की ओर

शी जिनपिंग अपने आप को आज के युग के चीनी सम्राट के रूप में पेश कर रहें हैं। अमेरिका और यूरोप को माल बेचकर हासिल हुई अपनी आर्थिक ताकत से अमेरीका और यूरोप को ललकारा जा रहा है। ताकि चीनी लोग आर्थिक सुधारों और अपने नागरिक अधिकारों की मांग की बात को भूलकर चीन के खिलाफ गोलबंद हो रहे लोकतांत्रिक देशों का सामना करने में चीनी कम्यूनोस्ट पार्टी का साथ दें।  

चीनी कम्युनिस्ट पार्टी इस महीने अपनी स्थापना शताब्दी मना रही है। पार्टी की स्थापना शंघाई की फ़्रांसीसी कॉलोनी के पास हुआंगपू नदी की एक नाव में हुई थी जहाँ माओ-त्से दोंग और दर्जन भर युवा क्रांतिकारियों ने पुलिस से बचते-बचाते एक बैठक की थी। कहते हैं कि माओ इस बैठक की तिथि को भूल गए थे। इसलिए चीनी कम्युनिस्ट पार्टी का स्थापना दिवस पहली जुलाई को मनाया जाता है।

राजधानी बीजिंग के तियानन्मैन चौक में हुए भव्य शताब्दी समारोह में बोलते हुए राष्ट्रपति शी जिन्पिंग ने चीन को घेरने की कोशिश में लगी ताक़तों को चेतावनी देते हुए कहा, ‘चीन किसी की धौंस में नहीं आएगा। जो चीन को दबाने की ज़ुर्रत करेगा उसका सिर तोड़ दिया जाएगा।’ उन्होंने अमेरिका की तरफ़ इशारा करते हुए कहा कि ‘हम नैतिक पाठ नहीं पढ़ेंगे और हमारा अटल संकल्प है कि हम ताइवान को चीन में मिलाएँगे। कोई इसे हल्के में न ले।’

शताब्दी समारोह के अवसर पर शी जिन्पिंग के इस तेवर के दो लक्ष्य थे। पहला, लोगों में चीनी अस्मिता और राष्ट्रवाद की भावना जगाना और यह याद दिलाना कि वह चीनी कम्युनिस्ट पार्टी और उनकी सरकार के हाथों में ही सुरक्षित है। उन्होंने अपने भाषण में कहा, ‘समाजवाद ही चीन को बचा सकता है और चीनी ख़ूबियों वाला समाजवाद ही चीन का विकास कर सकता है।’ चीनी ख़ूबियों वाले समाजवाद का मतलब पूँजीवादी उद्योगनीति और समाजवादी राजनीति का वह दिलचस्प मिश्रण है जो चीन में पिछले 40 साल से चल रहा है। दूसरा लक्ष्य दुनिया को यह संकेत देना था कि चीन अब अपनी नई आर्थिक और सैनिक ताक़त का प्रयोग अपने प्रभाव और हितों के साम्राज्य को फैलाने में करेगा।

ध्यान देने की बात है कि यह वही चीनी कम्युनिस्ट पार्टी की सरकार है जिसे 1949 में सत्ता में आने के बाद 21 वर्षों तक संयुक्त राष्ट्र में अपनी सीट पर नहीं बैठने दिया गया था। सत्ता के आरंभिक वर्षों में जिसकी आर्थिक दशा उत्तरी कोरिया से भी ख़राब थी, जिसने मुख्यतः माओ के नेतृत्व वाले पहले 30 वर्षों में ‘ग्रेट लीप फ़ॉरवर्ड’ और ‘सांस्कृतिक क्रांति’ जैसे ऊल-जलूल प्रयोगों से देश को भुखमरी और बरबादी के गर्त में धकेला। माओ के मार्चों से बरबाद हुई खेती और भीषण अकाल ने, और एक वर्ग के लोगों को दूसरे वर्ग के लोगों पर छोड़ने की नीति ने कम-से-कम साढ़े चार करोड़ लोगों की जान ले ली। मानव इतिहास में इससे बड़ी जनहानि नहीं हुई।

