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As the second wave of Covid-19 shows signs of abating, concerns have risen regarding a possible third wave. Health experts are taking their cue from the Spanish flu of 1918, which occured in three waves with an estimated count of 500 million people infected and 50 million fatalities. The occurrence of the second wave showed us that we cannot be complacent, when dealing with the virus. The resurgence of Covid-19 cases and the repeated mutations mean that health authorities must remain alert and prepared.
The possibility of the third wave has also raised concerns about the likelihood of children being affected. This apprehension is based on the fact that the first wave saw high numbers among the elderly, while the second wave saw a number of cases emerging in the youth. Hence, it is expected that the third wave will follow the same pattern in lower ages to finally target children. The fact is that a number of children were also infected during both the first and second wave of covid. Additionally, we are also seeing post-covid complications, particularly the emergence of multi-system inflammatory syndrome among children. Given these apprehensions, it is important to deconstruct some of the emerging news and take a cautionary note.
While we do not have definite data on infection among children in India, anecdotal evidence indicates that the second wave saw a rise of covid-19 cases among children. According to the Center for Disease Control and Prevention in the US, the number and rate of Covid-19 infections among children has been steadily rising since March of last year. However, it is important to note here that while the cases may be rising, hospitalisation of children due to coronavirus is much less when compared to adults.
According to the third national serosurvey by the Indian Council of Medical Research earlier this year, nearly 25% of Indians have developed covid-19 antibodies. This means that every fourth person in India has had a past incident of the virus. Since then, the vaccination drive has further helped in raising the immunity levels in the 18+ population. Ironically, this may also explain the rising number of comparative cases in children. In simple words, since the drive now targets everyone above the age of 18, it is the children who may be left behind and hence, more vulnerable.
The good news here is that the Covid mortality rate in children is very low when compared to adults. A research published in the European Journal of Pediatrics found that in a cohort of 203 children, close to 13% were diagnosed as asymptomatic, 79.60% were mild/moderate, and 7.46% were severe. This indicates that most children will show only mild or moderate symptoms with just a few likely to develop severe symptoms.
The biggest concern for paediatric Covid care is the possibility of post-Covid complications like multi-system inflammatory syndrome or MIS-C. It is a condition where vital organs of the body, including the brain, lung, heart, eyes, and skin become inflamed. While the exact cause of MIS-C is unknown, the symptoms typically occur in children who had contracted covid in the past or were exposed to someone with covid-19.
It is a serious condition and can also turn fatal. Symptoms include fever, rash, diarrhea, vomiting, neck pain, bloodshot eyes, and lethargy. Severe symptoms can include breathing problems, confusion, inability to stay awake, abdominal pain, pressure in the chest, or pale/blue-tinged lips or skin. Children can recover if treated in time. Hence, parents are advised to remain cautious and seek medical help immediately.
For parents, it is important to strike a balance between caution and providing a child scope for an active life. While staying at home is advisable, children also need to stay active and mix with others in a safe environment. Given the likelihood of lower incidences of severity in children, parents should:
Vaccination has already been approved for pregnant and lactating women. While the healthcare system tries to bring vaccination for children of all ages, parents should not panic. As most cases of pediatric Covid-19 are mild, it is advisable to keep the child at home while under consultation and supervision of a doctor. Stay calm and stay safe.