Corona Daily 023: Are Children Next? (Part One)

In April, an American family of three flew to Hawaii for a long awaited holiday. The parents were fully vaccinated. Their ten-year old son was not eligible for any vaccine. In Hawaii, the boy developed covid symptoms, and in a few days, died. It must be mentioned the child had underlying health conditions.

Anywhere in the world, where vaccines are available, adults are rushing to get vaccinated. The USA has given emergency approval for shots for everyone from 12 years of age. In most places, young people have difficult access to vaccination, and teenagers, young children, and infants remain unvaccinated. The age ‘de-escalation’ is common for clinical trials. However, for a long time, we may have a situation of vaccinated parents and unvaccinated children. Last year, adults were worrying about their elderly parents. Now, they are worried about the children instead.

With countries gradually freeing themselves, covid guidance may require kids to wear masks indoors, while parents lead a normal pre-pandemic life. On flights, the airhostess asks the passengers to first take care of themselves in case of low oxygen. First mask yourself and then think about putting mask on your toddler. For most parents, that is counter to their natural reflex. The vaccine strategy has followed a similar line, inoculating adults before children.

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Of course, the risk for children and young people is low this time. But it is not the same with every disease. When in 1950s, the polio epidemic was raging; it essentially sent children to wheelchairs and made many wear lifelong crutches. The alternative name for polio was ‘infantile paralysis’.

This month, after decreases in the past few months, child cases are increasing in America. This week 23,500 child cases were added. In states like West Virginia, proportion of cases among people under 20 has gone from 16% to 26%. In most states of America, every fourth infected person is likely to be young, under 20. Just one year ago, child covid cases made up only 3% of the USA total.

There are three main reasons for this. With adults getting vaccinated, their proportion from the infected population is going down. As it becomes difficult for the virus to penetrate the adult population, it tries to attack the younger lot. Secondly, new covid-19 variants, delta in particular, are spreading among the young. Third, in developed nations, in-person schools have started.

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In the USA, until 22 July 2021, there have been 34 million covid-19 cases and 609,000 deaths. These figures include 4.09 million cases and 346 deaths among children.

Children have suffered severely in Brazil, Indonesia and India.

The Brazilian children have complained of severe muscle aches, diarrhea, coughing, abdominal pain. As per the official data, 2,216 children aged between 0-9 died from covid. That includes 1,397 babies under one year of age. In the 0-9 age group, 67,000 children have been hospitalized. In 2021, a lot more young people are dying in Brazil as compared to 2020.

In Brazil as well as India, diagnosis of covid-19 in children often comes too late. It is assumed there is little or no risk for children. As a result, they are severely unwell, and treatment is more difficult, by the time they are admitted to a hospital.

India’s second wave saw a large number of positive cases among young kids and adolescents.

 One of the theories as to why children are less susceptible to the virus is that they have fewer receptors known as ACE2 in their respiratory tract. This is the entry point for the coronavirus which clings to those receptors. During India’s first wave, this was assumed to be the reason why cases among the young were low.

The strain in the second wave apparently bypasses this apparatus required for entry, and is able to evade the immune system better. The number of cases as well as the severity in infection has increased.

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(C0ntinued tomorrow)

Ravi