Categories: COVID-19

Will the third wave of Covid-19 hit children badly?

The Government of India recently announced that a third wave of the Covid-19 pandemic is inevitable and that both they and the citizens must brace themselves for it. The announcement was based on advice or recommendations from top physicians and medical institutions across the country. The physicians’ opinion was based on analysis of trends or patterns of mutation of the virus in the last 18 months.

While 2020 saw fewer but longer waves with fewer mutants involved, 2021 would have multiple waves that are shorter and deadlier. As per predictions made, the third wave is expected to hit India between the months of August and October 2021 and will hugely impact minors or children below 18 years of age.

This has triggered enormous panic across the country. Till date, there are few vaccines that have been tested extensively on those below 18 years of age ( Pfizer has just reported good efficacy on adolescents between 12 and 18 years of age), although some countries are giving the same vaccines given to adults, but in smaller doses. India may adopt the same approach but vaccines are again in short supply, so this has only added to the panic and paranoia.

It’s important to understand this better so that the right responses can be elicited or provided.

Why there is no need to panic

The Indian Academy of Pediatrics (IAP) is an independent body dedicated to the health and well-being of children. It’s recognized by the Government of India and publishes several journals and research papers on various topics regarding the health and ailments of minors.

The IAP has been studying the pandemic closely since early 2020, with the aim of understanding the risk and mitigation of Covid-19 infection in minors. The IAP has made many observations about the expected third wave.

The IAP has categorically stated that while children may be affected in the third wave as projected, the severity or fatality risk is much less than that of adults. Most cases will present themselves as mild, asymptomatic infections, or moderate, symptomatic infections. With standard medication, the condition can be managed. Very few patients will require hospitalizations, and the number of fatalities would only be a tiny fraction of that for adults who have succumbed to the Infection since early 2020.

This is not mere speculation or wishful thinking. This is solely based on analysis of Covid-19 infection patterns in adults and children since early 2020. Scientists and doctors have found that there is a lesser expression of specific receptors to which this virus binds, in order to enter the host and their immune system. In layman terms, this means, the virus will find very little support or encouragement from the body of minors compared to that of adults. This does not imply that children have a better immune system than adults. Not necessarily. This only refers to how the immune systems of minors have reacted biochemically to the virus, so far, since the start of the pandemic.

Further, the IAP in consultation with several physicians has come out with treatment protocols for minors in case of Covid-19 infections. This is found to be effective in diagnosing and treating minors with Covid-19 infections till date, so the same, or more enhanced protocols will be followed in the coming days. There is plenty of clarity on dos and don’ts for minors with Covid-19 infections.

All these imply children or their parents need not panic

Also Read: Covid-19 Virus and Airborne Transmission

Why one should be prepared

But does this mean that there is nothing to worry about and children can live perfectly normal lives, like what existed before the pandemic? Far from it! There are 2 reasons for this:

The Covid-19 virus is mutating at a very high rate in recent months compared to 2020. This explains the severity of the 2^nd wave, and hence the possibility of a 3^rd wave. Very little is known about what kind of mutants will emerge in the coming months, how deadly will they be, and how they would affect adults and children. Not being aware of this and becoming complacent can be dangerous. We may be taken by surprise with many children showing severe infection.
Viral load refers to the quantum – both absolute numbers and concentration in a particular volume of air – of any virus and in this case the Covid-19 virus. As we have seen since March 2020, whenever people have exercised caution and shown Covid-appropriate behavior, the infection rates have been lesser and whenever they have been callous or complacent, the infection rates have also shot up. It also explains the severity of the current 2nd wave. Caution and Covid-appropriate behavior reduce the viral load significantly. This goes a long way in reducing the risk of Covid-19 infections in adults and minors alike. However, if one becomes complacent and the viral loads increase, with newer mutations, one can never say how the immune systems of minors will react. Certain viral loads and certain mutants may trigger wide-scale and/or severe infections in minors.

This only implies that we cannot afford to be complacent. We need to prepare ourselves and our minors in order to prevent Covid-19 infections in the days ahead.

How to prepare for the same

Preparing minors for the 3^rd wave and reducing the risk of infection in them is no different from how we would do this for adults. As we have been hearing from the day1 of the pandemic, this involves 2 major changes to our lifestyle.

Covid appropriate behavior: This will remain a constant whether one is an adult or minor, has received 1 or 2 shots of any vaccine, whether one has been infected in the past or not, one is showing symptoms or not. This is the same 3 points: wearing a mask outside the home, social distancing, and washing hands as often as possible.
Building better immunity: Immunity is important for anybody, adult or minor, to fight any virus, bacteria, or health hazard. This includes

Eating a healthy diet: Avoid junk food, refined foods, and excessive sugar consumption
Exercising regularly: Since gyms are closed, you can jog or run closer home and do free-hand exercises at home
Ensure a healthy lifestyle: Assuming minors are already doing this – limit smoking and alcohol consumption
De-stress: Lockdown fatigue combined with the lack of vaccination and fear of the 3^rd wave can increase your stress. This can have other health consequences. De-stress with calisthenics, yoga, meditation, and indulging in a hobby of your choice.

Outlook

When the 3rd wave will hit us exactly, and how much damage it will do to adults or minors is not clear at this point in time. In such a scenario, caution and common sense are our best weapons in the fight against Covid-19. Do not be complacent but at the same time, do not allow panic-mongers to affect you. Stay sensible and we can overcome the 3rd wave better than the earlier ones.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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