Third wave of COVID-19, vulnerability to children


Er P L Khushu

Experts say that children below 18 years are at risk during COVID 3rd wave. They further say that children and newborns are at risk in possible third COVID-19 wave as they are yet to be inoculated against COVID-19 infection.
Several children below age of 18 years and newborns have been tested positive for COVID-19 in Maharashtra’s Akola and Amravati districts as India continues to grapple with second wave of coronavirus pandemic with a record surge in daily cases and deaths due to the virus. In past seven days, 10-12 per cent of COVID-19 cases were reported among those below the age of 18 years in Akola and Amravati. In past one week, as per print media reports, Amravati district has recorded 6,826 COVID-19 cases, of which, 408 were reported among new-borns and children aged below 18 years.
If children under age of 18 years cannot be vaccinated, the only host left for virus to attack will be children. As per population figures we have 165 million of children, less than 12 years old. Even if we assume that just 20 per cent of them get infected and 5 per cent of the infected need critical care, we need 1.65 lakh pediatric ICU beds. Do we have so much capacity, probably not at all.
The COVID virus mutates to attack as many new hosts as possible. During the first wave, COVID attacked mainly elderly and spared youngsters. The second wave is attacking a large number of young bread-earners. The third wave is likely to attack children, since most adults are already infected or immunized.
It is understandable that one cannot afford to have a two-month-old baby in the COVID ICU without association of one of the parents. Infants and small children cannot be left in ICU without their parents. Mothers need to breastfeed their babies and take care of them. That means we need to quickly vaccinate all parents of young children with two doses. And this should happen right now. We need to vaccinate at least 300 million young parents in next few months. The brighter side is that vaccination protects people to a great extent.
It is mostly established that vaccinated people with both doses hardly need ICU treatments. So, to vaccinate young parents of the children is to save the children first from onslaught of the virus. Like adults, children also can transmit the coronavirus to others if they’re infected, even when no symptoms are present. The COVID-19 vaccine protects against this potential harm to the child and others, including family members and friends who may be susceptible. Another reason to consider a COVID-19 vaccine for parents of the children and child is to protect the health of general community at large. Each child or adult infected with the coronavirus provides a chance for the virus to mutate and create a variant that might prove more dangerous or resistant to available vaccines and therapies. Fewer overall infections among the population mean less chance of dangerous coronavirus variants and not high potential treatments in case COVID visits them.
Building a fair and equitable healthcare system, which works for all people, may be the only solution to prevent and restrict deadly impact of pandemic in future. The arrival of the second deadly wave of COVID due to which the entire country is suffering badly at present, was an abrupt happening to a larger extent which took almost everybody by sudden shock, partly by default, but partly by design too. While blaming the Governments be it central or that of states and rightly so, because of its unpreparedness, a lot of blame has to go to people of this country in general too.
We need to blame ourselves first before blaming the governance of varied classification in the country, responsible for COVID -19 care and its stoppage. The ritualistic norms set around the country and the world around to be followed in this regard were brazenly violated and flouted. No regard to social distancing and uses of masks were ever adhered to religiously. Bigger social gatherings like marriage parties, religious and cultural gatherings continued to be performed as usual, knowing fully damn consequences.
It goes beyond doubt that Prime Minister Narendra Modi worked untiringly during last year when the first phase of COVID-19 was in severe operation, and ensured that the India gets its own vaccine, which he accomplished with merit and accuracy. But probably the skies had something else in store for India, when the second wave over whelmed the first wave with more severe blow. Here it can be claimed that due to vaccination given to more than 15 crore Indian population, this deadly onslaught gave a good respite to the sizeable population by immunizing them fully or partially, thus saving some sections of people. The unfortunate part is that the vaccination process for the front-line workers, people of more than 60 years of age, followed with vaccination of 45 years and above age people were not adhered to by people in certain sections and areas of this country on some vicious grounds of paradoxical phobias, claiming that such a vaccine is going to impart impotency to such people who get vaccinated. It is a big pitfall in this regard. All did not turn out for vaccination.
