The Pune Platform for COVID-19 Response (PPCR) has urged all hospitals in the city to set up pediatric intensive care units in preparation of the third wave of the pandemic. While positivity rates and daily positive cases in Maharashtra are gradually reducing, the state is drawing up plans to prepare for the third wave, which health experts warn could hit children.
PPCR is a virtual platform of all stakeholders working to support the healthcare system, patients and families dealing with the pandemic. Sudhir Mehta, lead and coordinator of PPCR and president of the Mahratta Chamber of Commerce, Industries and Agriculture (MCCIA) said that while the adult population is getting vaccinated, India will not be vaccinating those below 18 years till end of the year. As they are not protected, the virus could affect this age group, and the health system has to be prepared, Mehta said.
The percentage of children getting affecting by the virus is low, but it will increase and the healthcare infrastructure would be inadequate.
Dr BD Bande, senior consultant, critical care, anaesthesiology and internal medicine at Noble Hospital in Pune, said the second wave has hit the younger population, and when schools and colleges re-open, the number of cases among children will go up, as was seen in the United States.
India has been following the US in the pandemic, and the US has 37 lakh children with the Covid-19 infection. Considering India’s population, the number here could go into crores, he said. The number of children getting critical would be low, but in absolute terms, the number of children getting infected and becoming critical will increase, Dr Bande warned.
The chaos and shortage seen in the second wave will be repeated and get even worse if the system is not geared up, he said.
A possible third wave could hit the country in the August-September period, and there is no vaccination plan for those under the age of 18, nor are there any drugs or vaccine trials for children under way, Dr Bande said. Drugs and investigational therapies being used for adults with Covid-19, such as anti-virals, immunomodulators and anti-fungal agents, have not been tested for children.
The Covid-19 treatment guidelines mention three main categories of drugs to be used: extrapolation of Remdesivir use, dexamethasone and few immunomodulatory drugs used for adults, besides antibiotics and antifungal agents that are similar in pediatrics. Similarly, better preparation with ICU beds and ventilators with pediatric capability is needed, he said. There are only a handful companies making pediatric ventilators, Dr Bande said.
The Maharashtra government has already started working in this direction. Deputy Chief Minister Ajit Pawar has announced that the Rajiv Gandhi Hospital in Pune will be converted into a children’s Covid-19 hospital, and another one will come up in Pimpri Chinchwad.
A taskforce of pediatricians has also been set up. Chief Minister Uddhav Thackeray held a meeting with the state’s leading pediatricians and asked the taskforce to work on treatment protocols and a standard operating procedure for treating children with Covid-19.