Children falling seriously ill in third Covid wave unlikely: Experts

BENGALURU: As the second wave of Covid-19 continues to wreak havoc in the country, speculation is rife that the possible third wave will impact children more. Paediatricians and the Indian Academy of Paediatrics (IAP), however, don’t seem to agree.

The sero-survey of December 2020-January 2021 showed that the percentage of infected children in the age group of 10-17 was around 25%, which is the same as adults. “This indicates that while children are being infected like adults, they are not contracting the severe form of the disease. It is highly unlikely that the third wave will predominantly or exclusively affect children,” the IAP had stated last month, even as it reiterated that it has developed a management protocol for disease categories in kids, and there was no need to panic.

“Children have less expressed ACE2 receptor that results in lesser attachment of the SARS-CoV-2 virus to the respiratory passage. There is no scientific evidence of them falling seriously ill in large numbers in the possible third wave. More children may fall sick if the adults are not vaccinated, and don’t follow Covid-19 appropriate behaviour,” said Dr Sanwar Agrawal, director and DNB coordinator at Ekta Institute of Child Health, Raipur.

“The review of available literature from third waves around the world and our hospital’s comparative two wave data doesn’t suggest that we will have large numbers of ICU admissions of children with severe Covid-19, or those requiring hospitalisation. The large unimmunised adult population will still drive the third wave, especially those with comorbidities,” said chief medical officer and professor, paediatrics, St John’s Medical College & Hospital, Dr Sanjiv Lewin.

He  cautioned about Multisystemic Inflammatory Syndrome-Children (MIS-C). “We had 33 such children following the first wave, and 15 so far in the second wave. This is what we need to be prepared for through education and strong referral systems. Delaying the third wave and intensive, massive accelerated vaccination campaigns are vital,” he  said.  

“There is no data from across the countries that the third wave has been devastating to children. In Mumbai, children constitute around 6% of the total Covid infections. Children fell sick because adults in the family were stepping out and were not vaccinated,” said Dr Sanjay Prabhu, senior consultant paediatrician, BJ Wadia Hospital, Mumbai.

Professor, paediatrics, Subbaiah Institute of Medical Sciences, Shivamogga, Dr Vikram S Kumar concurred with his fellow paediatricians, and said those not vaccinated will remain susceptible, including children. “But there is a difference between getting infected and falling seriously ill. There is no scientific data yet on children falling seriously ill in the third wave,” he said. Regarding pneumonia and MIS-C, he said they are treatable conditions if diagnosed early.