There is no immediate evidence to suggest a third COVID-19 wave will affect children more than adults, the National Institute of Disaster Management has said in a report that cites the Indian Academy of Paediatrics and the Lancet COVID-19 Commission’s Regional (India) Task Force.
The report, however, also says there is “cause for worry, if not panic” since children in India remain unvaccinated, and existing paediatric facilities “are not robust enough to treat on a large scale”.
The issue of vaccines for children has been at least partially resolved with the national drug regulator last week approving Zydus Cadila’s three-dose RNA vaccine for children over 12. A second vaccine – Bharat Biotech’s Covaxin – is expected to be approved by September.
The issue of adequate paediatric healthcare facilities is also being addressed, the NIDM said in its report, with the centre directing all hospitals to allocate 20 per cent of available beds for children.
Several states have also begun building new paediatric facilities and stockpiling medicines and oxygen – the latter with memories of the crisis during the second wave still painfully fresh.
Linked to concerns over a possible third wave and its impact on children is the question of re-opening schools. The NIDM report referenced a micro-district strategy proposed by the World Health Organisation to ensure schools can be re-opened with minimal risk of virus transmission.
The report also outlines a series of measures for children’s safety – including awareness campaigns so they may be familiar with Covid protocols, programmes to ensure children in rural areas and from disadvantaged communities are protected, and, critically, recognition that “‘children’ are not a homogeneous group and the policies cannot be the same for different groups of children”.
The NIDM report also discusses general preparedness to face a third wave of COVID-19 cases; it referred to a slowdown in the rate of decline of new cases and an uptick in the ‘R’ factor, or reproductive rate of the virus, as a warning sign and said “this indicates a third wave is upon us”.
Earlier this month the centre said the ‘R’ value had risen above the danger mark of 1.0′; the last time it was over this level was in March when it was 1.32, and that was before the second wave.
It has since dropped – but only marginally, to 0.94 as of Monday morning.
Concerns over a third wave have been frequently expressed over the past weeks, particularly with potentially more virulent variants of the virus in circulation – such as the ‘delta plus’.
Concerns have also been raised over relaxation of restrictions and lockdown rules, as the centre and state governments push for economic and commercial activity to restart.
A mathematical model by IIT Kanpur suggests three likely third wave scenarios, based on the level of unlocking. These range from over two lakh cases per day to five lakh per day.
The key point is that all three scenarios predict a third wave between September and October.
To that end the report emphasises continued adoption of Covid-appropriate behaviour by the public and a consciously gradual loosening of restrictions.
In terms of general preparedness, the NIDM report also stressed that future waves may be “significantly challenged” by increasing the pace of vaccinations. At the current rate of vaccination India will fall well short of the target of vaccinating 34 per cent of its population by the end of the year.
The report also flags the need for campaigns to overcome both vaccine hesitancy (reluctance to get vaccinated) and apathy (believing there is no need because the pandemic is over).
With emergency use approvals for Zydus Cadila and Johnson & Johnson, India now has seven Covid vaccines, although across-board availability is still an issue with some yet to be readily available.