लेकिन पिछले चालीस सालों के आर्थिक विकास ने पहले तीस सालों के ज़ख़्म भर दिए हैं। चीन का आर्थिक विकास इतिहास में सबसे तेज़ और अनवरत चलने वाला आर्थिक विकास है। 1980 में चीन का सकल घरेलू उत्पाद केवल 191 अरब डॉलर था और प्रति व्यक्ति आय 195 डॉलर प्रति वर्ष थी और वह भारत से पीछे था। आज उसकी अर्थव्यवस्था 143 खरब डॉलर और प्रति व्यक्ति आय 10,261 डॉलर हो गई है जो भारत से पाँच गुना है। 

आख़िर फ़र्श से अर्श की इस उड़ान का रहस्य क्या है? ऐसा क्या है जो दुनिया की कोई और कम्युनिस्ट पार्टी नहीं कर पाई और चीन ने कर लिया? चीनी कम्युनिस्ट पार्टी की प्रेरणास्रोत सोवियत कम्युनिस्ट पार्टी ने चीनी कम्युनिस्ट पार्टी से भी लंबे समय तक शासन किया। पर अपने 74 साल के शासन में उसने सोवियत संघ का दिवाला निकाल दिया। यही हाल उत्तरी कोरिया, क्यूबा और वेनेज़ुएला जैसे देशों का हुआ। चीन के अलावा कोई ऐसा कम्युनिस्ट देश नहीं है जो चीन जैसी आर्थिक उन्नति कर पाया हो जो पूँजीवादी देशों को सोचने पर मजबूर कर दे। चीनी कम्युनिस्ट पार्टी ने यह काम सत्ता पर अपनी पकड़ बनाए रखते हुए किया है। मज़दूरों को अपने हक़ों के लिए लड़ने, लोगों को अपने विचार और असहमति प्रकट करने और असहमत लोगों को सरकार की आलोचना करने का अधिकार नहीं है। फिर भी लोगों से बात करके देखने पर लगता है कि वे ख़ुश हैं।

विशेष :हमारा मानना है आलमी स्तर पर आसन्न खतरे से घिरे शी चिनपिंग बेहद डरे हुए हैं। कमज़ोर आदमी ही धमकी देता है। बंदर घुड़की से ज्यादा असर नहीं रखती हैं ऐसी धमकियां। आखिर कब तक नयी सोच पर आप  ढ़क्कन लगाए रहियेगा।  एक दिन ये अंदर के दाब से उड़ जाएगा। बेहद सटीक विश्लेषण के लिए जाने जाते हैं शिवकांत जी। इतिहास के झरोखों में ले जाकर आप पाठक को वर्तमान में लाके छोड़ देते हैं अपना निष्कर्ष खुद निकालने को।आपका यह आलेख 'सत्य हिंदी ' दैनिक की आज ४ जुलाई २०२१ की लीड स्टोरी (अग्र लेख )बना मुखरित है।  

शिवकांत जी लंदन से (पूर्व सम्पादक बीबीसी )
Image result for Shiv Kant BBC london ex .ed.images ?

बुधवार, 5 मई 2021

The story is now being revealed ,Mamta Banerji of Mamtabadi fame is now part of a bigger conspiracy to maign the Central Government ,known as Congres Kit the agenda of which is now known to one and all .Tikait gang is also a part of that conspiracy .

The story is now being revealed ,Mamta Banerji of Mamtabadi fame is now part of a bigger conspiracy to maign the Central Government  ,known as Congres Kit the agenda of which is now known to one and all .Tikait gang is also a part of that conspiracy .

That she instructed and prevented DM of a Mamtabadi district to attend PM meeting on line and herself attended just to make allegations in person against Modi .The fight is not against Corona it is Modi.

