Even as India is in the midst of a ferocious second wave of the coronavirus pandemic, there have been reports that the eventual third wave will impact children more. There are worries about our paediatric infrastructure not being ready, and concerns from parents on how to safe-guard the children.
During The Quint's webinar on Variants, Data and Pandemic Planning, we spoke with Dr Giridhar R Babu, he’s an epidemiologist and a professor at Public Health Foundation of India.
We also spoke with Dr Rakesh Mishra, he’s the former director of CSIR-Centre for Cellular and Molecular Biology in Hyderabad. He’s also a member of INSACOG, India’s Genome Sequencing Consortia set up to sequence COVID variants and to work as a warning system for government. This is what the experts had to say.
There is considerable panic among parents since reports emerged 3rd wave will impact children more. How real this fear?
Dr Rakesh Mishra: We haven't seen anything in the virus that indicates it prefers certain age-groups. During this time, younger people were more infected by the virus, but it had more to do with human behaviour.
For a year, children were at home and isolated, when schools opened and they stepped out, it's difficult to impose masking and COVID-appropriate behaviours in adults, in children it's even more difficult. They interact with each other, they'll exchange masks, this leads to unusual higher level of exposure among children.
We don't see anything in the virus that is very different. There's no co-relation we can draw that a particular variant prefers a certain age-group.
Social vaccine is so difficult to manage among adults, with children it will be an even bigger challenge.
Dr Giridhar R Babu: The virus will seek those who are uninfected. So any age-group that is uninfected or unvaccinated, the virus will find them when it transmits. These people, who we call susceptible, are at a risk of catching the virus in the future waves. This includes children because they are out of the schools, they are at home and now they are at risk of getting it from others.
Children generally do well with the virus, either because they don't have enough receptors or their immune system is different from the adults.
But a minor proportion of them will have a multi-system inflammatory disorder, which is like a Kawasaki-like syndrome where multiple organs are involved.
In some countries like Japan this has been reported as a major event, and there has been reporting of it in Delhi and Mumbai as well.
The problem with India is, when you have a small percentage, that will result in large absolute numbers, it's a concern.
That's why we need to build paediatric ICUs, bring in multi-specialists, scale up infrastructure so that we don't make the same mistakes we made with adults.
How prepared is our paediatric infrastructure to deal with the surge?
Dr Giridhar R Babu: We all know what happened with adults when it came to seeking ICU care. Paediatric ICUs are even more difficult to find compared to other ICUs. It's not just ICUs, you need multi-specialists to manage different systems, and we don't have those kind of resources everywhere.
So how do you protect the children?
1st, as Dr Mishra said, you have to protect the children from getting infected. Adopt COVID-appropriate behaviours.
2nd, we need to vaccinate all adults, atleast the more vulnerable as soon as possible.
3rd, facilitate faster trials for children where possible.
Next you need to step up all our paediatric ICUs and specialists at a block level and have a referral pathway where whoever is affected is transferred in time. Start identifying these facilities. I can already tell you in some metros, they are identifying zonal level jumbo ICUs for paediatric age-group, and they are saying it's not just for COVID-19, anyway we don't have, let's build them.