Covid 19 pandemic had a devastating effect all over the world. In India, the first and second waves affected everyone, be it elderly, young, or children. The eruption of a third wave driven by the Omicron variant has posed new challenges. India is a densely populated country and the population of children is 164.5 million. If the infection starts to spread among children, it will have dangerous consequences.
New paediatric Covid hospitalisations have hit a record-high in the United States, as children are increasingly swept up in Omicron’s lightning spread. According to the American Academy of Pediatrics, almost 199,000 children were reported infected with Covid-19 in the week ending December 23, the last week for which data is currently available, which was a 50 percent rise on figures earlier in the month. Recent reports from South Africa suggest that more children are being hospitalised with moderate to severe symptoms following the Omicron outbreak in the country. The head of Karnataka’s Covid-19 task force to prepare for the third wave in an editorial had projected that “The third wave is likely to attack children since most adults are already infected or immunised.” He argued that treating children and babies in ICU units was different from treating adults. “Even if we assume that just 20% of them get infected and 5% of the infected need critical care, we need 1.65 lakh pediatric ICU beds,” he wrote. The Indian Academy of Paediatrics (IAP), a representative association of paediatricians, released a detailed statement stating that children are as susceptible as adults and older individuals to the infection.
The report of a committee of experts constituted under the National Institute of Disaster Management (NIDM), which was set up by the Union home ministry, pointed out that paediatric [control] facilities including doctors, staff, equipment like ventilators, ambulances, etc, are nowhere close to what may be required in case a large number of children become infected. According to the report, children remain a cause of concern as they are still not vaccinated. Also, the existing paediatric health care facilities are not robust enough to treat children on a large scale. The Lancet Covid-19 Commission India Task Force report found that the mortality rate amongst severe COVID-19 positive children below the age of 10 was 2.4 percent. 40 per cent of the children who had succumbed to the disease had co-morbidities and 9 per cent of all hospitalised COVID-positive children had severe symptoms. All the participating kids in the study were below the age of 10. Globally, children constituted 1.3-3.2 per cent of the total reported hospitalised cases.
While national age-wise data have not been released by the Indian government, state governments have periodically analysed how waves have affected different age groups. The latest survey (December 2020-January 2021) showed that the percentage of infected children in the age group of 10-17 years was around 25%, the same as adults. This indicates that children are being infected like adults.
A study titled, “Third Wave Preparedness: Children Vulnerability” explored the possible impact of Covid-19 on children and the strategies required to deal with the pandemic. The report stressed on vaccination to avoid severe impact on children. The study also recommended identification and rehabilitation of Covid-affected children – both in the short as well as the long term.
India has begun to prepare for the emerging variants, with a special focus on protecting children. In the first instance, the parents are being vaccinated to dismantle any threat to the children below 18 years. The Lancet COVID-19 Commission India Task Force was asked to evaluate the evidence and suggest practical clinical tools and strategies for providers and guidance to the policymakers and the public, to collectively protect the children during this crisis. A massive vaccination drive has been launched to vaccinate children between 15-18 age groups in India. Over 40 lakh persons between 15-18 age group received their first jab of COVID-19 vaccine on the first day of the vaccination drive for children, as tweeted by the Health Minister of India. According to the COWIN dashboard, 37,84,212 people in the 15-17 age group were administered the COVID-19 vaccine on Monday and 49,07,874 (in this age group) have registered for the vaccine so far.
The role of the government in controlling the transmission of the virus is crucial here. We have to get responsible and well prepared before the emerging variants hit the country and start affecting the children. Robust and committed vaccination drives need to be sustained to achieve 100% vaccination among all age groups. The government needs to prepare healthcare institutions and infuse a fresh strength into the infrastructure to deal with any untoward situation. The sooner the better.

—The writer works with Child Protection Service (CPS), Government of Jammu & Kashmir.

Muzamil Bashir