While ICMR alerts that the aerosols from the exhalations of a Covid patient travels 10 meters in the air and remains live like Rahul eager to treat .He is roaming like a stray cattle without getting vaccinated like his cohorts at the Delhi boarders .   

WEST BENGAL ASSEMBLY ELECTION

Mamata asked officials to not send me reports on post-poll violence: Jagdeep Dhankhar

"The home secretary conveyed to me that he has been instructed by her (CM) not to give a law and order update report asked by me, and also not to forward the reports that the DGP and the police commissioner had sent to him."
By Vinod Sharma, New Delhi
UPDATED ON MAY 06, 2021 04:28 AM IST

West Bengal governor Jagdeep Dhankhar spoke to Vinod Sharma from Kolkata soon after administering the oath of office as chief minister to Mamata Banerjee. Edited Excerpts:

You apparently spoke to Mamata Banerjee on the need to promptly put a stop to post-poll violence. Are you reassured by her response?

It is shocking and sickening that, May 2 onwards, post-poll violence, arson, loot, killings and crimes against women and children have continued unbated. There have been virtually no deterrent steps by state functionaries. In such a situation, it is difficult to discount the widespread belief that it is state-sponsored terror. The underlying message is that there is no space for opposition. Such a state of affairs is antithetical to democracy’s essence.

Finding the situation worrisome, I summoned the state home secretary, DGP and Kolkata police commissioner so as to sensitise them. While they responded, the ground reality reflected a worsening of the situation. My office was flooded with reports of violence, in which vandalism was ruthlessly let loose on political opponents by torching their houses, shops and vehicles. The women victims suffered unspeakable torture.

ICMR releases new Covid testing guidelines, asks to avoid RT-PCR if...

दोस्तों !स्वास्थ्य सेवाओं  पर बढ़ते दवाब के मद्देनज़र ये नै सिफारिशें और अनुदेश भारतीय चिकित्सा अनुसन्धान परिषद् ने ज़ारी किए हैं। एक से दूसरे राज्य और नगर में जाने से पहले भी अब आरटी -पीसीआर जांच की अनिवार्यता वापस ले ली गई है अलबत्ता आप सुरक्षित दैहिक दूसरी परस्पर बनाकर रखें यात्रा में या घर दुआरे कहीं भी मास्क लगाएं और कोरोनाचार कोरोना उपयुक्त व्यवहार करें। कोरोना प्रोटोकॉल का पालन करें। 

रेपिड एंटीजन टेस्ट (RAT )के तहत जिसके नतीजे १५ -२० मिनिट में उपलब्ध हो जाते हैं ,कोरोना वायरस सार्स -कोव -२ से संगत एक विशिष्ठ एंटीजन (एक प्रकार की ख़ास प्रोटीन के खंडों )का ज़ायज़ा लिया जाता है जबकि रिवर्स ट्रांस्क्रिप्टेज़ पोलीमरेज़ चेन रिएक्शन के अंतर्गत वायरस के आनुवंशिक पदार्थ आरएनए (एक प्रकार की सर्पिल या एकल कुंडली नुमा संरचना )का पता लगाया जाता है यह भी खासुलखास होती है खुसूसियत विशिष्ठ्ता लिए रहती है कोविड संक्रमण के   मामलों में। इसकी रिपोर्ट एक से तीन दिन के अंदर उपलब्ध हो जाती है। मामले बेहद बढ़जाने पर आज़माइशों की नताइशें नतीजे आने में ६ -७ दिन भी लग जाते हैं। कोरोना यौद्धा दिन रात हमारी मदद कर रहें हैं। सरकारें सचेत हैं केंद्र अहर्निश जुटा  हुआ है रणनीति बनाने आलमी स्तर पर उपलब्ध चिकित्सा सामिग्री लक्ष्य तक पहुंचाने में। 
रेपिड टेस्ट के नतीजे निगेटिव आने के बाद भी जिन लोगों में कोरोना के लक्षण बने रहते हैं यथा ज्वर ,गले में खराश ,अतिसार वह निश्चित तौर पर आरटीपीसीआर जांच करवाएं। 
रेपिड जांच अब मोहल्ला कल्याण रेज़िडेंट वेलफेयर के प्रांगण में ,सामुदायिक केंद्रों  स्कूलों ,उपलब्ध होगी। आरटीपीसीआर जांच भी आप अपनी कार में बैठे बैठे भी करा सकते हैं। 

The Indian Council of Medical Research has come out with a new set of guidelines for Covid testing, with an aim to take the load off existing laboratories as Covid cases continue to grow in the country.

