The daily Covid-19 numbers reported in the past few days in Karnataka point at the downward trend of the second wave of the pandemic, with experts saying the spike in cases would stabilise by mid-June. They, however, warned against lowering the guard, and added that the third wave was inevitable by the end of October. Looking at the experiences of the European countries, experts said, the third wave could be deadlier than the first two.
“It is a clear indication that by the third wave, we have to strengthen the medical infrastructure in order to treat higher number of patients than the second wave. The next few months should be used for that,” said Giridhar Babu, a professor of epidemiology and member of the state’s Technical Advisory Committee (TAC) on Covid-19.
However, the preparation for the third wave has to go beyond just medical infrastructure and oxygen supply, experts said, adding that the younger population might be the most vulnerable group in the third wave. Babu said with most senior citizens getting vaccinated by then, those below 18 years, if not vaccinated by then, would be the most vulnerable. He also said that infections among children would be a bigger concern.
In Karnataka, during the first wave between March and September 2020, as many as 19,378 children under the age of 10 were infected. From then until May this year, 49,257 in the age group have tested positive for Covid-19. As many as 68,635 children under the age of 10 have been infected till May 20 this year, according to state health department data.
The case was similar in the 10-19 age group as 41,895 tested positive for the virus between March and September 2020, while another 131,391 got infected since then, taking the total to 173,286 so far, the state data suggests.
State health director Om Prakash Patil, who held consultations with 17 experts and members of the state unit of the Indian Academy of Paediatricians (IAP) on Friday, said Karnataka will come out with guidelines on handling paediatric Covid-19 infections. “We discussed what can be done to prevent spread among children and how we can ramp up our infrastructure and train manpower to handle paediatric cases if at all the projections come true,” Patil said.
Shivananda, former director of the state-run Indira Gandhi Institute of Child Health, who attended the meeting, said the state needs more manpower trained in handling child cases as the existing number of paediatricians may not be adequate. “Only a fraction of the infected child cases may require ventilators. Most of the new ventilators come with settings that can be adjusted for paediatric use. What the state may require is more paediatric BIPAP (Bilevel Positive Airway Pressure) machines and paediatric ICU beds,” he said.
“Also, as home isolation of infected children is very difficult without parents’ supervision, we have asserted that vaccination of parents should be given priority. If they are immunised, the risk of them getting infected while handling Covid positive children will be minimal,” Shivananda added.
Another point of concern has been the deaths among the 30-45 age group, experts said. Compared to the first wave, more deaths were reported in this age category in the second wave. Babu said in many cases undetected comorbidities could have been the reason for deaths. “As we are expected to witness the third wave, it was important that people get themselves tested to understand the various comorbidities they have. In India, people get these comorbidities at least 10 years before other countries,” he said.
Babu added that the pace of vaccination will be a key factor in preparing for the third wave. “We are vaccinating elderly, and it is showing results, but it important that we vaccinate the younger population as well. We can’t emphasise this enough,” Babu said.
The Karnataka government has formally announced a 13-member committee of medical experts, headed by noted cardiac surgeon Devi Prasad Shetty, to prepare a roadmap to tackle the possible third wave of the Covid-19 pandemic. Chief minister BS Yediyurappa had announced Shetty’s name on May 14, after the Karnataka high court asked the government to submit its plans to tackle the pandemic.
Experts also said it was important to increase the number of beds in hospitals and other infrastructure, referring to the countless reports of patients dying without getting a hospital bed. In the second wave of Covid-19, the proportion of people who died without getting a hospital bed increased exponentially. While 3.8% of all deaths in the first wave were reported outside of hospitals, in the second wave, it jumped up to 9.3%, or one in every 10 Covid fatalities in Karnataka, shows the analysis of health bulletins released by the Karnataka state health department on so far.
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