IAP to consider expert opinion before recommending whether schools can re-open

IAP releases advisory, developed management protocols for disease categories in children. There is no reason to panic.

The Indian Academy of Paediatrics (IAP) has said that though children remain susceptible to Covid-19 infection, it was “highly unlikely that the third wave will predominantly or exclusively affect children”. It also said that there was no evidence to suggest that most children with Covid-19 infection will have severe disease in the third wave.

In an advisory issued on Saturday, IAP, one of the largest associations of paediatricians in the country, has said that almost 90 per cent of the infections in children so far has been mild or asymptomatic.

“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 moderate-severe disease. If there is a massive increase in the overall numbers of infected individuals, a large number of children with moderate-severe disease may be seen,” it said.

“In the first wave, the severe disease occurred primarily in the elderly and individuals with co-morbidities. In the current (second) wave, large number of younger age group (30-45 years) individuals have developed severe disease as also those without co-morbidities. After the second wave is over, if we do not continue following Covid appropriate behaviour, the third wave, if it occurs, is likely to infect the remaining non-immune individuals – that may include children also,” the advisory said.

“Children are as susceptible as adults and older individuals to develop infection, but not severe disease. It is highly unlikely that the third wave will predominantly or exclusively affect children,” it said.

As reported by The Indian Express, paediatricians from the Covid task force set up by IAP have been urging parents not to panic.

One of the members of IAP’s Covid task force, Dr Umesh Vaidya, who is in charge of the neonatal intensive care unit of KEM Hospital in Pune, said parents had no reason to be “disproportionately scared” but asked them not to be careless as well.

The IAP advisory also asked parents to watch out for mental health issues in children, and be alert to prevent instances of child abuse and violence. “Also, it is worth limiting screen time and prepare children for safe school reopening,” it said.

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“The spectrum of illness is likely to be much less severe in children than adults. There is only a remote possibility of children being more severely affected than adults in the next wave. As per data collected in the first and second waves, even severe Covid infections in children are less likely to require ICU admissions. However, we need to be watchful about how the mutant strains will behave.

“Severe disease occurs in children, but there is no evidence indicating that most children with Covid-19 infection will have severe disease in the third wave,” it said.

The IAP said that severe illness related to children due to Covid-19 infection included instances of pneumonia and MIS-C (multisystem inflammatory syndrome in children).

“However, Covid pneumonia in children is uncommon as compared to adults. In some cases, after two to six weeks of asymptomatic or symptomatic Covid-19 infection, MIS-C may be seen due to immune dysregulation with the incidence of one or two cases per lakh population. Some of these cases may also be severe. It is a treatable condition with good outcome, if diagnosed early. Also, most children suffering from MIS-C cannot transmit the infection to others,” it said.

On the issue of vaccination for children, the IAP said that since data from across the world showed that adults were at least a thousand times more likely to die from Covid-19 disease compared to children, older people were being vaccinated on a priority.

“When there is a remote possibility of children getting infected, some countries consider vaccination in children and adolescents. The same vaccines being used in adults can be used in children, but only after adequate trials. One of our India-made vaccines will soon undergo trials in children, and if proven immunogenic and safe, it could be fast tracked for mass vaccination in children,” it said.

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