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As India witnesses an exponential surge in Covid-19 cases, the Indian Council of Medical Research (ICMR) has released a new set of guidelines for Covid testing, talking about reducing RT-PCR tests in order to take the load off existing laboratories.

HERE'S WHEN RT-PCR TEST Is NOT NEEDED

  • If Rapid Anigiden Test identified a patient as Covid positive
  • If RT-PCR test has identified a patient as positive once
  • If one has been in home isolation for 10 days with no fever in the last three days
  • At the time of getting discharged from the hospital
  • If a healthy individual has undertaken inter-state travel.

At present testing is being conducted in 2,506 labs in India and the decision is aimed at preventing them from being burdened as cases increase.

The ICMR said, "At present, the laboratories are facing challenges to meet the expected testing target due to extraordinary case load and staff getting infected with Covid-19. In view of this situation, it is imperative to optimise the RT-PCR testing and simultaneously increase the access and availability of testing to all citizens of the country."

To help the exhausted labs, the ICMR is now suggesting Rapid Antigen Test (RAT) for mass detection. It said the RAT should be allowed in government and private healthcare facilities across the country in cities, towns, schools, colleges, and community centres. The ICMR also suggested creating drive-through RAT facilities.

WHEN TO TAKE RT-PCR TEST?

The ICMR has said if an individual identified as negative by Rapid Antigent Test continues to face symptoms of Covid, then the person should be linked with an RT-PCR testing facility.

Vaccine status mandatory

The ICMR said, "The vaccination status of all individuals tested for Covid-19 must be entered into the Sample Referral Form (SRF) in the RT-PCR app both for individuals tested by RT-PCR and RAT. This information is of critical importance."

 

शनिवार, 24 अप्रैल 2021

ऐसा नहीं है कि गए साल पहली कोरोना लहर में नौनिहाल संक्रमण से अछूते रहे थे ,बेशक गैर -लाक्षणिक रहे हमारे नौनिहाल लेकिन एक फीसद को यह संक्रमण छू कर चुपचाप निकल गया था। इस बरस अनुमान है संक्रमण की दर बालकों में 1. २ फीसद है। कोई प्रामाणिक आंकड़ें बाबत सामने नहीं आये हैं।

