A woman sits with her child inside a COVID-19 quarantine centre at an indoor sports complex, New Delhi, September 22, 2020. Photo: Reuters/Anushree Fadnavis
- The National Institute of Disaster Management constituted the group of experts, who presented their report to the Prime Minister’s Office over the weekend.
- The report says the third wave is likely to affect children more, highlighted a big paediatrician shortage in health centres and recommended setting up children-friendly care wards.
- The major COVID-19 vaccines in India for adults have been tailored to prevent severe disease and not to cut transmission – the primary concern with children.
Bengaluru: As India’s states tentatively step out of lockdowns and the national capital reports the lowest number of daily new cases in more than a year, a group of experts at the Union home ministry has said the country’s third COVID-19 outbreak could peak in October 2021.
India’s first wave peaked in September 2020 and the second in May 2021. Many experts have expected the third wave to affect children more because all of them are unvaccinated.
The National Institute of Disaster Management in the home ministry put together the group of experts, who compiled and presented their report to the Prime Minister’s Office over the weekend.
According to Times of India, the report recommends stepping up vaccination among children, focusing on those with disabilities, and setting up paediatric care centres tailored to the needs of children.
The group members were:
- Anurag Agarwal, director, CSIR-IGIB;
- M.C. Mishra, ex-director, AIIMS New Delhi;
- Naveen Thacker, president, Indian Paediatricians Association;
- Gagandeep Kang, professor, CMC Vellore; and
- A.K. Pandey, chair, state monitoring committee on shelter for urban homeless
There is growing consensus that herd immunity is impossible to achieve with the delta variant of SARS-CoV-2, and that the virus could become endemic to India and cause seasonal outbreaks of COVID-19.
The principal concern with children is not mortality, considering scientific reports thus far suggest the disease is much less dangerous in younger people. It’s that they can carry the virus in their bodies and transmit it to others.
For this reason, it’s not yet clear how much the existing crop of COVID-19 vaccines can help. Neither Covaxin nor Covishield, the major vaccines in India, have been tested for sterilising immunity – the ability to cut transmission of the virus. Instead, they are tailored to prevent severe disease and death.
While COVID-19 mortality about children is lower than that among adults, many children around the world have developed a post-recovery condition called multi-system inflammatory syndrome (MIS-C). According to Mayo Clinic:
… in children who go on to develop MIS-C, some organs and tissues — such as the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes — become severely inflamed. Signs and symptoms depend on which areas of the body are affected. … MIS-C is rare, and most children who have it eventually get better with medical care. But some kids rapidly get worse, to the point where their lives are at risk.
Union health minister Mansukh Mandaviya said last week that COVID-19 vaccines for children would be launched “very soon”. PTI also reported that AIIMS New Delhi director Randeep Guleria expected data from Covaxin’s trials among people aged 2-18 years would arrive in September.
On August 20, the Drug Controller General of India approved ZyCoV-D, a COVID-19 vaccine made by Ahmedabad-based Zydus Cadila, for people aged 12+ years. This is the first vaccine in India approved for people younger than 18 years.
However, only data from the pre-clinical and phase 1 clincial trials of ZyCoV-D are available. Phase 2 and 3 findings are not in the public domain. Zydus Cadaila also came under fire over the weekend after it said it would publish the results in 4-6 months, an unusually long timeline.
On the same day, August 20, Johnson & Johnson applied to conduct a clinical trial in India for its COVID-19 vaccine among participants aged 12-17 years.
According to Times of India, the experts’ report also pointed out that 82% of paediatrician positions in primary health centres and 63% of the same position in community health centres are currently unoccupied. This, the report added, could exacerbate the severity of the third wave.
Notably, the Narendra Modi government have been repeatedly criticised for ignoring experts’ recommendations. Most recently, there were allegations in May that the Centre had ignored an expert committee’s warning in early March that new, more contagious variants of the virus were circulating in the population and that a big surge was coming.
The government also ignored widespread concerns ahead of the Kumbh Mela in Haridwar, Uttarakhand, and demands to cancel the event in favour of public health.
India’s second COVID-19 outbreak that followed was marked by the world’s highest daily case load, very high mortality, rampant medical oxygen shortage and overworked crematoria.