Very low risk to newborns from moms with COVID-19, says study
New York: Moms with COVID-19 who take basic precautions rarely pass the novel coronavirus to their newborns, even if breastfeeding, according to a new study which says more extensive measures like separating the infected mothers from their babies may not be warranted.
The research, published in the journal JAMA Pediatrics, examined outcomes in the first 101 newborns born to COVID-19-positive mothers at the NewYork-Presbyterian Hospital in the US from March 13 to April 24, 2020.
"Our findings should reassure expectant mothers with COVID-19 that basic infection-control measures during and after childbirth -- such as wearing a mask and engaging in breast and hand hygiene when holding or breastfeeding a baby -- protected newborns from infection in this series," said Cynthia Gyamfi-Bannerman, a co-author of the study from Columbia University Irving Medical Center in the US.
To reduce the risk of transmitting the SARS-CoV-2 virus to newborns after delivery, the researchers said the hospital staff practised social distancing, wore masks, and placed COVID-positive moms in private rooms.
They said the hospitals also provided the mothers with educational materials about COVID-19 and shortened hospital stays for those without complications from delivery.
Most of the newborns roomed with their mothers, including during the first postpartum checkup, while some were admitted to the intensive care unit for non-COVID-related health reasons, the study noted.
The scientists said they placed the infants who roomed with their moms in protective cribs six feet away from the mothers' beds when resting.
They encouraged direct breastfeeding and skin-to-skin contact with babies, provided the moms wore masks and washed hands and breasts with soap and water.
"During the pandemic, we continued to do what we normally do to promote bonding and development in healthy newborns, while taking a few extra precautions to minimise the risk of exposure to the virus," Gyamfi-Bannerman said.
According to the study, only two of the newborns tested positive for the coronavirus, but they had no clinical evidence of illness. However, the researchers were unable to pinpoint how the babies became infected.
When the physicians followed up with about half of the infants, including the two that tested positive for the virus, during the first two weeks of life, they found that all remained healthy.
According to the researchers the interim guidelines released by pediatric and health organisations for pregnant women with the coronavirus, recommends the separation of mothers and newborns during their hospital stay, no direct breastfeeding, and bathing newborns as soon as possible.
However, they said these recommendations were made in the absence of data on rates of mother-to-newborn transmission of the virus. The scientists said these guidelines are based on experience with mother-newborn transmission of other infectious diseases.
"But some of the recommendations conflict with what we know about the developmental benefits of early breastfeeding and skin-to-skin contact," said study lead author Dani Dumitriu from the Columbia University Vagelos College of Physicians and Surgeons in the US.
"Our study shows that these measures may not be necessary for healthy newborns with COVID-positive moms," Dumitriu said.
The researchers believe it is particularly important that mothers with COVID-19 have the opportunity to directly breastfeed their newborns.
"Breast milk is known to protect newborns against numerous pathogens, and it may help protect newborns against infection with SARS-CoV-2. Most studies have not found SARS-CoV-2 in breast milk, and breast milk has been found to contain antibodies against the virus," Gyamfi-Bannerman explained.
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MP HC sets up judicial commission to probe water contamination in Indore
Indore (PTI): The Indore bench of Madhya Pradesh High Court on Tuesday set up a commission of inquiry comprising a former HC judge to probe the issue of water contamination in city's Bhagirathpura, saying the matter requires probe by an independent, credible authority and "urgent judicial scrutiny".
It also directed the commission to submit an interim report after four weeks from the date of commencement of proceedings.
A division bench of Justices Vijay Kumar Shukla and Alok Awasthi constituted the commission while hearing several public interest litigations (PILs) filed simultaneously regarding the deaths of several people in Bhagirathpura due to the consumption of contaminated water.
The HC reserved the order after hearing all the parties during the day, and released it late at night.
The state government on Tuesday told the HC that the deaths of 16 people in Indore's Bhagirathpura area was possibly linked to a month-long outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The government presented an audit report of 23 deaths from the current gastroenteritis epidemic in Bhagirathpura before the bench, suggesting that 16 of these fatalities may have been linked to the outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The report, prepared by a committee of five experts from the city's Government Mahatma Gandhi Memorial Medical College, stated that the deaths of four people in Bhagirathpura were unrelated to the outbreak, while no conclusion could be reached regarding the cause of death of three other people in the area.
During the hearing, the high court sought to know from the state government the scientific basis behind its report.
The division bench also expressed surprise at the state government's use of the term "verbal autopsy" in relation to the report, sarcastically stating that it had heard the term for the first time.
The HC expressed concern over the Bhagirathpura case, stating that the situation was "alarming," and noted that cases of people falling ill due to contaminated drinking water have also been reported in Mhow, near Indore.
In its order, the HC said the serious issue concerning contamination of the drinking water supply in Bhagirathpura area allegedly resulted in widespread health hazards to residents, including children and elderly persons.
According to the petitioners and media reports, death toll is about 30 till today, but the report depicts only 16 without any basis or record, it said.
It is averred that sewage mixing, leakage in the pipeline, and failure of civic authorities to maintain potable water standards have led to the outbreak of water-borne diseases. Photographs, medical reports, and complaints submitted to the authorities prima facie indicate a matter requiring urgent judicial scrutiny, the HC said.
"Considering the gravity of the allegation and affecting the right to life under Article 21 of the Constitution of India and the need for an independent fact-finding exercise, the Court is of the opinion that the matter requires investigation by an independent, credible authority," it said.
"Accordingly, we appoint Justice Sushil Kumar Gupta, former judge of the Madhya Pradesh High Court, a one-man commission of inquiry into the issues relating to water contamination in Bhagirathpura, Indore, and its impact on other areas of the city," the HC added.
As per the order, the commission shall inquire into and submit a report on the cause of contamination -- whether the drinking water supplied to Bhagirathpura was contaminated; and the source and nature of contamination (sewage ingress, industrial discharge, pipeline damage etc).
The panel will also probe the number of actual deaths of affected residents on account of contaminated water; find out the nature of disease reported and adequacy of medical response and preventive measures; suggest immediate steps required to ensure safe drinking water as well as long-term infrastructural and monitoring reforms.
It will also identify and fix responsibility upon the officers and officials found prima facie responsible for the Bhagirathpura water contamination incident, and suggest guidelines for compensation to affected residents, particularly vulnerable sections.
The commission shall have powers of a civil court for the purpose of summoning officials and witnesses; calling up records from the government department, hospitals, laboratories and civic bodies; ordering water quality testing through accredited laboratories; conducting spot inspections.
All state authorities involving district administration, Indore Municipal Corporation, public health engineering department and Madhya Pradesh Pollution Control Board shall extend full co-operation and provide records as sought by the commission, it said.
The state government shall provide office space, staff, and logistical support to the commission, it said.
During the hearing in the day, the state government also presented a status report to the court in this matter.
According to reports, a total of 454 patients were admitted to local hospitals during the vomiting and diarrhea outbreak, of whom 441 have been discharged after treatment, and 11 are currently hospitalised.
According to officials, due to a leak in the municipal drinking water pipeline in Bhagirathpura, sewage from a toilet was also mixed in the water.