ऐसा नहीं है कि गए साल पहली कोरोना लहर में नौनिहाल संक्रमण से अछूते रहे थे ,बेशक गैर -लाक्षणिक रहे हमारे नौनिहाल लेकिन एक फीसद को यह संक्रमण छू कर चुपचाप निकल गया था। इस बरस अनुमान है संक्रमण की दर बालकों में 1.  २ फीसद है। कोई प्रामाणिक आंकड़ें  बाबत सामने नहीं आये हैं। 
माहिरों  की राय में डबल ,ट्रिपल अन्य वेरिएंट्स सबकी सब के प्रति बालक टोली ज्यादा अरक्षित है निहथ्थी है ,इनके लिए फिलाल कोई कोरोना प्रोटोकॉल भी अभी सामने नहीं आई है।जिन घरों में माँ बाप में से कोई एक या अन्य कोई भी संक्रमित है वह घर से बाहर न निकलें  इसमें ही अन्यों का बचाव है बच्चे अभी भी कितने ही अलाक्षणिक (asymptomatic )बने  रह सकते हैं लेकिन अन्यों को सुगमता से संक्रमित कर सकते है। 
कोरोना का डबल म्युटेंट खुद प्रतिरक्षातंत्र के पहरुवों का भेष धरके बैठ जाता है इम्यून सिस्टम को चकमा दे प्रतिरक्षा व्यवस्था को चौपट कर अपना काम कर जाता है। 
यही वजह है दूसरी लहर में बालकों में   मल्टीसिटेम इंफ्लेमेटरी सिंड्रोम दिखलाई दिया है। 
गए साल के ३१ फीसद की वनिस्पत अब इससे तीस बरस के नीचे के ३२ फीसद लोग असरग्रस्त  हो सकते हैं। ऐसा प्रतीत होता है यह लहर नहीं कोरोना सुनामी है। 
श्वसन तंत्र को निशाने पे लेने के अलावा इसके अन्य लक्षणों में चिल्स (शरीर में कम्प का होना ),उच्च ज्वर ,बे-दमी सांस की धौंकनी का  जल्दी-जल्दी चलना ,उदर -आंत्र संक्रमण के लक्षण ,भूख न लगना उलटी दस्त ,माइएल्जिया (पेशियों की दुखन ,पेशीय शूल ),श्लेष्म -त्वचीय शोथ (mucocutaneous inflammation  )आदि हो सकते हैं। 
कुछ अन्य मामलों में अग्नाश्य -शोथ ,यकृत की असरग्रस्तता ,लीथारजी ,सीज़र्स आदि भी दर्ज़ हुए हैं। 
भारत में नेत्रश्लेष्मल शोथ (conjuctivitis ),के अलावा कुछ मामलों में चमड़ी पर चकत्ते रैशिज़ भी दिखलाइ दिए हैं। सबके लक्षण यकसां नहीं होंगे। 

 

Why are more children testing positive for Covid-19 in second wave? What are the symptoms usually shown by children? What precautions should parents take? We dissect each question by talking to experts

A girl wearing a mask walks near India Gate in New Delhi. A high number of children and adolescents are contracting the novel coronavirus in the second wave (Source: PTI)
Relatively unaffected during the first wave of Covid-19 last year, a high number of children and adolescents are contracting the novel coronavirus in the second wave. A large number of Covid-19 cases in ages more than 10 years and also between 1-8 years are being reported in the fresh surge -- though most are mildly symptomatic.

"If Covid-19 affected 1 per cent of children last year, it is about 1.2 per cent now. But it is a huge increase in terms of numbers in India," Dr Anjan Bhattacharya, consultant pediatrician, Apollo Hospital, told IndiaToday.in. Presently, there is no government data on Covid-19 among children.

While there is no vaccine for kids yet, several companies have started clinical trials among adolescents and young children. India is yet to come up with a treatment protocol for children.

Why are more children testing positive for Covid-19 in second wave? What are the symptoms usually shown by children? What precautions should parents take? What have other countries done to check Covid-19 infections among children? We dissect each question by talking to experts.

Why is the second wave of Covid-19 affecting more children and adolescents?

Experts say the double mutant coronavirus variant alongside a cocktail of other strains have a higher tendency to infect children. Children getting infected from members of family who go outside and are lax in maintaining Covid-19 appropriate behaviour are also part of the spread seen during the second wave.

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"The double mutant variant has immune escape phenomena. It masquerades as our own body system and then escapes our immunity protection. This is why more children are contracting Covid-19," said Dr Anjan Bhattacharya.

Dr Jaydeb Ray, Department of Pediatric Medicine, Institute of Child Health, Kolkata, said children were getting infected by Covid-19 in the first wave as well, but most cases were asymptomatic. "But now, we are seeing kids coming to hospitals coming with MISC (Multisystem Inflammatory Syndrome in Children). This time it is showing parallel to an active infection," he said.

However, Dr Sagnik Biswas, Senior Resident, AIIMS, said that given the rapid spread of the virus, the overall number of patients (both young and elderly) is expected to rise, but there doesn't seem to be any indication that the virus affects younger population more than the elderly. "The percentage of afflicted individuals under 30 years can be placed to around 32% as compared to 31% in the previous wave," Dr Biswas told IndiaToday.in.

