New Delhi: Ever since principal scientific adviser to the central government, Prof K. VijayRaghavan, set the cat among the pigeons by describing a Covid third wave in India as “inevitable”, as early as May last year, speculation on how the wave would affect Indian children has been high.
Reports so far suggest there has been no alarming increase in infections among minors. Those who have tested positive have not needed too much medical care either.
India started vaccinations for 15-18-year-olds from 3 January, just as the wave rolled in earlier this month. To date, 3,73,04,693 vaccine doses have been administered in that age group. The total target population is about seven crore. About 45 crore of India’s 135 crore population are children. Currently, only Covaxin is being administered to minors.
Although the Omicron surge has not hit children hard till now, there are concerns over long-term consequences of Covid in children, especially a condition called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect the vital organs.
ThePrint reached both the Union Ministry of Health & Family Welfare and the NITI Aayog over the phone and through WhatsApp messages, seeking a breakup of the percentage of cases in children. No response was received till the time of publication.
“When children report positive, we usually treat the symptoms. Nothing needs to be targeted to the virus in children. If there is fever, we use paracetamol. For vomiting, we use anti-vomiting medications for a day or two, after which it settles down,” said Dr Krishan Chugh, principal director & head of department, Paediatrics, Fortis Gurgaon.
“If there is diarrhoea, use ORS. If there is regular cough and if the child is old enough, we use cough syrup, but not in young children,” he added.
Chugh said he had “used medications for a runny nose too, but not prescribed anything beyond that”.
“Parents want to give steam, that may help, but we have seen more accidents happening with hot water than benefits of steam. Lozenges don’t work, they are not required. Multivitamins etc also, there is no evidence that they work. No antibiotics, no ivermectin, no chloroquine. We had used all of that in the first wave, but now we know they do not work. There are no special foods either, just stick to a balanced diet,” he added.
Short durations of disease
Senior paediatrician Dr Praveen Mehta, who is also a former general secretary of the Indian Academy of Paediatrics, said “most children are becoming alright in three to four days”.
“The commonest complaint is of throat pain and also a runny nose. There may be a bit of cough or fever for one or two days, but there is no change of taste or smell. This [variant of the] virus does not affect the lungs, so there are no lower respiratory tract symptoms like breathlessness and pneumonia,” he added.
Short durations of the disease in children have also been the hallmark in South Africa during the Omicron wave.
In an interview with ThePrint last month, Dr Angelique Coetzee, chairperson of the South Africa Medical Association, said that, in her experience, children often complain of sore throat, headache, and report a low-grade fever and an elevated pulse rate. However, they are usually back to their usual schedule, playing outside in three days, she added.
Concerns about long-term effects
The real concern in children often is not the immediate symptoms, but the long-term consequences, particularly MIS-C.
The US Centers for Disease Control and Prevention (CDC) defines MIS-C as “…a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We do not yet know what causes MIS-C”.
“However, we know that many children with MIS-C had the virus that causes Covid-19, or had been around someone with Covid-19. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care,” it adds.
According to Dr Sanjeev Bagai, paediatric nephrologist and chairman, Nephron Clinic, MIS-C can take anywhere between two and four weeks to develop.
“There is cardiac, neurological, pulmonary and intestinal involvement, mortality is often very high. There can also be serious long-lasting consequences. That is why it is very important to get children vaccinated if they are eligible,” said Bagai.
Dr Veena Kalra, former professor of paediatrics at AIIMS Delhi and a paediatric neurologist currently with Indraprastha Apollo Hospital, said that unlike after the first and the second wave — fuelled mostly by the Alpha and Delta variants of the virus — MIS-C patients have not come in during the current wave.
“We used to see a lot of MIS-C patients in the first wave and then in the Delta wave. But in this current Omicron wave, we are not seeing them. It could be a little early for that too, so we cannot say for sure, we may still see some in the end, but in the Omicron surge, even adults are not getting too sick,” she said, “MIS-C, however, is not linked to how sick a child gets with Covid. It is an unusual reaction in an individual child.”
(Edited by Saikat Niyogi)