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Mangaluru, May 6: Amidst preparation for the paid evacuation of Indians stuck in Gulf countries amidst coronavirus lockdown, the central government has announced that it would only do a medical screening of the passengers before the flight and only asymptomatic persons would be allowed to travel.

Each passenger will have to fill a self-reporting form to be presented at the health and immigration counter at their destination.

The passengers are required to state whether they are suffering from fever, cough, diabetes or any respiratory disease. This form is similar to the one filled by passengers landing in India during the early days of the COVID-19 outbreak.

As per the announcement by the government, returnees would undergo COVID-19 once they complete 14-day quarantine in a hospital or government –arranged institution on a payment basis.

However, the form asks the applicants to keep themselves isolated at home for 28 days unless they develop any symptoms such as fever and cough.

During the journey, they will have to follow the protocols such as those issued by the Health Ministry and the Civil Aviation Ministry. Applicants from the UAE are yet to receive instructions on these.

On reaching the destination, passengers will have to register on the Arogya Setu app, India’s mobile application for COVID-19 surveillance.

No physical distancing!

Air India Express (AIE) which is set to operate the first two flights to Kerala on Thursday will operate its Boeing 737-800 flights, with a seating capacity of 186 economy class seats.

With nine seats reserved for isolation, only 177 passengers would be flown, sources said.

While most of the UAE flights in the first week will be operated by the AIE, Air India will operate two of its Dreamliner aircraft with a seating capacity of 256 seats. These flights would also reserve some seats for isolation.

However, the plan has made it clear that the Indian government will not be following the rules of physical distancing to prevent the spread of coronavirus in the repatriation flights.

Several people, including the Chief Minister of Kerala Pinarayi Vijayan, expressed concern over flying passengers, who will not be tested for COVID-19, without observing physical distancing.

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.