Q. What is the meaning of a wave? A. The term ‘wave’ is used to signify the rising and falling trends of a disease over a long period of time. In India, there were two distinct waves of Covid-19 infections, with the first wave reaching its peak in September last year and the second wave from March-May 2021.

Q. Will the third wave come? A. Yes, health authorities have been warning of a possible third wave of Covid-19 infection. The Susceptible–Infected–Recovered (SIR) model is formulated for epidemiology. As per SIR Model analysis, the third wave will start in the first week of August 2021 and will end during October 2021. Some other models have predicted a later wave. The third wave may be controlled by following Covid-appropriate behavior.

Q. Will the third wave affect children?

A. Various experts are predicting a third wave with a disproportionately high burden among the pediatric population, because of new variants and vaccine for children is yet in the trial phase. Both waves till now saw the virus affecting all age groups and mortality was predominantly high in older people (22%) and the least among children (0.3%). Kids usually have mild illness and recover fast. ACE 2 receptors, which provide a binding site to virus for entry into cell are poorly developed in children making them less vulnerable to Covid19.

Q. What are the symptoms of COVID-19 in children? A. Common symptoms include fever, cough, cold, sore throat, body pains, headache, fatigue, breathlessness, vomiting, diarrhea, loss of smell & taste causing loss of appetite etc.

Q. What is Multisystem Inflammatory Syndrome in Children (MIS-C) and why it is cause of concern in children? A. MIS-C is a severe post-COVID-19 inflammatory disorder in children which is frequently associated with complications such as cardiac dysfunction, coronary aneurysms, thrombosis, multi-organ dysfunction, etc. Incidence of serious multi inflammatory Syndrome MIS -C is less than 1:1000 cases. MIS-C cases tend to peak 2-6 weeks following the peak of COVID-19 cases in the community. MIS-C should be suspected in children with persistent fever beyond 3 days with clinical manifestations (rash, bilateral non-purulent conjunctivitis, diarrhoea, vomiting, or abdominal pain, bleeding, respiratory distress, shock), especially if the child had contact with COVID-19 patient in past 1-2 months or had an acute Covid infection.

Q. What is the care of neonates born to COVID-19 positive mothers? A. Up to 10% of neonates born to COVID-19 positive mothers may be RT-PCR positive for SARS-CoV-2 during birth. Majority of these neonates remain asymptomatic. Occasionally, moderate to severe infections with oxygen requirement can occur. Breastfeeding, rooming-in, kangaroo mother care (when required) should be encouraged in all cases. Routine immunization should be done for stable neonates. The mother should follow COVID norms and breastfeed the newborn baby and avoid unnecessary handling of baby. A care-taker should be present to take care of the newborn baby.

Q. Government and hospitals have geared up for the third wave; what are the responsibilities of the public?

A.
• People should reduce hospital visits for simple issues.
• Avoid 3 Cs: Crowded places, Close contact with others, Confined places with poor ventilation.
• Wash hands frequently or clean with sanitizer.
• Wear mask properly. Children above 5 years can be encouraged to wear masks.
• Parents must not take the children outside unless it is a dire necessity.
• Individuals above 18 years must take the vaccine without undue delay and apprehensions.
• Routine vaccinations of children need to be given with prior appointment.