Even as India grapples with the second wave of Covid-19 that left health systems across the country crumbling, experts are already calling for preparations for the third wave, which they predict will hit the country later this year. They have warned children would be affected by the third wave.
In a meeting with district magistrates and field officials of 10 states on Thursday, Prime Minister Narendra Modi called for the collection of data on the transmission of Covid-19 among youth and children in each district. He said such data must be analysed regularly to protect them.
This comes after Delhi chief minister Arvind Kejriwal raised concerns about a ‘new strain’ in Singapore affecting children. This triggered a row with Singapore, with the country claiming that there was no new strain. The Singapore High Commission clarified, “There is no truth in the assertion that there is a new COVID strain in Singapore. Phylogenetic testing has shown that the B.1.617.2 variant is the prevalent strain in many of the COVID cases, including in children, in recent weeks in Singapore.” Singapore on Sunday said it was shutting down schools as the B.1.617 was also affecting children.
The B.1.617 variant is said to be behind the severe second wave of Covid in India, which has affected more children than in the first wave. This time, India reported children as young as newborns being infected with the virus, something that was rarely heard of during the first wave in 2020. About 60% of Covid-19 cases in Maharashtra by mid-February are said to have been the B.1.617 variant. This variant also has three sub-lineages — B.1.617.2, B.1.617.3 and B.1.617.1.
Why are children vulnerable and must be vaccinated?
Several experts have warned that the third wave will likely affect children, as Singapore has already reported.
Virologist Dr V Ravi told the Hindustan Times that it was common sense that the virus will attack people who are not immune. “You can get immunity from this virus either through infection or through vaccination. If not, the virus will definitely catch you. Adults, more people are getting infected — most in the first wave and second wave. Adults have vaccine so they are getting vaccinated. Children in the first wave we had only 4% (infection) across the country, in the second wave 10-15%”
Ravi explained that it left about 60% of children vulnerable because there are no vaccines for children yet in India.
Dr Bakul J Parekh and Dr Samir H Dalwai wrote in an opinion piece in News18 that the government must consider vaccinating children as during March-April 2021 the number of children affected by Covid-19 significantly went up.
“Additionally, the number of children with Covid-19 needing hospitalisation and intensive care has significantly gone up. This has brought children (or an additional 40% of the population) directly into the segment of patients suffering from Covid-19 infection who would need significant medical care. This undoubtedly paves the way for an immediate vaccination programme for children and adolescents in India,” they wrote.
How is India preparing to protect its children?
With warnings from experts, and a second wave that has served as a lesson on how prepared the country is, states are already taking steps to ensure there are arrangements in place to protect children. States like Delhi, Karnataka and Maharashtra, worst hit by the second wave, are already taking measures.
Delhi: The government has already planned a special task force to protect children in the national capital. Kejriwal said on Thursday, “If the third wave of corona emerges, we must be prepared in advance to fight it. Took some important decisions today in a meeting with the officials. 1. To create a special task force to protect children from the third wave 2. Adequate beds, oxygen and better management of essential medicines.”
Karnataka: The state’s women and child welfare minister Shashikala Jolle has announced several measures for Covid-19 management among children. While paediatric Covid care centres will be set up in all districts, rehabilitation centres will be set up for orphans.
Maharashtra: The Indian Express reported that in light of experts warning of a third wave, the Brihanmumbai Municipal Corporation (BMC) has planned to set up a paediatric Covid care facility in Mumbai and a crèche network for children whose parents are in hospital for Covid treatment. Officials told the newspaper that the paediatric facility for children before 12 years of age will come up within the next two months.
Meanwhile, the Osmanabad district administration has formed a task force to protect children in the possible “third wave” of the Covid-19 pandemic. On Wednesday district collector Kaustubh Divegaokar held a meeting with child specialist doctors regarding the measures to be taken to protect children in future. The administration also decided to set up separate Covid wards for children. The collector said almost 8 per cent of all the Covid-19 patients in the district are children.
Child rights body writes to states, Centre
The National Commission for Protection of Child Rights (NCPCR), India’s apex child rights body, on Thursday said with a third wave projected to hit the country, the Centre and states should ramp up their preparations to protect children and neonates. NCPCR chairperson Priyank Kanoongo wrote to Union Health Secretary Rajesh Bhushan saying the ongoing second wave was impacting a slightly greater number of younger people and a third wave is projected to hit the country, and will affect children too.
Underlining the urgent need to reorganise the National Emergency Transport Service (NETS), Kanoongo requested the health ministry to issue necessary directions for the service and ambulances to prepare specifically for neonates and children. In a letter to health secretaries of states and union territories, the chairperson said keeping in view the high risk involved for infants and children in the projected third wave, the NCPCR has developed a format to collect information on functioning of neonatal intensive care units, paediatric intensive care units and special newborn care units.
Vaccination among children
While most countries across the world are still in the process of vaccinating its adults, several other countries have begun vaccinating children.
The US Centers for Disease Control and Prevention Director Rochelle Walensky said on Tuesday that the US has administered Covid-19 vaccinations to around 600,000 children ages 12 to 15 last week after regulators cleared Pfizer Inc’s BioNTech shots for use in that age group. Meanwhile, expert Anthony Fauci has said that children aged 4-6 will likely be able to get vaccinated by the end of 2021 and beginning of 2022.
And even as Singapore shut down its schools, it’s also vaccinating children aged 12 to 15. Health Minister Ong Ye Kung said that those aged 12 to 15 are to be vaccinated against Covid-19 with the Pfizer-BioNTech injection. The Pfizer-BioNTech Covid-19 vaccine was previously given only to those aged 16 years and above.
The UAE too is vaccinating children of the same age group with the Pfizer shot.
However, the World Health Organization has urged rich countries to reconsider plans to vaccinate children and instead donate shots to the COVAX scheme for poorer countries.
When will India vaccinate children?
At the moment there are only two vaccines available in Indian markets, and neither of them have data on trials on children.
While Bharat Biotech got the approval of the Drug Controller General of India to start Phase 3 trials of its vaccine for the 2-18 age group, it is going to begin in the next 10-12 days. AztraZeneca is also carrying out trials for its vaccine in the 6-17 age group, but so far there is no data on it yet.
However, Pfizer has said earlier this month that it was in discussions with the Indian government seeking an “expedited approval pathway” for its Covid-19 vaccine.
Meanwhile, 20 children in Karanataka’s Belgavi received the first dose of Zydus Cadila’s ZyCoV-D Covid-19 vaccine as part of its phase three trials.
While other vaccines like Johnson and Johnson’s Janssen vaccines and Russia-manufactured Sputnik V is likely to hit Indian markers soon, it is unclear when vaccines will be available in India for children before 18 years of age.
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