As the number of COVID-19 cases and test positivity rates are showing signs of rise in major urban centers across India, we see desperate scenes in small towns and villages. We read about people dying in their homes unable to access medical care. We see pictures of people waiting for their turn to cremate their loved ones in funeral grounds. Taking cues from recent COVID devastations, mostly because of our laxity in this regard and partly because of the apathy of power corridors, who failed to visualize such a disaster of the second wave and were caught unawares to the disaster of the Indian population, we need to take the COVID protocol norms now very seriously as responsible citizens and follow these norms lock stock and barrel, to save ourselves and the nation as a whole from the expected onslaught of the anticipated third wave which as per experts is expected to be more serve.
Before start of COVID-19 third wave, if people, particularly young parents are not vaccinated on highest priority and if citizens do not follow the ‘social vaccines’ (hand washing, use of masks and physical distancing), it is for sure that a disaster is knocking our doors particularly for our children lot, which will be an unmanageable affair. Let the people in authority managing COVID pandemic of the nation both at the central government levels and the state government levels become conscious and concerned in this regard, before it attains mass destruction. Most of the responsibility in this regard is on the states, who have to prepare on war footings their arrangements, like appropriate provisions of oxygen with a COVID bed facility in the hospitals, rather than approaching higher courts afterwards shielding their incompetence to control the pandemic and blame the central government. This in particular applies to our metropolitan capitals and cities, when during the first and the second wave some of these governments politicized the issues to take a political mileage out of it, rather than giving relief to its people. We have seen people dying in metropolitan cities for proper oxygen and beds, when there was complete chaos around and the patients were left to their fate to die horrifying deaths. Situation is still in a fluid state at some of the locations across the country.
No respiratory viral infection has been as deadly as 1918 Spanish flu. Data from the United Kingdom shows us that the disease followed three waves. The second wave was deadlier and more long-lasting than first or third ones.
As historical evidence counts, in case of Spanish flu, the destruction caused by World War-I and lack of laboratory surveillance capacity may have played a part in augmenting spread and increasing mortality; but the learning from that outbreak is definitely applicable in case of COVID-19. As per experts, we are seeing a lot of parallels between Spanish Flu virus and the one causing COVID-19, though they are very different phylogenetically. Therefore, it is only reasonable to anticipate a third wave of virus infections and be prepared for it.
Vaccine is the most potent tool that we have against COVID-19 infections. Though we do not have concrete data on level of protection offered by the various vaccines against mutant strains, but most of the experts agree that a great degree of protection against severe infections does exist. Therefore, relying on vaccines is the most rational way to prevent a third wave.
Presently as is apparent, our country may not have the capacity to produce vaccines fast enough to vaccinate our entire population in the next few months. As per reports available, the combined production capacity of Covishield and Covaxin is only around 60-70 million doses/month and at this rate it may take more than two years to vaccinate India’s population. So, we have to look at other options. The scaling up of capacity promised by the Serum Institute of India (SII) and Bharat Biotech, which manufactures the vaccines currently used in India, is going to take time and we cannot rely on that process to rapidly increase the rate of vaccination.
As short-term measures, pre-prepared vaccines from other countries seem to be the only viable option if we want to vaccinate the most vulnerable groups and sections of the population rapidly. The decision to allow the import and use of Russian-made Sputnik-V is a welcome step in this regard.
This pandemic has shown us vital deficiencies in our healthcare system. It shows that systemic under-investment in public health over the last half a century has proved to be quite costly now both in human lives as also in terms of abrupt financial burden, apart from a severe setback to the economic fabric of our country. Thus, the creating a competitive and an equitable healthcare system, which works for all the people, may be the only solution to prevent and rather limit impact of future waves of such types of pandemics in our country.
(The author of this article is a chartered civil engineer who loves his motherland the Union Territory of J&K).