Skip to main content

Why India needs to redefine management of third wave for children with chronic ailments

By Dr Palash Baruah, DL Wankhar* 

The United Nations’ “Policy Brief: The impact of Covid-19 on children” dated April 15, 2020 was convinced that “Children are not the face of this pandemic.” This was also evident in India when the ‘first wave’ of Covid-19 hit the country. Scientists and experts were convinced that children were less susceptible as compared to adults of advanced age or those with co-morbid conditions.
But as India is going through the somewhat now abated ‘second wave’ of Covid-19, experts are of the opinion that whenever the ‘third wave’ approach it will witness a major transformation when more and more children will be also be impacted, though the severity of the virus on the children is still not clear.
We are at a stage when it became more and more obvious that persons across all age groups are equally susceptible. Specific reasons are unclear. Mutations, variants and strains of the virus has created havoc and it seems unsurmountable at the moment for the health authorities.
It is often said that Indians develop chronic diseases at a younger age, which raises their risk of severe disease and death. That if the vulnerability of children to the virus would characterise the ‘third wave’, then it will require a re-look at the strategies and protocol in Covid-19 management. Equally critical is also the need to pay special and adequate attention to children with chronic, co-morbid and other under-lying conditions.

Empirical evidence

High rate of Covid-19 fatalities of persons with existing chronic conditions or compromised immune systems are being observed not only in India but across the world. Taking care of chronic conditions is critical as Covid-19 raises the risk for people with such underlying medical issues.
There is no publicly available information on the extent of children with chronic ailments infected by Covid-19 virus. But it would be of interest to wade through the available information and data on children with chronic ailments in India to understand how and where we are placed. 
We analysed the data of the 75th Round of the National Sample Survey Organization (NSSO) on “Household Social Consumption: Health, 2017-18” to appreciate the issue at hand. According to this Survey, approximately 3.1 percent of all persons with chronic ailments are children below 18 years of age and it is almost evenly distributed across this age group. Noteworthy is also the fact that, rural areas accounted for 78 percent of children with chronic ailments.
Interestingly, ten States [viz., West Bengal (26.9%), Uttar Pradesh (16.1%), Kerala (10.7%), Rajasthan (10%), Orissa (5.7%), Maharashtra (5.3%), Bihar (4.5%), Telengana (3.3%), Andhra Pradesh (2.9%) and Madhya Pradesh (2.7%)] accounted for 88 percent of children with chronic ailments. In these States too, the rural areas accounted for the larger share of such children, except in Maharashtra and Andhra Pradesh. We depicted this in the form of graphical representation below.
Children with chronic ailments will present a different sets of vaccination issues whenever vaccination is open for children. Moreover, these children faced higher risk of being infected especially from asymptomatic adults. Quarantine would be beset with various obstacles and challenges.
Adhering to Covid-appropriate behaviour would be easier said than done for such children. These factors are likely to increase the risk of Covid-19 related severe morbidity and mortality amongst children with chronic ailments. It present before us a unique and complex Covid-19 management.
Health infrastructure and manpower in urban areas have already been overwhelmed, not only with the increasing number of Covid-19 related cases in the urban areas itself, but also the inflow of such patients from the rural areas. In view of the fact that a large number of children with chronic ailments resides in the rural areas, it is going to present substantial challenges to the already inadequate healthcare resources.
No doubt children with chronic ailments will require a different set of approach in this pandemic but identifying such children is the starting point. States (especially in the ten major States) need to put in place a system to identify and assess risk across age and gender of children with chronic ailments. It then need to work out appropriate and adequate strategies to deal with as and when these children happen to contract Covid-19 virus.

