Children, it is feared, will be the target of the third wave of Covid. Experts allay fears—no evidence to support this theory. Data presents a different picture

The son of a senior district official in Ghaziabad just recovered from covid-19. “Ramesh (name changed) is brave. But tired, lacking enthusiasm, this will continue for some time. I’m happy that the worst is over,” says his father, 41 years of age, who doesn’t want his son to be identified in a newspaper as a Covid patient. “I know at least a dozen kids who were infected,” he recounts. None of them had severe symptoms but his son had to be admitted to a local hospital for a couple of days.   

Last week the National Commission for Protection of Child Rights (NCPCR) asked the government to put in place necessary infrastructure and equipment to deal with any contingency that a third wave may present. NCPCR has also written to the Union Ministry of Health and Welfare (MoHFW), Indian Council of Medical Research (ICMR) and various state governments to supply information about their preparedness—facilities available—in their respective districts to provide treatment for Covid-19 to children. NCPCR’s insistence to boost pediatrics infrastructure sent shockwaves in the already ailing public health setup.

The data points to the fact that children are vulnerable in various parts of the country. For example, over 345 children between the age of 10 to 12 years have tested Covid-19 positive in the Dausa district, Rajasthan. Uttarakhand has also seen a sharp increase in the number of cases amongst children—in the 0-9 and 10-19 years’ age groups in the hill state have jumped by 155% and 170%, respectively. Between March 2020 and March 2021, the total number of cumulative cases of Covid-19 in children (0-9 years) in a year stood at 2,131 in Uttarakhand. However, from April 1 to May 19 alone, the state has registered 3,313 new cases — exhibiting a surge of 155.46% in a period of 49 days over the past year. Karnataka reported 20,206 Covid infections, including 17 fatalities, among children below 10 years from March 1 to May 15 this year. 

This is not just a pan-India phenomenon, children are recognised to be vulnerable globally. For this reason many countries like the US, Canada have approved vaccines for children 12 and above. India has given a nod to the 18 to 44 years age group category.

There was an effort by the public health infrastructure to allay fears that the third wave will target only children. AIIMS Director Randeep Guleria at a press conference clarified that there is no evidence, so far, that there will be a severe infection in children or there will be more cases in them in the upcoming wave of Covid-19. He added, “Data from the first and the second wave shows that children are usually protected from Covid and even if they get it, they have a mild infection,” he said and added, “the virus hasn’t changed so there is no indication that children will be more affected in the third wave.”

And that the third wave will affect children the most is a mere theory with little evidence to support it. “Those who floated this theory said that children have so far not been affected, so perhaps they will be most affected in the third wave. But there is so far no evidence that there will be a severe infection in children or there will be more cases in them in the upcoming wave,” Guleria clarified. His views found resonance with the Indian Academy of Pediatrics, which is of the view that, though children seem susceptible like adults it’s “highly unlikely that the third wave will predominantly or exclusively affect children.”

But there seems to be a shift in the age profile of Covid patients. Last month, Delhi chief minister Arvind Kejriwal informed that 65% of Covid-19 patients in the city-state are below the age of 45 years. There’s a change in age profile, agrees virologist Upasana Ray from Kolkata’s CSIR-Indian Institute of Chemical Biology, “there is a general increase or a shift in infection numbers towards children and younger groups as compared to older people.”

Private hospitals in Delhi are reporting a surge in the number of cases in children, the youngest being a six weeks old child. “The number was insignificant last year but it has increased exponentially this time. The families of most of the younger ones are also positive. Even teenagers are getting infected, and, in that case, only one or two family members are affected,” Dr Rahul Nagpal, Director, Pediatric and Neonatology at Fortis Hospital Vasant Kunj informed a leading daily. The death of five months old girl, Pari, in GTB hospital, she is amongst many infants to have perished due to the pandemic, sent a shock wave in the capital. 

Upasana Ray is of the view that there’s no need to panic as this surge in the number of cases amongst children could be due to the fact that the virus had already infected more of the older age groups last year which lead to the development of immunity, and also older age groups were a priority to get vaccinated, or it could simply be better reporting as children with ‘now known’ symptoms are getting tested more and thus the “infections in this age group are getting reported as well,” she added. 

However, the indirect effect of the pandemic on children is severe, the Ministry of Women and Child Development said that 577 children across the country have been orphaned in the past 55 days during the second wave. While experts maintain that there’s no evidence to suggest the third wave will target children, the recent trends show more and more cases of children being reported. And they will be the only segment of the population that will remain unprotected by the vaccine. Past experience has shown that it is better to be prepared than regret later. So the government must take heed of NCPCR’s concerns. 

While Ramesh tries to study his textbooks after three weeks, his father says, “Children are so vulnerable—Covid breaks their spirit. My son spent a week sitting idle on his bed—listlessly. It breaks my heart to see him suffer like this.”