Bullying: Could Bystanders Help

It is difficult to believe that bullying has ceased to exist at workplace or educational institutions.

Recent studies from across the globe have revealed that 60 to 80% of interviewed people admitted witnessing bullying in their organizations. When administrators or teachers vehemently deny the existence of this menace in their institutions, it is often the “Ostrich phenomenon” wherein it does not seem to happen because we choose to keep our eyes shut and not see it.

Bullying occurs when a student or employee is subjected to repeated negative behaviors that harass, exclude, humiliate or frighten him, and may range from physical violence to the subtle mocking, ridiculing, excluding or ostracizing conducts. It can seriously impact the victim’s health – physical or mental, and can sometimes lead to harm or suicide.

Up until now, the conventional approach to tackling bullying has been to formulate strict rules, try and catch the bully, and punish him. This requires someone to stick his neck out and report, risking retaliation and vengeance. Further, what this approach does is merely push bullying underground and changing the format to psycho-social than physical forms.

Recent research is shifting the focus to the role of bystanders in controlling the practice. There are 2 broad types, each with 2 subtypes:

1. Constructive:
   1.  The Active Constructive bystanders actively discourage or confront the bully or report him or her to the authorities. If they are in significant numbers, bullies tend to become the minorities, and often change their behavior.
   2. The Passive Constructive ones may not directly take on the bully, but empathize and support the victim, mitigating some of the trauma caused.
2. Destructive:
   1. The Active Destructive type encourages the bully, often joining him in the act. This is how “bully groups” are formed and expand in size, each one member venting his bullying instinct on the victim.
   2. The Passive Destructive ones, who often watch but do nothing, often finding the whole episode amusing, thus encouraging the bully.

Bullying is a psycho-social disease, and its control requires much more than strict rules and action. Sensitizing and converting workers or students to play constructive anti-bullying roles could be the workplace environment changer.

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COVID is affecting Kids too this time

In sharp contrast to the first phase of COVID in mid-2020 during which few children were affected, the second phase is proving to be different.

Children had constituted less that 10% of cases then. And when affected at all, had been mostly asymptomatic.

During the present 2^nd phase, the situation is not quite the same. Hospitals in Mumbai alone have reported over 80,000 cases. Pediatricians, who keep themselves aware of new information in their subspecialty more than their adult counterparts, are indeed recognizing and treating many more.

There are two types of illnesses that SARS-CoV-2 virus is causing in kids:

The first is the milder version of usual syndrome it causes in adults: fever, sore throat, dry cough, loss of smell and taste, body aches. When these set of symptoms come on in older children (10-18 years) along with an outbreak at home, there is no missing it. COVID RT-PCR test is usually positive and treatment is along the lines of that for adults. Children usually fare better and recover faster than grown-ups and elderly.

The second presentation can be foxing. It presents usually in younger children with some or most of the symptoms:

1. Fever that lasts for more than a day
2. Rash on the skin.
3. Vomiting
4. Diarrhoea
5. Feeling unusually drowsy—inability to stay awake
6. Red eyes
7. Enlarged lymph nodes
8. Fast heartbeat
9. Rapid breathing
10. Redness or swelling of the lips, tongue, hands, and feet

The child looks toxic and sick, and small children being vulnerable as they usually are, often do not make it if diagnosis and treatment are delayed.

This recently recognised illness called MIS-C (Multi-system Inflammatory Syndrome in Children) is caused by an exuberant immunological reaction of the body to COVID antigen. Hence, the COVID-RT PCR test is often negative but antibodies to COVID are strongly positive, indicating that the child had recently suffered from the viral infection. As are other immunoglobulins such as IgG.

Treatment consists of anti-inflammatory agents (corticosteroids), blood thinners, anti-biotics and other supportive measures.

Mrs Khushnooma Kapadia, wife of a doctor and mother of two kids who suffered this condition, has recently been campaigning extensively to create awareness on MIS-C so that other children can be diagnosed on time and saved.

Last year, a handful of cases were reported in children and called Kawasaki’s disease: another hyperactive inflammatory response seen in children…that also had enlarged lymph nodes as a prominent feature.

Call it by any name you wish, but as long as doctors are aware and can recognise this special presentation in small children, and provide TIMELY appropriate care, Mrs Kapadia’s work would have been well done.

And scientists are talking loudly about the impending 3^rd wave of COVID that is feared to affect kids far more. So let us be prepared.