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May 12: Children suffering from non-respiratory disease symptoms like diarrhea and fever, or those with a history of exposure to the novel coronavirus, should be suspected of having COVID-19, a new study says.

According to the research, published in the journal Frontiers in Pediatrics, gastrointestinal symptoms first suffered by some children hints at potential infection with SARS-CoV-2 through the digestive tract.

"This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children," the scientists from Tongji Hospital in China wrote in the study.

They explained that the gastrointestinal symptoms could be arising since the type of receptors in lung cells targeted by the virus can also be found in the intestines.

Most children are only mildly affected by COVID-19, and the few severe cases often have underlying health issues, the researchers said.

"It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms, or suffers from another illness," said study co-author Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital.

"Based on our experience of dealing with COVID-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus," Li said.

In the study, the scientists described the clinical features of children admitted to hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.

"These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma," Li said.

The study noted that all the children had pneumonia, which was confirmed by chest X-ray scan before or soon after admission.

These children were then confirmed to have COVID-19.

While their COVID-19 symptoms were initially mild or relatively hidden before their hospital admission, four out of the five cases had digestive tract symptoms as the first manifestation of this disease, the researchers said.

Li hopes that doctors will use the findings to quickly diagnose and isolate patients with similar symptoms, which may aid early treatment and reduce transmission.

According to the researchers, the children's gastrointestinal symptoms, which have also been recorded in adult patients, could be an additional route of infection.

"The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans," Li explained.

Since the virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines, COVID-19 might infect patients not only through the respiratory tract in the form of air droplets, but also through the digestive tract by contact or fecal-oral transmission, the study noted.

While COVID-19 tests can occasionally produce false positive readings, Li said all the five children assessed in the study were infected with the disease.

However, he cautioned that more research is needed to confirm their findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital. The incidence and clinical features of similar cases needs further study in more patients," he said.

As democracy is seeping in slowly all over the world, there is an organization which is monitoring the degree of democracy in the individual countries, The Economist Intelligence Unit. As such in each country there are diverse factors which on one hand work to deepen it, while others weaken it. Overall there is a march from theoretical democracy to substantive one. The substantive democracy will herald not just the formal equality, freedom and community feeling in the country but will be founded on the substantive quality of these values. In India while the introduction of modern education, transport, communication laid the backdrop of beginning of the process, the direction towards deepening of the process begins with Mahatma Gandhi when he led the non-cooperation movement in 1920, in which average people participated. The movement of freedom for India went on to become the ‘greatest ever mass movement’ in the World.

The approval and standards for democracy were enshrined in Indian Constitution, which begins ‘We the people of India’, and was adopted on 26th January 1950. With this Constitution and the policies adopted by Nehru the process of democratization started seeping further, the dreaded Emergency in 1975, which was lifted later restored democratic freedoms in some degree. This process of democratisation is facing an opposition since the decade of 1990s after the launch of Ram Temple agitation, and has seen the further erosion with BJP led Government coming to power in 2014. The state has been proactively attacking civil liberties, pluralism and participative political culture with democracy becoming flawed in a serious way. And this is what got reflected in the slipping of India by ten places, to 51st, in 2019. On the index of democracy India slipped down from the score of 7.23 to 6.90. The impact of sectarian BJP politics is writ on the state of the nation, country.

Ironically this lowering of score has come at a time when the popular protests, the deepening of democracy has been given a boost and is picking up with the Shaheen Bagh protests. The protest which began in Shaheen Bagh, Delhi in the backdrop of this Government getting the Citizenship amendment Bill getting converted into an act and mercilessly attacking the students of Jamia Milia Islamia, Aligarh Muslim University along with high handed approach in Jamia Nagar and neighbouring areas.  From 15th December 2019, the laudable protest is on.

It is interesting to note that the lead in this protest has been taken by the Muslim women, from the Burqa-Hijab clad to ‘not looking Muslim’ women and was joined by students and youth from all the communities, and later by the people from all the communities. Interestingly this time around this Muslim women initiated protest has contrast from all the protests which earlier had begun by Muslims. The protests opposing Shah Bano Judgment, the protests opposing entry of women in Haji Ali, the protests opposing the Government move to abolish triple Talaq. So far the maulanas from top were initiating the protests, with beard and skull cap dominating the marches and protests. The protests were by and large for protecting Sharia, Islam and were restricted to Muslim community participating.

This time around while Narendra Modi pronounced that ‘protesters can be identified by their clothes’, those who can be identified by their external appearance are greatly outnumbered by all those identified or not identified by their appearance.

The protests are not to save Islam or any other religion but to protect Indian Constitution. The slogans are structured around ‘Defence of democracy and Indian Constitution’. The theme slogans are not Allahu Akbar’ or Nara-E-Tadbeer’ but around preamble of Indian Constitution. The lead songs have come to be Faiz Ahmad Faiz’s ‘Hum Dekhenge’, a protest against Zia Ul Haq’s attempts to crush democracy in the name of religion. Another leading protest song is from Varun Grover, ‘Tanashah Aayenge…Hum Kagaz nahin Dikhayenge’, a call to civil disobedience against the CAA-NRC exercise and characterising the dictatorial nature of the current ruling regime.

While BJP was telling us that primary problem of Muslim women is Triple talaq, the Muslim women led movements has articulated that primary problem is the very threat to Muslim community. All other communities, cutting across religious lines, those below poverty line, those landless and shelter less people also see that if the citizenship of Muslims can be threatened because of lack of some papers, they will be not far behind in the victimization process being unleashed by this Government.

While CAA-NRC has acted as the precipitating factor, the policies of Modi regime, starting from failure to fulfil the tall promises of bringing back black money, the cruel impact of demonetisation, the rising process of commodities, the rising unemployment, the divisive policies of the ruling dispensation are the base on which these protest movements are standing. The spread of the protest movement, spontaneous but having similar message is remarkable. Shaheen Bagh is no more just a physical space; it’s a symbol of resistance against the divisive policies, against the policies which are increasing the sufferings of poor workers, the farmers and the average sections of society.

What is clear is that as identity issues, emotive issues like Ram Temple, Cow Beef, Love Jihad and Ghar Wapasi aimed to divide the society, Shaheen Bagh is uniting the society like never before. The democratisation process which faced erosion is getting a boost through people coming together around the Preamble of Indian Constitution, singing of Jan Gan Man, waving of tricolour and upholding the national icons like Gandhi, Bhagat Singh, Ambedkar and Maulana Azad. One can feel the sentiments which built India; one can see the courage of people to protect what India’s freedom movement and Indian Constitution gave them.

Surely the communal forces are spreading canards and falsehood against the protests. As such these protests which is a solid foundation of our democracy. The spontaneity of the movement is a strength which needs to be channelized to uphold Indian Constitution and democratic ethos of our beloved country.