Protocol for testing children

Protocols on Covid-19 testing of children with chronic ailments need to be developed in a manner that such children should not be made to travel far from their place of residence for Covid-19 related treatment or vaccination. This will reduce the discomfort and jeopardize their health further.
Regular monitoring the health status of children with chronic ailments can provide quick and timely response in case of any emergencies. ASHA, ANM, community health workers, etc can be made aware of the best practices and trained accordingly.
Ramping up of health resources, especially in rural areas, is sine qua non for riding the ‘third wave’ to ensure minimization of severity and mortality and this is all the more relevant and critical for children with existing chronic ailments.
Parallel to the Ministry of Health & Family Welfare’s “Protocol for Management of Covid-19 in the Paediatric Age Group”, a separate comprehensive and specific protocol should be formulated for children with chronic ailments.
Adequate, timely and effective communication should be disseminated through visual and print media to create awareness amongst the general public and health workers on the steps to shield, protect and care for children with chronic ailments with special focus and emphasis on Covid-19 pandemic.
The chronic health conditions of children in India is a matter of concern and their vulnerability to Covid-19 cannot be ruled out. Focused, pragmatic, targeted, robust and coordinated policy, especially in those States which have a considerable section of children with chronic ailments, need to be worked out immediately to face the impending ‘third wave’ of Covid-19.
---
*Dr Palash Baruah is Senior Research Analyst, National Council of Applied Economic Research (NCAER), New Delhi; DL Wankhar is retired Indian Economic Service Officer. Views are personal

Comments

TRENDING

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

World Bank proved right, Narmada is already a destructive project: Medha Patkar

By Rajiv Shah  Narmada Bachao Andolan leader Medha Patkar has said that the World Bank’s independent review mission, which brought out the Morse Commission report , has been proved right: The Sardar Sarovar dam has not only failed to live up to the loud promises made for irrigating large arid areas of Saurashtra and Kutch in Gujarat, those who were displaced and resettled in Gujarat are getting increasingly restive as many of them are unable to get the promised water for irrigation and some for drinking water too. While 50,000 families have been resettled in three states and 20,000 have received land rights as land or cash, the authorities have not calculated what should be done with 15,000 families, whose houses are acquired for Sardar Sarovar but following changing backwater levels of the Sardar Sarovar dam, they are denied rehabilitation, Patkar tells Counterview in an interview (part1*): *** Q: What is the latest position in your view as far as the Sardar Sarovar dam is concerned?

Upholding labour rights, Nehruvian scientific temper, Rajni Patel opposed Emergency

By Harsh Thakor*  Rajni Patel, who died 40 years ago, whatever his flaws, had one great quality: his human touch to offer selfless service and ability to galvanise or influence human beings from all walks of life. Few people would ever go out of the way to help someone or serve as selflessly without aim of personal gain. Rajni championed Nehruvian secular ideas and scientific temper. As a master in public relations he revealed utmost humility. As a barrister, he never appeared against the trade unions or workers. A Fabien Socialist he opposed liberal capitalism and radical socialism. Unlike most lawyers, he did not succumb to the lure of amassing wealth. Rajni was born in Sirsa, in Gujarat, on the very day Gandhi set foot on Indian soil, on 9th January, 1915. He gained his baptism through one of Gandhi's speeches calling for the boycott of foreign goods, which was the virtual turning point of his life. Rajni toed Gandhi to organise boycott of foreign goods. Rajni was able to cros

Vadodara violence: Fine Arts Faculty alumni raise fingers at Varsity's political appointee

Hasmukh Vaghela with PM Counterview Desk  In a statement, alumni of the Faculty of Fine Arts (FoFA), Maharaja Sayajirao University (MSU), Baroda, Gujarat, referring to the “violence” by right-wing groups for displaying “objectionable” paintings that “hurt religious sentiments” at the one of India’s top fine arts institute May 5, have taken strong exception to “the assault and rustication” of one of the students, and lack of action taken against those who “violated” the institution and committed the act. Floated as an online petition seeking wider support, the FoFA alumni, in their statement, addressed to the vice chancellor, MSU, said, there should be “thorough” investigation in the whole incident and “immediate action” should be taken against syndicate member Hasmukh Vaghela, MSU, who sparked the assault, and “other co-conspirators” for breaching “university code of conduct and unlawful activities committed in broad daylight”. While the alumni statement doesn't say so, Vaghela

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

UK leader cites Indian farmers' struggle one of top global fights against neoliberal order