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What symptoms are children showing?

The second wave has shown that Covid-19 symptoms are not limited to just the respiratory system. The most common symptoms observed in children include high fever, chills, shortness of breath, cough, loss of smell, sore throat, myalgias, and mucocutaneous inflammatory signs. In the second wave, more Covid-19 positive children are showing gastrointestinal (GI) symptoms like loss of appetite, vomiting and diarrhea.

"Case reports are now emerging from several countries saying that Covid-19 may even lead to episodes of pancreatitis and decompensated liver disease, although these are based on clinical experience of few cases," said Dr Sagnik Biswas.

Dr Jaydeb Ray said warning signs such as elevation of inflammatory markers, fast breathing, lethargy and seizures should be monitored by parents for early detection of Covid-19 in children.

Why are Covid-19 positive children showing more gastrointestinal (GI) symptoms this time?

Although respiratory symptoms are more prominently highlighted, gastrointestinal manifestations are seen in up to 40-50 per cent cases, said Dr Sagnik Biswas, Department of Gastroenterology, AIIMS.

"Novel coronavirus uses ACE2 as a viral receptor for entering the GI tract. It is highly expressed in the glandular cells of gastric, duodenal, and rectal epithelia, supporting the entry of coronavirus into the host cells," he said.

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Several studies have identified the presence of SARS-CoV-2 in stool samples. "A study comprising 10 pediatric patients evaluated their nasopharyngeal and rectal swabs. Eight children persistently tested positive on rectal swabs even after nasopharyngeal clearance of the virus. Furthermore, a cohort study demonstrated a significant enhancement of ACE2 expression in cholangiocytes as well as liver cells, indicating that the virus can lead to direct damage to intra hepatic bile ducts," Dr Sagnik Biswas said.

ALSO READ | Covid-19: Children exhibiting behaviour disorders due to curfews and lockdowns

What should be done when a child tests Covid-19 positive? What precautions should be taken?

Experts say children showing mild symptoms should be home quarantined for 14 days. "If symptoms are mild and oxygen saturation is greater than 94 per cent, we have to give supportive care, adequate hydration, proper nutrition and paracetamol," said Dr Jaydeb Ray. If CRP (C-reactive protein) and ferritin (blood protein that contains iron) levels are elevated, then children must be admitted to a hospital, he said.

In the absence of any definitive therapy, social distancing, wearing masks, and hand washing are still the gold standard in prevention of disease among this age group, experts told IndiaToday.in.

What has the government said on Covid-19 affecting children?

Union Health Minister Harsh Vardhan told Parliament that children in the age group of 0-14 years were less affected by Covid-19. He said infection among children was mild and most of them remain asymptomatic.

"Hence no specific action plan has been formulated in the current response phase to minimize the adverse effects of Covid-19 on such children," Dr Harsh Vardhan said in a written reply.

Dr Vardhan further said that rarely a severe illness, in form of multi-system inflammatory syndrome, had been identified. This usually happens three to six weeks after the infection, he said. The Department of Pediatrics, AIIMS, is documenting the long-term effect of Covid-19 in children.

Are there any Covid-19 vaccines for children?

No, presently there is no Covid-19 vaccine that can be administered to those below 18 years of age. The Health Ministry has said clinical trials are underway to test the safety and efficacy of Covid-19 vaccines among children.

In February, Hyderabad-based Bharat Biotech had sought approval from the national drugs regulator for Phase 3 clinical trial of its Covid-19 vaccine -- Covaxin -- in children between the ages of 5 and 18 years. However, it was not granted permission since it did not produce efficacy data on adults.

Last week, Pfizer announced that trials of its vaccine in children aged 12 to 15 showed 100 per cent efficacy and a strong immune response, with no unusual side effects. It has now sought emergency approval from the US Food and Drug Administration to use its vaccine in this age group.

The University of Oxford had started testing the Covid-19 vaccine it developed with AstraZeneca in children and teenagers (this vaccine is available in India under the brand name Covishield). However, it has paused the trial following blood clotting issues in adults who received the jab.

