While COVID continues to pose challenges, there have been instances in Kerala of even children - above the age of 12 - suffering long-COVID issues like breathing difficulties and tiredness for several months. Efforts are on to facilitate nationwide COVID vaccination for children too, very soon. And the state is planning to reopen schools for regular classes. Given the circumstances, experts have advised caution stressing on the importance of vaccinating children on a priority basis.
Various studies have comprehensively concluded that COVID presents a relatively low risk to the health of children, compared to adults. However, they can be carriers of the virus, putting at risk their families, friends and the public at large.
Several experts have raised concerns on the likelihood of a scenario wherein a large number of children test COVID positive, leading to a contact-tracing nightmare, and forcing schools to shut again.
"Before reopening of schools, it is essential to bear in mind that children can carry a significant viral load, and spread the virus among the general public, even if they stay asymptomatic. The Task Force constituted by the Indian Academy of Paediatrics (IAP) has recommended that the reopening of schools should be decided depending on the local COVID situation at district level, rather than that at the national or state levels," said Dr Rekha Zacharias, consultant paediatrician, Medical Trust Hospital, Kochi.
She felt resuming regular classes all of a sudden would have adverse consequences. It requires adequate planning and strict adherence to COVID protocol, she pointed out.
"Batches can be started in rotation, with a section of students staying home for online classes while another going to school on a particular day. This will also ensure that all children get the exposure they are lacking now," she said.
Dr Rekha, who is also an office-bearer of IAP, said the Multi-system Inflammatory Syndrome in Children (MISC) is a post-COVID complication, though rare, that needed to be guarded against. But most children can recover with timely treatment. "Generally, COVID infection appears asymptomatically in children or with minor symptoms like non-specific body aches. Compared to adults, symptoms in them are not specific. MISC is seen in some cases after two to six weeks of asymptomatic or symptomatic COVID infection, due to immune reaction in the body against the antigen developed to counter the infection. It can affect organs like the heart, liver and kidneys in children. It is not life-threatening but sometimes affects children badly. According to the IAP, the incidence of MISC is 12 cases per 1,00,000 population," she said.
Dr Suma Balan, consultant paediatrician and paediatric rheumatologist at Amrita Hospital, Kochi, said all the staff in schools, and parents and family members of students, should have received vaccination.
"Children with high health-risks should consult their paediatrician before joining school. With children facing a lot of issues of their own, mentally and physically, due to the COVID pandemic and its associated restrictions, it is high time we give them back their childhood. The state government decision regarding reopening of schools should not be delayed to wait for vaccination for children," Dr Suma said.
Meanwhile, since COVID does not affect children severely, varied arguments have been out forth regarding their vaccination. Trials for minors are currently progressing in the country, with vaccines expected to be approved by October. "Opinion is still divided when it comes to vaccinating children. Countries such as the US and those in the Middle East that have commenced COVID vaccination for children have not reported any adverse events so far. Yet, since the vaccines don't prevent the infection, the logic of vaccinating a group that is not going to be severely affected is also an aspect that needs to be considered. The priority should be the vaccination of all adults," said an immunologist based in Thiruvananthapuram.