Amid prediction of the third wave of COVID 19, the Indian Academy of Paediatrics (IAP), in its presentation to the state government and the concerned authorities, said it is difficult to predict its timing and severity. Children from 0-18 age group are as susceptible as adults and older individuals to develop an infection but not a severe disease. It is highly unlikely that the third wave will predominantly or exclusively affect children.
Almost 90% of infections in children are mild/asymptomatic. Therefore, the incidence of severe disease is not high in children.
Fortunately, children have been relatively less affected so far due to several factors. The most important reason is the lesser expression of specific receptors to which this virus binds to enter the host and also their immune system. A very small percentage of infected children may develop the moderate-severe disease.
“If there is a massive increase in the overall numbers of infected individuals, a larger number of children with moderate-severe disease may be seen. Apart from the infection, parents should watch out for mental health issues in children and keep a watch to prevent child abuse and violence. Also, it is worth limiting screen time and preparing children for safe school reopening,” said IAP President Dr Piyush Gupta and past president Dr Bakul Parekh in their presentation.
“As per data collected in waves 1& 2, even severe Covid infections in children are less likely to require ICU admissions. However, we need to be watchful about how the mutant strains will behave. The dictum here is: better be ready and prepared for the worst and hope for the best. Severe disease occurs in children, but there is no evidence indicating that most children with the COVID-19 infection will have severe disease in the 3rd wave,” said Dr Parekh.
According to IAP, children occasionally get severe disease and may need ICU care, both during the acute illness and after 2-6 weeks due to an immune condition (MIS-C) caused by covid-19. But the majority are likely to recover if treated in time. “We need to be prepared with more in-patient beds and intensive care beds for children. IAP has already developed the management protocol for disease categories in children. There is no reason to panic. Our preparations are in full swing,” said Dr Gupta.
Further, IAP said children do get severe disease, even if it is small in numbers. Thus, there is no harm in considering vaccination for them. The safety and efficacy, however, are being assessed in trials for this age.