Can newborns get Covid-19?

A very small number of cases have emerged where pregnant women infected with coronavirus have passed the disease on to their babies. Infants can also become infected shortly after being born. The US Centers for Disease Control and Prevention (CDC) has said that most newborns who test positive for Covid-19 have mild symptoms or none at all, and recover, but serious cases have occurred.

How have other countries dealt with child Covid-19 patients?

In the US, children represent about 13 per cent of all Covid-19 cases, according to the American Academy of Pediatrics and the Children's Hospital Association. The National Institutes of Health, which is the US's medical research agency, has formulated guidelines for treatment of children with Covid-19.

According to the NIH, most children with mild or moderate disease can be managed with supportive care alone. The NIH says Remdesivir can be considered for hospitalised children of all ages with Covid-19 who have an emergent or increasing need for supplemental oxygen. It also suggests that dexamethasone may be beneficial in pediatric patients with Covid-19 respiratory disease who are on mechanical ventilation.

The UK and Israel are planning to start inoculating children within the next six months, reports said. In other countries, specific strategies are being taken to treat severe cases as per the symptoms.

While there is no vaccine for kids yet, several companies have started clinical trials among adolescents and young children. India is yet to come up with a treatment protocol for children.

Why are more children testing positive for Covid-19 in second wave? What are the symptoms usually shown by children? What precautions should parents take? What have other countries done to check Covid-19 infections among children? We dissect each question by talking to experts.

Why is the second wave of Covid-19 affecting more children and adolescents?

Experts say the double mutant coronavirus variant alongside a cocktail of other strains have a higher tendency to infect children. Children getting infected from members of family who go outside and are lax in maintaining Covid-19 appropriate behaviour are also part of the spread seen during the second wave.

"The double mutant variant has immune escape phenomena. It masquerades as our own body system and then escapes our immunity protection. This is why more children are contracting Covid-19," said Dr Anjan Bhattacharya.

Dr Jaydeb Ray, Department of Pediatric Medicine, Institute of Child Health, Kolkata, said children were getting infected by Covid-19 in the first wave as well, but most cases were asymptomatic. "But now, we are seeing kids coming to hospitals coming with MISC (Multisystem Inflammatory Syndrome in Children). This time it is showing parallel to an active infection," he said.

However, Dr Sagnik Biswas, Senior Resident, AIIMS, said that given the rapid spread of the virus, the overall number of patients (both young and elderly) is expected to rise, but there doesn't seem to be any indication that the virus affects younger population more than the elderly. "The percentage of afflicted individuals under 30 years can be placed to around 32% as compared to 31% in the previous wave," Dr Biswas told IndiaToday.in.

What symptoms are children showing?

The second wave has shown that Covid-19 symptoms are not limited to just the respiratory system. The most common symptoms observed in children include high fever, chills, shortness of breath, cough, loss of smell, sore throat, myalgias, and mucocutaneous inflammatory signs. In the second wave, more Covid-19 positive children are showing gastrointestinal (GI) symptoms like loss of appetite, vomiting and diarrhea.

"Case reports are now emerging from several countries saying that Covid-19 may even lead to episodes of pancreatitis and decompensated liver disease, although these are based on clinical experience of few cases," said Dr Sagnik Biswas.

Dr Jaydeb Ray said warning signs such as elevation of inflammatory markers, fast breathing, lethargy and seizures should be monitored by parents for early detection of Covid-19 in children.

Why are Covid-19 positive children showing more gastrointestinal (GI) symptoms this time?

Although respiratory symptoms are more prominently highlighted, gastrointestinal manifestations are seen in up to 40-50 per cent cases, said Dr Sagnik Biswas, Department of Gastroenterology, AIIMS.

"Novel coronavirus uses ACE2 as a viral receptor for entering the GI tract. It is highly expressed in the glandular cells of gastric, duodenal, and rectal epithelia, supporting the entry of coronavirus into the host cells," he said.

