Let us take no chances on covid with children
PremiumA report has picked holes in our preparation for a potential third wave that might affect kids worse than ever. These gaps need to be closed fast. But we mustn’t rush to vaccinate under-18s
A constant state of preparedness in our war against covid is imperative. A report submitted to the Prime Minister’s Office, however, has flagged serious gaps in our defences that must be plugged before a potential third wave arises. The report, prepared by an expert panel set up under the National Institute of Disaster Management (NIDM), points to the possibility of our infection count rising sharply again in the weeks ahead to peak in late October. It has called for a ramp-up of medical facilities for children, especially, who might be at greater risk than before. Our current resources for paediatric healthcare, it warns, “are nowhere close to what may be required in case a large number of children become infected". Apart from prioritizing the immunization of children with underlying health problems and disabilities, the committee wants covid wards at hospitals reconfigured to let children’s parents or attendants stay safely with them. Among its bigger worries is an acute shortage of paediatricians. That such a medical specialization exists should suffice to explain why children cannot be treated like under-18 adults, but this point is magnified by the peculiar age-affliction profile of this pathogen.
Kids were far less vulnerable than grown-ups when the pandemic first took hold, but the second wave that caught India dozing earlier this year served an alarm that this age gap could close as the virus evolved. Under-18s were found less easily able to fend off Delta, which drove up those infections, than past strains of Sars-CoV-2. One plausible explanation for this difference was that its survival pressure was pushing it down paths of evolution guided by a genetic easing of its ability to spread. This would make its spikes reach for new targets, such as those who had gotten away lightly all this while—the under-age, alas, included. That younger and younger people had been falling prey to it over the pandemic’s course gave this scare its bit of extrapolatory backing. How susceptible our children are to a vicious variant today, however, remains unclear. So far, no mutation has been reported that has new claws out for kids. Also, India’s infection curve is flat. Yet, so long as the threat to children could surge in theory, the crisis that may erupt would be so severe that we cannot afford to take chances.
The same applies to vaccinating children, who are too young to take informed decisions on risk-versus-benefit on their own and depend on us for their safety. While a vaccine by Zydus Cadila got approval last week for emergency use on those aged above 12, it is a DNA plasmid formula, a new kind, and so, even though a regulatory go-ahead means it cleared its safety tests, it would be best to wait for post-trial data on its effect on adults before dosing kids. As adverse reactions to vaccines generally vary by age, with the young slightly less safe, this sequence is a must-follow. The NIDM panel would have children at higher covid-risk immunized on priority. But a rush to dose the rest would be justified only if our kids actually get exposed to a wave led by a variant worse than Delta, which would alter the risk-benefit calculus. For now, our need to reopen schools must not result in a hasty call on kids. It’s another matter that their education must resume and lost learnings regained at the earliest. This is especially so for students on the dark side of our digital divide. But covid protocols and class ventilation can offer protection. A roll-call of vaxxed kids must wait for a better-informed scientific analysis
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