Counterview Desk  Jeremy Corbyn, member of the UK Parliament, former leader of the UK Labour Party and founder of the  Peace and Justice Project , in his  inaugural speech to the  Progressive International’s  Summit at the End of the World on May 12, 2022, has said, what is happening across globe suggests that "image of apocalypse -- bombs and raids, oil spills and wildfires, disease and contagion -- is a reality for people across the planet." In an adaptation of his speech, distributed by  Globetrotter , Corbyn, however, said, there are fresh examples action, too -- by Indian farmers forcing Prime Minister Narendra Modi to withdraw three neo-liberal laws;  by workers, communities and activists against the top giant multinational Amazon's "greed and exploitation"; and by Latin American people's struggle to say "no more to the domination by imperialism, the destruction of their communities and the abuse of their environments." Stating that this is n

Why is NIOH-ICMR 'official' making false claims on silicosis?: Health rights NGO

Counterview Desk In a letter to the Director General, Indian Council of Medical Research (ICMR), New Delhi, Dr Jagdish Parikh, trustee, health rights NGO People’s Training and Research Centre (PTRC), Vadodara, and Jagdish Patel, director, PTRC, have said that the claim being made for the use of biomarker for detection of silicosis raises concern about scientific tenacity of the diagnosis of the deadly occupational disease. The letter also objects to the reported claim by a top health official that it is possible to detect silicosis at the sub-radiological stage. It asks, “What is this subradiological stage of silicosis? We have not heard any such scientific term being used. Again, the report is using a term which is not found in any scientific literature so far. Is this term acceptable by ICMR? Is ICMR thinking of any explanation?” Text : This is with reference to our letter dated November 28, 2021. In our communication we had raised our concern about the scientific tena

Welfare? Govt of India spends just 19% of manual scavengers' rehabilitation budget

By Bharat Dogra*  While the Dalit community has been always known for higher levels of poverty as well as social discrimination, even within the Dalits there is a sub-section known for even worse levels of poverty as well as social discrimination. This is the section which was traditionally involved in manual scavenging. The shocking injustice they have suffered from over the years has been widely recognized leading to a ban on manual scavenging. At the same time there is urgent need for the rehabilitation of those engaged in manual scavenging. Hence a self-employment scheme for the rehabilitation of those engaged in manual scavenging was drawn up. The allocations and the expenditure for this scheme for the last eight years are shown in the Table below: Union Budget for Self-Employment Scheme for Rehabilitation of  Manual Scavengers (in Rs crore) By Budget Estimate we mean the original allocation made when the budget is presented. It is clear from this table that the actual expenditure

This Maoist justified US, western Europe's anti-Soviet stance, even Bhindranwale

By Harsh Thakor*  A glaring example of the extent to which those seeking to identify themselves as revolutionaries can go in making odd compromises with those normally considered as “class enemies” in Marxist jargon is late Kondapalli Seetharamiah. Few know that this Maoist organiser two decades ago was so enamoured by the Chinese three worlds theory that he called for a united front with the United States and other western countries against what he considered Soviet social imperialism! This wasn’t the only “compromise” Seetharamiah made during his career as a revolutionary. On Punjab he took a most eclectical stand of supporting Jarnail Singh Bhindranwale, thus soft-pedalling the terrorist Khalistani movement. Among his other opportunist alliances, about which few are aware of, include support to the Akalis in Punjab, on one hand, and the NTR Telugu Desam regime in Andhra Pradesh, on the other – all part of his anti-Congress thrust. Also known as KS, this Maoist started his career as

Dalit Hindi professor intimidated, harassed by saffron brigade: 400 activists, academics

Counterview Desk  Over 400 academics and activists have expressed alarm at the Lucknow University ‘protests’ on May 10 against Dr Ravi Kant, associate professor of Hindi and a Dalit, stating it is nothing but “intimidation and abuse” over his remarks on the online channel Satya Hindi, which were taken out of context and made viral on social media. “We are even more concerned that such an incident should occur within the confines a university campus, where free speech and expression without fear must ideally be the norm. Violence and intimidation over differences of opinion should never occur in a university”, the statement regrets, asking the authorities at the university and the Uttar Pradesh government to assure him and his family “protection from further harassment or intimidation.” Text: We are a group of academics and activists deeply concerned by the public heckling and intimidation of Dr. Ravi Kant, Associate Professor of Hindi and well known Dalit scholar, on the premises of t