The third wave will be potentially about protecting our childrenJune 9, 2021
India has one of the largest proportions of population in the younger age groups in the world. It is well known that SARS-CoV-2 infects everyone across all age groups, but older age groups tend to have severe symptoms compared with younger groups. The vaccination of people above the age of 45 was the first step taken by the Indian government and now some of the states have moved on to vaccinating people above 18 years of age. This can really help reduce the spread of the virus, but it also creates the very important problem of tackling the younger population below the age of 18 which cannot be vaccinated as of yet. It was observed that infants below the age of 1 year are most vulnerable due to high hospitalization rates. The average incubation period for SARS CoV2 in children is about 6.5 days in comparison to 5.4 days in adults. The severity of infection in children can vary based on the condition of the immune system, pulmonary pathology, the age of the infant and the presence of type 1 diabetes and other underlying diseases such as asthma or obesity. A vaccinated adult can easily take home the virus, thus infecting children. Even though the symptoms of paediatric patients are mild, virologic data indicates that the viral load is almost the same. Several children below the age of 18 years tested positive in Maharastra’s Akola and Amravati districts, which account for 10-12% of the total infections reported in India. Therefore, the imminent third wave may be more about children than about the adults if vaccination targets are achieved. The biggest challenge will then be about the capability of hospitals to take the load of paediatric patients.
Another upcoming challenge will be to take precautions to keep our children safe from emerging mutants or variants of the virus. As several mutants have been shown to evade the immune responses in adults, we do not know how they may affect children. In the first wave, less than 1% of the affected were children, but in the ongoing wave, it has increased ten-fold and some of the children are having very serious conditions which is very worrisome.
COVID-19 infected children may recover quickly. However, the long-term effects of the infection are less understood and might really play a major role in their adult life. It was observed that a small percent of the children suffer from months of fatigue, rapid heart rate, memory loss, depression and other symptoms. These post-infection symptoms are difficult to handle and impact the entire family. Young people also have to go to colleges and schools where interactions are bound to happen and, in such cases, infections will spread. The initial infection and associated symptoms may not always be the only thing to care about. Instead, the long-haul or lasting effects of COVID-19 will have to be dealt with among the younger population. This is not a fight for protecting elders anymore. It is a fight to protect our future generation from the upcoming third wave. India needs to gear up now to meet this imminent threat rather than wait for it to happen.
The author is a medical scientist and former director of SGRF, Bangalore