"Paediatric Facilities Nowhere Close," Report Warns On 3rd Wave, Children

There is insufficient evidence to suggest a third Covid wave will affect children more than adults, the National Institute of Disaster Management has indicated, while warning there is still "cause for worry, if not panic" so long as they remain unvaccinated and existing medical facilities remain inadequate.

"Paediatric facilities - doctors and equipment, like ventilators and ambulances, are nowhere close to what may be required in case a large number of children become infected," the NIDM, which operates under the Home Ministry, said as part of a report on recommendations to prep for the third wave.

The NIDM also red-flagged the issue of co-morbidities (leading to weakened immune systems) among infected children, and said their vaccination must be an "immediate priority". Between 60 and 70 per cent of Covid-positive children have co-morbidities, according to Health Ministry data.

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. Rollout, however, has not yet begun; Health Minister Mansukh Mandaviya has said this will happen "very soon".

The issue of adequate paediatric healthcare facilities is also being addressed. States have begun building hospitals and establishing task forces to stockpile critical equipment, medicines and oxygen.

In building new paediatric facilities, the report said, a key concern is to ensure they accommodate both children and their parents - to minimise the mental and emotional impact of being hospitalised.

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.

Last month the centre issued an advisory to states warning against "blatant violations of Covid norms".

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.

India has administered over 58 crore vaccine doses so far. However, only 13.1 crore of these are second doses and this has to increase drastically to ensure maximum protection against the virus.

This morning the country reported 25,072 new cases and 389 deaths from the preceding 24 hours.