SINGAPORE - Noah Fatrish and Luth were born during the Covid-19 pandemic, when lockdowns, mask wearing and social distancing were the norm.

Both boys, who are three years old in 2023, were kept safe and far from the madding crowd from birth.

Since many Singaporeans no longer wear masks and behave more like they did pre-pandemic, both boys have been introduced to life at childcare centres – and have fallen sick frequently. Their mothers find themselves making regular trips to clinics and hospitals.

Luth’s mother, Ms Nabilah Awang, 30, said: “It felt like I had dipped my son into a cesspool of childhood germs. Luth came back with Covid-19, HFMD (hand, foot and mouth disease) and flu – the illnesses were a monthly occurrence. Last November, he was in intensive care at National University Hospital (NUH) with both Influenza A and RSV (respiratory syncytial virus).”

Ms Nabilah, who works in commodities, “freaked out then because of the death of a boy who was infected with Covid-19, Influenza A and RSV, and Luth had two of the three viruses”. She was referring to Zaheer Raees Ali, aged 1½, who died in June 2022 after being infected with Covid-19 and two other viruses.

Dr Li Jiahui, head of the Infectious Disease Service of the Department of Paediatrics at KK Women’s and Children’s Hospital (KKH), said it is not uncommon to catch infections by respiratory viruses “now and then”.

“The easing of safe management measures has contributed to an increase in the number of infections caused by respiratory viruses. Children in 2020 and 2021 had less exposure to common respiratory viruses compared with those of similar age in the previous years, due to enhanced hygiene practices during the Covid-19 pandemic. The lack of exposure has contributed to a rise in the number of children experiencing respiratory tract infections caused by common respiratory viruses,” Dr Li said.

Agreeing, Dr Rie Aoyama from the Division of Paediatric Infectious Diseases at the Khoo Teck Puat – National University Children’s Medical Institute at NUH said that while the lockdown, social distancing and mask wearing did not necessarily “affect, compromise or make significant changes to our immune systems, it does result in an immunity debt”.

“There was reduced exposure to viruses such as influenza, respiratory syncytial virus and rhinovirus, when children were younger. They are currently ‘catching up’ on the exposure to all the circulating viruses that they were not exposed to,” she said.

Infectious diseases specialist Leong Hoe Nam said: “Without the Covid-19 years, we would have had our regular infections for two to three years running. But when masks came down, the infections went up. All three years of infection are squeezed into a six- to 12-month session.”

“Children who were born just before and during Covid-19 were not exposed to minimal infections and now, they are exposed to all at the same time. We had our revenge travel. The viruses now have their revenge infection,” he said, adding that children seem sicker because they have not “earned their stripes” by going through different infections during the pandemic and immediately after.

It is this revenge infection that has put Noah Fatrish in the throes of a viral attack. He was hospitalised last Monday after his fever, which started on April 5, got worse.

His mother Izyan Shubli, 29, an infantcare teacher, said: “We had noticed he was slightly off his game when he came back from childcare and had a fever of 38 deg C. Since he had a history of bronchitis, we didn’t want to gamble with his health. At the clinic, he tested negative for Covid-19 and was diagnosed with a viral fever. When his chesty cough got worse after the Good Friday weekend, we immediately took him to hospital.”

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