Symptomatic child Covid cases on the rise in third wave, doctors warn

Medicos are not panicking just yet, saying that intensive therapy and/or critical care infrastructure for children is not stressed at this point

Medical experts have warned about a rising number of symptomatic Covid-infected children across India with those aged below two years showing signs of acute infection, as the third wave of the virus grips the nation.

Doctors face two key challenges — the rise of a multisystem inflammatory syndrome in children (MIS-C), which could manifest four to six weeks after Covid infection, and an increase in cases that could overwhelm an already strained medical system ill-equipped for paediatric care, according to a report by Business-Standard.

A senior paediatrician in Delhi told the publication that he had 40 young patients come in with Covid in one day, against single-digit cases he tended to in the earlier wave. “The number of children infected is much higher. Many more children are coming to us with mild symptoms like fever and gastrointestinal disorders. Acute symptoms last for two to three days. But very few hospitalisations so far,” he said.

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“Children need special care. They need paediatric nurses and doctors. Adult ICUs cannot be blocked. It will be a logistical nightmare. Even in ICUs, you need a parent/guardian/attendant on call. That causes another group of people to be masked,” Rahul Nagpal, director-paediatrics and neonatology, Fortis Hospital, Delhi, said, adding that while the disease among adolescents settles down in two to three days, all respiratory diseases can be severe in babies less than two years old.

Fearing under-preparedness, states have also reserved more than double the Covid-19 hospital beds for children than recommended by federal experts, although doctors say not many youngsters have needed critical care yet.

Data showed that India has more than 24,000 paediatric ICU beds, compared to the recommendation of fewer than 10,000 beds from a federal task force. Similarly, there are 64,796 non-ICU beds for children, much higher than the suggested 27,682.

Medicos are not panicking just yet, saying that intensive therapy and/or critical care infrastructure for children are not stressed at this point. However, they admit that Covid cases among children are being under-reported.

“According to rough official estimates, around 2 per cent of total Covid cases reported in Maharashtra are of children. The numbers in the 11-20 age bracket are threefold higher than the 1-10 age group since these children are more social and have higher exposure. The numbers on the ground are way higher,” a Mumbai-based doctor said.

He says nearly 80 per cent of his paediatric patients in the past fortnight have had influenza-like symptoms but eventually tested positive for Covid.

India has some 1,39,000 Covid-19 ICU beds in total against the 1,95,390 recommended. Oxygen-supported beds, which ran short during the second wave last year, have increased to nearly 4,95,000, still lower than over 5,19,000 suggested by experts. More than 10 lakh basic isolation beds are available.

Nitin Verma with Madhukar Rainbow Children's Hospital, Delhi, stressed the importance of children's vaccination. “It is the post-Covid impact that is worrying, especially MIS-C, which comes four to six weeks after recovery,” he is quoted as saying. “Child infection in the US was 2.5 per 1,00,000 in the last wave; now it is 4 per 1,00,000.”

(With agency inputs)

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