Exclusive: COVID-19 Third wave – ‘majority of children to be asymptomatic or with mild symptom’

New Delhi: COVID-19 second wave in India saw an increase in the number of kids getting infected from the novel deadly Coronavirus. While kids could always be carriers of the disease, more children are also becoming symptomatic.

According to the Sero survey, children between the age group of 10 to 18 years would have the same type of infection as the adults had in the second wave.

The reason for this could be a mutation in the virus, which is making it more infectious and this age group is also not vaccinated against the disease.

However, the third wave would not target children alone.

According to the Indian Academy of Pediatrics (IAP), it is “highly unlikely that the third wave will predominantly or exclusively affect children”. It also added that there is no evidence to suggest that most children with COVID-19 infection will have severe disease in the third wave.

Talking about the same, Dr Yogesh Kumar Gupta, Head of Pediatric Intensive Care Unit, Fortis Hospitals predicts that most children will remain asymptomatic or with mild symptoms even during the third COVID-19 wave because of their ‘innate protection against the disease.

He lists out the points that provide children with this protection. They are:

• Children have fewer ACE2 receptors in their lungs so less binding of the virus to these receptors hence less severe would be the disease.
• Secondly, young children have high Melatonin (A Sleep Hormone) level which has shown to confer some protection against COVID though it is still under study.
• Thirdly for the first five years of life children keep getting their regular vaccine shots which keep their immune system alert and more active than their adult counterparts hence fight the COVID-19 virus better.

Dr Gupta however cautions, “There is a possibility of having very few moderate as well as severe cases especially in children with comorbidities mentioned earlier.”

Symptoms of a COVID-19 positive kid

COVID-19 symptoms observed in kids are similar to the ones observed in adults. “Most Common symptoms which are observed during this wave are cold, cough, fever, body pain, headache, loss of smell (> 8 years of age). We have observed new abdominal symptoms in the form of vomiting, pain in the abdomen, loose stools during the second wave. Symptomatology may vary as the virus mutates during the course of the pandemic,” shares Dr Gupta.

Treatment for COVID-19 positive kids

“Most of the infections are asymptomatic hence home isolation under the supervision of the Pediatrician should be sufficient. Ensure a good diet and Hydration. No medicines are required except simple paracetamol for managing the fever. Ensure to monitor the child for danger signs and seek medical help in case of worsening symptoms,” says Dr Gupta.

He adds that children with comorbidities should be observed in the hospital and those with moderate and severe diseases should be admitted to HDU/ICU care facilities.

Talking about the importance to ramp up the medical infrastructure to treat kids, Dr Gupta asserts, “We have to ramp up our Pediatric ICU /hospital beds. As ‘children are Not mini adults’, their needs and requirements are different so we should be prepared to tackle those issues.”

States worst affected by COVID-19 in the second wave like Maharashtra, Delhi and Karnataka have started preparing for health infrastructure to support COVID-19 affected kids in the possible third wave of the virus.

Maharashtra and Delhi have formed a separate pediatric task force to protect children.

Vaccinating children against COVID-19

Many experts feel that the vaccination program against the novel coronavirus should extend to children as well. Clinical trials for the same need to be conducted. While Pfizer’s COVID-19 vaccine can be given to children above the age of twelve in developed countries, research results for other vaccines are awaited.

“In India, Covaxin manufacturers have started the trials in children from 2-18 years of age and soon we will be having data in the coming months and if we get good Sero protection data, the vaccine will be rolled out for this vulnerable group. Till we have a vaccine for children we need to make sure that kids follow COVID appropriate behaviour and vaccinate every vulnerable and eligible individual around them,” states Dr Gupta.