There has been news about the possibility of the 3rd wave of Covid in India. Many doctors and virologists have talked about children getting affected in the 3rd wave the most. But there has been a recent claim that there is no evidence of children getting affected more in the upcoming wave of Covid-19. This article is an attempt to provide you with information about both the claims and either way, how we should be preparing for the upcoming wave with regards to children in India.
Covid-19 3rd wave and the claims made by experts
Dr Devi Shetty (Chairperson, Narayana Health) with other experts have claimed that there is a possibility of 3rd wave looking at what happened in the US and Europe. According to him, the virus will predominantly target the children mainly because adults are mainly infected and immunised or vaccinated. He added Covid has to find a new host and the most vulnerable group in large numbers are the children less than 12 years old.
Dr V Ravi, top virologist on Hindustan Times have said that the 3rd wave of Covid-19 is inevitable. However, how big the wave is going to be will depend on how many people will be vaccinated, how responsible are the people in avoiding crowds, masking and social distancing. He said if we are able to follow all the safety protocols, this 3rd wave will be small.
He also claimed, he was in fact one of the 1st people to say that children are at risk in the 3rd wave. To support his claim, he asserted that the virus always finds people who are not immune and people will get immune either by getting a viral infection or through vaccination which most adults already have and children have not. He also added, in the 1st wave 4% of the children in India were infected by Covid and in the 2nd wave,10-15% of the children have been infected so far which leaves a huge chunk of children who are not infected. He also said that though Sero-survey shows 20-25% are exposed but it still leaves 70% of the children vulnerable as we have no vaccines for them as of now. Vaccines for children are now under trial and it will take at least 3-4 months to come, he added. (news published on 18th May'21)
Dr Girdhar R Babu (Professor, Life Course Epidemiology, PHFI) on The Quint said that virus would seek who are not protected either from not being infected or vaccinated and are susceptible in the future waves which include children. However, he believes that children will do well because they do not have the required receptors and their immune system is different from the adults. He has also mentioned that a very minor proportion of them may have a multisystem inflammatory disorder and some prevalence have been reported in Delhi and Mumbai. He pointed out that the problem with India is when you have a small percentage of infection, it will result in many absolute numbers. Even in the 2nd wave, the percentage of mortality percentage in young people is much lower compared to the elderly, but in terms of absolute numbers, it is shocking how many people are dying, he added.
Dr Randeep Guleria (AIIMS Chief) has a different take on responding to the impact of the third wave on children. He said that the theory, the children will be affected more in the 3rd wave is not proved or indicated. He also added that the Paediatric Association said there is no danger to children and people shouldn’t panic. He said the data of 1st wave and 2nd wave are quite similar and children tend to stay protected in the pandemic and even if they get it, they are mild ones.
Mr Guleria has put forward a hypothesis and talked about Ace receptors to support his claim. According to this hypothesis, these receptors are relatively less in children as compared to adult and therefore less chance of getting infected. (Ace receptors are a kind of protein that allows the virus to infect human cells) He added further that children are still protected now and proportionally, children may get infected more but there’s no evidence they will get infected most.
Preparations to face the 3rd Wave
Precaution is always better than cure and it should hold true for facing the 3rd wave with regards to children in spite of differences in the claims. Let’s see further what the experts have suggested preparing for the 3rd wave.
Dr. Devi Shetty has recommended that all the parents should be vaccinated within 3 months so that the chance of kids getting infected is less. He said that managing children in the ICU is dramatically different from managing adults. According to him, adults take care of themselves as long as they get oxygen while children cannot be left alone with the doctors and nurse. He also mentioned that there are very few nurses in the covid ICU at night to handle them. These kids cannot be sedated as they need to breathe and when they are restless with low oxygen they will throw the mask. He asserted that during this time, only parents can manage the children and they can’t push the parents into the ICU without vaccination. He said even after vaccination, it will take two weeks to get the antibodies. He said that parents should be prepared to get in the ICU if required. He talked about Paracetamol and other children medicines to be manufactured in large numbers before the wave. He said, if half a million kids fall sick, the entire medicines will be gone, the stocks are made on current requirements and the stock can’t ramp up in few days including even oxygen mask, oxygen hood etc. According to him, the biggest problem will be the shortage of nurses and doctors in the ICU. At night 20-30 patients and in some hospitals, only 4-5 nurses are managing. The kids will need more attention, and these few staffs are not sufficient and need to get more doctors and nurses apart from those already working in the hospital.
Dr Ravi also talked about planning for treating infected children, where to treat them, whether we have intensive care beds and look at how to handle within the hospital where there will be both Covid infected and uninfected children. He also talked about considering whether we need to open schools or not, if we are then, will there be interrupted schedules to break virus transmission? He added gathering of children in schools can be a super spreading image as it has happened in Europe and America. He said the country should start planning as the wave will come with a gap of 3-5 months after one wave subsides and we don’t want the same crisis again. He also points out the importance of planning human resources in the health sector as those working are already stressed.
Dr Girdhar Babu talked about the need to built paediatric ICUs, Paediatric facilities, ensure enough pediatric resources are available so that we don’t make the same mistakes with children that we made with the adults. He added, paediatric ICUs are more difficult to find as compared to adult’s and it’s even in terms of managing, specialists to handle different systems and this kind of resources are not available everywhere. He believes that the first thing is to prevent the infection from coming to the children by following Covid appropriate behaviour and ensuring vaccinations for all the adults mostly vulnerable ones. He added the vaccination trial for children should be sped up, built paediatric ICUs and specialist resources at the block level where infected children can be transferred to the hospitals on time.
Whether the 3rd wave affects the children more or not, the need for planning is required. The 2nd wave has also taken us all by surprise and have affected and caused many deaths that have already led to a grim situation. The reason mainly is because of lack of facilities and resources and zero preparation. We definitely don’t want another wave hitting us like the 2nd wave and hence the need for planning and precautionary measures. With proper planning in the health care sector and following Covid-safety protocols like masking up, social distancing, avoiding crowd gathering, vaccination etc., we can beat Corona to a large extent.
Take care & stay safe!