Nature Of The Pandemics

  • Pandemics occur in waves, and each wave causes many cases.
  • Eventually, most of the population may get immune by asymptomatic or symptomatic infections (herd immunity).
  • Over time disease may die out or may become endemic in the community with low transmission rates.

Behaviour Of The Current Pandemic

  • In the first wave, the severe disease occurred primarily in the elderly and individuals with co-morbidities.
  • In the current (second) wave, large numbers of younger age group (30-45 years) individuals have developed the severe disease as also those without comorbidities.

Is The Pandemic Over?: No! If we don’t follow the COVID appropriate behaviour, a third way is very much likely.

Who Is Likely To Get Affected By The Third Wave? The third wave, if it occurs, is likely to infect the remaining non-immune individuals that may include children as well.

Are Children Likely To Get Infected?

Fortunately, children have been relatively less affected so far due to several factors. The most important reason is the lesser expression of specific receptors to which this virus binds to enter the host and also their immune system. A very small percentage of infected children may develop the moderate-severe disease.

What Is The Role Of The Parents During The Pandemic?

  • Apart from the infection, parents should watch out for mental health issues in children
  • Keep a watch to prevent child abuse and violence
  • Limiting screen time and preparing children for safe school reopening as per the guidelines.
  • Almost 85-90% of infections in children are mild / asymptomatic. Therefore, the incidence of severe disease is not high in children.

Severe COVID Illness Affects Children?

  • Severe illness related to COVID-19 like pneumonia and Multi-system inflammatory syndrome (MIS-C) occurs in children.
  • COVID pneumonia in children is uncommon as compared to adults.
  • MIS-C in some cases, after 2-6 weeks of asymptomatic or symptomatic Covid-19 infection, MIS-C, may be seen due to immune dysregulation with the incidence of 1 2 cases per 100,000 population; some of these cases also may be severe. It’s a treatable condition with a good outcome if diagnosed early. Also, most children suffering from MIS-C cannot transmit the infection to others.

What Kind Of Preparation Is Required If A Third Wave Comes And Affects Children?

  • Most affected children may get a mild disease with fever and need to be supervised home care with monitoring.
  • Guidelines are in place on the management of Covid in children and Paediatricians have been sensitized and trained on Covid management.
  • To be ready for a more significant number of patients seeking consultations, educating the parents regarding illness and warning signs on different platforms, arranging more Covid wards for children with more special wards such as high-dependency units (HDU) and intensive care units (ICU).
  • Preventive behaviours are the same for children. Parents should also be ideal role models to their children regarding wearing the mask, hand hygiene, and social distancing. Children above the age of 2 to 5 years can be trained to use a mask.
  • Severe disease occurs in children, but there is no evidence showing that most children with the COVID-19 infection will have severe disease in the 3rd wave.
  • Some countries consider vaccination in children and adolescents. The same vaccines being used in adults can be used in children only after adequate trials.
  • India-made vaccines will soon undergo trials in children, and if proven immunogenic and safe, they could be fast-tracked for mass vaccination in children.

There is a possibility of a third wave, but it is difficult to predict its timing and severity. It is highly unlikely that the third wave will predominantly or only affect children. There is no reason to panic.

The dictum here is: better be ready and prepared for the worst and hope for the best!

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