While several experts had warned that the third wave could see children infected the most, as COVID vaccination had not yet been rolled out for them then, data from the State Health Department show that the second wave saw the highest number of children infected (0-18 age group.)
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While 2,35,639 children were infected in the second wave, less than half of this number was reported in the third wave at 1,05,799. The first wave saw 91,191 kids getting infected, the least among the three waves.
The highest number of children infected was in the 10-18 years age group across all three waves. While 63,852 children were infected in the first wave, 1,69,483 were infected in the second wave. The third wave saw 89,179 children in this age group getting infected, data revealed.
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In the 0-9 years age group, while 27,339 were infected in the first wave, the second and third wave saw 66,156 and 16,620 child infections respectively.
In terms of overall deaths in the 0-18 years age group, the third wave saw the least number of children succumbing to the virus at 39. While 82 child deaths were reported during the second wave, 56 were reported in the first wave, according to the data.
The 13-member expert committee (headed by cardiologist Devi Prasad Shetty) that was set up by the Karnataka Government to analyse, advise and control the third wave of COVID-19 had estimated that around 3.4 lakh out of the total 2.3 crore population in the 0-18 age group might get infected during the peak of the third wave.
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Better immune system
V Ravi, member of the State’s COVID-19 Technical Advisory Committee (TAC) who also heads the State’s Genomic Surveillance Committee, said child infections were less because children generally handle respiratory viruses much better than adults as their immune system is strong. “The fourth wave is likely to follow a similar pattern and could target adults the most,” he said.
“The receptors for SARS-CoV-2 virus are not fully expressed in children as much as in adults. And, it is because of this the chances of children developing severe forms of the disease are very less. However, some children did develop multisystem inflammatory syndrome (MIS-C) during the later half of recovery period. This was mainly in those who did not develop good neutralising antibodies,” he said.
Chikkanarasa Reddy, professor of Paediatrics at Bowring and Lady Curzon Medical College and Research Institute, also said children are at a much lower risk compared to older adults. “It is because of this, only a fraction of the infected children developed severe forms of the disease,” he said.
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Fewer testing
He said the lesser number of infections in the third wave could also be because many did not get tested. “Many parents did not get their kids tested mainly because the symptoms were mild. Parents waited for two-three days before consulting a doctor and by then most children recovered. This is similar to what most people did in the third wave. As all who developed symptoms did not get tested, the actual number of child infections may not have been recorded,” he said.
Asha Benekappa, former director of the State-run Indira Gandhi Institute of Child Health, said children do not tend to develop a severe form of the disease because their immunological system is intact and active.
“Children are less susceptible to infection by COVID as the expression of the ACE2 receptors, which is the entry point for the virus, is lower. This varies with age. Very young children getting infected and dying with COVID have alternate receptors like GPP-78 for virus entry,” she said.
No comorbidities
“Except for 5%-10%, children do not have comorbidities, which is an added protective factor. Moreover, as all childhood vaccines are live viral vaccines, they are all the more protected,” said Dr. Benekappa, who now heads the Department of Paediatrics at Dr Chandramma Dayananda Sagar Institute of Medical Education and Research.