Several studies have identified the presence of SARS-CoV-2 in stool samples. "A study comprising 10 pediatric patients evaluated their nasopharyngeal and rectal swabs. Eight children persistently tested positive on rectal swabs even after nasopharyngeal clearance of the virus. Furthermore, a cohort study demonstrated a significant enhancement of ACE2 expression in cholangiocytes as well as liver cells, indicating that the virus can lead to direct damage to intra hepatic bile ducts," Dr Sagnik Biswas said.

What should be done when a child tests Covid-19 positive? What precautions should be taken?

Experts say children showing mild symptoms should be home quarantined for 14 days. "If symptoms are mild and oxygen saturation is greater than 94 per cent, we have to give supportive care, adequate hydration, proper nutrition and paracetamol," said Dr Jaydeb Ray. If CRP (C-reactive protein) and ferritin (blood protein that contains iron) levels are elevated, then children must be admitted to a hospital, he said.

In the absence of any definitive therapy, social distancing, wearing masks, and hand washing are still the gold standard in prevention of disease among this age group, experts told IndiaToday.in.

What has the government said on Covid-19 affecting children?

Union Health Minister Harsh Vardhan told Parliament that children in the age group of 0-14 years were less affected by Covid-19. He said infection among children was mild and most of them remain asymptomatic.

"Hence no specific action plan has been formulated in the current response phase to minimize the adverse effects of Covid-19 on such children," Dr Harsh Vardhan said in a written reply.

Dr Vardhan further said that rarely a severe illness, in form of multi-system inflammatory syndrome, had been identified. This usually happens three to six weeks after the infection, he said. The Department of Pediatrics, AIIMS, is documenting the long-term effect of Covid-19 in children.

Are there any Covid-19 vaccines for children?

No, presently there is no Covid-19 vaccine that can be administered to those below 18 years of age. The Health Ministry has said clinical trials are underway to test the safety and efficacy of Covid-19 vaccines among children.

In February, Hyderabad-based Bharat Biotech had sought approval from the national drugs regulator for Phase 3 clinical trial of its Covid-19 vaccine --

Covaxin -- in children between the ages of 5 and 18 years. However, it was not granted permission since it did not produce efficacy data on adults.

Last week, Pfizer announced that trials of its vaccine in children aged 12 to 15 showed 100 per cent efficacy and a strong immune response, with no unusual side effects. It has now sought emergency approval from the US Food and Drug Administration to use its vaccine in this age group.

The University of Oxford had started testing the Covid-19 vaccine it developed with AstraZeneca in children and teenagers (this vaccine is available in India under the brand name Covishield). However, it has paused the trial following blood clotting issues in adults who received the jab.

Can newborns get Covid-19?

A very small number of cases have emerged where pregnant women infected with coronavirus have passed the disease on to their babies. Infants can also become infected shortly after being born. The US Centers for Disease Control and Prevention (CDC) has said that most newborns who test positive for Covid-19 have mild symptoms or none at all, and recover, but serious cases have occurred.

How have other countries dealt with child Covid-19 patients?

In the US, children represent about 13 per cent of all Covid-19 cases, according to the American Academy of Pediatrics and the Children's Hospital Association. The National Institutes of Health, which is the US's medical research agency, has formulated guidelines for treatment of children with Covid-19.

According to the NIH, most children with mild or moderate disease can be managed with supportive care alone. The NIH says Remdesivir can be considered for hospitalised children of all ages with Covid-19 who have an emergent or increasing need for supplemental oxygen. It also suggests that dexamethasone may be beneficial in pediatric patients with Covid-19 respiratory disease who are on mechanical ventilation.

The UK and Israel are planning to start inoculating children within the next six months, reports said. In other countries, specific strategies are being taken to treat severe cases as per the symptoms.

Reference:https://www.indiatoday.in/coronavirus-outbreak/story/covid-19-second-wave-children-infants-symptoms-treatment-what-should-parents-do-1794307-2021-04-23