Members of the Crisis Board of the Zagreb Child and Youth Protection Center, Deputy director, Prim. Assist. prof. Vanja Slijepčević Saftić, PhD-MD, Specialist pediatrician, Subpecialist in pediatric neurology, and psychologist Ella Selak Bagarić made a guest appearance on Croatian Television’s show “Dobar dan Hrvatska” on March 18, 2020, where they gave numerous tips on how parents can protect children from corona viruses – medically and psychologically, why forget about stuffed toys for a while, what are the risks of getting sick in different age groups of children, how to explain to adolescents the real dangers and encourage them to agree not to go outside during this period, set boundaries…. Here’s the transcript:
“Could we say that children are at risk for coronavirus?
Slijepčević Saftić: Certainly we have an enemy in front of us whose face is not completely clear to us. What we definitely know is that, unlike the very beginning of the pandemic, the infestation in the children population also began. The first article in the British Medical Journal of Pediatrics, one of the most renowned journals, said that a study was conducted on over 2000 children, primarily in China, and stated what they came to know: symptoms are mild, it is definite, but not for all ages.
The child is not a young adult and therefore the most difficult clinical picture is for children up to the first year of life. Also, today we know, according to the latest findings that are being updated day by day, that there is probably a good chance that the so-called vertical transmission from mother to child can also count as one form of transmission of coronaviruses and that newborns are indeed ill. A heavier clinical picture will be developed by about 11 percent.
As we move towards the later chronological age of children, this percentage will decrease: in early preschool age to about 7%, then 6% by the age of 10, and will fall between 11 and 15 years to about 3%.
What is significant is that the symptomatology in children is colorful and nonspecific, and today the assumption is that this is why a large number of children have not passed the tests because it is not even thought to be (talking about experiences and the world) about coronavirus. In fact, these children become the vector of transmission to adults. Children are probably protected by having their mucous membranes intact, healthy, potent, young, well-blooded and thus viruses have a difficult path to enter the body itself, unlike people over 60 years of age where involuntary changes in the airways begin, etc., which is considered one of the risks.
Therefore, it is an important recommendation that children now do not go to their grandparents.
What is particularly dangerous is that people who do not have any symptoms can also be carriers of the disease, which was not the case with SARS.
Slijepčevic Saftić: That’s the absolute truth. We don’t know much about it, but some things empirically, in the experience of those who have already gone through it, we definitely know.
We definitely know that there is an incubation period that we do not know how long it is, but we know that in that incubation period, unfortunately, unlike other viral diseases, the one who carries the virus is infectious to everyone around them. Therefore, it is advisable to reduce the two-way process of transmission of the at-risk population to the elderly, I would say to those over 60, especially those with chronic illnesses. Social distance is a new term used in medical circles, and serves as the best guide to how to reduce disease transmission.
You have a Crisis Board at the Zagreb Child and Youth Protection Center, you get calls from concerned parents on a daily basis. What is their biggest concern, what can you advise them on how to deal with this whole situation?
Selak Bagarić: We really, in coordination with the City Health Office, and according to the recommendations of our Crisis Board of the City of Zagreb, tried to organize ourselves so that our children and parents really get help because there is no health without mental health. Our experts are not on vacation, we are all available to our patients, just by another modality.
We need to follow the preventative measures that have been taken so we make phone calls, reply to emails. The first thing I would like to emphasize is that when the door closed behind the clinic, when the door closed behind mental health centers, cities, states … somehow as to wider open the heart, and our patients’ parents who are called us first asked how we were, and then we agreed how to get help for their children.
Parents of young children these days have been mostly focused on what information to give to children, how to explain it to them. Kids see people with masks, they see they can’t go to their grandparents, they know they should have gone on their birthday, and now that birthday is gone. For the most part, parents were focused on how to present this situation to their children, rather than pretending that nothing was happening because the children saw, heard and felt. Kids feel the emotional energy we have in the house, the whole climate. So parents were given tips on how to talk to their children.
Parents of older children, adolescents, have mostly sought our help in how to set boundaries for them when they, as a normal part of their growing up, at this age do not understand the dangers, think they will live forever, that there is no danger …
How to communicate with adolescents so that they are informed that the situation is serious and that they are still managing the broader community to deal with it.
Selak Bagarić: It seems to me that all of us experts who are communicating these days, both in the media and with our parents, first say “try to hear the children, ask them what they know”, and then sit down with the adolescents and ask for answers, but from relevant sources.
Children are influenced by various media and will receive various unverified information that can tell them that there is no risk. That’s what adolescents I talk to on the phone tell me.
They should be told that we have relevant sources. In this situation we have to be modest and humble and trust the profession, trust the science.
So, each of us can have an opinion, but we must focus on the facts and the science that tells us that this moment is something that can save our lives, the lives of our loved ones and the lives of people we don’t even know just by staying at home and avoid unnecessary social contacts.
It is specific that our adolescents find it easier to stay home when they know it will help someone else.
And when I talked to my clients, who were 16, 17, 18 years old, they made it easier to accept staying at home knowing that it meant that someone else would stay healthy thanks to that, and then they needed to activist call their friends and say, “OK. I will not come, but neither should you.”
It is also necessary to change life habits. That routine has actually changed. More emphasis was placed on hygiene. What would you recommend?
Slijepčević Saftić: Absolutely everything has changed. In fact, we have entered a period where we have something unknown about ourselves that no one has experienced on the planet.
What I would definitely commend is our General Crisis Team who provide us with very relevant, clear and decisive information, and they say the following: while reducing contact, maintaining hygiene is what saves lives.
Most often simple things carry the greatest values in life, and so is the case here.
First, it is washing hands countless times a day, after various activities, after touching various objects. This is one of the basic parameters that must be applied.
Furthermore, the use of disinfectants, but not those made at home, is another, as they must have a substance value that is active over 60 percent.
Number three is handling various items. Today we have information, published two days ago, that the virus is transmitted by droplet, but it does not disappear somewhere in the air, but falls on different objects. It stays on metal objects and plastic items for two to three days. Therefore, we are not protected the moment we once washed our hands.
Speaking of young children, please be nice, forget the stuffing toys for a while. Wash them, store them in a safe place, and it will be time, hopefully, that these teddy bears will re-enter the lives of the children. Very careful with toys. Toys need to be cleaned on a daily basis, repeatedly, and these are actually ways that contribute to the improvement of health and the prevention of disease in the community.
Avoid playgrounds, avoid parks, avoid slides, nobody has talked about it enough. I am in very close contact with my colleagues working in primary care, they also have over 80 examinations throughout the day. Of these, one good number is preventative, in terms of vaccination, the child is not sick, can you check it preventively, can you look at it. This should be avoided now, because such arrivals in ambulances are potential small foci of epidemics within the healthcare system, and as we already know, we have a big problem with that.
Selak Bagarić: One more preventive measure at this time is critical thinking. And we only receive emergency patients at the infirmary. People are generally reasonable. Call, check, don’t expose yourself or your loved ones. There are things that can be delayed. This is one very important life lesson that the coronavirus teaches us; to set our priorities, to sit down and have perhaps the hardest conversation at the moment, and that is one with ourselves, and see what our life priorities are.
The world stopped for a moment, but in fact we can get a lot. We can get close in another way, we can get solidarity, we can get time for us and our families, and we really should not look at this time as a punishment but a privilege when we can all be there for each other more, but also take care about yourself, about your health. We may see from this how much we actually care about ourselves.”
Source: HRT https://www.hrt.hr/
