Fatality rate in those below 18 is 0.15 per cent. (Photo: Deepak Joshi)

AS governments debate when and how to open schools, data collected by the Maharashtra Public Health Department show that those below the age of 20 account for 11 per cent of the cases in the state but just 0.5 per cent of its Covid deaths were of infected children and teens aged 18 or less.

Out of the 5.95 lakh cases of the novel coronavirus infection (including both active and cured/discharged cases) in Maharashtra — which tops the country in absolute case count and number of deaths — over 66,000 have been children and young people up to age 20, the data, arranged age-wise by the state government, show. However, of the 19,830 Covid-19 deaths in the state analysed until August 16, just 99 were of children and teens aged 18 or below (51 of them aged 0-9).

Fifty-two per cent of the deaths were of patients aged 60 or older.

The case fatality ratio (CFR) – the number of deaths against the number of confirmed cases – in the age group of 18 years or younger is 0.15 per cent, the government data show. That is far lower than the CFR for Maharashtra as a whole (3.35 per cent). India’s overall CFR has been falling steadily even as case numbers have risen, and stands at 1.92 per cent now.

In Maharashtra, those aged below 20 account for 36.07 per cent of the total population as per the 2011 Census.

As of August 17, Maharashtra had recorded 23,995 cases of Covid-19 among children under age 10, and 42,529 in the age group 11-20 years, including both active and cured/discharged cases. However, between 1,000 and 1,200 children and young people aged 20 years or less have been testing positive every day on average in the state since the beginning of August, the data show.

Chief Minister Uddhav Thackeray has indicated that it may be a while before schools in Maharashtra are allowed to reopen, and has stressed on the promotion of e-learning. “Maharashtra was the first state to start online school education,” Thackeray said during a webinar on August 15 with Dr Shashank Joshi and Dr Rahul Pandit, members of the state’s Covid-19 task force. This had helped control case numbers, he said.

Most deaths among children and teens were on account of respiratory failure caused by the virus, the Public Health Department data show.

In some cases, children suffered multi-inflammatory syndrome following the infection. There are plans to maintain a separate record of such cases, state Health Department officials said.

While comorbidities such as diabetes and hypertension are usually not seen in children and teenagers, a survey of 1.8 crore children under the Rashtriya Bal Swasthya Karyakram by the state Health Department last year found over 10,000 children in the 0-18 age group had type 1 diabetes mellitus.

The surveyed children were from zilla parishad schools, ashramshalas and government schools. State officials said they plan to screen such groups, which are vulnerable to severe Covid-19 infection.

“Overall, Covid-19 is a mild disease in children. But infected children may carry the infection home to their grandparents, who are a vulnerable group,” Dr Tanu Singhal, infectious disease expert at Kokilaben Dhirubhai Ambani hospital, said.

While the severity of the infection is low among children, they can be more infectious than adults, Dr Satish Pawar, joint commissioner, Directorate of Health Services, said. “Children have more nasal secretions than adults,” Dr Pawar said.